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July 6, 2010, 7:15 AM CT

Revolutionary therapy slows advanced breast cancer

Revolutionary therapy slows advanced breast cancer
A novel treatment designed to attack tumors in patients with a genetic mutation in either BRCA1 or BRCA2, slowed tumor growth in 85 percent of advanced patients with breast cancer treated in a small study, scientists report in the July 6 issue of the Lancet

"That is really an enormous response rate in a population of patients who have received a median of three previous therapies," says co-author of study Susan M. Domchek, MD, associate professor of Medicine, University of Pennsylvania School of Medicine, and director of the Cancer Risk Assessment Program at Penn's Abramson Cancer Center.

"This is the first time that we have been able to take the genetic reason a person has developed cancer and make it a target," Domchek says. "Most of the time we look at what is going on in the tumor itself and then figure out how to target it. But in this situation, the women all had an inherited mutation in either the BRCA1 or BRCA2 gene and we could exploit that weakness in the tumor. It is a strategy that may cause fewer side effects for patients".

The new agent, called olaparib, inhibits a protein called poly(ADP-ribose) polymerase (PARP). Both PARP and the BRCA proteins are involved in DNA repair. And while cells seem to be able to do without one or the other, inhibiting PARP in a tumor that lacks a BRCA gene is too much for the cells, and causes them to die.........

Posted by: Janet      Read more         Source


June 24, 2010, 11:01 PM CT

Polarized arguments about breast screening

Polarized arguments about breast screening
Polarised arguments about the benefits and harms of breast screening are not helping women to make an informed decision, argues a senior doctor on bmj.com today.

Klim McPherson, Professor of Public Health Epidemiology at the University of Oxford looks at the evidence and calls for dispassionate analysis of all available data.

The burden of breast cancer is unremitting and we must do anything we can to contain it, he says. But screening for a progressive disease is justified only if earlier diagnosis and therapy improve disease progression.

A recent US report on screening for breast cancer estimated that the mortality reductions attributable to breast screening are 15% for women aged 39-49, 14% for those aged 50-59, and 32% for those aged 60-69. Worse still, estimated numbers of women needed to be invited to a US screening programme in order to save one life are high. For the younger group it is nearly 2,000 while in those aged 60-69 it is still nearly 400. In the UK, the figure is 1,610 for women aged 40-55.

A recent analysis from the Nordic Cochrane Centre also claimed that one in three breast cancers detected in screening programmes is overdiagnosed, eventhough others argue that the lives saved by screening greatly outnumber overdiagnosed cases.........

Posted by: Janet      Read more         Source


June 22, 2010, 7:11 AM CT

Reduce number of breast biopsies

Reduce number of breast biopsies
By combining two relatively inexpensive technologies based on sound and light waves, scientists hope to lower the rate at which women undergo breast biopsies for suspicious lesions. Results of the study on ultrasound-guided optical tomography are reported in the online edition and the August print issue of Radiology

"The goal of our study was to investigate the potential of diffuse optical tomography in the near infrared spectrum with ultrasound localization as a means of differentiating early-stage cancers from non-malignant lesions of the breast," said lead researcher Quing Zhu, Ph.D., professor of bioengineering at the University of Connecticut.

When mammography and ultrasound cannot determine whether a suspicious breast lesion is cancerous or benign, physicians typically recommend a needle biopsy to extract samples of the suspicious tissue for laboratory testing. In current clinical practice, 70 to 80 percent of biopsies performed reveal non-malignant lesions, leading to unnecessary cost and anxiety for women.

Diffuse optical tomography is an emerging noninvasive imaging technique that measures light absorption within tissue to quantify blood content (hemoglobin level) and blood oxygen levels. Because malignant lesions have a number of more blood vessels than normal tissue, hemoglobin levels can help distinguish cancerous from non-malignant lesions.........

Posted by: Janet      Read more         Source


May 21, 2010, 7:25 AM CT

Hormonal drugs minimize surgery in breast cancer

Hormonal drugs minimize surgery in breast cancer
Breast surgeon Julie Margenthaler, M.D., looks at a mammogram. Margenthaler was one of the lead investigators in a nationwide trial that tested how estrogen-lowering drugs before breast cancer surgery affected surgical outcomes.

Credit: Robert Boston

A nationwide study has confirmed the benefit of giving estrogen-lowering drugs before surgery to patients with breast cancer. The therapy increased the likelihood that women could undergo breast-conservation surgery, also called lumpectomy, instead of mastectomy.

The study's chair, Matthew J. Ellis, MD, PhD, the Anheuser-Busch Endowed Chair in Medical Oncology and a breast cancer specialist with the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, will present the findings June 7 at the annual meeting of the American Society of Clinical Oncology.

Sponsored by the American College of Surgeons Oncology Group, the study took place at 118 hospitals across the country and involved 352 postmenopausal women with estrogen-receptor positive (ER+) breast tumors. The participants received aromatase inhibitors for 16 weeks before surgery for breast cancer, and the extent of their tumors was monitored before and after the drug therapy.

The lead investigator at the Washington University site was Julie A. Margenthaler, MD, assistant professor of surgery and a breast surgeon at the Siteman Cancer Center.

Aromatase inhibitors are also referred to as estrogen-lowering agents because they interfere with the body's production of estrogen, a hormone that stimulates the growth of ER+ breast tumors. ER+ is the most common breast cancer, accounting for three-quarters of cases.........

Posted by: Janet      Read more         Source


May 6, 2010, 6:35 AM CT

Whole body MRI ifor breast cancer spread

Whole body MRI ifor breast cancer spread
Whole body magnetic resonance imaging (MRI) should be the imaging modality of choice for the detection of breast cancer metastases (when the cancer has spread beyond the breast) as it is highly accurate and can detect bone metastases while a patient is still asymptomatic (shows no symptoms), as per a research studyto be presented at the ARRS 2010 Annual Meeting in San Diego, CA.

Whole body MRI is a noninvasive medical test that helps physicians diagnose and treat breast cancer. Breast cancer cells usually spread to the bones, lungs, liver, or brain. Metastatic breast cancer tumors appears to be found before or at the same time as the primary tumor, or months and even years later.

"It is important that we detect metastases early in order to ensure the patient is getting the appropriate therapy. This study shows that whole body MRI can accomplish this task and is ready to be used for this indication," said Joshita Singh, MD, main author of the study.

Besides MRI, other imaging modalities usually used to detect breast cancer metastases include positron emission tomography computed tomography (PET/CT), chest X-rays, bone scans, and ultrasound of the abdomen and pelvis.

The study, performed at Deenanath Mangeshkar Hospital and Research Center in Pune, India, included 99 patients with known breast cancer who were reviewed for metastases using whole body MRI. "Of the 99 patients, MRI accurately revealed that 47 patients were positive for metastases while 52 were negative. Of those patients who were positive for metastases, whole body MRI frequently detected bone metastases earlier when the patient was still asymptomatic," said Singh.........

Posted by: Janet      Read more         Source


April 14, 2010, 11:04 PM CT

Childhood body size affects future breast cancer

Childhood body size affects future breast cancer
Thinner girls appears to be at higher risk of breast cancer. Scientists writing in BioMed Central's open access journal Breast Cancer Research observed that girls who were leaner at age seven were at higher risk of cancer during the later part of life.

Jingmei Li worked with a team of scientists from the Karolinska Institutet, Sweden, to study the relationships between childhood body size and tumour characteristics in a group of 2,818 Swedish patients with breast cancer and 3,111 controls. She said, "Our main finding was that a large body type at age seven years was linked to a decreased risk of postmenopausal breast cancer. Eventhough strongly linked to other known risk factors such as age of menarche, adult BMI and breast density, size at age seven years remained a significant protective factor after adjustment for these other issues".

Size at age seven was also found to determine tumour characteristics, in particular, estrogen receptor status. A large body size at age seven was particularly protective against estrogen receptor negative tumours, which generally fare worse in terms of prognosis. The researchers' classification of childhood body size was derived from nine numbered pictograms ranging from very skinny (S1) to very fat (S9). Subjects assessed their own body type at present and how they remembered themselves at seven years old. These selections were then used to group them as lean (S1 to S2), medium (S3 to S4) and large (S5 to S9). Li said, "It appears counterintuitive that a large body size during childhood can reduce breast cancer risk, because a large birth weight and a high adult BMI have been shown to otherwise elevate breast cancer risk. There remain unanswered questions on mechanisms driving this protective effect".........

Posted by: Janet      Read more         Source


March 25, 2010, 7:56 PM CT

Breast cancer and anthracyclines

Breast cancer and anthracyclines
An international team of scientists has discovered a new way of detecting which patients with breast cancer are going to respond best to chemotherapy that includes anthracycline antibiotics*.

The research, presented at the seventh European Breast Cancer Conference (EBCC7) in Barcelona today (Thursday), is important because, until now, there was conflicting evidence about the best way of predicting response to anthracyclines and it was unclear whether any of the known biomarkers, such as the genes HER2 and TOP2A, were accurate indicators of response to these drugs.

By conducting a meta-analysis of four large breast cancer trials including nearly 3,000 patients, the scientists have discovered that an abnormality on chromosome 17, called CEP17, is linked to a worse outcome for patients, but also that its presence is a highly significant indicator that the tumour will respond to anthracyclines.

After adjusting for additional factors relating to the tumour and its therapy, the scientists observed that if patients with CEP17 were treated with anthracyclines, they were approximately two-thirds more likely to survive and to survive without a recurrence of cancer than those who did not receive anthracyclines (recurrence free survival was 67% and overall survival was 63%).........

Posted by: Janet      Read more         Source


March 24, 2010, 12:15 AM CT

Does screening reduce breast cancer deaths?

Does screening reduce breast cancer deaths?
A study from Denmark published on bmj.com today finds no effect of the Danish screening programme on breast cancer deaths.

Similar results have been seen in other countries, including the UK, leading the authors to question whether screening has delivered the promised effect on breast cancer mortality.

A 2005 study suggested that screening had reduced breast cancer deaths by 25% in Copenhagen. But Karsten Jrgensen and Peter Gtzsche from the Nordic Cochrane Centre in Copenhagen, together with Per-Henrik Zahl from Folkehelseinstituttet in Oslo, identified important problems in this study and decided to undertake a more comprehensive analysis of the data.

They compared annual changes in breast cancer deaths in two Danish regions offering publicly organised screening programmes (Copenhagen and Funen county) with non-screened regions across the rest of Denmark.

Their analysis covered 10 years after screening could have had an effect on breast cancer mortality. For comparison, they also looked at the 10-year period before screening was introduced.

Data for each area were divided into three age bands. Women aged 55-74 years, who could benefit from screening, and women aged 35-55 years and 75-84 years, who were largely unaffected by screening.........

Posted by: Janet      Read more         Source


February 17, 2010, 7:26 AM CT

Genetic link between mammographic density and breast cancer

Genetic link between mammographic density and breast cancer
A University of Melbourne study has revealed that certain breast cancer genetic variants increase mammographic density, confirming the link between mammographic breast density and breast cancer.

Professor John Hopper of the University's School of Population Health says women vary greatly in their underlying risk of breast cancer. "These findings provide an insight into possible new pathways into the development of breast cancer".

"We hope our research on mammographic density will eventually help identify women at higher risk of getting breast cancer. That is still a way off, but for now women should follow national guidelines for screening," he says.

The research was conducted in the University's School of Population Health and Department of Pathology along with key national and international collaborators. The paper was published recently in the prestigious international journal Cancer Research

"Prior twin studies have suggested there is a genetic link between mammographic density and breast cancer. For the first time, we have been able to identify some of the breast cancer genetic variants involved".

The amount of light areas on a mammogram reveals the mammographic density of a woman's breast. Women who have high mammographic density for their age are at an increased risk of breast cancer.........

Posted by: Janet      Read more         Source


January 29, 2010, 8:08 AM CT

Change in mammography guidelines

Change in mammography guidelines
The methodology and evidence behind a widely publicized change in national mammography guidelines is questionable, as per a review in the Journal of Diagnostic Medical Sonography (JDMS), published by SAGE.

In November 2009, the US Preventive Services Task Force (USPSTF) published a report in the Annals of Internal Medicine discussing the screening techniques for the early detection of breast cancer. A few isolated portions of that report, regarding recommended changes for the use of mammography, were widely discussed in the media, and garnered tremendous public attention.

This new JDMS article provides an evidenced-based review of the work and recommendations contained in the USPSTF report and raises the question whether the controversial conclusions for breast cancer screening were supported by established scientific measurement and research standards. The JDMS review found low methodological scores in the USPSTF report, which may place in question the recommendations generated from the report.

The article concludes that, despite the report's depiction as a systematic review, the USPSTF report was actually just a review of literature, which reduces the overall scientific impact of the report to a much lower level in the hierarchy of evidence.........

Posted by: Janet      Read more         Source



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Breast cancer
Every year, more than 200,000 women are diagnosed with breast cancer in the United States. Breast cancer ranks second as the leading cause of cancer deaths in American women. Until recently breast cancer topped the list of leading causes of cancer deaths in women, but lately lung cancer has claimed the top position. If skin cancer is excluded, breast cancer is the commonest cancer among American women.

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