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October 8, 2006, 6:01 PM CT

Some Breast Cancer Patients Unhappy With Lumpectomy

Some Breast Cancer Patients Unhappy With Lumpectomy
Women with breast cancer often undergo a lumpectomy and radiation to save their breasts and avoid the need for additional reconstructive surgery. However, approximately one-third of all patients are unhappy with how their breasts look after undergoing breast conservation treatment and a number of would consider reconstruction, as per a research studypresented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2006 conference in San Francisco.

"I have patients walking into my office saying lumpectomy was supposed to save their breast but what's left doesn't look like a breast to them," said Howard Wang, ASPS Member Surgeon and co-author of the study. "Conservation is thought to bean acceptable way of saving a woman's breast. But a number of of these women are coming to plastic surgeons for help, saying it isn't so".

In the study, 28 percent of the patients with breast cancer stated they were dissatisfied with the cosmetic result of their lumpectomy. Of those patients, 46 percent stated their physical appearance was worse or much worse after the surgery and were considering reconstruction. Only nine percent of patients who were satisfied with the outcome, however, would consider reconstruction if it were offered.

Approximately 26 percent of patients were unhappy with their physical appearance after the lumpectomy but had an improved sense of body image. Plastic surgeons believe this disparity occurred because a number of patients felt relieved to be free of the cancer, leading them to feel better about their bodies even though they were not happy with how their breasts looked.........

Posted by: Janet      Permalink         Source


October 3, 2006, 10:26 PM CT

Treat the Woman, Not Her Age

Treat the Woman, Not Her Age
Women age 65 years or older constitute half of new patients with breast cancer each year, and the number of older women with breast cancer is forecast to double by 2030 as the baby boomers age. Yet despite their increasingly large numbers, older women who develop breast cancer often fail to receive the same care as offered to younger women as per Jeanne Mandelblatt, M.D., of Georgetown University's Lombardi Comprehensive Cancer Center.

In an editorial entitled "Treating Breast Cancer: The Age Old Dilemma of Old Age" which appears in the September 20, 2006, issue of the Journal of Clinical Oncology, she calls on doctors treating breast cancer in older women to look beyond the year in which a woman was born and to take into account her overall health, frailty and ability to tolerate various cancer therapy.

"Older women who perceive more ageism in their interaction with providers are less likely to receive radiation or chemotherapy," Mandelblatt wrote.

Women want their physicians to consider their disease, not their birthdays. "In our work with older women, we observed that 33 percent would choose chemotherapy if it would extend their lives by 12 or more months," she said.

Older women in good health may do better than younger women in poorer health. "At this time, we do not need more research to document what we already know: older women get less intensive therapy. What we need is an understanding of the biology of cancer in this population [women 65 or older with breast cancer], tools that can help clinicians identify physiological reserve and ability to withstand the rigors of more aggressive therapy, and more consistent elicitation of women's informed preferences".........

Posted by: Janet      Permalink         Source


September 25, 2006, 4:43 PM CT

Combination of Xeloda And Taxol Metastatic Breast Cancer

Combination of Xeloda And Taxol Metastatic Breast Cancer
Combination of Xeloda and Taxol is an effective therapy for women with metastatic breast cancer. New research from US Oncology Network and the University of North Carolina has recently reported that the combination of Xeloda (capecitabine) and Taxol is an effective and tolerable regimen for initial therapy of women with metastatic breast cancer. Women who were HER-2 negative were not included in the study. This is a phase II study and it is reported in the latest issue of the Journal of Clinical Oncology.

In this study the scientists reviewed 55 patients who were newly diagnosed metastatic breast cancer. These patients received oral Xeloda and weekly Taxol. Patients who had HER-2 positive tumors were not included in the study.

No patient had a complete response, however percent; of patients achieved a partial response. When stable disease is also taken into account 65 percent of patients derived benefit for the therapy. On average the response lasted for 10 months and median survival was 17 months.

From these findings the scientists have concluded that Xeloda plus Taxol is an effective, well-tolerated, and fairly convenient therapy combination as initial treatment for women with metastatic breast cancer.........

Posted by: Janet      Permalink


September 25, 2006, 4:33 PM CT

Breast Density Contributes to Breast Cancer Risk

Breast Density Contributes to Breast Cancer Risk
Recently there has been some discussion regarding inclusion of breast density in breast cancer prediction models. In a recent issue of the Journal of the National Cancer Institute this issue is highlighted. The discussion revolves around the question: should breast density be added to the Gail model in predicting breast cancer occurrence?

The Gail model is a breast cancer prediction tool that is widely used. Gail model estimates a woman's risk of developing breast cancer taking into account several factors like age, family history of breast cancer, reproductive history and history of previous biopsies. This model is widely used to identify the group of women who have high risk of developing breast cancer. This model was originally introduced for evaluation of Caucasian women and is yet to be validated in other ethnic groups.

Researchers have recently identified other risk factors like breast density and postmenopausal hormone replacement therapy. In continuing effort to improve the accuracy of the Gail model experts are suggesting that these new risk factors should be included in calculation of the risk.

The term breast density refers to the extent of glandular and connective tissue in the breast. Breasts with more glandular and connective tissue are denser by definition. A mammogram gives an estimate of breast density. Increased breast density is linked to increased risk of breast cancer. Breast density is estimated on a scale of one to four, with one being "almost entirely fat" and four being "extremely dense." ........

Posted by: Janet      Permalink


September 25, 2006, 5:11 AM CT

What's The Best Strategy For Follow Up Of An Abnormality?

What's The Best Strategy For Follow Up Of An Abnormality?
You might be getting your regular mammogram follow ups, and some of you might get an abnormal result on the mammogram. You might be worried, quite understandable, but mammogram abnormality does not mean breast cancer. More important, now what should you do if the mammogram detects an abnormality?

Experts in the field indicate that if an abnormality is detected in the mammogram performing a breast biopsy is the best strategy, for follow up of the abnormality even though there are several other options available.

Breast biopsy is considered to be the standard approach to mammogram abnormality, and recently a report by the Agency for Healthcare Research and Quality (AHRQ) compared the effectiveness of biopsy, with four other available options. These options includes magnetic resonance imaging (MRI), ultrasound imaging, positron emission tomography (PET) scanning; and scintimammography.

The report convincingly concludes that biopsy is the gold standard; when it comes to the long-term follow up an abnormality that is detected in the mammogram.

Of course biopsy is more invasive, but is a more accurate test and requires sampling of the breast tissue. The removed tissue is analyzed under the microscope using special stain to determine the presence of malignancy.........

Posted by: Janet      Permalink


September 23, 2006, 11:43 AM CT

Chronic Pain After Breast Cancer Surgery

Chronic Pain After Breast Cancer Surgery
A woman's young age, extensive surgery, and whether she suffered severe, post-operative pain are risk factors for developing chronic pain after breast cancer surgery, a University of Rochester study found.

Up to half of all women who undergo a lumpectomy or mastectomy feel pain weeks or months later near the breast, adjacent armpit and upper arm on the same side. It is often described as burning, throbbing, and/or a sharp pain.

As per a research findings reported in the September 2006 Journal of Pain, lead author Robert H. Dworkin, Ph.D., a University of Rochester Medical Center professor of anesthesiology, neurology, oncology and psychiatry, and international pain management expert, recommends that women facing breast-cancer surgery should be counseled beforehand to alleviate any distress they may have and improve coping skills. Results of the study suggest that a combination of analgesic drugs and counseling immediately after surgery might also help to prevent long-term problems, he said.

"Women with breast cancer have unique concerns and fears that may be connected to pain," Dworkin said. "And despite considerable changes over time in surgical approaches, these results are consistent with other studies".

Few prospective studies have identified the characteristics of patients who are most likely to develop chronic pain, which can diminish a woman's quality of life by leading to job loss or marriage stress, even if the cancer is successfully treated.........

Posted by: Janet      Permalink         Source


September 20, 2006, 4:57 AM CT

Higher Suicide Rate Among Women With Breast Implants

Higher Suicide Rate Among Women With Breast Implants
Does women with breast implants have a higher mortality rate? This was the question the researchers were asking, but they came up with a surprising finding. In study that evaluated 24,600 women by the Canadian Public Health Agency and Cancer Care Ontario found that having breast implants does not increase mortality risk. However, the study found that the suicide rate among women with breast implants is 73% higher than in the general population. Researchers have published these findings in a recent issue of the American Journal of Epidemiology.

Reserchers Universit Laval's Jacques Brisson and Louis Latulippe and their colleagues collected data on 17,400 women from the province of Quebec and 7,200 from Ontario who had received breast implants for cosmetic purposes between 1974 and 1989. These women, who had undergone the surgery at an average age of 32, were followed regularly during a 15-year period. The researchers found that a total of 480 women with breast implants died during that period, comparable to the mortality rate of the general population.

Researchers found mortality rate in women with breast implant to be 26% lower than in the control group. Fewer deaths occurred from breast cancer and heart occurred in this group. The researchers say that this lower mortality rate is not the result of the breast augmentation procedure itself, but rather of a double selection bias. "First, a woman must be in relatively good health to undergo breast implant surgery," points out Dr. Brisson. "Also, women who receive breast implants tend to be of higher-than-average socioeconomic status. Thus, women who undergo breast augmentation surgery are more likely to be in better health than the general population".........

Posted by: Janet      Permalink         Source


September 15, 2006, 2:13 PM CT

Selecting Breast Cancer Patients For Chemo

Selecting Breast Cancer Patients For Chemo
A test that measures the amounts of two members of the same protein family - one of which appears to act as an oncogene, and the other as a tumor suppressor - helps identify breast cancer patients who will likely benefit from chemotherapy and those who won't, as per researchers.

The test, known as OncoPlanTM, is already commercially available, and studies have shown that it can predict the aggressiveness of the patient's tumor and the relative risk of disease recurrence following surgery in breast, colon and gastric cancers. Now, scientists in the U.S. and Canada have studied whether it also can help identify patients with breast cancer who would benefit most from chemotherapy.

Results were presented at the first meeting on Molecular Diagnostics in Cancer Therapeutic Development, organized by the American Association for Cancer Research.

OncoPlan measures two forms of Shc protein, which are known to drive the formation of protein complexes involved in signal transduction pathways and have been found to be involved in a number of of the pathways important to development of aggressive cancer. These two forms have a "push pull" relationship with each other: tyrosine-phosphorylated (PY)-Shc helps drive these dangerous cell pathways, but p66 Shc, after initial stimulation, works to inhibit the very growth pathway the other Shc proteins promote.........

Posted by: Janet      Permalink         Source


September 14, 2006, 9:02 PM CT

Detecting Breast Cancer Metastasis

Detecting Breast Cancer Metastasis
In the U.S., a novel technology soon may be available to detect the spread, or metastasis, of breast cancer earlier than now possible, as per research presented at the first international meeting on Molecular Diagnostics in Cancer Therapeutic Development, organized by the American Association for Cancer Research.

Since secondary tumors, ignited by spreading cancerous cells, and not the primary breast cancer tumor, are the primary cause of cancer death, early detection of metastatic spread is crucial to a woman's prognosis.

It should enable the patient's doctor to adjust the woman's therapy so that it will target the spreading cancer early, said Winfried H. Albert, Ph.D., chief scientific officer of AdnaGen, the German biotech company that developed the technology.

Albert said that the company's diagnostic tool, which is being reviewed in clinical studies at The University of Texas M. D. Anderson Cancer Center in Houston, can spot one cancerous cell in a typical blood sample. A typical sample is 5 milliliters and contains over 2.5 x 1010 cells.

As a biomarker for breast cancer metastasis, cancer cells circulating in the blood system have not been easy to detect and analyze because they are a "needle in the haystack" among the millions of cells in the bloodstream.........

Posted by: Janet      Permalink         Source


September 2, 2006, 10:10 PM CT

MRI Best To Detect Cancer Spread Into Breast Ducts

MRI Best To Detect Cancer Spread Into Breast Ducts
MRI is better than MDCT for determining if and how far breast cancer has spread into the breast ducts and should be used before patients receive breast conserving treatment, a new study shows.

"Patients have a lower survival rate if their surgical margins are positive for tumor cells. A positive surgical margin is commonly the result of inadequate resection of the cancer's intraductal component," said Akiko Shimauchi, MD, at Tohoku University in Sendai, Miyagi, Japan. "Accurate preoperative diagnosis of the intraductal component allows the surgeon to achieve a cancer-free surgical margin," she said.

The study included 69 patients with proven invasive cancer, 44 of which had an intraductal component, said Dr. Shimauchi. MRI correctly identified 33 of the 44 cases, while MDCT correctly identified 27. "MRI revealed the presence of the intraductal component with significantly higher sensitivity (75%) in comparison to MDCT (61%), Dr. Shimauchi said.

"The lesions that were missed by both examinations were the ductal extension type, i.e. the tumor included a dominant mass with an outward extension of cancer cells, with a relatively small ductal component," said Dr. Shimauchi. MRI was better able to detect the smaller ductal components than MDCT, she said.........

Posted by: Janet      Permalink         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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