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July 8, 2008, 8:49 PM CT

Young women's breast cancers have more aggressive genes

Young women's breast cancers have more aggressive genes
Young women's breast cancers tend to be more aggressive and less responsive to therapy than the cancers that arise in older women, and scientists at the Duke Comprehensive Cancer Center and the Duke Institute for Genome Sciences & Policy may have discovered part of the reason why: young women's breast cancers share unique genomic traits that the cancers in older women do not exhibit.

"Clinicians have long noted that the breast cancers we see in women under the age of 45 tend to respond less well to therapy and have higher recurrence rates than the disease we see in older women, especially those over the age of 65," said Kimberly Blackwell, M.D., a breast oncologist at Duke and senior investigator on the study. "Now we're really understanding why this is the case, and by understanding this, we may be able to develop better and more targeted therapies to treat these younger women".

The results appear in the July 10 Journal of Clinical Oncology The study was funded by the National Cancer Institute.

Duke scientists looked at samples of nearly 800 breast tumors from women in five countries on three continents, and divided them into age-specific cohorts. The researchers found more than 350 sets of genes that were active only in the tumors from women under age 45. On the other hand, tumors arising in women over age 65 did not share these activated gene sets.........

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June 18, 2008, 9:02 PM CT

Understanding Of Cell Behaviour In Breast Cancer

Understanding Of Cell Behaviour In Breast Cancer
The invasion and spread of cancer cells to other parts of the body, known as metastasis, is a principal cause of death in patients diagnosed with breast cancer. Eventhough patients with early stage, small, breast tumours have an excellent short term prognosis, more than 15 to 20 per cent of them will eventually develop distant metastases, and die from the disease. Vascular invasion - through lymphatic and blood vessels - is the major route for cancer spreading to regional lymph nodes and to the rest of the body.

Dr Stewart Martin, Professor Ian Ellis and their colleagues at The University of Nottingham, and worldwide, are combining many approaches in a dynamic effort to improve our understanding of cell behaviour in breast cancer. Discovering how these cells operate is vital in improving diagnosis and therapy for the cancer patient in the longer term, and in identifying therapeutic targets. Already the results of their work have been excellent - with findings in relation to the spread of cancer through the lymphatic vessels prompting a much larger study funded by Cancer Research UK.

A research student within the Nottingham team, Rabab Mohammed, showed recently that specific factors that regulate the growth of blood and lymphatic vessels can identify a subset of tumours which have a high probability of recurring or spreading.........

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June 10, 2008, 10:13 PM CT

Raloxifene reduces risk of invasive estrogen-receptor positive breast cancer

Raloxifene reduces risk of invasive estrogen-receptor positive breast cancer
Women who took raloxifene were less likely to develop invasive estrogen-receptor (ER) positive breast cancer compared with women who did not, as per data from a randomized controlled trial published online June 10 in the Journal of the National Cancer Institute The drug did not reduce the risk of non-invasive cancer or invasive ER-negative cancers.

A prior analysis of data from the Raloxifene Use for the Heart (RUTH) trial, which enrolled women with coronary heart disease or those at an increased risk for the disease, showed that the drug did not protect against heart disease, which was one of the primary aims of the trial. But after a median follow up of 5.6 years, it did reduce the risk of invasive breast cancer by 44 percent, compared with women not taking the drug. Raloxifene is a selective estrogen receptor modulator (SERM), which might suggest that the drug would have a preferential effect on hormone-responsive breast cancers. The drug is approved by the FDA for the prevention and therapy of osteoporosis in postmenopausal women and for invasive breast cancer risk reduction in postmenopausal women with osteoporosis or at high risk for breast cancer.

To investigate the specific types and stages of breast cancer affected by raloxifene, as well as the timing of its action and the types of patients it can help, Deborah Grady, M.D., of the University of California at San Francisco and his colleagues examined the RUTH trial data in more detail.........

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May 21, 2008, 8:50 PM CT

Deceptive high-risk breast tumors

Deceptive high-risk breast tumors
A unique genetic signature can alert physicians to high-risk breast tumors that are masquerading as low-risk tumors, as per research at Washington University School of Medicine in St. Louis and collaborating institutions. Eventhough these tumors are apparently estrogen-receptor positive meaning they should depend on estrogen to grow they don't respond well to anti-estrogen treatment.

Until now, doctors had no way to know these tumors would be unresponsive because their pathology is deceptive the tumors appear to be more easily treatable estrogen-receptor-positive tumors, but they rapidly lose their estrogen receptors. The scientists demonstrated that the chance for cancer recurrence in such patients is significantly higher, and standard post-operative care with long-term anti-estrogen treatment is often not effective. The genetic signature defined by the scientists will permit doctors to identify their high-risk patients and direct them to more effective treatment.

"These tumors are like wolves in sheep's clothing," says Matthew Ellis, M.D., Ph.D., associate professor of medicine in the Division of Medical Oncology and a faculty member at the Siteman Cancer Center. "When these patients come in, their tumors test positive for estrogen receptors, so they are started on anti-estrogen therapy with the thought that they will do fine. But these tumors don't depend on estrogen at all for growth and will keep growing during the treatment. Now we have a robust way to identify such tumors soon after diagnosis".........

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May 15, 2008, 7:22 PM CT

Link between vitamin D status, breast cancer

Link between vitamin D status, breast cancer
Food containing vitamin-D
Using newly available data on worldwide cancer incidence, scientists at the Moores Cancer Center at University of California, San Diego (UCSD) and the Department of Family and Preventive Medicine have shown a clear association between deficiency in exposure to sunlight, specifically ultraviolet B (UVB), and breast cancer.

UVB exposure triggers photosynthesis of vitamin D3 in the body. This form of vitamin D also is available through diet and supplements.

Approximately 1,150,000 cases and 410,000 deaths from breast cancer occur annually worldwide, including 215,000 new cases and 41,000 deaths in the United States.

The study is reported in the May-June 2008 issue of The Breast Journal.

This is the first study, to our knowledge, to show that higher serum levels of vitamin D are linked to reduced incidence rates of breast cancer worldwide, said Cedric F. Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and member of the Moores UCSD Cancer Center.

This paper used worldwide data only recently available through a new tool called GLOBOCAN, developed by the World Health Organizations International Agency for Research on Cancer. GLOBOCAN is a database of cancer incidence, mortality and prevalence for 175 countries.........

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May 14, 2008, 9:32 PM CT

Risk For Developing Breast Cancer

Risk For Developing Breast Cancer
Dr. David Euhus
A chemical reaction in genes that control breast cancer provides a molecular clock that could one day help scientists more accurately determine a woman's risk for developing breast cancer and provide a new approach for therapy, UT Southwestern Medical Center scientists have found.

As per a research findings published in today's issue of Cancer Epidemiology Biomarkers & Prevention, researchers from UT Southwestern show that the chemical process, called methylation, is strongly correlated with breast-cancer risk and with premalignant changes in the breast cells.

The scientists determined that methylation acts as a type of biological clock, indicating how a number of times a cell has divided. This information could aid scientists in determining an individual's cancer risk.

"The more a cell has divided, the greater the risk for cancer," said Dr. David Euhus, professor of surgical oncology. "Monitoring methylation levels could give scientists a way of seeing how often cells have divided and where a woman stands on that clock. Once the clock reaches a certain hour, breast cancer is more likely to ensue".

During methylation, small molecules called methyl groups attach themselves to a gene and turn off, or "silence," the gene.

Prior studies by Dr. Euhus have shown that apparently normal breast cells from women with breast cancer had increased methylation of a tumor-suppressor gene called RASSF1A.........

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May 13, 2008, 7:46 PM CT

Adding ultrasound screening to mammography

Adding ultrasound screening to mammography
Adding a screening ultrasound examination to routine mammography reveals more breast cancers than mammography alone, as per results of a major new clinical trial. The trial, however, also observed that adding an ultrasound exam also increases the rate of false positive findings and unnecessary biopsies.

Results of the clinical trial, conducted by the American College of Radiology Imaging Network (ACRIN) and analyzed by Brown University statisticians, appear in the May 14, 2008 issue of the Journal of the American Medical Association.

The trial uncovered a significant trade-off with ultrasound screening, said Jeffrey Blume, an associate professor in the Department of Community Health and the deputy director of the ACRIN Biostatistics and Data Management Center at Brown. While supplemental ultrasound screening uncovers more breast cancers, it also substantially increases the risk of a false positive cancer finding and unnecessary biopsy.

The medical community may well decide that the screening benefit is offset by the increase in risk to women from a false positive finding, Blume said. However this study also shows that supplemental ultrasound may be beneficial in women at high risk of breast cancer who could not, or would not, otherwise undergo a magnetic resonance imaging scan. Women should consult their doctor for more information.........

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May 12, 2008, 9:43 PM CT

Physical activity prevent breast cancer

Physical activity prevent breast cancer
Physically active women are 25 per cent less likely to get breast cancer, but certain groups are more likely to see these benefits than others, finds a review of research published online ahead of print in the British Journal of Sports Medicine.

The type of activity undertaken, at what time in life and the womans body mass index (BMI) will determine how protective the activity is against the disease.

Lean women who play sport or undertake other physically active things in their spare time, particularly if they have been through the menopause, have the lowest risk of breast cancer.

The scientists evaluated the literature and analysed 62 studies looking at the impact of physical activity on breast cancer risk. They then examined the findings to find out how breast cancer risk appeared to be affected by type of activity, intensity of activity, when in life the activity waccording toformed and other factors.

They found the most physically active women were least likely to get breast cancer. All types of activity reduced breast cancer risk but recreational activity reduced the risk more than physical activity undertaken as part of a job or looking after the house. Moderate and vigorous activity had equal benefits.

Women who had undertaken a lot of physical activity throughout their life had the lowest risk of breast cancer, and activity performed after the menopause had a greater effect than that performed earlier in life.........

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May 8, 2008, 8:43 PM CT

Benign Lesions Needs 6-month Mammogram Follow Up

Benign Lesions Needs 6-month Mammogram Follow Up
Radiologists can, with confidence, recommend a six-month follow-up diagnostic mammogram rather than an immediate biopsy for patients with probably non-malignant breast lesions, a new study emphasizes.

The study observed that six-month short-interval follow-up examinations had an 83% sensitivity, which is similar to the sensitivity of other diagnostic mammograms, said Erin J. Aiello Bowles, MPH, lead author of the study from the Group Health Center for Health Studies. High sensitivity means identifying a high proportion of true positives (actual cancer cases) and a low proportion of false negatives (cases mistakenly deemed benign).

The study included 45,007 initial short-interval follow-up mammograms. Short-interval follow-up mammograms are done to monitor for changes in probably non-malignant breast lesions (findings seen on mammograms that have a very low probability of being cancer). Because the probability of cancer is so low, we dont want to put the patient through an unnecessary biopsy, which is an invasive procedure that increases both patient anxiety and medical costs, said Aiello Bowles. At the same time, we want to closely monitor these patients, because changes in probably non-malignant lesions occasionally mean cancer, and we want to detect the cancers as early as possible, she said. In the study, 360 women with probably non-malignant lesions were diagnosed with breast cancer within six months; and 506 women were diagnosed with cancer within 12 months (altogether about one in 100 of the probably non-malignant lesions), Aiello Bowles said.........

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April 28, 2008, 5:31 PM CT

Predicting breast cancer patient outcome

Predicting breast cancer patient outcome
Not a day goes by without a new story about the environment. Eventhough we often consider the environment on a global scale, cells in our body also have to contend with environmental factors. New studies from a team of scientists from the Research Institute of the MUHC and McGill University show that the environment surrounding breast cancer cells plays a crucial role in determining whether tumor cells grow and migrate or whether they fade away. Their study is the first to identify the genes behind this environmental control and correlate them with patient outcome. Their findings appear in this weeks issue of Nature Medicine.

A tumour can not exist on its own. It has to be supported and nourished by the cell types around it, the microenvironment, says senior author Dr Morag Park, Director of the molecular oncology group at the Research institute if the MUHC. When we began this study there was little known about the importance of this microenvironment on cancer initiation and progression. We now know that this environment is pivotal; different patients have distinct tumour microenvironments at a gene level. Our findings show that the gene profile of these distinct microenvironments can be used to determine clinical outcome who will fare well and who will not.

Dr Park, a professor of oncology, biochemistry, and medicine at McGill University, and her team analyzed tissue from 53 patients with breast cancer. They used a unique technique, laser capture microdissection (LCM), to separate tumour cells from microenvironment tissue. They compared the gene expression between the microenvironment tissue and controls using micro-array analysis. From thousands of genes they identified 163, which correlated with patient outcome. A good outcome was defined as having no tumour metastasis and tumour migration and non-responsiveness to treatment was considered poor outcome.........

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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. Archives of breast-cancer-blog

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