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April 24, 2008, 5:04 AM CT

Advances In Breast Reconstruction

Advances In Breast Reconstruction
Lumpectomy or breast conservation surgery is the most common type of breast cancer surgery currently performed. A benefit of the surgery is that only part of the breast is removed, but a drawback can be the resulting physical appearance of the breast, which may be disfigured, dented or uneven. A report in April's Plastic and Reconstructive Surgery® , the official medical journal of the American Society of Plastic Surgeons (ASPS), examines advances plastic surgeons have made in breast reconstruction to repair the damage left when cancer is removed.

"Eventhough breast conversation therapies are a huge advance in the therapy of breast cancer, women are still concerned about how their breast will look after surgery," said Sumner Slavin, MD, ASPS Member and report co-author. "Breast conservation surgery or lumpectomy can mean a number of things; a biopsy, partial mastectomy, wedge resection, or having a quarter of the breast taken. Women are often left with portions of their breasts removed and there are currently no implants that can address this unique cosmetic issue".

After lumpectomy or breast conservation surgery, plastic surgeons are now approaching the challenge of misshapen breasts by immediately remodeling the breast with remaining breast tissue or tissue taken from another area of the body. The result is a more natural looking breast that is more symmetrical with the unaffected breast.........

Posted by: Janet      Read more         Source


April 17, 2008, 3:56 AM CT

Capecitabine combo produces side effects

Capecitabine combo produces side effects
Adding capecitabine, a drug that inhibits DNA synthesis and slows the growth of tumour tissue, to docetaxel, in patients with early breast cancer, leads to more toxicities and does not improve the efficacy of therapy, a German scientist told the 6th European Breast Cancer Conference (EBCC-6) today (Thursday 17 April). Previously, such a combination had improved patient survival in metastatic disease, where the cancer has spread to other parts of the body.

Professor Gunter von Minckwitz, Chairman of the German Breast Group, Neu-Isenberg, Gera number of, and his team set out to look at the use of the combination in early breast cancer. We recruited 1510 patients with previously untreated primary tumours, he said. Each received the normal preoperative therapy of four cycles of epirubicin and cyclophosphamide. We then randomised them to either four cycles of docetaxel alone, four cycles of simultaneous docetaxel and capecitabine, or four cycles of docetaxel followed by four cycles of capecitabine. If capecitabine were to improve outcomes, we wanted to see how best to use it simultaneously or in sequence.

The researchers planned to study the pathologic response at surgery the way, if any, in which the tumour had reacted to the administration of the chemotherapy drug.........

Posted by: Janet      Read more         Source


April 17, 2008, 3:53 AM CT

Lapatinib shrinks breast cancer tumors in just 6 weeks

Lapatinib shrinks breast cancer tumors in just 6 weeks
A drug that targets the cell surface receptors that play an important role in a number of types of cancer can bring about significant tumour regression in breast cancer after only six weeks of use, a scientist told the 6th European Breast Cancer Conference (EBCC-6) today (Thursday 17 April). Dr. Angel Rodriguez, from the Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, USA, said that the work shown for the first time that the tyrosine kinase inhibitor lapatinib could decrease tumour-causing breast cancer stem cells in the primary breast cancers of women receiving neoadjuvant therapy (treatment given before the primary surgery for the disease).

Dr. Rodriguez and his colleagues studied 45 patients with locally advanced breast cancer in which the gene HER-2 was over-expressed. The patients received lapatinib for six weeks, followed by a combination of weekly trastuzumab and three-weekly docetaxel, given over 12 weeks, before primary surgery. Biopsies were performed at the time of diagnosis and also after six weeks of lapatinib and cells from the tumours were obtained and analyzed.

We saw significant tumour regression after six weeks of single agent lapatinib, said Dr. Rodriguez. Bi-dimensional tumour measurements showed a median decrease of minus 60.8%. We had previously showed that tumour-causing breast cancer stem cells were resistant to conventional preoperative chemotherapy; indeed, residual cancers that were exposed to such chemotherapy showed an increase in tumour-causing cells and enhanced tumour initiation by the formation of mammospheres, small tumours that form when tumour-causing cells are cultured in a test tube, which reflect the capacity of the cells to self-renew. So we were excited to see that the results with lapatinib were different.........

Posted by: Janet      Read more         Source


April 17, 2008, 3:31 AM CT

Standard chemo works better against BRCA2 related breast cancer

Standard chemo works better against BRCA2 related breast cancer
The first study to investigate the effects of chemotherapy on metastatic breast cancer in women with the BRCA1 or BRCA2 gene mutation has shown that standard chemotherapy works better in these patients than in women without the BRCA1/2 mutation.

The authors of a study presented today (Thursday) at the 6th European Breast Cancer Conference (EBCC-6) in Berlin observed that women with BRCA2-associated breast cancer had a significantly higher response rate, a longer time without the disease progressing, and a longer overall survival when treated with anthracycline-based regimens than did women with sporadic breast cancers that were not linked to BRCA1/2.

Women with BRCA1-associated breast cancer also did better than women with sporadic breast cancer, but the rates were not statistically significant.

Scientists at the Daniel den Hoed Cancer Centre/Erasmus Medical Centre (Rotterdam, The Netherlands) conducted the study. They matched 112 women with BRCA1-associated metastatic cancer and 29 women with BRCA2-associated metastatic cancer with 141 women with sporadic breast cancers. The women had been treated with anthracycline-based or taxane-based regimens, CMF (cyclophosphamide, methotrexate and fluorouracil 5FU) or other chemotherapy regimens.

BRCA2 women had a higher response rate to chemotherapy (89% versus 50%), a longer progression-free survival (nearly a third better) and a longer overall survival (47% better) than did women with sporadic cancers. When the scientists looked more closely at the type of chemotherapy the women had received, they observed that the improved progression-free survival mainly occurred in patients on anthracyclines and disappeared for those treated with CMF.........

Posted by: Janet      Read more         Source


April 13, 2008, 9:45 PM CT

Screening mammography in elderly patients

Screening mammography in elderly patients
Eventhough guidelines keep changing regarding screening mammography in elderly patients, those older than 70 years old continue to benefit from this exam, showing that with frequent mammograms breast cancers can be found sooner, as per a recent study conducted by scientists at Jacobi Medical Center and Albert Einstein College of Medicine, in Bronx, NY.

Our initial interest was sparked by the changing mammographic guidelines in the elderly age group and the differences in the guidelines between organizations including the American Cancer Society and American College of Radiology, said Jason Salsamendi, MD, lead author of the study. We also noticed that we were performing a significant number of screening mammograms in elderly patients at our institution and became curious about the occurence rate of occult breast cancer in this age group, he said.

The study consisted of the review of 24 cases of breast cancer in 22 elderly patients age 70-89.

The scientists reviewed the mammograms for masses and calcifications and correlated the results to surgically proven histology, lymph node involvement and initial surgical management.

As per the study, 19 of the 24 cases of breast malignancy were initially identified on screening mammography. The study showed that mammographic findings in these 19 cases included 12 masses, 4 suspicious calcifications and 3 masses with calcifications. Of these, surgical management was available in 18 cases with 15 being treated by lumpectomy and 3 being treated with mastectomy. The study also showed that the average time interval from most recent previous mammogram to diagnosis was 2.6 years.........

Posted by: Janet      Read more         Source


April 13, 2008, 9:12 PM CT

Radiation beneficial for older breast cancer patients

Radiation beneficial for older breast cancer patients
A patients with breast cancer age alone should not determine whether or not she receives standard breast-conservation therapys, including a lumpectomy and radiation treatment; however, if additional health problems (comorbidities) are present, therapys should be individualized based on age and the type of comorbidities, as per a research studyin the April 1 edition of the International Journal for Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

The occurrence of breast cancer in women increases as women age. As per the National Cancer Institutes SEER Cancer Statistics Review, women between the ages of 75 and 79 have the highest occurence rate of breast cancer diagnoses at 497 cases per 100,000 people. Along with cancer, most women in this age group are dealing with additional health problems. As per a 1999 womens health and aging study in the Journal of Clinical Epidemiology, the majority of older patients diagnosed with cancer have at least one other medical condition and more than half of patients with cancer over the age of 65 have three or more associated medical conditions.

This study, conducted by the departments of Radiation Oncology, Biostatistics and Epidemiology, and Medicine, Division of Geriatrics, at the University of Pennsylvania School Of Medicine in Philadelphia, sought to determine the impact of these additional medical problems on patients with breast cancer who receive the same standard therapys as patients with no additional medical problems and if old age is a reason to deny some standard therapys.........

Posted by: Janet      Read more         Source


April 13, 2008, 8:43 PM CT

Connection between protein and prognosis in breast cancer

Connection between protein and prognosis in breast cancer
Oregon Health & Science University Cancer Institute scientists have observed that a tumor protein present in an aggressive form of breast cancer is correlation to a poor prognosis.

The presence of the protein, called growth factor receptor-bound protein-7, often referred to as GRB-7, in breast cancer tumors, is strongly correlation to the growth and spread of the cancer, as per principal investigator Shiuh-Wen Luoh, M.D., Ph.D., assistant professor of medicine (hematology/medical oncology) in the OHSU School of Medicine.

The research will be presented Sunday, April 13, at 1 p.m. at the annual American Association for Cancer Research meeting in San Diego.

The GRB-7 protein previously has been shown to be important to cell communication in the spread of cancer. The GRB-7 gene is located close to the HER-2/Neu gene that regulates breast cancer growth. The OHSU Cancer Institute scientists discovered that the levels of GRB-7 protein are often heightened at the same time that HER-2/Neu levels are high. Also, not infrequently, they found breast tumors that overexpressed one but not the other protein. Overexpression means that there is an abundant presence of the protein.

It is surprising that we found discordance in the overexpression of these genes because they are so close together, Luoh said.........

Posted by: Janet      Read more         Source


April 3, 2008, 10:00 PM CT

Breast cancer risk lingered years after HRT

Breast cancer risk lingered years after HRT
A follow-up study of postmenopausal women who took the combination of estrogen and progestin for more than five years as part of the landmark Women's Health Initiative shows that the women continued to face an increased risk for breast cancer nearly three years after they quit taking the hormones.

The new study also shows that while some of the other health risks and benefits diminished after the women had stopped taking the estrogen-progestin combination, the overall health risk was 12 percent higher at the end of eight years (with women on the pills for an average of 5.6 years and then off for 2.4 years) compared with those who took placebos. This was largely due to the high risks of breast cancer, strokes and serious blood clots during the original trial while the women took the hormones.

The Stanford University School of Medicine researcher who is the senior author of the follow-up study said the results indicate that the potential harms from estrogen-progestin treatment still outweigh the benefits, and that women should continue to be cautious in deciding whether to take the hormones to relieve menopausal symptoms.

"Menopausal women really need to think through whether using estrogen-progestin is the right thing to do, especially if continued for more than a few years," said Marcia Stefanick, PhD, professor of medicine at the Stanford Prevention Research Center, noting that the breast-cancer risks apply only to women who take the combination treatment, and not those who take estrogen alone. A different portion of the WHI study showed that estrogen-only treatment doesn't increase the risk of breast cancer.........

Posted by: Janet      Read more         Source


April 1, 2008, 8:48 PM CT

Hormone replacement therapy and breast cancer

Hormone replacement therapy and breast cancer
Millions of post-menopausal women use hormone replacement treatment (HRT) as a method to reduce symptoms linked to menopause. In a recent University of Missouri study, scientists observed that one of the hormones used in HRT, a synthetic progestin, could be a major factor in promoting breast cancer. At the same time, the scientists have compelling evidence that using an antibody that prevents new blood vessel formation in tumors, or a small molecular drug, known as PRIMA, with similar properties as the antibody may be effective in treating or preventing the negative effects of progestin.

As per a research findings reported in the journal, Cancer Research, MU scientist Salman Hyder and his research team observed that exposing tumor cells to progestin caused an increase in a growth factor that is involved in the formation of new blood vessels in tumors. Increasing the blood supply allows the tumors to expand as the availability of nourishment increases. However, when they used an antibody that inhibits the growth factor, the tumor shrank. Hyders team found similar results using PRIMA, which re-activated a protein known as p53. When p53 was activated within tumor cells, the number of breast cancer cells reduced significantly.

As women age, a number of develop tiny lesions in their breasts, said Hyder, professor of biomedical sciences in the College of Veterinary Medicine and the Dalton Cardiovascular Research Center. The majority of the time, these lesions never expand. We think this might be due to a specific protein, p53, that, under normal circumstances, prevents tumor cells from living. We found in our study that when the protein is active, it reduces the number of breast cancer cells in the body by inhibiting the growth factor that supplies blood vessels to the tumor. However, when the cells of these lesions are exposed to progestin in a body that does not have an active p53 protein, we observed that the cells might start expanding and turn into tumors.........

Posted by: Janet      Read more         Source


March 27, 2008, 9:36 PM CT

Too many women still dying from breast cancer

Too many women still dying from breast cancer
Thousands of women die from breast cancer each year because current therapys are not always effective and in some cases fail to stem the disease, warns Breast Cancer Campaign today.

In a comprehensive review of breast cancer research published recently, 56 of the UKs most influential breast cancer experts have identified the key research gaps and priorities for the greatest potential impact on patients.

Breast cancer therapy has improved over the past few decades and led to increased survival rates and better quality of life, the report highlights. However over 44,000 women in the UK are diagnosed with breast cancer each year and around 12,500 will die.

Unfortunately, not enough is known about why therapys dont work for some patients or why breast cancer can return, sometimes a number of years later, says Breast Cancer Campaign.

The new study, one of the largest ever carried out in the UK and published by the open access journal Breast Cancer Research, is a unique insight into the current state of breast cancer research and its future challenges.

Gaps in key areas of breast cancer research have been identified in the report, says the charity: prevention, detection, spread or recurrence of the disease, therapy, pathology, physiology, genetics and psychosocial aspects of breast cancer.........

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.

Medicineworld.org: Archives of breast-cancer-blog

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