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Patients With Breast Implants Frequently Develop Complications
Breast cancer is the most common malignancy among women in North American, Europe, Australia, New Zealand and some parts of South America, according to background information in the article. Women with breast cancer and their physicians may face several choices in the course of therapy, including whether to remove the breast (mastectomy) or undergo breast-conserving therapies, when and whether to reconstruct the breast following mastectomy and what materials to use in doing so. Surgeons performing postmastectomy reconstruction can form the new breast from flaps of skin and other tissue from the woman's body (autologous tissue) or insert an implant, and sometimes use both techniques at once. A number of women choose implants alone because the procedure is simpler and requires less operation time than those using autologous tissue, and it can preserve the color of the skin of the breast and possibly some of its sensitivity.
Trine F. Henrikson, M.D., of the Danish Registry for Plastic Surgery of the Breast (DPB), Copenhagen, Denmark, and his colleagues analyzed data from 574 women in the registry who underwent postmastectomy breast reconstruction between June 1, 1999, and July 24, 2003. The patients' surgeons reported the dates and details of each implantation and filled out follow-up forms when the women returned for subsequent visits. The women, ages 21 to 78 years with a mean (average) age of 51 years, were monitored through Sept. 15, 2003.
Following their first implantation, 31 percent of the women developed at least one adverse event, 16 percent developed two complications and 8 percent experienced three or more during the course of the study. The most common complications were infection, blood clotting, seroma (collection of serum in the tissues) and skin perforation. Forty-nine percent of these complications occurred within three months and 67 percent within six months.........
December 28, 2005
Annual Mammogram Is All That Needed
The report suggests that more intensive lab tests like liver scans and molecular tumor markers do not improve the chances of detecting a recurrence of cancer or increase survival rates among former breast cancer patients.
The finding is at odds with the usual therapy for breast cancer patients, according to Dr. Roldano Fossati of the Mario Negri Institute in Italy and his colleagues.
Fossati says "intensive follow-up is quite common in clinical practice and represents a significant workload for radiotherapy, surgical and oncologic departments".
The review appears in the recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The new analysis is an update of a 20-year-old Cochrane report on the topic. The current review includes four randomized controlled trial studies of 3,055 patients that compare different types of breast cancer follow-up care.
After analyzing data from two of the studies, the scientists found no significant difference in terms of survival, detection of new cancers or quality of life between a group of women who got regular physical exams and annual mammograms and a group who underwent a more extensive battery of laboratory tests that included liver scans, molecular tumor markers, chest x-rays and blood and liver function tests.
Another study included in the review found that follow-up care by hospital-based specialists was not significantly different from that offered by general practitioners in terms of improvements in the patient's quality of life or speed in detecting new cancers. However, patients were more likely to be satisfied with care by their general practitioner.........
December 27, 2005
Breast Cancer Numbers Increase Among New Zealand Women
Evans Bay New ZealandThe number of women in the upper South Island diagnosed with breast cancer is soaring as access to screening services improves.
Pressure is now on therapy providers who are faced with an influx of newly diagnosed cancer patients seeking radiotherapy or chemotherapy.
Mammographies provided by BreastScreen South led to 244 women in Canterbury, Nelson, Marlborough and the West Coast being diagnosed with breast cancer in the year to November. That figure compares with 159 the prior year and 143 the year before that.
A Canterbury District Health Board manager says the extra costs of treating the women with chemotherapy have added to a $2.48 million budget overrun in Christchurch Hospital's medical and surgical services division this financial year.
The age range for Government- funded breast cancer screening was extended in July last year to include all women aged 45 to 69.
However, a lack of staff and equipment meant women in the younger age bracket have only recently been able to access the programme.
Breast cancer is the leading cause of cancer deaths among New Zealand women. About 2200 women develop the disease each year and 640 die from it.
BreastScreen South clinical director Richard Chisholm said the higher number of diagnoses showed the screening extension had been a success. "It's a predictable increase, but over all we're pleased that we're detecting breast cancers".
He said some of the extra women would have been picked up anyway through private screening or by going to their GP after finding a lump.........
December 25, 2005, 10:32 AM CT
Merry Christmas To All Our Readers
Oh, jingle bells, jingle bells
Jingle all the way
Oh, what fun it is to ride
In a one horse open sleigh
Jingle bells, jingle bells
Jingle all the way
Oh, what fun it is to ride
In a one horse open sleigh........
December 23, 2005
Chinese Remedy For Breast Cancer
In a new study, two University of Washington bioengineers found that the substance, artemisinin, appeared to prevent the onset of breast cancer in rats that had been given a cancer-causing agent. The study appears in the latest issue of the journal Cancer Letters.
"Based on earlier studies, artemisinin is selectively toxic to cancer cells and is effective orally," according to Henry Lai, research professor in the Department of Bioengineering, who conducted the study with fellow UW bioengineer Narendra P. Singh, a research associate professor in the department. "With the results of this study, it's an attractive candidate for cancer prevention".
The properties that make artemisinin an effective antimalarial agent also appear responsible for its anti-cancer clout. When artemisinin comes into contact with iron, a chemical reaction ensues that spawns free radicals -- highly reactive chemicals that, when formed inside a cell, attack the cell membrane and other structures, killing the cell.
The malaria parasite can't eliminate iron in the blood cells it eats, and stores it. Artemisinin makes that stored iron toxic to the parasite.
The same appears to be true for cancer. Because they multiply so rapidly, most cancer cells have a high rate of iron uptake. Their surfaces have large numbers of receptors, which transport iron into the cells. That appears to allow the artemisinin to selectively target and kill the cancer cells, based on their higher iron content.
In the latest study, the researchers administered to rats a single oral dose of 7,12-dimethylbenz[a]anthracene, a substance known to induce multiple breast tumors. Half of the rats then were fed regular food, while the other half were fed food with 0.02 percent artemisinin added. For 40 weeks, researchers monitored each group for the formation of breast tumors.........
December 21, 2005
Emotional Recovery From Breast Cancer
"We thought we'd find that women do worse psychologically after therapy," says Washington University psychology expert, Teresa L. Deshields, Ph.D., assistant professor of medicine. "That's the clinical lore. After all, a number of of the patients referred to us are the ones struggling at the end of therapy. But our study shows that within two weeks most women adjust very well to survivorship".
The research team surveyed 94 women drawn from patients of the radiation oncology practice at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. The women, averaging 55 years of age, had stage 0, I, II or III breast cancer and at the start of the study were completing the last of a six- to seven-week course of daily radiation therapys.
The women were surveyed five times: on their last day of radiation therapy, two weeks later, several days before their first follow-up appointment (four to six weeks post-treatment) and at three and six months. The survey measured patients' depressive symptoms and quality of life (the quality of life measurement quantifies a set of attributes that include physical, social/family, emotional and functional well-being, and breast-cancer-specific concerns). For the group of breast-cancer survivors, the average score for indications of depression was heightened at the end of therapy compared to a group of healthy men and women. A higher score on the depression index indicates more severe depressive symptoms.........
December 20, 2005
Expanding Mammography's Power
A team of researchers, including Bradley J. Lucier, has found that digitized mammograms, the X-ray cross sections of breast tissue that doctors use to search for cancer, are actually interpreted more accurately by radiologists once they have been "compressed" using techniques similar to those used to lessen the memory demand of images in digital cameras. Though compression strips away much of the original data, it still leaves intact those features that physicians need most to diagnose cancer effectively. Perhaps equally important, digitization could bring mammography to a number of outlying communities via mobile equipment and dial-up Internet connections.
"Any technique that improves the performance of radiologists is helpful, but this also means that mammograms can be taken in remote places that are underserved by the medical community," said Lucier, who is a professor of mathematics and computer science in Purdue's College of Science. "The mammograms can then be sent electronically to radiologists, who can read the digitized versions knowing they will do at least as well as the original mammograms".
The research paper will appear in today's (Dec. 20) issue of Radiology, the journal of the Radiological Society of North America. Lucier developed the file-compression method used in the study, which was run at the Moffitt Cancer Center at the University of South Florida in Tampa.
Discerning the potential seeds of cancer within the chaff of extraneous detail present in a mammogram requires the expert eye of a radiologist, who must pick out salient features at a number of different scales within the image. Clues can be very small clusters of tiny calcium deposits, each less than one-hundredth of an inch in diameter. Clues also can range up through the edges of medium-sized objects - which could be non-malignant cysts with smooth edges, for example, or malignant tumors with rough edges - up to large-scale patterns in tissue fiber.........
December 15, 2005, 7:32 PM CT
Radiotherapy after lumpectomy saves lives
An international team of scientists found that a woman's five-year risk of the cancer returning in or near the breast after a lumpectomy dropped from 26 percent to seven percent if she also received radiotherapy, and the 15-year risk of dying from the disease dropped from 36 percent to 31 percent.
They carried out a worldwide overview of trials of radiotherapy and of different types of surgery, involving 40,000 women with early breast cancer, and found that for every four breast cancer recurrences avoided by radiotherapy, one death is prevented.
The findings from this Cancer Research UK and Medical Research Council funded study will help doctors and patients decide on the most appropriate therapy.
Present UK guidelines on improving outcomes in breast cancer already state that radiotherapy should be regarded as standard therapy after a lumpectomy. But, as with any procedure, the therapy given depends on discussions between doctors and patients about the benefits and side effects, and may, in a minority of cases, result in non-standard therapy being offered.
The study also shows similar benefits from radiotherapy for women who had their entire breast removed but whose cancer had already spread to the armpit. The chances of the cancer coming back in or near the breast or armpit dropped from 23 percent to six percent, and the risk of dying from breast cancer dropped from 60 percent to 55 percent.
However, for women who had a breast removed, but whose cancer had not spread to the armpit, radiotherapy was found not to be appropriate; any benefits were slight and were outweighed by the side effects of radiotherapy. These can include permanent swelling of the arm, permanent limitation of shoulder movement and, occasionally, life-threatening diseases such as heart attack or a new cancer in the lung or opposite breast.........
December 12, 2005
Two Treatments Similar Results
Paclitaxel and docetaxel are members of a class of drugs called taxanes, and both are approved for the therapy of patients with breast cancer that has spread to the lymph nodes. Eventhough these drugs have been shown to be beneficial in treating breast cancer, this is the first time they have been directly compared and the first time that a weekly dosing schedule has been compared with a standard every three-week dosing schedule in the therapy of early-stage breast cancer.
"Eventhough both drugs are used as adjuvant breast cancer therapys, which taxane and which schedule are most effective has been a question for a number of years," said JoAnne Zujewski, M.D., who oversees breast cancer trials for NCI's Cancer Therapy Evaluation Program. "Now doctors and patients will be able to consider side effects, convenience, and cost in determining taxane therapy without concern that effectiveness will be compromised."
A total of 4,988 women were enrolled in the trial between 1999 and 2002. All of the women had axillary lymph node (a lymph node in the armpit region that drains lymph channels from the breast) positive or high-risk (their tumor was at least 2 centimeters in size) node-negative breast cancer. All of the women were first treated with doxorubicin and cyclophosphamide, a standard therapy protocol referred to as AC (representing the drugs doxorubicin and cyclophosphamide). Following AC chemotherapy, patients were randomly assigned to groups that received either paclitaxel or docetaxel, administered weekly for 12 weeks or every third week over a 12-week period.........
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Did you know?
Scientists from the National Surgical Adjuvant Breast and Bowel Project (NSABP) who conducted the landmark Breast Cancer Prevention Trial (BCPT), report a seven-year and final update of the trial results in the November 16, 2005, Journal of the National Cancer Institute*. In this final report, reductions in breast cancer incidence among participants taking tamoxifen were found to be very similar compared to those reported in 1998 when initial findings from the BCPT were released. The conclusion is supported by the observation that the incidence rate of breast cancer was relatively constant through seven years of follow-up among women who received tamoxifen and by the fact that the rate remained stable for at least two years beyond the time that women stopped taking the drug. The risks of stroke, deep-vein thrombosis, and cataracts -- possible side-effects of tamoxifen treatment -- were also similar to those reported previously.
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