Archive for August, 2009
August 31st, 2009 -- Posted in Breast Cancer News, Breast Cancer Signs |
Medical centers providing both mammography and clinical exams were more likely to detect breast cancer than centers offering mammography alone, but also far more likely to produce false positives, a Canadian study found.
In nine regional centers, all of which offer both types of screening, the sensitivity of an initial screen was 94.9% (95% CI 90.1 to 97.4), while in 59 affiliated centers offering both types, the sensitivity was 94.6% (95% CI 91.7 to 96.5).
By way of contrast, in 34 centers providing mammography alone, the sensitivity was 88.6% (95% CI 83.4 to 92.3), according to Anna M. Chiarelli, PhD, of Cancer Care Ontario in Toronto, and colleagues.
However, in the regional centers the false positive rate was 12.5% (95% CI 12 to 12.9) and in affiliated centers with both modalities it was 12.4% (95% CI 12.1 to 12.7).
That compared with a false positive rate of only 7.4% (95% CI 7.1 to 7.7) in the centers offering only mammography, the researchers reported in the Sept. 16 issue of the Journal of the National Cancer Institute.
For each additional cancer detected by clinical breast examination, there were an additional 55 false positive screens. So women should be advised of the risks and benefits of having a clinical exam in addition to mammography, the investigators said.
Controversy has persisted regarding the value of clinical breast examination, with randomized trials finding similar mortality reductions whether or not a mammogram is accompanied by a clinical exam.
Moreover, the examiner’s experience and technique can affect the accuracy of clinical examination, and inappropriate referrals can increase cost, risk, and anxiety for patients.
Nonetheless, breast cancer experts contacted by MedPage Today and ABC News continue to disagree on the utility of clinical breast examination.
The Canadian researchers analyzed data from the Ontario Breast Screening Program to evaluate the accuracy of referrals for further assessment from the regional centers that began screening in 1990 and affiliated centers that began screening in 1995.
The screenings for the study were conducted between January 2002 and December 2003.
Clinical breast examinations were performed by 167 highly trained nurses, and standard craniocaudal and mediolateral oblique view mammograms were made using high-quality machines.
Among the 290,230 women who were screened, 232,515 had both clinical examinations and mammography, while 57,715 had mammography alone.
At centers offering both types of screening, the cancer detection rate for mammography alone was 5.9 per 1,000 and the false positive rate was 6.5%, while the detection rate with both types of screening was 6.3 per 1,000 and the false positive rate was 8.7.
“Therefore, with [clinical breast examination] an additional 0.4 cancers are detected per 1,000 women screened with an increase of 2.2 percentage points in the false positive rate,” they wrote.
This meant that for 10,000 women screened, an additional four cancers would be detected, and among the 9,937 women without cancers there would be an additional 219 false positive screens.
An editorial accompanying the study stated that these numbers represent “a steep price for the potential gains” of adding clinical examination to mammography.
For women to make informed decisions about their healthcare, they must understand the risks as well as the benefits of screening tests, wrote editorialists Mary B. Barton, MD, of the Agency for Healthcare Research and Quality in Rockville, Md., and Joann G. Elmore, MD, of the University of Washington School of Medicine in Seattle.
The way this information is presented can influence patients’ decisions, they noted.
Positive framing, for example, emphasizes beneficial outcomes (four more cancers would be detected) while negative framing emphasizes the risks (for every cancer detected by examination there will be 55 false positives).
“Low-tech primary care interventions that can decrease the burden of cancer in women are extremely appealing. At the same time, ineffective practices, or those with even marginal net benefit, would be a disservice to our patients,” they wrote.
The study had limitations, according to the investigators. One was workup bias, with women being referred for a positive clinical examination being less likely to receive intensive follow-up than those referred because of an abnormal mammogram.
The findings also may have limited generalizability, because the nurses in the Ontario project were highly skilled and trained.
As the editorialists pointed out, clinical breast examination “must be done well if it is to be done at all.”
When contacted by MedPage Today and ABC News, Daniel B. Kopans, MD, director of the Breast Imaging Division at Massachusetts General Hospital in Boston, argued that only mammography has been proven to save lives, and that randomized trials are needed to determine if breast examination does too.
“The only breast cancer screening test that has been shown to significantly decrease the death rate from breast cancer in randomized, controlled trials … is mammography,” Kopans said.
“Those of us who developed the field of breast imaging recognized the importance of standardizing the technique, monitoring outcomes, and adjusting our approaches as we learned more and more about breast evaluation. I strongly urge this approach be applied to [clinical breast examination].”
Freya Schnabel, MD, director of breast surgery at New York University, was more supportive of clinical exams.
“I cannot imagine that anyone could advocate abandoning clinical breast exams, even in a screened population,” she said. “It’s clear that the pickup rate is low when patients are well screened, but superficial and central lesions are frequently missed on mammography, and young women with dense breasts represent a specific population where there is a substantial false negative rate for mammography, making clinical exam particularly important.”
She added, “As to the false positives on exam, many are resolved with simple, quick, relatively painless needle biopsies — not such a big price to pay.”
The study was funded by the Canadian Breast Cancer Foundation-Ontario Region, and editorialist Elmore received funding from the National Cancer Institute. The investigators did not report any conflicts of interest.
This article was developed in collaboration with ABC News.
Technorati Tags: breast cancer, breast exam, clinical exam, mammogram, mammography, risks, screening
August 30th, 2009 -- Posted in Breast Cancer Pictures |
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The second part in a demonstration on a product that will assist in the early detection of breast cancer.
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Technorati Tags: breast cancer, breast cancer picture, demonstration, detection, exam
August 28th, 2009 -- Posted in Breast Cancer News, Breast Cancer Risks |
Two studies find no clear link; other research supports fiber to ward off the disease
FRIDAY, Aug. 28 (HealthDay News) — An adult woman’s intake of meat, eggs and dairy products should not boost her risk for breast cancer, new research shows.
For years, dietary factors have been debated as either boosting or reducing the risk of breast cancer, with research yielding conflicting results. But in the new research, scientists could not conclude that meat, eggs or dairy product intake as an adult raised breast cancer risk.
A second new study didn’t find that conjugated linoleic acid (CLA) — found in dairy products and in meat such as beef — provided any protective effect again breast cancer, as some experts had suggested. It did not raise the risk, either.
“So far, we haven’t seen a strong link between meat intake and fat intake in adulthood and breast cancer in adulthood,” concluded Dr. Eleni Linos, MD, an epidemiologist at Stanford University Medical Center, who has also researched the link and co-authored an editorial to accompany the two research reports. All are published in the September issue of the American Journal of Clinical Nutrition.
But, she cautioned, “women should probably try to reduce their red meat intake to prevent cardiovascular disease.”
In the first study, Italian researchers from Istituto Nazionale dei Tumori in Milan and other institutions used data from the European Prospective Investigation into Cancer and Nutrition (EPIC). They looked at diet information collected from almost 320,000 women between 1992 and 2003.
The women were from numerous European countries, including Denmark, France, Germany, Greece, Italy and the U.K. The team found 7,119 cases of breast cancer during follow up that lasted a median of nearly nine years (half of the patients were followed longer, half less). While they found a link between high butter consumption and breast cancer risk, it was only in premenopausal women. They did not find overall that meat, egg or dairy product intake was linked with an increased risk for breast cancer.
The researchers did find that a high intake of processed meat products was linked with increased breast cancer risk in postmenopausal women, but not overall meat intake.
Also, high red meat consumption was associated with an increased breast cancer risk in some countries, but there was no consistent link overall, the team said.
In the second study, researchers evaluated the diets of more than 61,000 women, all cancer-free, who answered a questionnaire from 1987 to 1990. Researchers from the Karolinska Institute in Stockholm and Central Hospital in Vasteras, Sweden, noted almost 3,000 cases of breast cancer from women in the group over an average follow-up of more than 17 years. When they evaluated links between the cancer cases and CLA intake, they found no effect, either good or bad.
”These two studies are a reminder that the connections between what we eat and disease development are multifactorial,” said Connie Diekman, a registered dietitian and director of university nutrition at Washington University in St. Louis.
Recall bias — people not remembering exactly what they had eaten — might have skewed the results, she said.
The study result, however, “does not give us permission to eat as much as desired,” she said. “I would remind readers to keep their food choices focused on what we know, not on every emerging study. So, using the Dietary Guidelines to shape choices and portions will be the best bet for health promotion and disease prevention.”
In yet another study in the same journal, researchers found that dietary fiber intake reduced the risk of breast cancer, confirming previous research. That study, the National Institutes of Health–AARP Diet and Health Study, looked at the intake of fiber to breast cancer among more than 185,000 postmenopausal women, with an average age of 62.
The researchers found 5,461 cases of breast cancer during an average of seven years of follow-up. Those who ate the most dietary fiber — 26 grams a day — had about a 13 percent reduction in risk of breast cancer compared to those who ate the least, just 11 grams a day.
An intake of 25 grams a day of fiber is considered adequate for adult women.
More information
There’s more on risk factors for breast cancer at the American Cancer Society.
Technorati Tags: breast cancer, Breast Cancer Risks, dairy products, dietary fiber, fat intake, fiber intake, meat intake
August 26th, 2009 -- Posted in Breast Cancer Signs |
What are the signs of breast cancer?
The chances of breast cancer in a teenager are close to zero. It’s mainly a disease of ageing – 80% of those diagnosed are over 50 (the average age for diagnosis is 60) and only around 5% are under 40. Fewer than 0.1% of all those diagnosed with breast cancer are under 30, and it’s almost unheard of in under 20s.
The American Cancer Society and other cancer organisations recommend that women begin breast self-examination at the age of 20. At the age, your breasts are still growing and developing; every day on this board there are questions from teenage girls who are terrified they have breast cancer because of perfectly normal hormonal changes. Of course it may be that you are asking on behalf of someone older; early breast cancer usually has no symptoms at all.
Symptoms of possible breast cancer are: change in size – one breast may have become noticeably larger or lower nipple change – if it becomes inverted (pulled in) or changes its position or shape rash – on or around the nipple discharge – from one or both nipples puckering or dimpling – around nipple swelling – in your armpit or around your collarbone (from lymph nodes) lump or thickening – that feels different from the rest of the breast tissue – BUT remember that most breast lumps are not cancerous. These are changes that an adult woman should be looking out for and reporting. In a teenager any changes to the breast are almost certainly hormonal.
Technorati Tags: breast cancer, Breast Cancer Risks, Breast Cancer Signs, breast changes
August 25th, 2009 -- Posted in Inflammatory Breast Cancer |
My mother got diagnosed last year in november with (IBC)! She has gone through so many rounds of chemotherapy and radiation but it seems like it keeps growing. She has a doctor from M.D. Anderson and they have a research study. She is starting a new experimental chemo for just IBC. But i was wondering if anyone survived this type of breast cancer?
Seek out support groups for this type of breast cancer in order to find out information and the best resources . . they will help you:
IBC Support http://www.ibcsupport.org/
Inflammatory Breast Cancer Research Foundation http://www.ibcresearch.org/
About IBC http://www.aboutibc.co.uk/
IBC Survivors http://www.ibcsurvivors.org/
Technorati Tags: breast cancer, chemo, IBC, Inflammatory Breast Cancer
August 24th, 2009 -- Posted in Breast Cancer News, Breast Cancer Risks |
Finding could lead to new cancer treatments, researchers say
THURSDAY, Aug. 20 (HealthDay News) — New information about how sugar “feeds” tumors has been uncovered by U.S. researchers, who said the finding may also have implications for other diseases such as diabetes.
“It’s been known since 1923 that tumor cells use a lot more glucose than normal cells. Our research helps show how this process takes place, and how it might be stopped to control tumor growth,” Don Ayer, an investigator at the Huntsman Cancer Institute and a professor in the Department of Oncological Sciences at the University of Utah, said in a university news release.
Ayer and his colleagues found that restricting an amino acid called glutamine halts a cell’s ability to utilize glucose.
“Essentially, if you don’t have glutamine, the cell is short-circuited due to a lack of glucose, which halts the growth of the tumor cell,” Ayer explained in the news release.
The study appears in the Aug. 17 online issue of the Proceedings of the National Academy of Sciences.
The next step in this research involves developing animal models to test theories about how a protein called MondoA and a gene called TXNIP control glucose uptake by cells.
“If we can understand that, we can break the cycle of glucose utilization, which could be beneficial in the treatment of cancer,” Ayer said.
More information
The U.S. National Cancer Institute has more about cancer.
Technorati Tags: breast cancer, Breast Cancer News, cancer, gluatamine, glucose, tumor
August 20th, 2009 -- Posted in Breast Cancer News, Breast Cancer Signs, Stage 3 Breast Cancer |
Chapter Five of Breast Cancer? Breast Health! by Susun Weed
Available at www.Ash-Tree-Publishing.com
Perhaps no aspect of breast cancer is more widely publicized than screening mammography. Ads on television, in magazines, and in the daily paper urge women to deal with fear about breast cancer by having a yearly mammogram. We’re even told that doing this is a way to “really care for yourself.”
But screening mammograms don’t prevent breast cancer. A mammogram is an x-ray and x-rays cause cancer. The ads promoting regular screening mammography are paid for by those who stand to profit from their widespread acceptance and use-the manufacturers of the equipment and x-ray film. Whose health does this technology really benefit? Women’s health? Or corporate health?
Should you have a screening mammogram? At what age? How frequently? Science hasn’t agreed on answers to these questions.1 I believe that my anti-cancer lifestyle (see page xv) will decrease my risk of dying from breast cancer in a way that regular mammograms won’t. I care for my breasts with infused herbal oils, regular loving touch, organic foods, and healthy exercise-and forgo regular screening mammograms. Of course, you can do it all in the Wise Woman Tradition. The point is to pay attention to your breasts.
A mammogram uses radioactive rays to “see” breast tissues. X-rays are known to cause DNA damage in breast cells.
A diagnostic mammogram is used when a woman or her practitioner feels a lump and wants to see it. (Sonograms-a non-radioactive test-can be used instead.) Most diagnostic mammograms are not one x-ray, but a series of x-rays.
A screening mammogram is done on a healthy woman to determine if there are unsuspected signs of cancer, such as a shadow or micro-calcifications. A screening mammogram is not one x-ray, but a series of x-rays, usually two per breast, four in all.
Low-radiation mammograms are safer mammograms, but less radiation means a fuzzier picture. Standard x-rays-rarely used any more for breasts-create an easy-to-interpert high-radiation image. Xerograms use half that radiation, but are twice as hard to read. Film-screen mammography, the latest very-low-radiation exam, gives an image that’s even more difficult to interpret. More than 10 percent of all screening mammograms done at one large center in 1992 couldn’t be read and had to be redone.2
A 1994 study showed wide variation in the accuracy with which mammograms are interpreted. Understandably, those who read screening mammograms regularly are more accurate than those who rarely do; in some hospitals, however, work loads are so heavy that accuracy suffers from lack of time, not inexperience.
Roughly 8 out of 10 “positive” mammographic reports are “false positive,” that is, a subsequent biopsy does not confirm the presence of cancer. And as many as half (10-15 percent at an excellent facility) of all “negative” mammographic reports are “false negative.” 3
According to current data, if all American women 40-50 years old were screened yearly by mammogram, 40 out of every 100 breast cancers would be missed.4 If all women over 50 were screened, 13 out of every 100 breast cancers would be missed. Half of all breast cancers in women under 45 are invisible on a mammogram.5 Screening mammograms often miss the deadliest breast cancers: fast-growing tumors in premenopausal women.
Neither diagnostic nor screening mammograms detect cancer. Mammograms can reveal areas of dense tissue in the breasts. These areas may be cancer, or may be associated with cancer, or may be normal tissue, but a mammogram can’t tell.6 The only medically accepted way to tell is to do a biopsy. Over 80 percent of the biopsies done to follow up on a suspicious screening mammogram find no cancer.
Women find their own breast cancers most of the time. (Ninety percent of the time according to one English study.7)
Monthly breast self-exam (or breast self-massage) provides early detection at lower cost, with no danger-and more pleasure-than yearly screening mammograms.
Most breast cancers (80 percent) are slow growing, taking between 42 and 300 days to double in size. A yearly mammogram could find these cancers 8-16 months before they could be felt, but this “early detection” does little to improve the already excellent longevity of women with slow-growing, non-metastasized breast cancers.
The 20 percent of breast cancers that are fast growing are the trouble-makers. They can double in size in 21 days. Monthly breast self-exams are much more likely to find these aggressive cancers than are yearly mammograms. (A 21-day doubling cancer will be visible on a mammogram only 6 weeks before it can be felt.) If you massage or examine your breasts even six times a year, you can take action on fast-growing lumps. If you rely on mammograms exclusively, the cancer could grow undetected for months.
In a recent look at 60,000 breast cancer diagnoses in the United States, 67 percent were found by the woman or her doctor -and over half of these were not visible on a mammogram-while 33 percent were discovered by mammogram. (This may seem like a substantial number of cancers found by mammography, but the majority of them were in situ cancers, a controversial type of cancer that may-but often does not-progress to invasive cancer.)
Technorati Tags: biopsy, breast cancer, Breast Cancer News, dense tissue, mammogram, mammography, self-exam
August 14th, 2009 -- Posted in Breast Cancer Signs |
Breast cancer patients undergoing radiation may be helped by drinking a glass of wine every day. That’s because a recent study suggests it may cut the risk of treatment-related skin toxicity by two thirds. Scientists divided 348 patients into three groups and found that those who drank wine on the days they had their treatment had lower rates of toxicity than those who did not drink wine. Researchers say the wine has other benefits as well, because unlike some drugs for the problem it does not protect cancer cells.
A glass of wine a day cut the risk of treatment-linked skin toxicity by two-thirds in women undergoing radiation therapy for breast cancer, Italian researchers report.
Skin reactions are a common side effect of cancer radiation therapy, and, while medications can help prevent these problems, they can be expensive and often have their own side effects. In some cases, drugs used to reduce radiation-linked side effects can actually protect breast cancer tumor cells, according to a news release from the American Society for Radiation Oncology.
So, researchers at Catholic University and the National Research Council in Italy wondered if the natural antioxidants found in wine might work to ward off radiation-linked damage.
In the study, 348 women with breast cancer were divided into three groups depending on the dose of radiation received. The researchers found that patients who drank wine on the days they had their treatment had lower rates of Grade 2, or higher acute toxicity, than those who did not. In fact, women who drank one glass of wine a day had a 13.6 percent rate of skin toxicity compared to a 38.4 percent incidence among patients who did not consume wine, according to the study.
“If wine can prevent radiotherapy-induced toxicity without affecting antitumor efficacy, as we observed, it also has the potential to enhance the therapeutic benefit in cancer patients without increasing their risk of serious adverse effects,” study author Dr. Vincenzo Valentini, a radiation oncologist at Catholic University in Rome, said in the news release. “The possibility that particular dietary practices or interventions can reduce radiation-induced toxicity is very intriguing.”
The findings were published in the August issue of the International Journal of Radiation Oncology Biology Physics.
More information
Find out more about breast cancer at the American Cancer Society.
August 7th, 2009 -- Posted in Inflammatory Breast Cancer |
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Learn more at www.mdanderson.org Inflammatory Breast Cancer is a rare type of breast cancer. Unlike more common breast cancer types, Inflammatory Breast Cancer appears as a rash or infection instead of a lump in the breast. MD Anderson is home to a clinic for women with inflammatory breast cancer (IBC), believed to be the first such clinic in the world. The Inflammatory Breast Cancer Clinic accepts patients who are newly diagnosed or previously treated, and offers the most innovative …
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Technorati Tags: breast cancer, breast infection, cancer clinic, Inflammatory Breast Cancer, MD Anderson
