Breast Cancer Treatment Options

Study Shows Family History May Not Be So Useful in Predicting Breast Cancer Risk

2009-08-24T01:25:00.000-07:00

Family history is a much poorer predictor of early breast cancer risk than most women realize, say researchers whose latest study argues against using family history alone to determine a young woman's risk for the disease.

When they examined the predictive value of family history for assessing breast cancer risk early in life, researchers from Leiden University Medical Center in the Netherlands found little correlation between family history and breast cancer incidence at a population level.

A predictive model developed by the researchers found that roughly one in 10 women with a strong family history of the disease could be expected to develop breast cancer before the age of 50 and just one in 100 would develop the disease before their 30th birthday.

The findings suggest that too many women may be undergoing genetic testing and close surveillance for breast cancer based on family history, the researchers say.

"Applying family history related criteria results in the screening of many women who will not develop breast cancer at an early age," epidemiologist Geertruida H. de Bock and colleagues write in the latest issue of BMC Cancer.

Family History of Breast Cancer
According to the American Cancer Society, a family history of breast cancer does increase a woman's risk of breast cancer. This risk is higher in women whose close relatives (maternal and paternal relatives) have the disease. Having a mother, sister, or daughter with breast cancer approximately doubles a woman's risk, even though 70% to 80% of women with breast cancer do not have a family history.

A family history of breast cancer is not the same as breast cancer risk associated with the inherited mutations of BRCA1 or BRCA2 genes.

In an effort to better understand the predictive value of family breast cancer history, de Bock analyzed its impact in close to 2,000 women with and without breast cancer.

Breast cancer risk was assessed based on four accepted indicators of family risk:

Having at least two female first-degree relatives (sister, mother, or daughter) with breast cancer.
Having at least two female relatives -- either first- or second-degree -- diagnosed with breast cancer before the age of 50. Second-degree relatives include grandmothers, aunts, and nieces.
Having at least one female first- or second-degree relative diagnosed before the age of 40.
Having a relative with a diagnosis of breast cancer in both breasts.
Women with only one first-degree relative diagnosed with breast cancer before the age of 50 were not found to be at increased risk for developing breast cancer early in life.

The researchers concluded that women with none of these family risk factors or just one of them had a very small risk of developing breast cancer early in life and would probably not benefit from genetic testing or intensive early screening.

At the population level, risk was still relatively low for women with two or more family risk indicators.

"Due to the low prevalence of early breast cancer in the population, the predictive value of family history of breast cancer was 13% before the age of 70, 11% before the age of 50, and 1% before the age of 30," de Bock notes in a press statement.

Many Women Overestimate Risk
The findings suggest that most women with a family history of breast cancer have little to worry about.

That comes as no surprise to Debbie Saslow, PhD, who is director of breast and gynecologic cancers for the American Cancer Society (ACS).

"Even a woman who is 35 with a mother who had breast cancer in her 30s and an aunt who had it in her 40s may be just borderline high risk," she tells WebMD. "You really do have to have a significant family history to be considered high risk."

Assessing family-related breast cancer risk is very complicated, and Saslow recommends seeking the help of a medical professional who has experience with risk-assessment tools.

The ACS also recommends that women who are considering genetic testing first talk to a genetic counselor, nurse, or doctor qualified to explain and interpret the test results.

Saslow agrees that many women may be overestimating their breast cancer risk based on family history.

She adds that companies that promote genetic testing for breast cancer may be part of the problem.

"Some of these companies recommend that anyone with even one relative who had breast cancer before the age of 50 should be tested," she says. "That is just not justified."

source: http://www.webmd.com/breast-cancer/news/20080722/family-poor-predictor-of-breast-cancer?page=2

No Need For Gene Screens In Breast Cancer Families, Study Shows

2009-08-22T01:13:00.000-07:00

Research reported today should provide relief to women who are worried after a relative's breast cancer diagnosis. The study shows that a family history of breast cancer does not give a useful indication of the likelihood that a woman will develop it herself at an early age.

An increased risk of breast cancer for relatives of breast cancer patients has been demonstrated in many studies. As physicians and the general population have become more aware of this increased risk, the demand for referring healthy women with a family history of breast cancer for intensive screening or genetic testing has risen. Geertruida H. de Bock led a team from Leiden University Medical Centre in the Netherlands who investigated whether the increased risk was significant enough to accurately predict breast cancer.

According to de Bock, "Due to the low prevalence of early breast cancer in the population, the predictive value of a family history of breast cancer was 13% before the age of 70, 11% before the age of 50, and 1% before the age of 30." These numbers are much lower than most women would probably expect. As the authors explain, "Applying family history related criteria results in the screening of many women who will not develop breast cancer at an early age."

Given the psychological harm that screening visits can cause, more stringent criteria should be applied to early screening. The researchers recommend that these results be used to "reassure a large number of women regarding their personal breast cancer risk."

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Journal reference:

1.Geertruida H De Bock, Catharina E Jacobi, Caroline Seynaeve, Elly M.M. Krol-Warmerdam, Jannet Blom, Christi J. Van Asperen, Cees J. Cornelisse, Jan G.M. Klijn, Peter Devilee, Rob A.E.M. Tollenaar, Cecile T.M Brekelmans and Johannes C. Van Houwelingen. A family history of breast cancer will not predict female early onset breast cancer in a population-based setting. BMC Cancer (in press), (in press)
Adapted from materials provided by BMC Cancer, via EurekAlert!, a service of AAAS

source: http://www.sciencedaily.com/releases/2008/07/080722192348.htm

Increase in Breast Cancer Among Alaska Native Women Appears To Be Slowing, Researchers Say

2009-08-20T01:11:00.000-07:00

The 30-year increase in breast cancer rates among Alaska Native women appears to be leveling off, according to researchers making a presentation on Tuesday at a cancer symposium in Anchorage, Alaska, the Anchorage Daily News reports.

Breast cancer once was a rare occurrence among Alaska Native women, but the group's rate in Alaska now equals the rate of white women nationwide and is 50% higher than that of American Indians and Alaska Natives who live in other states, according to the Daily News.

According to new research, there were 40 breast cancer cases per 100,000 women among Alaska Natives from 1969 to 1973. That number increased to 138 cases per 100,000 women from 1994 to 1998, and then fell to 132 cases per 100,000 women from 1999 to 2004.

Janet Kelly, an epidemiologist with the Alaska Native Tribal Health Consortium, said that the findings might indicate that the increase is leveling off. However, she added, "I think you'd be hard-pressed to say there's anything (like a decline) going on yet."

A new report Kelly co-wrote with Anne Lanier, director of the consortium's research office, found that Alaska Native women's susceptibility to different types of cancer appears to vary by geographical region. The study looked at cancer in Alaska Natives from 1969 through 2003 and found that while breast cancer was the most prevalent type of cancer among Alaska Native women in Anchorage and the Interior, colorectal cancer was most prevalent among women in Barrow and coastal areas of western Alaska. The breast cancer rate in those areas was half the rate found in Anchorage.

Lanier said the small number of cancer cases in sparsely populated rural areas of Alaska makes it difficult to make statistically sound conclusions. She said, "This is a population that -- when I started working here 40-plus years ago -- we didn't even think cancer was a problem [in]," adding, "And what we have observed is a dramatic change ... particularly in lung cancer, but also in breast and prostate, which are also going up" (Bryson, Anchorage Daily News, 7/22).

source:http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=53472

Breast Cancer: Breast Cancer in Men

2009-08-18T21:20:00.000-07:00

Men Don't Have Breasts. How Can Men Get Breast Cancer?
Even though men do not have breasts like women, they do have a small amount of breast tissue. In fact the "breasts" of an adult man are similar to the breasts of a girl before puberty, and consist of a few ducts surrounded by breast and other tissue. In girls, this tissue grows and develops in response to female hormones, but in men -- who do not secrete the same amounts of these hormones -- this tissue does not develop.

However, because it is still breast tissue, men can develop breast cancer. In fact, men get the same types of breast cancers that women do, although cancers involving the milk producing and storing regions of the breast are very rare. According to the American Cancer Society, an estimated 1,690 cases of breast cancer will be diagnosed in men in 2005.

Why Do I Not Hear About Breast Cancer In Men As Much As I Hear About Breast Cancer In Women?
Breast cancer in men is a very rare disease. This is possibly due to their smaller amount of breast tissue and the fact that men produce smaller amounts of hormones like estrogen that are known to affect breast cancers in women.

In fact, only about 1 in 100 breast cancers affect men and only about 10 men in a million will develop breast cancer.

Which Men Are More Likely to Get Breast Cancer?
It is very rare for a man under age 35 to get breast cancer, but the likelihood of developing the disease increases with age, with most being detected between the ages of 60 - 70 years. Family history in a close female relative and a history of radiation exposure of the chest can also increase the risk.

The clearest risk for developing breast cancer seems to be in men who have had an abnormal enlargement of their breasts (called gynecomastia) in response to drug or hormone treatments, or even some infections and poisons. Individuals with a rare genetic disease called Klinefelter's syndrome, who often have gynecomastia as part of the syndrome, are especially prone to develop breast cancer. Men with severe liver disease tend to have lower levels of male hormones (androgens) and higher levels of female hormones (estrogens) putting them at an increased risk of developing gynecomastia and breast cancer.

How Serious Is Breast Cancer In Men?
Doctors used to think that breast cancer in men was a more severe disease than it was in women, but it now seems that for comparably advanced breast cancers, men and women have similar outcomes.

The major problem is that breast cancer in men is often diagnosed later than breast cancer in women. This may be because men are less likely to be suspicious of an abnormality in that area. In addition, their small amount of breast tissue is harder to feel -- making it more difficult to catch these cancers early, and allowing tumors to spread more quickly to the surrounding tissues.

source: http://www.webmd.com/breast-cancer/guide/breast-cancer-men

Breast Cancer Detection: A Simpler Alternative To Mammograms?

2009-08-16T19:11:00.000-07:00

(Credit: Image courtesy of Medical College of Georgia)

Whether a painless, portable device that uses electrical current rather than X-ray to look for breast cancer could be an alternative to traditional mammograms is under study at the Medical College of Georgia.

MCG is one of 20 centers internationally and the only place in Georgia studying new technology developed by Z-Tech Inc., to compare traditional mammograms with impedence scanning, a technique based on evidence that electrical current passes through cancerous tissue differently than through normal tissue.

This phase of the study will focus on women age 40-50. Older women have less dense breast tissue so cancer is easier to find, says Dr. James Craft, MCG radiologist and principal investigator on the study. Mammograms, also performed in the study, are more accurate in this population, so this phase will be a tougher test of the new technology, he says. The first phase of the study, which began in 2005, was open to women of all ages.

“Normal breast tissue is very dense, especially in younger women, and can hide tumors,” Dr. Craft says. “While we’ve known for a while that water flows more freely through cancerous cells, we also know that electrical current flows easier through cancerous and tumor tissue.”

The Z-Tech scan works by placing a flower-shaped grouping of electrodes over each breast and sending a small, painless amount of electricity through them. Unlike traditional mammography, the scan does not involve breast compression or radiation.

“It’s like doing an EKG of the breast,” Dr. Craft says.

A computer immediately calculates and presents a report based on the electrical signature of the breast tissue. Rather than waiting on breast image from a traditional mammogram, the computer immediately notes whether the scan is positive or negative for cancer.

However, for study purposes, neither Dr. Craft nor the patient will know the results. Patients must undergo a mammogram within 90 days, which Dr. Craft interprets. Z-Tech compares those results to the electrical study.

The hope is that the new test – called HEDA for Homologous Electrical Difference Analysis – will provide an alternative to mammograms. While Dr. Craft believes that having this test should help find more cancers, he doesn’t think it will replace traditional mammography.

“This method doesn’t use radiation, is portable and there is no pain associated with the squeezing that mammograms require,” he says. “I can see it being used as an additional test. I don’t think it will replace mammography, but it could increase our chances of catching breast cancer.”

The second phase of the Z-Tech trial is open to women age 40-50 having routine mammograms as well as those who have a suspicious lump scheduled for biopsy.

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Adapted from materials provided by Medical College of Georgia.

source: http://www.sciencedaily.com/releases/2008/07/080722113019.htm

Mammograms a Pain? Gel Helps

2009-08-15T19:06:00.000-07:00

Are you putting off getting a mammogram? It's easy for women to wince at the mere thought of getting screened for breast cancer.

A new study shows that a numbing gel eases pain associated with getting a mammogram and may make women more likely to return for subsequent screenings.

The study's lead author says in a news release that the numbing gel may act as a simple secret weapon: "We now have something that we know reduces discomfort with screening mammography in women who expect higher discomfort -- lidocaine gel."

Nurse practitioner Colleen Lambertz, with St. Luke's Mountain States Tumor Institute, says in a statement that reducing pain may mean more mammograms. "With a more positive experience, we hope women will undergo more regular mammography screening."

Painful Mammograms
Researchers gathered 418 women aged 32 to 89 years old.

All the participants had expected to have discomfort during a mammogram. In fact, 54 of the participants said they had "probably or definitely" delayed getting a mammogram because of the perceived discomfort associated with it.

The women were surveyed before the screening and after.
They were divided into three groups and given acetaminophen, ibuprofen, and/or the lidocaine gel before the mammogram. All of the medications were chosen because they are easy to get, over the counter, and have few side effects.

Less Pain After Mammogram Gel
Researchers found that those who received the numbing gel had "significantly" less breast discomfort.

Those who took the oral medications did not report significant easing of breast discomfort.

During a mammogram, the breasts are squeezed and pressed with a paddle so the X-ray can zone in to the dense tissue.

Women who expected to have a lot of discomfort during the mammogram did, as did women who had tender breasts.

Eighty-eight percent of the participants said they would "definitely" go back for a screening in the next year. Ten of the participants said they "probably" would go for their annual mammogram.

"Mammography is the only screening tool proven to reduce mortality from breast cancer in women over 40," according to prepared statements from study co-author James R. Maxwell, MD, medical director of St. Luke's Breast Care Services.

"Annual screening is the most important option available to a woman to best ensure early detection and decrease the chance of being diagnosed with an advanced stage breast cancer."

In background information published with the findings, study authors write that breast cancer accounts for "one-fifth of all deaths in women aged 40 to 50 years old."

The recent decrease in death rates from breast cancer is directly linked to better and increased screenings through mammograms.

The authors write, "Still, recent reports suggest that approximately one-half to two-thirds of women do not follow established guidelines for mammography."

As for the guidelines, the National Cancer Institute recommends that women get their first mammogram beginning at age 40 and every one to two years thereafter. Check with your doctor, as sometimes a screening mammogram is recommended before age 40 in women at higher than average risk.

source: http://www.webmd.com/breast-cancer/news/20080722/mammograms-a-pain-gel-helps

HEALTH TIPS: Weight, genes and breast cancer

2009-04-30T07:08:00.000-07:00

For some women with a higher risk of getting breast cancer, getting weight down can be a way to fight back.

These women are in the minority with mutations in genes known as BRCA1 and BRCA2, which raise the risk of developing the cancer. The study, supported by the National Institutes of Health, found women with BRCA mutations decreased their higher risk of cancer if they lost at least ten pounds between the ages of 18 and 30.

Steven Narod of the University of Toronto, who was senior author of the paper in the journal Breast Cancer Research, says the findings ought to apply to overweight women who have the mutation:

“For women in that category, I certainly would discuss and raise with them the possibility that they could reduce the cancer risk through weight loss.”

Health Tip courtesy of the U.S. Department of Health and Human Services.

source: http://healthtipsatoz.com/health-tips-weight-genes-and-breast-cancer/

Moderately Drinking Women May Suffer From Breast Cancer

2009-04-26T07:05:00.000-07:00

Everything we eat, do and think about has an impact on our health. As we look for ways to fight a wide range of diseases, the American Association for Cancer Research 2008 Annual Meeting suggested that continuous engaging in bad habits like drinking and eating fatty foods may lead to cancer, melanoma or other diseases.

The group is emphasizing the need to control our thirst for liquor and beer, especially among women, and food that may eventually post health hazards in the future. It was found that women consuming moderate amounts of alcohol may increase their risk of breast cancer. Comparing a heavy drinker woman consuming three or more glasses each day from a nondrinker, the former has a 51-percent increased risk of ER+/PR+ breast cancer.

Although links have yet to be established why women who drink alcohol have a greater risk of having breast cancer, but the results of the findings showed that many drinkers have suffered from breast cancer. At the same time, women who take hormone replacement therapy may suffer from the disease.

This was according to Jasmine Q. Lew, a fourth-year medical student at the University of Chicago who is conducting this research as a recipient of the Howard Hughes Medical Institute-National Institutes of Health Research Scholarship at the National Cancer Institute’s (NCI) Division of Cancer Epidemiology and Genetics.

In a study conducted on NIH-AARP Diet and Health in 1995, Lew and her colleagues had 184,418 post-menopausal women who joined the research and were open about their daily alcohol consumption. After seven years of follow-up, they found that women who drink moderately have higher risk of developing breast cancer.

But Lew said several studies have yet to be considered to validate their findings. She added that there might be other factors contributing to breast cancer aside from drinking alcohol. However, she advised that drinking women should cut their alcohol consumption to avoid breast cancer.

source: http://darkspiders.com/moderately-drinking-women-may-suffer-from-breast-cancer-3.html

Dense Breasts a Factor in Cancer Treatment, Recurrence

2009-04-23T06:57:00.000-07:00

THURSDAY, April 16 (HealthDay News) -- For years, researchers have known that breast density is almost as important as age in predicting who will develop breast cancer.

But now they're discovering how the density of a woman's breast tissue can also predict how she will respond to cancer treatment and whether her cancer will recur.

The denser a woman's breasts, the less fat they have, explained Diana Buist, an epidemiologist at Group Health Center for Health Studies in Seattle. "If you have a dense breast, it's harder to see breast tumors on a mammogram."

Women with dense breasts are more likely to have abnormal mammograms, Buist added. "Density on a mammogram is white, cancer on a mammogram is white," she said, so that makes it more difficult to detect signs of cancer and can prompt reports of possible abnormalities.

About 10 percent to 15 percent of women have low-density breasts, another 10 percent to 15 percent have very dense breasts, and the rest have breasts with a density somewhere in the middle, said Dr. Karla Kerlikowske, a professor of medicine, epidemiology and biostatistics at the University of California, San Francisco.

But the average woman may not have a clue whether her breasts are dense, she added.

For one thing, Kerlikowske said, it's not as easy to measure density as it is to measure cholesterol, for instance. "In the last 10 years, a lot of researchers have focused on how to measure it better, and what does it mean to have that density," she said.

Kerlikowske was part of a research team that discovered that high breast density predicts local, but not distant, recurrence of cancer after a lumpectomy and radiation for invasive breast cancer. The finding was published in the January issue of the International Journal of Radiation Oncology Biology Physics.

Another group of researchers found that changes in breast density during treatment with tamoxifen, a drug used to lower breast cancer risk, help predict how well the drug is working. Their research was presented in December at a breast cancer symposium in San Antonio, Texas.

Just how much high-density boosts breast cancer risk, though, is something that experts can only roughly estimate, Kerlikowske said. She said that women with very high-density breasts have about a fourfold increase in risk compared with women who have very low-density breasts.

And though density often decreases with age, especially after menopause, it remains a risk factor -- and one women can't do much about, Kerlikowske said.

Some experts have suggested that women with high-density breasts might consider a more frequent surveillance schedule. But she said there's not sufficient evidence to suggest, at least yet, that that would be a good idea. "We are trying to study that now," she said.

Women with dense breasts who are younger than 50 and premenopausal, though, might benefit from having digital rather than traditional mammograms, Kerlikowske said. "We are looking at different ways to measure breast density other than mammograms," she said, because "you can't keep having [frequent] mammograms," for safety reasons.

Buist said that older women who don't want to increase the density of their breasts could opt not to take combined hormone therapy, noting that "most women get an increase in density with that."

But beyond that, the two agreed, there's little additional advice doctors can offer women with dense breasts at this time.

source: http://www.empowher.com/news/2009/04/16/dense-breasts-factor-cancer-treatment-recurrence

Breast Cancer - What Everyone Should Know

2009-04-20T06:51:00.000-07:00

Posted by cinyak

Breast cancer is the most frequently diagnosed of all the cancers affecting women in America today. It strikes women of all ages and races but is particularly prevalent in women over forty.

Researchers are constantly seeking new methods for the diagnosis and subsequent treatment of this virulent cancer. The success of this research has played a big part in the early detection and successful treatment of more cases of breast cancer in recent years.

New treatments are constantly being sought to effectively seek out any potentially cancerous cells in a woman’s body. This reduces the number of cases of breast cancer significantly.

Thanks to this continued research, many more women are surviving breast cancer than ever before. The recovery rate has steadily been increasing. Early detection and treatment is the key to this success.

Information regarding breast cancer has become more widely available. It is no longer the silent killer that it once was. Women are being educated as to their risks of developing the cancer and methods of checking their breasts for signs of the disease.

A woman has an increased probability of developing breast cancer if she falls into certain categories. The first is that she has passed the age of 40, especially if she had children after that age. Obesity and excessive alcohol consumption can also contribute to the chances of a woman developing the disease being greater than average.

Initially, breast cancer is only detectable by a mammogram. The disease has no detectable symptoms but a mammogram would be able to highlight potentially cancerous cells. It is for this reason that women over 40 should have annual mammograms.

Self-examination of the breasts is a method that every woman should use to check for the presence of tumors in their early stage of growth. Your doctor or other medical practitioner can advise you on the best method of self-examination if you are unsure of the proper technique.

You should examine your breasts at least once a month, but the more frequently you do so, the earlier you will detect any lumps. If you think that you may have found a lump it is essential that you seek urgent medical advice.

Although research into breast cancer prevention is an ongoing process, there have been a number of breakthroughs recently. The National Cancer Institute has tested a number of drugs that could potentially prevent the disease altogether.

The two drugs that the NCI tested have shown that they have the potential to prevent the cancer are BCPT and Star. The first drug was given to 13,000 women who were at risk of developing the disease and 19,000 were given the second. These large studies showed that the predicted instances of cancer were significantly reduced. However, neither drug has had FDA approval to date.

Of course, it isn’t just American women who are at risk of this deadly form of female cancer. Women all around the globe are at risk. Researchers are constantly striving to discover methods of detecting and treating the disease. Women are still dying from this type pf cancer and it is essential that the work continues until the disease is eradicated. Until then, it is vital that all women perform regular self-examinations. Early detection is the best hope that a woman has of overcoming and surviving breast cancer.

Summary:

Although research into breast cancer prevention is an ongoing process, there have been a number of breakthroughs recently. The National Cancer Institute has tested a number of drugs that could potentially prevent the disease altogether.

source: http://www.cancer-disease.cinyak.com/breast-cancer/breast-cancer-what-everyone-should-know.html

Breast cancer danger rising in developing countries

2009-04-18T06:45:00.000-07:00

By Alvin Powell
Harvard News Office

Women in developing nations, once thought to have a small chance of contracting breast cancer, are increasingly getting the disease as lifestyles incorporate risk factors common in industrialized nations, panelists at the Harvard School of Public Health (HSPH) said Tuesday (April 14).

While their risk is rising, the prognosis for women in developing countries is poor because those nations often lack a strong health care infrastructure. Compounding the problem is the fact that cultural issues often cause delays in seeking care, so physicians see more cases in later stages when treatment options are limited.

The discussion, moderated by HSPH Dean Julio Frenk, was the inaugural event in a new series of “participatory panels” bringing together Harvard faculty to discuss public health issues.

“My hope is [that] we can begin to address some of the most pressing public health problems of our times,” Frenk said.

Frenk called breast cancer in developing nations “an unforeseen health priority” and said that the experience of his wife, Felicia Knaul, who has recently undergone treatment for breast cancer, gave him a new understanding of the challenges Mexican women face. Knaul, a senior economist at the Mexican Health Foundation, was a member of the panel.

“The days when we thought that communicable diseases were a problem of poor people and noncommunicable diseases were a problem of the [wealthy] are over. Now the poor are also subject to noncommunicable diseases,” Frenk said. “The health systems in developing countries are under enormous strain because they have to balance these complex priorities.”

Though cultural issues may be less concrete than medical ones, Frenk said they are considerable, with stigma, discrimination, machismo, and a tendency to reduce women to body parts all factors in the sometimes deadly delay in breast cancer screening and treatment.

Knaul, who had her last infusion to treat her breast cancer a week earlier, said there was no better way to celebrate than a panel discussion on the topic. She painted a picture of breast cancer in Mexico that not only showed that the disease is on the rise, but also that it’s striking younger women and causing a greater percentage of deaths than in the United States.

While roughly 60 percent of breast cancer cases in the United States are detected at Stage 1, just between 5 percent and 10 percent of cases in Mexico are. More than half of Mexican breast cancer cases are detected in Stage 3 or 4, when the disease is much more difficult to treat. Since 2006, Knaul said, breast cancer has been the number one cause of tumor-related death among women aged 30 to 54 and the number two cause of death from all causes.

Globally, though 45 percent of cases occur in the developing world, 55 percent of deaths from breast cancer occur there.

“The evidence is showing us that this is a disease striking all women of all ages of all socioeconomic backgrounds in developing and developed countries,” Knaul said.

The result, Knaul said, is that these nations’ health infrastructures are being forced to play catch-up with the disease, facing the challenge of detecting and treating an ailment they had previously thought they didn’t need to be concerned about.

Mexico has already proven it can act to improve cancer outcomes for women, as Knaul presented evidence of cervical cancer rates on the decline. Still, she said, cultural and financial barriers must be overcome. Government health care, for example, covers a woman’s treatment — but not screening — for breast cancer.

Lawrence Shulman, chief medical officer and senior vice president for medical affairs at the Dana-Farber Cancer Institute and associate professor at Harvard Medical School, said that screening and early detection remain the only effective ways to increase survivability for breast cancer patients.

Even in the United States, he said, the survival rate of women whose cancer is not detected until late stages is very poor. The improvements in breast cancer survival are related to advances that detect and treat the disease at its earliest stages. Mammography is a far more useful tool than breast self-exams, Shulman said, citing a United Kingdom study that showed mammography as the only technology that improved outcomes.

New digital technology may allow mammography to spread to parts of the world where medical expertise is scarce, because the digital images could be sent to experts elsewhere to be read, he said. Even in that case, however, a robust health care infrastructure is still needed to perform the medical follow-up, including biopsy and treatment.

Walter Willett, Fredrick Stare Professor of Epidemiology and Nutrition and chair of the HSPH Nutrition Department, reviewed research into breast cancer risk factors that show that the problem will likely continue to increase in the coming years.

Women around the world are having fewer children, a trend that increases breast cancer risk. In addition, the risk of breast cancer increases with weight gain as a woman ages; with reduced activity; with the use of hormone therapy; and with increased alcohol consumption — all factors on the increase as Western lifestyles spread around the world.

Jennifer Leaning, professor of the practice of global health at HSPH, said that though it is known that screening and early detection can dramatically improve outcomes, they may be difficult to implement in some places around the world. In traditional, male-dominated societies, the most important roles for women are those of bearing children, providing men sexual pleasure, and working to support the family. In some societies, women need the permission of men — and even have to be accompanied by them — to travel to hospitals and clinics.

Leaning said there are some occasions — childbirth and the illness of a child —where it is commonly accepted that women need to attend a medical facility. Interventions and screenings designed to take advantage of those occasions may provide some success, she said.

Another area of opportunity lies with the expansion of health care services in the fight against HIV, which requires that people regularly visit health clinics to get antiretroviral drugs, Leaning said.

source:http://www.news.harvard.edu/gazette/2009/04.16/11-breastcancer.html

Planning Your Treatment

2008-09-05T22:10:00.000-07:00

After a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your situation, based on your pathology report. Your treatment plan will be made up of one or more specific treatments that are intended to target the cancer cells in different ways and reduce the risk of future breast cancer recurrence. You and your doctor will base your treatment decisions on YOUR unique situation, including consideration of your overall medical condition and your personal style of making decisions. You may have to re-evaluate your decisions periodically. Your medical team will be your guide.

http://www.breastcancer.org/treatment/planning/

Triple-Negative Breast Cancer

2008-08-31T22:09:00.000-07:00

Your pathology report may say that the breast cancer cells tested negative for estrogen receptors (ER-), progesterone receptors (PR-), and HER2, also called human epidermal growth factor receptor 2 (HER2-). Testing negative for all three receptors means you have “triple-negative breast cancer.”

Without these receptors, the cancer’s growth is not likely to be fueled by estrogen or progesterone, or by growth signals coming from the HER2 protein. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as tamoxifen or aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin (chemical name: trastuzumab). However, other medicines can be used to treat triple-negative breast cancer.

About 10-20% of breast cancers — more than one out of every 10 — are found to be triple-negative. Researchers are very interested in finding new medications that can treat this kind of breast cancer. Early studies are trying to find out whether certain medications can interfere with the processes that cause triple-negative breast cancer to grow. In this section, you can learn about:

http://www.breastcancer.org/symptoms/diagnosis/trip_neg/

Are Hormone Receptors Present?

2008-08-25T22:08:00.000-07:00

Receptors for the female hormones estrogen and progesterone are another key personality feature of breast cancer. You can read about whether these receptors are present in your pathology report. These receptors are the eyes and ears of the breast cells, getting messages sent by the hormones and figuring out what to do with these messages. The hormones will tell the receptors to stimulate or "turn on" breast cell growth. Estrogen and progesterone can increase both normal and abnormal breast cell growth.

Your doctor will order a hormone receptors assay, a test to see if the cancer is sensitive to estrogen and progesterone. If a tumor is estrogen-receptor positive (ER-positive), it is more likely to grow in a high-estrogen environment. ER-negative tumors are usually not affected by the levels of estrogen and progesterone in your body. This is one time when hearing the word "positive" may really mean something good (so often, a "positive" test result really means that something not so good was found).

ER-positive cancers are more likely to respond to anti-estrogen therapies. If you have an ER-positive cancer, you may respond well to tamoxifen, a drug that works by blocking the estrogen receptors on the breast tissue cells and slowing their estrogen-fuelled growth. A study suggests that Herceptin (chemical name: trastuzumab) may be beneficial regardless of your ER/PR status.

More information on tamoxifen.

If you've gone through menopause, you may think that you are no longer at risk for estrogen-fuelled cancer growth. That's not true. While your ovaries are no longer producing estrogen after menopause, your adrenal glands produce another hormone that is converted into estrogen by the body. That estrogen can still stimulate tumor growth. So estrogen is an important consideration even for women who have stopped menstruating.

http://www.breastcancer.org/symptoms/diagnosis/horm_receptors.jsp

Lymph Node Involvement

2008-08-20T22:06:00.000-07:00

Some breast cancers spread to the lymph nodes under a woman's arm. When the lymph nodes are involved in the cancer, they are called "positive." When lymph nodes are free or "clear" of cancer, they are called "negative." Your doctors will examine samples from your lymph nodes under a microscope to determine whether any cancer cells have spread there.

In large medical studies, there seems to be a connection between the number of lymph nodes involved and how aggressive a cancer's personality will be. Knowing how many of your lymph nodes are affected by cancer will help you and your doctor find the appropriate treatment to fight the cancer. Read more about options for lymph node surgery.

Doctors think in terms of three types of lymph node involvement when they look at an individual node:

Minimal (or microscopic) lymph node involvement: Only a small number of cancer cells can be found in the lymph nodes.
Significant (or macroscopic) involvement: A particular lymph node or group of nodes has become involved with the cancer. These can often felt by hand or seen without a microscope.
Extra-capsular extension: A breast cancer tumor takes over a whole lymph node and spills beyond the wall of the lymph node into the surrounding fat.
In most cases, the more extensive the lymph node involvement, the more aggressive the cancer. But the extent of disease within a particular lymph node is less important than the total number of lymph nodes affected. The more lymph nodes that are involved, the more threatening the cancer may be.

http://www.breastcancer.org/symptoms/diagnosis/lymph_nodes.jsp

understanding the risks in breast cancer

2008-08-05T08:17:00.000-07:00

All women are at risk for getting breast cancer. As you get older, your risk increases. Assuming you live to age 90, your risk of getting breast cancer over your lifetime is about 14%. That might sound scary, because it means that an average of about one out of every seven women will get breast cancer over a 90-year life span.

You can also look at it another way: A 14% risk means there's an 86% chance that you WON'T get breast cancer.

How much do risk factors and preventive factors change your risk?
Knowing what factors can increase or decrease your risk for breast cancer is important. But you probably want to know just HOW MUCH those factors change your risk.

If you hear that a certain treatment can reduce your risk by 40%, what does that mean?

To understand what the numbers mean about YOUR risk for breast cancer, the key terms to know are relative risk and absolute risk.

Relative risk is the number that tells you how much something you do, such as taking a pill, can change your risk, compared to your risk without taking that pill. Relative risk can be expressed in percentages and in "hazard ratios." If you do nothing new, your hazard ratio is 1.0—this means that your risk doesn't change. If you do something and your risk decreases by half, or goes down to 0.5, then you are half as likely to have the risk. But if your risk goes up, from 1.0 to 1.88, then you are 88% more likely to encounter the risk. If your risk goes up to 3.0, then you have a threefold (300%) increased risk of having the problem.

Absolute risk is the size of your own risk. Absolute risk reduction is the number of percentage points by which your own risk changes if you do something, like taking a pill. The size of your absolute risk reduction depends on what your risk is to begin with.

Example of risk going up for a woman with no history of breast cancer
Smoking is associated with an increased risk of breast cancer as well as other diseases.

After lumpectomy with clear margins, your risk of the breast cancer coming back in the same breast is about 30%. But if you choose to have radiation therapy after your lumpectomy, you can reduce your risk of the cancer coming back by two-thirds or 66%. This is the relative risk decrease.

Knowing how much your breast cancer risk changes with lifestyle changes and treatment options can help you and your doctor make the best decisions for YOU.

source: http://www.breastcancer.org/risk/understanding.jsp

Foods to avoid when being treated for breast cancer

2008-07-31T22:27:00.000-07:00

According to the principles of traditional Chinese medicine (TCM), you should avoid the following types of foods, especially when being treated for breast cancer:

Charred and deep-fried foods. Both cause a condition known as "internal heat" in the stomach, which can cause a functional disorder of this organ. (It is especially important to avoid these foods when undergoing chemotherapy and radiation, since the treatments already create excess heat in the body.)

Raw vegetables. Eating too many raw vegetables weakens the stomach and spleen, two organs essential for breast-cancer prevention. Although some nutrition is invariably lost when cooking vegetables, raw vegetables take a great deal more energy to digest than cooked vegetables.

Cold or iced foods and beverages. Your stomach functions best when the food you eat is warm. Consuming cold foods and beverages day after day can unbalance the stomach function.

source: http://www.breastcancer.com/self-care/foods/foods_to_avoid/

10 Facts about breast cancer

2008-07-28T22:10:00.000-07:00

Fact # 1

All women are at risk.
Approximately 70% of breast cancers occur in women with none of the known risk factors.

Fact # 2

Only about 5% of breast cancers are inherited.
About 80% of women diagnosed with breast cancer will be the first to be victims in their families.

Fact # 3

Breast cancer is the leading killer of women ages 35 to 54 worldwide.
More than a million women develop breast cancer without knowing it and almost 500,000 die from it every year.

Fact # 4

One out of four who are diagnosed with breast cancer die within the first five years.
No less than 40% die within ten years.

Fact # 5

The incidence of breast cancer has been rising for the past 30 years.
And the supposed authorities and experts that should know, don't know why.

Fact # 6

Risk factors are not necessarily causes of breast cancer.
Enough evidence exist linking environmental pollution and contamination to cause breast cancer.

Fact # 7

Mammography fails to detect as much as 20% of all breast cancer
and as much as 40% in women under the age of 50.

Fact # 8

Early detection does not prevent breast cancer.
Avoiding and eliminating known causes will prevent breast cancer.

Fact # 9

One out of eight North American women will develop breast cancer.
The San Francisco Bay Area has the highest incidence rate in the entire world.

Fact # 10

The Philippines has the highest incidence rate of breast cancer in Asia
and is today considered to have the 9th highest incidence rate in the world today.

source: http://www.pbcn.org/wst_page5.html

breast cancer in the family

2008-07-20T16:50:00.000-07:00

breast cancer does not affect the one who is afflicted with the disease only. it affects the whole family. it is a disease that slowly eats away the family’s finances and esteem... that’s why it is important to have a support system during these trying times.

Types of Breast Cancer

2008-07-20T02:42:00.000-07:00

There are many types of breast cancer, though some of them are very rare. Sometimes a breast tumor can be a combination of these types and to have a mixture of invasive and in situ cancer.

Ductal carcinoma in situ (DCIS): This is the most common type of non-invasive breast cancer. DCIS means that the cancer is only in the ducts. It has not spread through the walls of the ducts into the tissue of the breast. Nearly all women with cancer at this stage can be cured. Often the best way to find DCIS early is with a mammogram.

Lobular carcinoma in situ (LCIS): This condition begins in the milk-making glands but does not go through the wall of the lobules. Although not a true cancer, having LCIS increases a woman's risk of getting cancer later. For this reason, it's important that women with LCIS to follow the screening guidelines for breast cancer (these are discussed later in this document).

Invasive (infiltrating) ductal carcinoma (IDC): This is the most common breast cancer. It starts in a milk passage or duct, breaks through the wall of the duct, and invades the tissue of the breast. From there it can spread to other parts of the body. It accounts for about 8 out of 10 invasive breast cancers.

Invasive (infiltrating) lobular carcinoma (ILC): This cancer starts in the milk glands or lobules. It can spread to other parts of the body. About 1 out of 10 invasive breast cancers are of this type.

Inflammatory breast cancer (IBC): This uncommon type of invasive breast cancer accounts for about 1% to 3% of all breast cancers. Usually there is no single lump or tumor. Instead, inflammatory breast cancer (IBC) makes the skin of the breast look red and feel warm. It also gives the skin a thick, pitted appearance that looks a lot like an orange peel. Doctors now know that these changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels in the skin. The breast may become larger, firmer, tender, or itchy. IBC is often mistaken for an infection in its early stages. Because there is no defined lump, it may not appear on a mammogram, which may make it even harder to catch it early. It usually has a higher chance of spreading and a worse outlook than invasive ductal or lobular cancer.

There are also many other less common types of breast cancer. You can get information about these through our toll-free number or on our Web site.

source: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_breast_cancer_5.asp?sitearea=

what is breast cancer

2008-07-17T02:40:00.000-07:00

Breast cancer is a malignant (cancerous) tumor that starts from cells of the breast. The disease occurs mostly in women, but men can get breast cancer too. The information here refers only to breast cancer in women. There is separate information about breast cancer in men available in the American Cancer Society's document

Normal Breast Structure

In order to understand breast cancer, it is helpful to have some basic knowledge about the normal structure of the breasts, as shown in the picture below.

A woman’s breast is made up of glands that make breast milk (lobules), ducts (small tubes that carry milk from the lobules to the nipple), fatty and connective tissue, blood vessels, and lymph (pronounced limf) vessels. Most breast cancers begin in the cells that line the ducts (ductal cancer), some begin in the lobules (lobular cancer), and the rest in other tissues.

The Lymph System

The lymph system is important because it is one of the ways in which breast cancers can spread. This system has several parts.

Lymph nodes are small, bean-shaped collections of immune system cells that are connected by lymphatic vessels. Lymphatic vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Breast cancer cells can enter lymphatic vessels and begin to grow in lymph nodes.

Most lymph vessels of the breast lead to lymph nodes under the arm. These are called axillary (ax-uh-lair-ee) nodes. If breast cancer cells reach the underarm lymph nodes and continue to grow, they cause the nodes to swell. Once cancer cells have reached these nodes they are more likely to spread to other organs of the body too. Knowing whether cancer cells have spread to lymph nodes is important because if they have, there is a higher chance that the cells have also gotten into the bloodstream and spread to other places in the body. This could affect the treatment plan.

Benign Breast Lumps

Most breast lumps are benign (be-nine); that is, they are not cancer. Benign breast tumors are abnormal growths, but they do not spread outside of the breast and they are not life threatening. But some benign breast lumps can increase a woman’s risk of getting breast cancer.

Most lumps turn out to be caused by fibrocystic (fi-bro-sis-tik) changes. Cysts are fluid-filled sacs. Fibrosis is the formation of scar-like tissue. Such changes can cause breast swelling and pain. The breasts may feel lumpy, and sometimes there is a clear or slightly cloudy nipple discharge. For more detail, please see the document,

source: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_breast_cancer_5.asp?sitearea=