Scientists have recommended that women undergo annual breast cancer screening with already 30 years


But not all need be examined only to those who have increased density of the mammary glands, there were cases of cancer in the family, or those who have already suffered the disease. These recommendations have been made at the annual conference of the Radiological society of North America.

Why is it necessary?

In the early stages of cancer usually does not manifest itself, and you can find it only in the survey. But it is much easier to cure before the illness go into running form. Therefore, women after age 40, experts recommend regular screening it is considered that at this age are diagnosed with cancer often.

Recently, however, American researchers compared the data of women aged 30 to 39 years, with rates in women aged 40-49 years. In the first group were risk factors, which we discussed in the beginning, but not the second. It turned out that those and other breast cancer has evolved and recurred with approximately the same frequency.

Therefore, the scientists concluded: women who are at risk need to be screened already with 30 years.

What tests are needed?

Mammography is the standard examination to detect breast cancer. The American cancer society recommends having it every year. At an average of 6 in 1,000 women who came to study, diagnose cancer of the breast.

In addition, you need to:

  1. To check the Breasts themselves

Studies have shown that 40% of cases, cancer was discovered, when the time of self-examination. However, in most cases, the tumor women feel only when it reaches a size of 2-3 cm Is already advanced stage – so home checks may not replace clinical.

This should be done even on young girls regardless of the evidence. But this survey is not much better. Some malignant tumors are located deep in the glands, and the usual probing impossible to detect them.

And that is in addition to palpation and mammography?

Genetic screening, magnetic and ultrasound examination of the mammary glands. However, these methods have not proven as quite effective. You can still get an MRI, but this service is quite expensive. Therefore, mammography is considered the best option.

And the fact that breast cancer is curable, confirms our article “7 famous women who have defeated breast cancer”.

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Younger Breast Cancer Survivors Suffer More Bone Loss From Treatment

TUESDAY, Dec. 11, 2018 — Younger breast cancer survivors are at increased risk for osteoporosis — weak, brittle bones — due to breast cancer treatments, new study finds.

The study included 211 women who had been diagnosed with breast cancer within the past nearly three years and 567 women with no history of cancer.

Over about six years of follow-up, women diagnosed with breast cancer at age 50 or younger had twice the risk of developing either osteoporosis or a severe bone-loss condition called osteopenia than those without cancer.

The risk was up to four times higher among breast cancer survivors who had undergone treatments that block estrogen production, according to the study.

“These findings show that even younger women have a relatively high risk of bone loss with standard breast cancer treatments, and in many cases we saw this bone loss occurring in just a few years,” said senior study author Dr. Kala Visvanathan. She’s a professor in the department of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore.

“These results suggest that we should monitor even young breast cancer patients for bone loss during and after therapy,” Visvanathan said in a Hopkins news release.

Previous research has shown that older breast cancer survivors are at increased risk of bone loss.

Breast cancer treatments can trigger premature menopause by damaging the ovaries or otherwise interrupting estrogen production, making women more vulnerable to bone loss.

This study found that the risk of bone loss was particularly high after certain types of breast cancer treatment. Women receiving the standard combination of chemotherapy plus hormonal therapy had a 2.7 times increased risk of osteopenia and osteoporosis compared to those without cancer.

Chemotherapy plus tamoxifen was associated with a 2.5 times higher risk, but not tamoxifen alone. Aromatase inhibitors, which reduce estrogen production, were associated with a 2.7 times higher risk for bone loss alone, and a 3.8 times higher risk when combined with chemotherapy, the study found.

The increased risk of bone loss in breast cancer survivors was evident even when women with premature menopause were not included in the analysis.

“There seems to be an effect of cancer treatment on bone health that works independently of menopause — perhaps by directly inhibiting bone formation,” Visvanathan said.

The study was published recently in the journal Breast Cancer Research.

More information

The U.S. Office on Women’s Health has more about osteoporosis.

Posted: December 2018

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Study finds higher risk of breast cancer for women after giving birth

Younger women who have recently had a child may have a higher risk of breast cancer than their peers of the same age who do not have children, according to a large-scale analysis co-led by a University of North Carolina Lineberger Comprehensive Cancer Center researcher.

The findings, published in the Annals of Internal Medicine, may seem contrary to conventional wisdom that childbirth is protective against breast cancer. Researchers say childbirth still does become protective, but it can take more than two decades for benefits to emerge. Breast cancer is more common in older women, with the median age of 62 at diagnosis in the United States. Researchers who led the study from the Premenopausal Breast Cancer Collaborative Group identified elevated breast cancer risk after childbirth in women younger than 55.

“What most people know is that women who have children tend to have lower breast cancer risk than women who have not had children, but that really comes from what breast cancer looks like for women in their 60s and beyond,” said UNC Lineberger’s Hazel B. Nichols, Ph.D., a professor in the UNC Gillings School of Global Public Health Department of Epidemiology. “We found that it can take more than 20 years for childbirth to become protective for breast cancer, and that before that, breast cancer risk was higher in women who had recently had a child.”

Other studies have shown an increase in breast cancer risk in younger women after childbirth, but have not had access to information about other factors that might impact risk, such as breastfeeding or family history of breast cancer, researchers said. For their analysis, researchers pooled data from 15 prospective studies from the around the globe that included 889,944 women. In addition to looking at breast cancer risk after childbirth, they also evaluated the impact of other factors, such as breastfeeding and a family history of breast cancer.

They found that, in women 55 years and younger, breast cancer risk peaked about five years after they gave birth, with risk for mothers 80 percent higher compared with women who did not give birth. Twenty-three years after giving birth, women saw their risk level off, and pregnancy started to become protective. The increased risk after childbirth was higher for women who also had a family history of breast cancer or who had a greater number of births or were older at first birth. The pattern looked the same whether or not women breastfed.

“We need to recognize that the traditional risk factors for breast cancer do not always operate the same way at younger ages,” Nichols said.

While breast cancer risk increased for mothers after pregnancy, researchers also noted that the overall risk of breast cancer is still low in this group. Between the ages of 41 and 45, there were 41 more cases of breast cancer diagnosed in every 100,000 women who had given birth in the previous three to seven years compared with women who did not have children. By age 50, there 247 more cases per 100,000 women in the group that had recently given birth.

“In this age group, breast cancer is uncommon,” Nichols said. “The risk of developing breast cancer is still low overall, even if you’ve had a child five years ago.”

Their findings were also not the same for all younger women. Risk was higher for women who had their first child after 35, but there was no increased risk of breast cancer after a recent birth for women who had their first child before 25. And while pregnancy did become protective against estrogen receptor-positive breast cancer years later, it did not become protective for estrogen-receptor negative breast cancer during the study.

“This is evidence of the fact that just as breast cancer risk factors for young women can differ from risk factors in older women, there are different types of breast cancer, and the risk factors for developing one type versus another can differ,” Nichols said.

The study’s findings could be used to develop better breast cancer risk prediction models to help inform screening decisions and prevention strategies, Nichols said.

“There are many ongoing studies that are trying to improve our ability to do breast cancer risk prediction on the individual level,” Nichols said. “This is one piece of evidence that can be considered for building new prediction models.”

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Breast Cancer Deadlier for Black Women, Despite Same Treatments

THURSDAY, Dec. 6, 2018 — Even with the same treatment, black women with the most common form of breast cancer experience higher recurrence and death rates than white women, a new trial reveals.

The finding pokes holes in the prevailing notion that black women with breast cancer fare worse due to less access to quality medical care, experts said. While that factor may contribute to poorer outcomes, other factors — such as the way drugs are metabolized based on race — may be at play.

“Going way back, there’s always been the concern about blacks in terms of cancer outcomes over time, but a lot of that was based on population [studies] where treatment wasn’t controlled,” said study author Dr. Kathy Albain. She’s chair of oncology research at Loyola University Chicago Stritch School of Medicine.

But “leveling the playing field by bringing women to the same doctors and getting the same treatment” didn’t equalize breast cancer outcomes between black and white women, Albain added.

More than 250,000 women in the United States were diagnosed with invasive breast cancer in 2017, according to the American Cancer Society. The disease claims the lives of about 40,000 people each year.

Albain and her colleagues evaluated the link between clinical outcomes and race in more than 10,000 women with early stage hormone receptor-positive, HER2-negative breast cancer, the most common type of the disease.

Findings from the same multinational research, known as the TAILORx trial, were released in June showing that most women with early breast cancer don’t benefit from chemotherapy. Treating them with chemotherapy and hormone therapy after surgery doesn’t improve outcomes more than hormone therapy alone.

In this latest analysis, patients’ tumors were analyzed using a molecular test that looks at the expression of 21 genes associated with breast cancer recurrence. About 84 percent of the patients were white, 7 percent were black, 4 percent Asian and 4 percent were of other or unknown race. Ethnically, 79 percent were non-Hispanic, 9 percent were Hispanic and 12 percent were of unknown ethnicity.

The types, use and length of treatments were similar between both black and white patients and between Hispanic and non-Hispanic patients.

But outcomes were significantly different: Black women experienced a 39 percent higher risk of breast cancer recurrence compared to white women and a 52 percent higher risk of dying.

These marked outcome disparities were not explained by reported adherence to therapy, or by factors such as age or tumor size or aggression level, Albain said. But she said it’s possible that differences in the way racial groups metabolize drugs could play a role.

“We inherit genes from our parents and the genes that metabolize drugs … differ,” Albain said. “It’s not any sort of racial bias, it’s just a fact.”

Also, because hormone therapy pill adherence was self-reported, she noted, the study authors don’t know if black and white patients actually took the pills according to directions, or in the same way.

“Patients will tell me all the time they’re taking their pills, and they’re not taking their pills,” Albain said. “Pill-counting wasn’t done in this trial” to confirm what patients reported.

Dr. Ann Partridge is a breast medical oncologist at Dana-Farber Cancer Institute in Boston and wasn’t involved in the new research. But she said she wasn’t surprised by the findings and agreed that black and white patients in the study may have adhered to hormonal pill therapy differently.

“We know that young people and African-Americans are less adherent with hormonal therapy — that’s been shown over and over again,” she said.

Partridge also noted that exercise behaviors have been shown to differ by race, and that white women tend to exercise more than black women, which could “have a profound impact” on cancer outcomes.

“This is also true for obesity and diet … which also tends to be different by race,” added Partridge, who’s also a professor of medicine at Harvard Medical School.

Albain and Partridge agreed that more research is needed to pinpoint all the reasons breast cancer outcomes differ according to race.

“We have to chip away at it all, increase our understanding of disease differences and not lump [factors together] as much as we do,” Partridge said.

The research is to be presented Thursday at the San Antonio Breast Cancer Symposium in Texas. Research presented at scientific conferences typically hasn’t been peer-reviewed or published, and results are considered preliminary.

More information

The U.S. National Cancer Institute offers more information on breast cancer treatment.

Posted: December 2018

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Adjuvant capecitabine did not improve outcomes for patients with early triple-negative breast cancer

Treating patients who had early-stage triple-negative breast cancer with the chemotherapy agent capecitabine after they completed surgery and standard chemotherapy did not significantly improve disease-free or overall survival compared with observation, according to data from the randomized, phase III GEICAM/CIBOMA clinical trial presented at the 2018 San Antonio Breast Cancer Symposium, held Dec. 4-8.

“Patients with early-stage triple-negative breast cancer are usually treated with surgery and chemotherapy, and sometimes radiotherapy,” said Miguel Martín, MD, Ph.D., professor of medicine and head of the Medical Oncology Service at Hospital Gregorio Marañón, Universidad Complutense, Madrid, Spain. “New therapeutic approaches are urgently needed, however, because the risk of relapse is high: 7 to 10 percent of those with stage 1 disease relapse, 15 to 20 percent of those with stage II disease, and 25 to 50 percent of those with stage III disease.

“We were disappointed to find that adding adjuvant capecitabine to the standard treatment did not significantly improve disease-free or overall survival,” continued Martín. “However, given that we found a subset of the patients with nonbasal-like disease seemed to have a significant benefit from capecitabine, and data from the CREATE-X trial showed that adjuvant capecitabine significantly reduced the rate of relapse and improved overall survival when administered to breast cancer patients with residual disease after neoadjuvant chemotherapy, we strongly recommend that patients with triple-negative breast cancer discuss adjuvant capecitabine with their oncologists.”

Martín and colleagues randomized 876 patients with early-stage triple-negative breast cancer who had been treated with surgery and chemotherapy in the trial to eight cycles of capecitabine or observation.

After a median follow-up of 7.3 years, five-year disease-free survival was 79.6 percent among the 448 patients randomized to capecitabine and 76.8 percent among the 428 patients randomized to observation. The improvement in five-year disease-free survival was not statistically significant, meaning that the trial result is formally negative, explained Martín.

“There was a nonsignificant trend in favor of capecitabine, but the trial had only 876 participants, which means it was not statistically powered to identify small but clinically relevant differences,” noted Martín. “One possible reason for the discrepancy in the results of the CREATE-X trial and our trial may be that the populations had different prognostic features; the risk of relapse of our population was much less than in the CREATE-X trial.”

In subgroup analyses, Martín and colleagues found that among the 248 patients with nonbasal-like disease, as defined by immunohistochemistry, those randomized to adjuvant capecitabine were 49 percent less likely to experience a disease event and 52 percent less likely to die compared with those randomized to observation.

“This is an intriguing finding,” said Martín. “However, it should be interpreted with caution because the interaction test was negative for disease-free survival (p=0.0694), although it was statistically significant for overall survival (p=0.0052).”

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Use genetic data to predict the best time of day to give radiotherapy to breast cancer patients, say researchers

A new clinical study led by the University of Leicester and conducted in the HOPE clinical trials facility at Leicester’s Hospitals has revealed the pivotal role that changing the time of day that a patient receives radiotherapy could play in altering radiotherapy toxicity. The findings could be used to optimise the treatment to reduce side effects for some breast cancer patients.

The prediction can be personalised by utilising the genetics that govern circadian rhythm. Circadian rhythm is the internal ‘clock’ that underlies the regular patterns of when people feel alert or drowsy – along with other bodily processes.

The research – which was funded by Breast Cancer Now, Hope Against Cancer and the European Union Seventh Framework Programme – found that, by identifying differences in two genes that help govern the body’s circadian rhythm, it may be possible to predict which patients may benefit from receiving their radiotherapy in the afternoon. This could reduce the side effects in some of the 30,000 breast cancer patients treated with radiotherapy in the UK each year.

In a study of 879 breast cancer patients across two independent cohorts (LeND and REQUITE), the team found that patients with variations of two genes in particular, called PER3 and NOCT, were more at risk of side effects if given radiotherapy in the morning.

Patients with these genetic variants were found to be at a greater risk of long-term side effects, including permanent thickening under the skin and chronic pain, and short-term effects such as temporary red, peeling skin, if they were treated in the morning compared to the afternoon.

Professor Paul Symonds, a consultant oncologist at Leicester’s Hospitals and professor of clinical oncology at the University of Leicester said: “Our study found that some patients with a particular genetic profile are more at risk of side effects if given radiotherapy in the morning. This happens because the skin of these particular patients divides earlier in the day than others and dividing cells are more easily damaged by X-rays. This could allow an easy way to personalise treatment just by recommending what time of day a patient should be treated.”

He continued: “Around 90 per cent of operable breast cancer patients are treated with radiotherapy so radiotherapy toxicity is a very real and important issue for these patients.”

Dr. Christopher Talbot, Senior Lecturer in Medical Genetics, Department of Genetics at University of Leicester, said: “Previously, we and others have found several genetic variants that affect reactions to radiotherapy, especially in the ATM and TNF genes. The REQUITE project set out to find many more. Those variants increase risk for reactions irrespective of time of day and are distinct from the cases in our new report that only affect the time of day response and not risk, as such.

“It was known before that cancer drugs show different effects according to the time of day, but the evidence was weak for radiotherapy. We now have better evidence but also a way to determine who would benefit.

“Where our paper is unique is that through a simple genetic test, we can identify the patients at most risk of side-effects if treated in the morning. Such patients could then be scheduled for afternoon treatment.”

Dr. Kotryna Temcinaite, Research Communications Manager at Breast Cancer Now, which helped fund the research, said: “This exciting study suggests that simply altering the time of day that radiotherapy is given could help alleviate its difficult side effects for some patients.

“If we are to ensure that by 2050, everyone who develops breast cancer lives, and lives well, not only do we need to develop new and kinder treatments, but we must also find ways to reduce the side effects of existing therapies.

“As a cornerstone of breast cancer treatment, thousands of patients each year experience the side effects of radiotherapy, such as burning, redness, and changes to the skin. It’s promising that smarter scheduling of appointments could help improve patients’ quality of life, but first we need understand the potential mechanisms.

“Further, multi-centre trials are now needed to replicate these findings and confirm whether gene tests could help identify patients that may benefit from having their radiotherapy in the afternoon. If confirmed, feasibility studies would then be needed to understand how this research could be translated into a clinical setting.”

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Breast Cancer Recurrence Rate Not Up With Autologous Fat Transfer

THURSDAY, Nov. 15, 2018 — For patients with breast cancer, reconstruction with autologous fat transfer (AFT) seems not to increase the rate of locoregional recurrence versus conventional breast reconstruction, according to a study published online Oct. 10 in JAMA Surgery.

Todor Krastev, M.D., Ph.D., from the Maastricht University Medical Center in the Netherlands, and colleagues matched 287 patients with 300 affected breasts receiving AFT between 2006 and 2014 to 300 nonexposed control patients based on age, type of oncologic surgery, tumor invasiveness, and disease stage. AFT patients were followed for a mean of 9.3 years, including 5.0 years following AFT; control patients were followed for a mean of 8.6 years after primary surgery.

The researchers identified eight locoregional recurrences in the treatment group and 11 among the control group, for an unadjusted hazard ratio of 0.63 (95 percent confidence interval, 0.25 to 1.60; P = 0.33). In relevant subgroups based on the type of oncologic surgery, tumor invasiveness, or pathologic stage, there were no increased locoregional recurrence rates. With respect to distant recurrences or breast cancer-specific mortality, no increased risks were detected with AFT.

“In line with reported rates from other published matched cohorts, there is no clinical evidence so far to suggest that AFT leads to increased rates of cancer relapse in patients with breast cancer,” the authors write.

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Posted: November 2018

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