In a new study published online Monday in the Journal of Clinical Oncology, researchers report that the rate of double mastectomy in women with single-breast cancer rose 150 percent in six years – even though the aggressive treatment doesn’t necessarily improve survival rates.

The researchers used a national cancer-treatment database to study the treatment decisions of more than 150,000 women who were diagnosed with cancer in a single breast from 1998 to 2003. White women, younger women and women whose cancer originated in their milk glands, increasing risk of occurrence in the other breast, were more likely to choose a double mastectomy, the researchers found.

“It’s a very vulnerable time for these patients. In a very short period of time they have to decide how to treat their breast cancer. Under the stress of the situation they will have both breasts removed because it seems logical at the time,” said lead author Dr. Todd Tuttle, chief of surgical oncology at the University of Minnesota.

The actual number of women choosing double mastectomy remains relatively small: Of all women undergoing mastectomies of any kind in the study, 4.2 percent chose double mastectomy in 1998, rising to 11 percent in 2003. A total of 4,969 women in the study received a double mastectomy.

The trend is troubling, Tuttle said. Cancer is more likely to spread to other parts of the body than it is to develop in the second breast. Women often make the irreversible decision too quickly, when they are under duress, he said.

“I often tell patients to wait, saying, ‘Let’s treat the cancer we know about and deal with that,’ ” Tuttle said.

One in every eight women will develop invasive breast cancer at some time in their lives, according to the American Cancer Society. In 2004, the most recent year for which federal data is available, nearly 187,000 women in the United States were diagnosed with breast cancer and nearly 50,000 women died.

Typically discovered through mammography or direct examination, breast cancer is treated with medication, chemotherapy, radiation, and surgeries ranging from lumpectomy, in which a part of the breast is removed, to mastectomy, in which the entire breast is removed and in many cases reconstructed with implants or tissue from other parts of the body.

Doctors and patients’ advocates urged women considering the procedure to go for counseling and take their time before making a decision, noting that other risk-reducing options were available.

Shirley McQueen is a fashion store owner. She lives in terror of something her family calls ‘the beast’. It’s killed 14 of her relatives, but Shirley McQueen has a radical plan to evade the disease. Shirley McQueen has spent most of her life preparing for her death; she has even planned her funeral.

“The Beast” in actual, the breast cancer, felled her mother, her older sister, five of her aunts, one great, great aunt and six of her cousins. Another cousin in the United States has just found out that “the beast” has attacked her too.

Shirley has decided to remove both her breasts to prevent her from getting the disease. “Every woman who has died in my family has died of breast cancer,” she says.

“The women in my family haven’t lived long enough to see their grandchildren. When my older sister was diagnosed, her daughter was pregnant and she said she was going to hang on to see the baby, but she didn’t manage it. If I ask to be here to see my grandchildren, am I asking too much?”

She will be checking into a clinic next month for pre-surgery checks before undergoing breast-removal surgery.

Frustrated with death and attending funerals, McQueen, whose mother died of breast cancer when she was five years old, is determined to see her children get married, hence her drastic pre-emptive move.

And not even a man would have a say in her decision.

She said: “Even if I had a man, it wouldn’t matter. I don’t want to die prematurely. I want to see my children marry. My mom did not have that opportunity. None of the women in my family did. This is a lot easier to deal with than finding a lump in my breast.”

“My family has tried to dissuade me. They think that illness comes directly from God and that you shouldn’t play around with God’s work,” she says.

But Shirley firmly believes that more can be done to reverse the horrible fate of women like herself, and that awareness needs to be raised about breast cancer, particularly in the black community. Regular breast checks, screening and, in cases like hers, preventative mastectomies should all be considered, she says.

McQueen says that she is undergoing her surgery for the sake of her children. “I’m not frightened of dying but I am frightened of leaving my children. I’m always thinking about dying and I want that to stop. Once I’ve had the surgery I’ll be able to sleep again. All I want is to have my life.”

A new study has shown that magnetic resonance imaging scans (MRIs) were more effective at detecting early stages of breast cancer than traditional mammograms.

The research, published in the Lancet medical journal, found that 92 per cent of cases of early breast cancer were detected by the MRI scan, whereas only 56 per cent of cases were detected by the mammogram.

At a national breast centre in Germany, the researchers analysed MRIs carried out for women who were at an increased risk of breast cancer, had an abnormal mammogram, or had a normal mammogram but were particularly concerned about breast cancer.

Cancer Research UK’s professor of screening Stephen Duffy welcomed the research: “The results are interesting and add weight to the findings of a UK study published in 2005 which found MRI to be more sensitive than mammography to invasive cancers in women at high genetic risk.”

However, he called for further studies to be conducted before conclusive results could be drawn: “While this study provides further evidence of the benefit of MRI examinations in high-risk women, none of these studies has concluded that MRI should replace mammography. The consensus is that they should be used in tandem for high-risk women.”

High-fat diet may increase breast cancer risk. According to a large study of middle-age women with a wide range of fat in their diet shows that eating a high-fat diet raises the risk of developing invasive breast cancer. This report in the Journal of the National Cancer Institute, stem from the National Institutes of Health-AARP Diet and Health Study, in which 188,736 postmenopausal women reported detailed information on their diet in the mid-1990s. During an average follow-up of 4.4 years, 3501 women developed breast cancer.

Based on responses to a 124-item “food frequency” questionnaire, researchers found that women who got 40 percent of their calories from fat had about a 15 percent increased risk of developing breast cancer compared with women got 20 percent of their calories from fat. The increased risk of breast cancer associated with a high-fat diet was seen for all types of fat (saturated, monounsaturated and polyunsaturated) and seemed to be confined to women who were not using hormone replacement therapy at the start of the study.

In a commentary on the study, two researchers from Harvard School of Public Health in Boston think that focusing on controlling body fat, rather than fat intake, would be more effective in preventing breast cancer.

The “modest associations” that have been observed between high-fat diets and increased breast cancer risk “stand in sharp contrast to the robust evidence for a strong link between (body fat) and the risk of postmenopausal breast cancer,” write Drs. Stephanie Smith-Warner and Meir Stampfer.

SOURCE: Journal of the National Cancer Institute, March 21, 2007

Researchers in Spain conducted a Phase III clinical trial called GEICAM. They wanted to compare different chemotherapy regimes in women diagnosed with metastatic breast cancer. The trial included 252 women who had already been treated with anthracyclines and taxanes and experienced a recurrence.One group of women was treated with Gemzar (gemcitabine) and Navelbine (vinorelbine), the other group was treated with Navelbine alone. The results were published in Lancet Oncology that states the combination of the two drugs improves progression free survival. It was also mentioned that this combination however did not improve overall survival.

When cancer recurs following treatment with anthracyclines and taxanes, some of the strongest chemotherapies for breast cancer, patients have limited treatment options. Researchers continue to search for different chemotherapy combinations that are effective against recurrent breast cancer.

The researchers concluded that anticancer responses were 36 percent for patients treated with Gemzar/Navelbine and 26 percent for patients treated with Navelbine alone.

The new drug exemestane for breast cancer treatment could improve survival rates by 17 percent, new research shows.

A study of 4,742 post-menopausal women found that switching from the present gold-standard breast cancer treatment tamoxifen to the new drug exemestane after two or three years resulted in a dramatic fall in death rates, The Times newspaper reported on Tuesday.

The new drug, sold under the brand name Aromasin, is recommended by the National Institute for Health and Clinical Excellence as an alternative to tamoxifen after two to three years, according to the report.

The study followed the progress of women treated for a total of five years and monitored for a further three years, and women assigned randomly to a full five years of tamoxifen, or treatment with tamoxifen followed by exemestane.

The researchers said that giving women tamoxifen after surgery already reduced the risk of dying by 33 percent, and after another two to three years of exemestane, and with a further three years of post-treatment follow-up, survival was found to be significantly improved with the risk of dying 50 percent lower than if they had received no drug therapy.

Read the rest of this entry »

Agendia has announced that the U.S. Food and Drug Administration (FDA) has cleared the company’s MammaPrint(C) breast cancer diagnostic test. MammaPrint® is a gene expression profiling service to assess the risk of recurrence in breast cancer patients.

The US Food and Drug Administration has approved MammaPrint, a new genetic test that can help predict whether a woman’s early stage breast cancer is likely to come back after initial treatment. The MammaPrint® test uses advanced genetic technology to predict whether existing cancer will spread to other parts of a patient’s body (metastasize). The test relies on microarray analysis, a powerful tool for simultaneously studying the patterns of activity of large numbers of genes in biological specimens.

“Today’s FDA clearance of MammaPrint® is a milestone for patient care and safety,” said Dr. Bernhard Sixt, Chief Executive Officer at Agendia.

“As the first test of its kind cleared by the FDA, this type of regulatory review benefits breast cancer patients and provides regulatory clarity to the medical community. At present, MammaPrint® is the first cleared IVDMIA which can be marketed in the US in compliance with these new FDA guidelines. We are exploring ways to make this product available in the US,” Sixt continued.

“We are pleased about today’s FDA announcement as it signifies an important first step in standardizing IVDMIAs to ensure a safe and welcomed advancement in cancer diagnostics,” said Diane Blum, MSW, Executive Director of CancerCare.

Agendia is located in Amsterdam, the Netherlands.

Results published at the annual San Antonio Breast Cancer Symposium, said that Abraxane in combination with Xeloda may be an effective treatment option for patients with metastatic breast cancer.Abraxane is a newer form of Taxol that uses albumin, a natural protein found in the body, to deliver high concentrations of the active ingredient into the cancer cells and has fewer side effect than Taxol. Abraxane treatments last around 30 minutes compared with 3 hours for Taxol.

Researchers conducted a small clinical trial that included 38 patients with metastatic breast cancer. Complete disappearance of cancer was achieved in nearly 9 percent of patients. Partial responses were achieved in about 44 percent of patients. Disease stabilization was seen in almost 33 percent of study participants.

Even though the study was a small one, researchers conclude that it appears that treatment with Abraxane and Xeloda may be effective for patients with metastatic breast cancer.

Touch imprint cytology (TIC) lymph node assessment during breast cancer surgery could prove to have advantages over the current standard lymph node assessment. TIC can be important to the breast cancer patient because usually the results from the lymph node dissection can take up to a week. It causes a lot of anxiety and stress waiting to find out if the breast cancer has metastasized to the lymph nodes. TIC would provide immediate results during the sentinel node extraction.

An economic assessment that was published in the November 15, 2006 issue of Cancer says TIC is less costly than standard lymph node assessment. They studied the cost effectiveness of the two techniques and found that especially in larger tumors TIC is more effective.

A synthetic steroid compound used to abort pregnancy could fight breast and ovarian cancer, caused by a mutant gene, from growing, according to researchers at the UniversityCalifornia, Irvine.

The research published in the December 1 issue of journal Science, revealed that by blocking the hormone progesterone in breast tissue cells, the drug can also prevent formation of tumors.

Read the rest of this entry »