Breast Cancer
Penn studies point to strategies for reducing painful breast cancer drug side effects
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Aromatase inhibitors, the same drugs that have buoyed long-term survival rates among breast cancer patients, also carry side effects including joint pain so severe that many patients discontinue these lifesaving medicines. New University of Pennsylvania School of Medicine research, however, has uncovered patterns that may help clinicians identify and help women at risk of these symptoms sooner in order to increase their chances of sticking with their treatment regimen. In a study published recently in the journal Cancer, researchers at Penn’s Abramson Cancer Center found that estrogen withdrawal may play a role in the onset of joint pain, also known as arthralgia, during treatment: Women who stopped getting their menstrual periods less than five years before starting breast cancer treatment were three times more likely to experience these pains than those who reached menopause more than a decade earlier. In a separate study published in the journal Integrative Cancer Therapies, the Penn researchers found that among women experiencing these symptoms during treatment with aromatase inhibitors (AI), those who received electro-acupuncture – a technique that combines traditional acupuncture with electric stimulation – reported a reduction in joint pain severity and stiffness. Those women also said they suffered less fatigue and anxiety.
“We are fortunate today to have many effective treatments for breast cancer. Unfortunately, many of these treatments have troublesome and debilitating side effects that can last for months or years after treatment, and really harm the quality of life and productivity of women who receive them,” says lead author Jun J. Mao, MD, MSCE, an assistant Professor of Family Medicine and Community Health. “These findings are just a first step in our comprehensive research program aimed at understanding the nature of treatment-related symptoms, who is likely to get them, the mechanisms by which they occur, and how best to treat them.”
Toxicity issues and side effects among patients taking aromatase inhibitors – drugs used in post-menopausal women to prevent recurrence of breast cancer following initial treatment, by reducing the amount of estrogen the body makes – lead as many as 20 percent of patients to miss prescription refills or discontinue their therapy altogether. Patients in the new study were taking aromatase inhibitors including Arimidex, Femara or Aromasin.
Inflammatory Breast Cancer: Why You Need to Know the Signs of This Deadly Disease
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It’s one of the most aggressive forms of breast cancer, but most women have never heard about it. Inflammatory breast cancer or IBC, is a silent killer because unlike many other cancers, patients often don’t recognize the symptoms.
According to the National Cancer Institute, approximately 200,000 new cases of inflammatory breast cancer will be diagnosed this year and more than 40,000 people will die from the disease. Though it occurs in both men and women, it is largely a disease that affects women.
“Inflammatory breast cancer accounts for one-to-five-percent of all breast cancers diagnosed and because it is uncommon, you don’t necessarily jump to that as a first diagnosis,” says Beth Overmoyer, MD, an IBC expert at Dana-Farber Cancer Institute. “In traditional breast cancers, a patient can feel a lump or we can see a mass on a mammogram. Inflammatory breast cancer is often not a lump or mass, but a rash or bruise and can be misdiagnosed as an infection.”
New Surgical Procedure Improves Quality of Life for Breast Cancer Patients
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Toronto Western Hospital has pioneered a new procedure - minimally invasive, outpatient spine surgery for cancer that has spread to the spine. Approximately, 40-50 percent of metastic cancers end up in the spine. The most common primary cancers to spread to the bones of the spine are breast and lung cancer. Spinal tumours can drastically affect a patient’s quality of life and result in pain and reduced mobility. A spinal tumour or a growth of any kind can impinge on nerves, leading to pain, neurological problems and sometimes paralysis.
Breastfeeding protects against breast cancer
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A woman with a mother or sister with breast cancer should “strongly” consider breastfeeding her baby, doctors advise in a report released today.
In a long-term study of more than 60,000 women, researchers found that women with a close family history of breast cancer had significantly lower risk of developing breast cancer before menopause themselves if they breastfed their babies, compared to women who did not breastfeed.
“Breastfeeding is good for mothers and for babies,” study chief Dr. Alison M. Stuebe, of University of North Carolina at Chapel Hill, told Reuters Health by email.
Why African-Americans Fare Worse with Some Cancers
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An analysis of almost 20,000 patient records from the Southwest Oncology Group’s database of clinical trials finds, for the first time, that African-American breast, ovarian, and prostate cancer patients tend to die earlier than patients of other races even when they get identical medical treatment and other confounding socioeconomic factors are controlled for. The finding points to biological or host genetic factors as the potential source of the survival gap.
“When you look at the dialogue about the issue of race and cancer survival that’s gone on over the years,” says the paper’s lead author, Kathy Albain, M.D., a breast and lung cancer specialist at Loyola University’s Cardinal Bernardin Cancer Center, “it always seems to come down to general conclusions that African-Americans may in part have poorer access to quality treatment, may be diagnosed in later stages, and may not have the same standard of care delivered as Caucasian patients, leading to a disparity in survival.”
The study, which will be published online by the Journal of the National Cancer Institute (JNCI) on July 7, found that when treatment was uniform and differences in tumor prognostic factors, demographics, and socioeconomic status were controlled, there was in fact no statistically significant difference in survival based on race for a number of other cancers—lung, colon, lymphoma, leukemia, and multiple myeloma.
Researchers find genetic key to breast cancer’s ability to survive and spread
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New research led by investigators at Memorial Sloan-Kettering Cancer Center (MSKCC) sheds light on a genetic function that gives breast cancer cells the ability to survive and spread to the bone years after treatment has been administered. The findings support the study of therapies that target this survival capacity and force the death of latent breast cancer cells before they get a chance to metastasize, or spread – a problem that accounts for a majority of breast cancer–related deaths. The research will be published in the July 7 issue of Cancer Cell.
Using gene-expression profiling techniques, researchers found that breast cancer cells that infiltrate the bone marrow can survive over time if they contain the gene product Src, which has known effects on cell mobility, invasion, and survival. The investigators discovered that genetically disabling Src activity in human breast cancer cells inhibits these cells from surviving in the bone marrow and forming metastases in mice. They also observed that treatment with the drug dasatinib inhibits the formation of bone metastasis by human breast cancer cells inoculated into mice.
“Our results should encourage oncologists to consider the study of Src inhibitors to attack reservoirs of disseminated, latent cancer cells and prevent metastasis in breast cancer patients after their tumor has been removed,” said the study’s senior author, Joan Massagué, PhD, Chair of the Cancer Biology and Genetics Program at MSKCC and a Howard Hughes Medical Institute investigator.
Declines in US breast cancer rates not uniform
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Between 2001 and 2004, new cases of breast cancer declined more than 8 percent in the United States. However, new research suggests that the decline was significantly less pronounced among poor women and among women living in rural areas.
“We looked closely at the previously reported decline in breast cancer observed in 2002-2003 using one of the largest databases available and found that the decline was faster in urban and affluent areas than rural or poorer areas,” Dr. Christina Clarke, from the Northern California Cancer Center in Fremont told Reuters Health.
In their study, reported online in the journal BMC Medicine, Clarke’s team looked at trends in the occurrence of breast cancer in US women by urban and rural status as well as poverty status for the period of 1997 to 2004.
Many at-risk women don’t follow mammogram schedule
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Women who have been treated for ductal carcinoma in situ (DCIS) tend to stop following the recommended guidelines for mammography screening over time, despite the fact that they still have a higher-than-average risk for recurrence and development of a new DCIS in the other breast.
This finding, published online ahead of print in the Journal of Clinical Oncology, is drawn from a study of more than 3,000 women who underwent breast-conserving surgery for DCIS between 1990 and 2001. Breast-conserving surgery is a procedure in which only the abnormal cells, or tumor, plus a margin - an area of normal cells surrounding the abnormal cells - are removed.
DCIS is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. These abnormal cells have not yet spread outside the duct to other tissues in the breast. Some physicians consider this a “precancerous condition,” while others classify it as very early-stage breast cancer.
Meat intake/prep not linked to breast cancer
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A large study has found no link between eating meat—total meat, red meat, processed meat, or meat cooked at high temperatures—and the risk of breast cancer in older women.
Some studies have found that women who eat a lot of red and processed meat are more likely to develop breast cancer than other women; but other studies have found no such link. Saturated fat, found mainly in animal products, has been tied to higher breast cancer risk in some studies, but not in others.
The current findings stem from 120,755 postmenopausal women who participated in the NIH-AARP Diet and Health Study. The women provided information on what they ate and how often they ate certain foods when they entered the study between 1995 and 1996. They also provided information on meat-cooking methods.
Developing New Treatments for Triple-Negative Breast Cancer
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Brian Rowan, Ph.D., professor of Cancer Research for the Tulane Cancer Center, is studying treatment options for an aggressive type of breast cancer that is prevalent in New Orleans among African-American women—triple-negative breast cancer. The term triple-negative refers to the fact that these tumors do not have estrogen, progesterone or HER2 receptors, effectively eliminating hormonal and targeted herceptin therapy from the list of possible treatment options. This limits therapeutic choices for these patients to surgery, radiation and chemotherapy.
Rowan is studying a therapy that targets a protein called Src kinase, which is required for tumor growth in triple negative breast cancer. Rowan and his team are working with Kinex Pharmaceuticals in Buffalo, N.Y. to test a new Src inhibitor called KX-01. Phase I trials for this new drug are complete and preliminary results indicate that KX-01 kills triple-negative breast cancer cells in both Petri dishes and in animal tumor models.
“KX-01 in combination with chemotherapy kills even more cancer cells,” said Rowan.
Red and white wine both raise breast cancer risk
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It seems that both red and white wine are “equal offenders” when it comes to increasing the risk of breast cancer, according to a study published today.
“We were interested in teasing out red wine’s effects on breast cancer risk. There is reason to suspect that red wine might have beneficial effects based on previous studies of heart disease and prostate cancer,” Dr. Polly Newcomb, of the Fred Hutchinson Cancer Research Center, Seattle, noted in a hospital statement.
“The general evidence is that alcohol consumption overall increases breast cancer risk, but the other studies made us wonder whether red wine might in fact have some positive value,” she explained.
Pregnancy has no impact on breast cancer, but can delay diagnosis and treatment
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A new study finds women who develop breast cancer while pregnant or soon afterwards do not experience any differences in disease severity or likelihood of survival compared to other women with breast cancer. The study is published in the March 15, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society.
So-called pregnancy-associated breast cancers (PABC), defined as breast cancer that develops either during or within one year following pregnancy, is relatively rare and presents a dilemma for clinicians. An estimated 0.2 to 3.8 percent of pregnancies are complicated by breast cancer, and approximately 10 percent of breast cancer patients under age 40 develop the disease during pregnancy. But as age at the time of pregnancy continues to increase, the incidence of PABC can be expected to increase.
Previous research has suggested that pregnancy is associated with poorer outcomes among women with breast cancer.
Mistrust makes some women delay breast exam
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A lack of trust in the health care system leads many women from minority groups to delay breast cancer screening, according to results of a study reported Thursday at the American Association for Cancer Research conference on the Science of Health Care Disparities in Carefree, Arizona.
“Our medical systems, in general, have some work to do to build better-trusted relationships with racial and ethnic women,” Dr. Karen Patricia Williams from Michigan State University in East Lansing told the conference.
Williams and colleagues analyzed medical mistrust and breast cancer screening behaviors among 116 African American, 113 Latina, and 112 Arab American women who were eligible for screening; their average age was 46 years.
Hispanic women and breast cancer: An understudied group
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Data from the ELLA Binational Breast Cancer Study will be released for the first time at the American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Carefree, Arizona.
“Hispanics are the fastest-growing minority group in the United States, but little is known about their risk for breast cancer,” said Elena Martinez, Ph.D., professor of epidemiology at The University of Arizona Mel and Enid Zuckerman College of Public Health and co-leader of the Cancer Prevention and Control Program at the Arizona Cancer Center, Tucson. “The study recruited women who were recently diagnosed with invasive breast cancer living in the United States and in Mexico. We hope to understand more about what puts these women at risk for specific types of breast cancer.”
Martinez will moderate a press conference in both English and Spanish at the Science of Cancer Health Disparities meeting. The English-language press conference will take place at 10:00 a.m. MST on Wednesday, February 4, while the Spanish-language press conference will take place at 11:00 a.m. MST on the same day. Reporters unable to attend in person can call in to each conference at 888-282-7404.
Breast cancer risk rapidly declines after women stop taking postmenopausal combined hormone therapy
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Women who stopped taking the postmenopausal hormone combination of estrogen plus progestin experienced a marked decline in breast cancer risk which was unrelated to mammography utilization change, according to a study from the Women’s Health Initiative led by a Los Angeles Biomedical Research Institute (LA BioMed) investigator that was published today in The New England Journal of Medicine.
“These findings support the hypothesis that the recent reduction in breast cancer incidence in the United States is predominantly related to a decrease in combined estrogen plus progestin use,” said Rowan T. Chlebowski, M.D., Ph.D., a LA BioMed chief investigator and lead author for the study.
Breast cancer in the United States began to decline in 2003, after the Women’s Health Initiative’s initial findings that combined hormone therapy was related to higher risk of breast cancer and heart problems.
