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Breast Cancer

Study examines effectiveness of mammography screening for women with prior breast cancer

Cancer • • Breast CancerFeb 23 11

Mammography screening in women with a personal history of breast cancer detects second breast cancers at an early stage, but has lower accuracy, compared to screening in women without prior breast cancer, according to a study in the February 23 issue of JAMA.

“The high prevalence of breast cancer survivors is due to general gains in life expectancy and to improved survival in women with a personal history of breast cancer (PHBC), attributable to improvements in local and systemic treatments and early detection,” the authors write. Women with PHBC are at risk of developing second breast cancers and are recommended for annual screening mammography, but few high-quality data exist on screening accuracy in PHBC women, according to background information in the article. The authors add that valid estimates of the accuracy of screening mammography are needed to guide clinical practice and policy and to inform clinicians and PHBC women of expected screening outcomes.

Nehmat Houssami, M.B.B.S., Ph.D., of the University of Sydney, Australia, and colleagues from the Breast Cancer Surveillance Consortium and Group Health Research Institute, Seattle, conducted a study to examine the accuracy and outcomes of screening mammography and factors associated with screening outcomes in women with a PHBC, who were matched to non-PHBC women and screened (1996-2007) through facilities affiliated with the Breast Cancer Surveillance Consortium. There were 58,870 screening mammograms in 19,078 women with a history of early-stage (in situ or stage I-II invasive) breast cancer and 58,870 matched (breast density, age group, mammography year, and registry) screening mammograms in 55,315 non-PHBC women.

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Strong social ties benefit breast cancer patients

Cancer • • Breast CancerJan 20 11

Breast cancer patients who have a strong social support system in the first year after diagnosis are less likely to die or have a recurrence of cancer, according to new research from Vanderbilt-Ingram Cancer Center (VICC) and the Shanghai Institute of Preventive Medicine. The study, led by first author Meira Epplein, Ph.D., assistant professor of Medicine at VICC, was published in a recent edition of the Journal of Clinical Oncology.

Patients in the study were enrolled in the Shanghai Breast Cancer Survivor Study, a large, population-based review of female breast cancer survivors in China, which Vanderbilt University Medical Center and the Shanghai Institute of Preventive Medicine have carried out since 2002 under the leadership of principal investigator Xiao Ou Shu, M.D., Ph.D., professor of Medicine at VICC, and senior author of the study.

From 2002 to 2004, a total of 2,230 breast cancer survivors completed a quality of life survey six months after diagnosis and a majority responded to a follow-up survey 36 months after diagnosis. The women were asked about physical issues like sleep, eating and pain, psychological well-being, social support and material well-being. The answers were converted to an overall quality of life score.

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Device Promising for Detecting Metastatic Breast Cancer Cells

Cancer • • Breast CancerJan 07 11

Research by engineers and cancer biologists at Virginia Tech indicate that using specific silicon microdevices might provide a new way to screen breast cancer cells’ ability to metastasize.

An image of their work provided to Biomaterials was selected as one of the 12 best biomaterials-related images published in the journal’s 2010 catalogue. http://www.elsevierscitech.com/pdfs/Biomaterials_2010.pdf

The Virginia Tech researchers are: Masoud Agah, director of Virginia Tech’s Microelectromechanical Systems Laboratory (MEMS) Laboratory in the Bradley Department of Electrical and Computer Engineering; Jeannine Strobl, a research professor in the Bradley Department of Electrical and Computer Engineering; Mehdi Nikkhah of mechanical engineering; and Raffaella DeVita of engineering science and mechanics and the director of the soft biological systems laboratory. Nikkhah was Virginia Tech’s Outstanding Doctoral Student in the College of Engineering for 2009.

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Pertuzumab and trastuzumab combination improved efficacy for women with HER2-positive breast cancer

Cancer • • Breast CancerDec 11 10

The combination of pertuzumab and trastuzumab had superior antitumor activity in women with early HER2-positive breast cancer, according to Phase II study results of the NeoSphere neoadjuvant trial.

Details of these study results were presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 8-12.

“The findings establish that the addition of pertuzumab to trastuzumab and the chemotherapy drug docetaxel has an impressive rate of tumor eradication (46 percent), which is 50 percent more than achieved with docetaxel and trastuzumab, the standard therapy,” said Luca Gianni, M.D., director of medical oncology at the Fondazione IRCCS Istituto Tumori di Milano.

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CTCs predict poor outcome from blood stem cell transplantation therapy for metastatic breast cancer

Cancer • • Breast CancerDec 11 10

Metastatic breast cancer patients who had circulating tumor cells (CTCs) in their blood before or after high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation had poor outcomes, according to researchers from the University of Texas MD Anderson Cancer Center.

Patients with CTCs in their blood before chemotherapy treatment had reduced survival and those with these cells in their blood after the stem cell transplant recurred faster and died earlier. These findings were presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium, held Dec 8-12.

While it has been known that CTCs in metastatic breast cancer are linked to cancer recurrence and lower survival, this study adds several new insights, the researchers said. One is that the process of collecting hematopoietic progenitor cells appears to recruit CTCs from bone marrow into the blood, and the other is that these CTCs are likely to be responsible for cancer recurrence.

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Combined imaging technologies may better identify cancerous breast lesions

Cancer • • Breast CancerNov 09 10

By combining optical and x-ray imaging, radiologists may be better able to distinguish cancer from benign lesions in the breast, according to a new study published in the online edition and January issue of Radiology.

Researchers at Martinos Center for Biomedical Imaging at Massachusetts General Hospital in Boston helped develop a combined optical/x-ray imaging system capable of obtaining both structural and functional information of the breast.

The two technologies used were digital breast tomosynthesis (DBT), a three-dimensional application of digital mammography, and diffuse optical tomography (DOT), which measures levels of hemoglobin concentration, oxygen saturation and other cellular characteristics, based on how light from a near-infrared laser is absorbed and scattered within tissue.

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Hormone therapy raises breast cancer deaths -study

Cancer • • Breast Cancer • • EndocrinologyOct 20 10

Women who took hormone replacement pills had more advanced breast cancers and were more likely to die from them than women who took a dummy pill, raising new concerns about the commonly prescribed drugs, U.S. researchers said on Tuesday.

The study, published in the Journal of the American Medical Association, is the first to report more breast cancer deaths among women taking hormone replacement therapy.

And it contradicts prior studies that suggest women taking the drugs had less aggressive, easier-to-treat breast cancers.

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Body Mass Index gain throughout adulthood may increase risk of postmenopausal breast cancer

Cancer • • Breast Cancer • • Gender: Female • • MenopauseApr 21 10

Reported mid-life increase in body mass index (BMI) may lead to substantially higher risk of postmenopausal breast cancer, according to results of a prospective cohort study presented at the American Association for Cancer Research 101st Annual Meeting 2010, held here April 17-21.

In previous studies, excess weight has been linked with increased risk of postmenopausal breast cancer. Scientists have speculated that in postmenopausal women, estrogen produced in adipose tissue, or body fat, may promote breast cell proliferation. Relatively few studies have looked specifically at increase in BMI and its timing in relation to postmenopausal breast cancer risk, which this study investigated.

The researchers analyzed information from 72,007 women in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial cohort, who were 55 to 74 years old at study entry. The analysis included 3,677 cases of postmenopausal breast cancer, which makes this one of the larger studies of its kind, according to the researchers.

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Obesity to blame for breast cancer

Cancer • • Breast Cancer • • ObesityMar 31 10

Obesity has been associated with some serious diseases in the past but a new study has now found that obese women face a significantly higher risk of developing breast cancer.

Carol La Vecchia who ran the study is a qualified health expert at the University of Milan. She subscribes to the opinion that 30% of women suffering with breast cancer are also obese. These conclusions were given at a conference in Barcelona.

Although it is difficult to say exactly why obese women run more of a risk, one theory put forward is that obesity can affect the chemicals in the body, raising the odds of developing oestrogen-related tumours. Whilst the details are somewhat unclear, the main details are – obese women are more likely to develop breast cancer.

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Thirty percent breast cancer caused by obesity

Cancer • • Breast Cancer • • ObesityMar 29 10

Up to a third of breast cancer cases could be avoided if women ate less and exercised more, researchers claim.

Experts believe more than 14,000 women a year would probably not develop the disease if they had adopted healthier behaviour from an early age.

Modern lifestyles which feature regular drinking, lack of exercise and increased obesity are fuelling the rise of the disease, reported dailymail.co.uk.

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New way discovered to predict which breast cancer patients should be treated with anthracyclines

Cancer • • Breast CancerMar 25 10

Barcelona, Spain: An international team of researchers has discovered a new way of detecting which breast cancer patients are going to respond best to chemotherapy that includes anthracycline antibiotics*.

The research, presented at the seventh European Breast Cancer Conference (EBCC7) in Barcelona today (Thursday), is important because, until now, there was conflicting evidence about the best way of predicting response to anthracyclines and it was unclear whether any of the known biomarkers, such as the genes HER2 and TOP2A, were accurate indicators of response to these drugs.

By conducting a meta-analysis of four large breast cancer trials including nearly 3,000 patients, the researchers have discovered that an abnormality on chromosome 17, called CEP17, is associated with a worse outcome for patients, but also that its presence is a highly significant indicator that the tumour will respond to anthracyclines.

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Doctors must collaborate so that patients get full benefit of tamoxifen treatment

Cancer • • Breast CancerMar 24 10

Barcelona, Spain: Recently published research has shown that some breast cancer patients taking tamoxifen may not be getting the full benefit of their treatment because they have also been taking selective serotonin reuptake inhibitors (SSRIs), prescribed drugs that inhibit the effect of an important enzyme. Now researchers have developed a strategy for overcoming this problem, the seventh European Breast Cancer Conference (EBCC7) in Barcelona will hear today (Wednesday). Mr. Sean Hopkins, a clinical pharmacy specialist in breast cancer at the Ottawa Hospital Regional Cancer Centre, Ottawa, Canada, will present his research which shows that changing drug therapy at an early stage can help patients get the full benefit of tamoxifen and aid the effectiveness of their treatment.

Tamoxifen is used both to prevent development of oestrogen-receptor-positive cancer and as a therapy to stop it coming back. Taking medications such as fluoxetine (Prozac) and paroxetine for depression (and in some patients hot flashes), and bupropion (Zyban) for smoking cessation, can inhibit the action of CYP2D6, an enzyme that is related to drug metabolism and response to treatment, and which is crucial to the metabolism of tamoxifen for breast cancer.

Mr. Hopkins and his team set out to investigate how many patients taking hormonal therapy for breast cancer were also being prescribed CYP2D6 inhibitors. Research has shown that up to 25% of breast cancer patients have depressive disorders, and many of them are prescribed SSRIs. Additionally, many patients with cancer try to give up smoking and may use non-nicotine replacement therapies, such as buproprion.

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Rare ATM gene mutations, plus radiation, may increase risk of a second breast cancer

Cancer • • Breast CancerMar 19 10

Certain rare mutations in the ataxia telangiectasia mutated (ATM) gene, combined with radiation exposure, may increase a woman’s risk of developing a second cancer in the opposite breast, according to a study published online March 19 in the Journal of the National Cancer Institute.

Breast cancer survivors are at increased risk of developing a second cancer in the other, or contralateral breast, compared to women who have not had breast cancer. The ATM gene is known to play a role in cells’ response to DNA damage caused by ionizing radiation, another breast cancer risk factor. But it has been unclear whether women who carry ATM mutations are especially susceptible to radiation-induced breast cancer.

To address this issue, Jonine Bernstein, M.D., of the Memorial Sloan-Kettering Cancer Center in New York, and colleagues, compared ATM mutations among women who had developed a second cancer in the contralateral breast to mutations in those who had a cancer in only one breast. The women were participants in the Women’s Environment, Cancer, and Radiation Epidemiology (WECARE) Study, an international case–control study. There were 708 case subjects—women with contralateral cancer—and 1,397 control subjects who did not have a second cancer but were similar to the case subjects in other respects, such as age and race.

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Cell-Enriched Fat Grafts Improve Long-Term Graft Retention in Breast Reconstructive Surgery

Cancer • • Breast Cancer • • SurgeryFeb 20 10

In a study published in the journal Annals of Plastic Surgery, researchers examine the science behind cell-enriched autologous fat grafting and its application to cosmetic and reconstructive surgery. The results demonstrate a doubling in graft retention in cell-enriched grafts and provide insight into the mechanisms behind this improvement. The results reinforce both commercial observations and interim data from the RESTORE 2 clinical study that was presented at the San Antonio Breast Cancer Symposium in December 2009.

The preclinical results described in the paper support the potential clinical utility for cell-enriched fat grafts in cosmetic and reconstructive surgery. The key results include:

Long term retention of cell-enriched autologous fat grafts was increased two-fold over controls.

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Exercise can lower breast cancer risk

Cancer • • Breast CancerFeb 18 10

Consistent observational epidemiologic evidence suggests that physical activity is associated with re- duced postmenopausal breast cancer risk. High endogenous estrogen and androgen levels are fairly consistently associated with an increase in breast cancer risk, whereas increased sex hormone– binding globulin (SHBG) levels are associated with a decrease in risk. This trial found that previously sedentary postmenopausal women can adhere to a moderate- to vigorous-intensity exercise program that results in changes in estradiol and SHBG concentrations that are consistent with a lower risk for postmenopausal breast cancer.

This study, the Alberta Physical Activity and Breast Cancer Prevention Trial, was a randomized controlled trial of exercise was conducted in 320 postmenopausal, sedentary women age 50 to 74 years. Participants were randomly assigned to a 1-year aerobic exercise intervention of 225 min/wk or to a control group who maintained their usual level of activity.

Baseline, 6-month, and 12-month assessments of hormone levels, namely estrone, estradiol, androstenedione, and testosterone were quantified. Women in the intervention group exercised an average of 3.6 d/wk for 178 min/wk.

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