Breast Health

Chemotherapy no longer required in 70 percent of breast cancer cases

New study says no chemotherapy needed to treat common breast cancer

A 21-gene test performed on tumors could enable most patients with the most common type of early breast cancer to safely forgo chemotherapy, according to a landmark study published in the New England Journal of Medicine.

Loyola Medicine oncologist Kathy Albain, MD, is among the main co-authors of the study and a member of the clinical trial's steering committee. First author is Joseph Sparano, MD, of Montefiore Medical Center in Bronx, N.Y. The study was published in conjunction with its Sunday, June 3 presentation at the plenary session of the American Society of Clinical Oncology 2018 meeting in Chicago.

"With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70 percent of patients who are diagnosed with the most common form of breast cancer," Dr. Albain said. "For countless women and their doctors, the days of uncertainty are over."

Dr. Albain, the Huizenga Family Endowed Chair in Oncology Research at Loyola University Chicago Stritch School of Medicine, has conducted research with the 21-gene test and also used it in her practice for years.

The test examines 21 genes from a patient's breast cancer biopsy sample to determine how active they are. The tumor is assigned a "recurrence score" from 0 to 100; the higher the score, the greater the chance the cancer will recur in distant organs and decrease survival. If patients with higher scores receive chemotherapy, this risk of recurrence will be significantly reduced, enabling more patients to be cured.

Previously, the challenge doctors and patients have faced is what to do if a patient has a mid-range score. It was uncertain whether the benefit of chemotherapy was great enough to justify the added risks and toxicity. Previous studies demonstrated that patients with low scores (10 or lower) did not need chemotherapy, while women with high scores (above 25) did require and benefit from chemotherapy.The new study examined the majority of women who fall in the intermediate range of 11 to 25.

The study enrolled 10,273 women who had the most common type of breast cancer (hormone-receptor positive, HER-2 negative) that had not spread to lymph nodes. Researchers examined outcomes of the 69 percent of patients who had intermediate scores on the 21-gene test.

Patients were randomly assigned to receive chemotherapy followed by hormonal therapy or hormone therapy alone. Researchers examined the chemotherapy and non-chemotherapy groups for several outcomes, including being cancer free, having cancer recur locally or to distant sites in the body and overall survival.

For the entire study population with gene test scores between 11 and 25 — and especially among women aged 50 to 75 — there was no significant difference between the chemotherapy and no chemotherapy groups. Among women younger than 50, outcomes were similar when gene test scores were 15 or lower. Among younger women with scores 16 to 25, outcomes were slightly better in the chemotherapy group.

"The study should have a huge impact on doctors and patients," Dr. Albain said. "Its findings will greatly expand the number of patients who can forgo chemotherapy without compromising their outcomes. We are de-escalating toxic therapy."


Story Source: See this article on Science Daily: "More breast cancer patients can safely forgo chemotherapy: Study." ScienceDaily. ScienceDaily, 3 June 2018. www.sciencedaily.com/releases/2018/06/180603193614.htm. Materials provided by Loyola University Health System. Study published in the New England Journal of Medicine.

Risk of heart disease goes up with breast cancer treatment

Some breast cancer therapies can damage the heart and healthcare providers should carefully monitor breast cancer treatment effects on the heart. Breast cancer survivors, especially older women, are more likely to die from cardiovascular diseases such as heart failure rather than breast cancer.Some breast cancer therapies can damage the heart and healthcare providers should carefully monitor breast cancer treatment effects on the heart. Breast cancer survivors, especially older women, are more likely to die from cardiovascular diseases such as heart failure rather than breast cancer.

Breast cancer patients may be at an increased risk of cardiovascular diseases including heart failure and may benefit from a treatment approach that weighs the benefits of specific therapies against potential damage to the heart, according to a new scientific statement from the American Heart Association published in its journal Circulation.

The statement is an overview of what we currently know about risk factors common to both heart disease and breast cancer, the potential heart damage from some breast cancer treatments, and suggested strategies to prevent or minimize the damage. Breast cancer survivors, especially older women over the age of 65, are more likely to die from cardiovascular disease than breast cancer, underscoring the importance of effectively managing heart disease risk factors during and following cancer treatment.

“Any patient who is going to undergo breast cancer treatment, whether they have heart disease at the beginning or not, should be aware of the potential effects of the treatments on their heart,” said Laxmi Mehta, M.D., chair of the writing group for the new scientific statement. “This should not deter or scare patients from undergoing breast cancer treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”

During cancer treatments, patients should pay attention not only to their breast health, but also to their general health, including their heart, said Dr. Mehta, who is director of the Women’s Cardiovascular Health Program and an associate professor of medicine at The Ohio State University in Columbus, Ohio.

For example, some cancer treatments, such as HER-2 targeted therapies, can cause weakening of the heart muscle, a condition known as heart failure. HER-2 is a specific type of breast cancer. In some cases, the reduction in heart function is temporary and cessation of the treatment and/or the addition of heart medicines can improve function. But in some breast cancer patients, heart failure can be permanent. Because of this, the early development of heart failure can signal a need to slow down and/or alter a patient’s breast cancer treatment because of the risk for worsening the condition or the development of permanent heart failure.

Some small studies suggest that administering common chemotherapy agents in new ways may reduce heart disease risks. Doxorubicin is a chemotherapy drug used in breast cancer therapy that can lead to the damage of heart cells. Studies have shown that when doxorubicin is administered slowly, rather than all at once, patients may have a lower risk of heart failure.

In addition, a drug called dexrazoxane that could reduce cell damage has recently been approved for patients with metastatic breast cancer who receive high doses of doxorubicin. More studies will need to be done to confirm whether the results of the smaller studies are seen in larger groups of patients.

Other treatments, such as radiation, can affect the heart arteries and cause the development of coronary artery disease or blockages. Some breast cancer treatment agents, such as anthracyclines, can result in abnormal heart rhythms that in some patients are benign but in others can lead to life-threatening heart rhythms. And, some treatments — like antimetabolites — can cause spasm of the heart arteries, which can cause chest pain symptoms but could lead to heart attacks as well.

Heart disease and breast cancer share a number of risk factors, including advanced age, poor diet, family history, physical inactivity and tobacco use. The fact that these diseases share some risk factors suggests that there are lifestyle choices, primarily diet and exercise, that could help decrease the risks of developing both diseases. Healthcare providers should monitor a woman’s heart health before, during and after breast cancer treatment.

Adherence to a number of ideal heart health behaviors or factors from the American Heart Association’s’ Life’s Simple 7 is associated with a trend towards a lower incidence of breast cancer. Life’s Simple 7 includes being physically active, achieving and maintaining a healthy body weight, eating a healthy diet, avoiding tobacco, maintaining healthy levels of blood pressure, cholesterol and blood sugar.

“Fortunately, with the advances in breast cancer treatment, there has been a growing number of survivors. However, during and after the treatment of breast cancer, having optimal control of heart disease risk factors is important, because older breast cancer survivors are more likely to die of heart disease than breast cancer,” Dr. Mehta said. “And that’s why Life’s Simple 7 is important for all patients with and without breast cancer.”

Although there are an estimated 47.8 million women in the U.S. who are living with cardiovascular diseases and approximately 3 million breast cancer survivors, many people regard breast cancer as the primary threat to women’s health. It is important to recognize the overlap of heart disease and breast cancer as both entities impact survival.

Story Source: Read this article on Science Daily: American Heart Association. “Breast cancer treatments may increase the risk of heart disease: American Heart Association scientific statement.” ScienceDaily. ScienceDaily, 1 February 2018. www.sciencedaily.com/releases/2018/02/180201085812.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

New Study Asks: Do women prefer annual mammograms?

Women prefer to get their mammograms every year, instead of every two years, according to a new study.

Women prefer to get their mammograms every year, instead of every two years, according to a new study.

“Women understand that yearly mammograms have been shown to save lives and do not consider previously reported ‘harms’ to be as important as getting screened,” said study author Ghizlane Bouzghar, M.D., chief radiology resident at Einstein Medical Center in Philadelphia.

For years, the standard recommendation among most medical groups was that women at average risk of breast cancer undergo screening mammography annually beginning at age 40. However, in 2009, the U.S. Preventive Services Task Force (USPSTF) issued a controversial recommendation that women at average risk be screened biennially, or every two years, beginning at age 50. This recommendation, reaffirmed in 2016, was based in part on the “harms” associated with screening mammography.

These “harms,” as defined by the USPSTF, include diagnosis and treatment of noninvasive and invasive breast cancers that would otherwise not have become a threat to a woman’s health and the unnecessary biopsies and associated anxieties resulting from false-positive results.

Others argue that while reducing over-diagnosis and false positives are a priority, the benefits of early detection far outweigh the negative factors associated with the perceived harms. Absent from the debate has been one notable opinion: that of the women being screened.

“The USPSTF associates annual screening mammography with ‘harm’ and recommends biennial screening mammography instead,” Dr. Bouzghar said. “However, there is no study to date that looked at women’s preference regarding annual versus biennial screening mammography, and whether women think that biennial screening causes less, equal or more anxiety.”

Dr. Bouzghar and colleagues at Einstein set out to determine whether women preferred annual or biennial screening and to investigate whether or not reported harms of mammography influenced this preference.

The research team surveyed 731 women (mean age 59) undergoing screening and diagnostic mammograms at Einstein from December 2016 to February 2017. Women were asked whether an abnormal mammogram or breast biopsy causes emotional harm, whether screening every two years was associated with less or more anxiety, and whether they preferred to have a screening mammogram every other year or every year.

Variables such as the patient’s age, race, family and personal history of breast cancer, prior biopsies and abnormal mammograms, and underlying anxiety disorder were also included.

Of the women surveyed, 71 percent preferred getting screened every year. A family history of breast cancer and prior breast biopsy were the only two variables to have an additional positive influence on annual screening preference.

“Many women are much better educated about the value of screening mammography than they are given credit for,” Dr. Bouzghar said. “I also think that some of the USPSTF’s concerns about the ‘harms’ were somewhat paternalistic, and in 2017 women are more empowered about many things, including their healthcare.”

Co-authors on the study are Debra S. Copit, M.D., and Justin R. Overcash, M.D.


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Materials provided by Radiological Society of North America. Note: Content may be edited for style and length.


Read this article on Science Daily: Radiological Society of North America. “Women prefer getting mammograms every year.” ScienceDaily. ScienceDaily, 22 November 2017. www.sciencedaily.com/releases/2017/11/171122151037.htm.

How to make healthy lifestyle choices for better breast health

Breast cancer prevention strategies from Shazah Khawaja, MD, of NCMA Women’s OB/GYN Center of Santa Rosa

Shazah Khawaja, MD, FACOGDuring October’s National Breast Cancer Awareness campaign, NCMA Women’s OB/GYN Center wants to empower women with knowledge that leads to healthy choices. “We believe that when a woman understands the facts about breast cancer she becomes empowered to take the necessary steps towards prevention. By working to detect the disease in its early stages, a woman is able to make lifestyle changes to reduce the odds of developing the disease in the first place,” explains obstetrician & gynecologist Dr. Shazah Khawaja, MD.

Despite decades of pursing an all-out cure and national efforts aimed at education and prevention, breast cancer remains the most common cancer among women in the United States, second only to skin cancer. Today millions of women are surviving the disease, thanks in part to early detection, improvements in treatment and by enacting healthy lifestyle choices.

The first step in staying healthy

Experts agree that the key to not only surviving a breast cancer diagnosis, but to thriving for years afterwards is early detection followed by early treatment. Routine breast exams and general awareness of how to maintain breast health are both important elements in staying healthy. Practitioners at NCMA Women’s OB/GYN Center encourage routine screening including regular self-breast exams, breast checks during annual gynecologic exams, and screening mammography – all approaches that help to detect breast problems early-on.  “I routinely tell my patients that when we have the opportunity to catch and treat breast problems early, we have a better shot of ensuring the treatment will be successful,” says Dr. Khawaja.

Understanding breast cancer risks for better outcomes

Although a having a higher risk for developing the disease may be frightening, it is also true that women who have one or more risk factors for developing breast cancer, never actually develop the disease. With increased awareness about the risk associated with certain factors — particularly those that revolve around lifestyle choices that can be changed — women of all risk levels can become empowered to make better choices.

Some risk factors such as age, genetics or race obviously cannot be changed. Other factors including environment, can also be difficult to modify. While some factors influence risk more than others, a person’s risk for developing breast cancer can change naturally due to aging and by making certain changes in habits and daily practices.

According to the American Cancer Society there are several factors that can affect a woman’s breast cancer risks. They include:

  • Having children after age 30
    Shown to increase the risk of breast cancer in some cases.
  • Birth control
    Oral and injectable contraceptives stand out in studies as contributors to breast cancer.
  • Alcohol consumption
    The more consumed, the higher the risk.
  • Weight
    Women who carry extra pounds have a higher risk for developing breast cancer, primarily due to the higher insulin levels that accompany obesity.
  • Smoking
    Evidence suggests a link between smoking and breast cancer risk, particularly in premenopausal women.

Known factors that lower risk

Researchers continue to pursue the link between diet and breast cancer risk and many studies actually indicate that diet does play a role. More and more studies cast a wary eye towards red meat consumption, and there is an increased risk associated with high-fat diets, which perpetuates weight gain and obesity (a known breast cancer risk factor).

There may be sure way to prevent breast cancer as of yet, but there are things women can do to help lower the risk. A short list of actions includes:

  • Breast feeding
    For women who breast feed for 1.5 to 2 years, studies suggest that there may be some benefit in reducing breast cancer risk.
  • Physical activity
    A growing body of evidence indicates that a person’s risk of developing almost any cancer, particularly breast cancer, is reduced by adopting a daily routine of physical activity. For example, as little as 1.25 hours of moderate physical activity per week may reduce the risk by up to 18 percent according to some studies.
  • Limit dose and duration of hormone therapy
    Combination hormone therapy for more than five years is known to increase the risk of breast cancer. If you and your healthcare provider decide that the benefits of short-term hormone therapy outweigh the risks, use the lowest dose possible.

How OB/GYN providers can help

Self-check breast exams are easy to perform in the home and should be conducted monthly in addition to annual breast exams with a physician at NCMA Women’s OB/GYN Center. Depending on a patient’s age and individual health, we may recommend a more frequent interval of regular check-ups with a health care provider. And of course, if you suspect a breast health problem contact a provider immediately.

About NCMA Women’s OB/GYN Center

The NCMA Women’s OB/GYN Center was conceptualized to bring comprehensive obstetrical and gynecological care to Sonoma County. Experience the NCMA Women’s OB/GYN Center up close and personal. As women, we play many roles in our life and take care of so many individuals. Allow our esteemed team to take care of your needs. It is our goal to empower women in their journey to achieve safe, excellent obstetric and gynecologic healthcare. NCMA Women’s OB/GYN Center strives to better the lives of all women with a holistic approach to women’s health. To learn more visit our website or call for an appointment at 707-579-1102.

Annual mammograms at 40 prevents the most cancer deaths

 
When to initiate screening for breast cancer, how often to screen, and how long to screen are questions that continue to spark emotional debates.

 

When to initiate screening for breast cancer, how often to screen, and how long to screen are questions that continue to spark emotional debates.When to initiate screening for breast cancer, how often to screen, and how long to screen are questions that continue to spark emotional debates. A new study compares the number of deaths that might be prevented as a result of three of the most widely discussed recommendations for screening mammography. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings may provide valuable guidance to women and their physicians about choosing a screening regimen.

To uncover insights that might help women make informed choices about mammography screening, researchers led by Elizabeth Kagan Arleo, MD, of Weill Cornell Medicine and New York-Presbyterian, and R. Edward Hendrick, PhD, of the University of Colorado School of Medicine, used computer modeling to estimate the possible effects of three schemes: annual screening starting at age 40 years, annual screening at ages 45 to 54 years and then biennial screening at ages 55 to 79 years, and biennial screening at ages 50 to 74 years.

The investigators estimated how many breast cancer deaths might be prevented with the different screening schemes. The team found that the recommendation of annual screening starting at age 40 would result in the greatest reduction in breast cancer-specific deaths: a nearly 40 percent reduction in deaths due to breast cancer, compared with 23 percent to 31 percent reductions with other recommendations.

“Our findings are important and novel because this is the first time the three most widely discussed recommendations for screening mammography have been compared head to head,” said Dr. Arleo. “Our research would be put to good use if, because of our findings, women chose to start annual screening mammography starting at age 40. Over the long term, this would be significant because fewer women would die from breast cancer.”

The researchers’ modeling also considered risks associated with screening, including callbacks for additional imaging and, in some cases, a needle biopsy, both of which may reveal the absence of breast cancer despite a suspicious mammography finding.

“Our results show the differences in the three current recommendations for screening mammography in terms of benefits and risks. Women and their physicians can use these findings to guide choices of when a woman begins screening mammography and how often she gets screened,” said Dr. Hendrick.

An estimated 252,710 new cases of invasive breast cancer and 63,410 new cases of non-invasive breast cancer are expected to be diagnosed in women in the United States in 2017, with 40,610 US women expected to die from breast cancer in 2017. About 33 million screening mammography exams are performed each year.

In an accompanying editorial, Otis Brawley, MD, of the American Cancer Society, noted that it is ultimately an individual’s value judgment as to how many false positive mammograms and biopsies are too many to save one life. He stressed that it is important to acknowledge the limitations of mammography and to make it a priority to develop a better test. “The ideal test would be easy to administer and accurate in women of all ages, meaning there would be few false positives and few tumors would be missed,” he wrote.


Story Source:

Materials provided by Wiley. Note: Content may be edited for style and length.


Journal Reference:

  1. Elizabeth Kagan Arleo, R. Edward Hendrick, Mark A. Helvie, Edward A. Sickles. Comparison of recommendations for screening mammography using CISNET models. Cancer, 2017; DOI: 10.1002/cncr.30842

View this article on ScienceDaily.com; “Comparison of screening recommendations indicates annual mammography: Starting at age 40 prevents the most cancer deaths.” ScienceDaily. ScienceDaily, 21 August 2017.

 

Breast Cancer Study Results: Put that glass of wine down and get jogging!

Breast Cancer Study indicates that drinking just one glass of wine or other alcoholic drink a day increases breast cancer riskBreast Cancer Study Revelations

Drinking just one glass of wine or other alcoholic drink a day increases breast cancer risk, finds a major new report by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF).The report also revealed, for the first time, that vigorous exercise such as running or fast bicycling decreases the risk of both pre- and post-menopausal breast cancers. Strong evidence confirmed an earlier finding that moderate exercise decreases the risk of post-menopausal breast cancer, the most common type of breast cancer.

“It can be confusing with single studies when the findings get swept back and forth,” said Anne McTiernan, MD, PhD, a lead author of the report and cancer prevention expert at the Fred Hutchinson Cancer Research Center.

“With this comprehensive and up-to-date report the evidence is clear: Having a physically active lifestyle, maintaining a healthy weight throughout life and limiting alcohol — these are all steps women can take to lower their risk.”

Brisk Walking, Alcohol and Breastfeeding

Diet, Nutrition, Physical Activity and Breast Cancer systematically collated and evaluated the scientific research worldwide on how diet, weight and exercise affect breast cancer risk in the first such review since 2010. The report analyzed 119 studies, including data on 12 million women and 260,000 cases of breast cancer.

The breast cancer study and report found strong evidence that drinking the equivalent of a small glass of wine or beer a day (about 10 grams alcohol content) increases pre-menopausal breast cancer risk by 5 percent and post-menopausal breast cancer risk by 9 percent. A standard drink is 14 grams of alcohol.

For vigorous exercise, pre-menopausal women who were the most active had a 17 percent lower risk and post-menopausal women had a 10 percent lower risk of developing breast cancer compared to those who were the least active. Total moderate activity, such as walking and gardening, linked to a 13 percent lower risk when comparing the most versus least active women.

In addition the report showed that:

  • Being overweight or obese increases the risk of post-menopausal breast cancer, the most common type of breast cancer.
  • Mothers who breastfeed are at lower risk for breast cancer.
  • Greater adult weight gain increases risk of post-menopausal breast cancer.

Breast cancer is the most common cancer in US women with over 252,000 new cases estimated this year. AICR estimates that one in three breast cancer cases in the U.S. could be prevented if women did not drink alcohol, were physically active and stayed a healthy weight.

Emerging Findings: Dairy and Veggies

The breast cancer study report points to links between diet and breast cancer risk. There was some evidence — although limited — that non-starchy vegetables lowers risk for estrogen-receptor (ER) negative breast cancers, a less common but more challenging to treat type of tumor.

Limited evidence also links dairy, diets high in calcium and foods containing carotenoids to lowering risk of some breast cancers. Carrots, apricots, spinach and kale are all foods high in carotenoids, a group of phytonutrients studied for their health benefits.

These links are intriguing but more research is needed, says McTiernan. “The findings indicate that women may get some benefit from including more non-starchy vegetables with high variety, including foods that contain carotenoids,” she said. “That can also help avoid the common 1 to 2 pounds women are gaining every year, which is key for lowering cancer risk.”

Steps Women Can Take

Aside from these lifestyle risk factors, other established causes of breast cancer include being older, early menstrual period and having a family history of breast cancer.

While there are many factors that women cannot control, says Alice Bender, MS, RDN, AICR’s Head of Nutrition Programs, the good news from this report is that all women can take steps to lower their breast cancer risk.

“Wherever you are with physical activity, try to nudge it up a bit, either a little longer or a little harder. Make simple food shifts to boost protection — substitute veggies like carrots, bell peppers or green salad for chips and crackers and if you drink alcohol, stick to a single drink or less,” said Bender.

“There are no guarantees when it comes to cancer, but it’s empowering to know you can do something to lower your risk.”


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com


Read this article on Science Daily: https://www.sciencedaily.com/releases/2017/05/170523084758.htm

Story Source: Materials provided by Fred Hutchinson Cancer Research Center. Original written by Diane Mapes. Note: Content may be edited for style and length.

Breastfeeding after a C-section may help manage pain

Breastfeeding after a cesarean section (C-section) may help manage pain, with mothers who breastfed their babies for at least 2 months after the operation three times less likely to experience persistent pain compared to those who breastfed for less than 2 months, according to new research being presented at this year’s Euroanaesthesia Congress in Geneva (3-5 June).

C-sections account for around a quarter of all births in the UK, USA, and Canada. Chronic pain (lasting for more than 3 months) after C-section affects around 1 in 5 mothers. It is widely accepted that breast milk is the most important and appropriate nutrition in early life, and WHO, the UK Department of Health, and US Department of Health and Human Services all recommend exclusive breastfeeding up to 6 months of age. But until now, little has been known about the effect of breastfeeding on a mother’s experience of chronic pain after C-section.

The study, by Dr Carmen Alicia Vargas Berenjeno and colleagues from the Hospital Universitario Nuestra Señora de Valme in Sevilla, Spain, included 185 mothers who underwent a C-section at the hospital between January 2015 and December 2016. Mothers were interviewed about breastfeeding patterns and the level of chronic pain at the surgical site in the first 24 and 72 hours after C-section, and again 4 months later. The researchers also looked at the effect of other variables on chronic pain including surgical technique, pain in the first 24-72 hours, maternal education and occupation, and anxiety during breastfeeding.

Almost all (87%) of the mothers in the study breastfed their babies, with over half (58%) reporting breastfeeding for two months or longer. Findings showed that around 1 in 4 (23%) of the mothers who breastfed for two months or less still experienced chronic pain in the surgical site 4 months post-op compared to just 8% of those who breastfed for 2 months or longer. These differences were notable even after adjusting for the mother’s age. Further analysis showed that mothers with a university education were much less likely to experience persistent pain compared to those who were less well educated. The researchers also found that over half (54%) of mothers who breastfed reported suffering from anxiety.

The authors conclude: “These preliminary results suggest that breastfeeding for more than 2 months protects against chronic post-cesarean pain, with a three-fold increase in the risk of chronic pain if breastfeeding is only maintained for 2 months or less. Our study provides another good reason to encourage women to breastfeed. It’s possible that anxiety during breastfeeding could influence the likelihood of pain at the surgical site 4 months after the operation.”

The authors are currently analyzing additional data from women interviewed between November 2016 to January 2017, which, when combined with data from all the other women, shows that anxiety is associated with chronic post Cesarean pain in a statistically significant way.


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Read this article on Science Daily: (European Society of Anaesthesiology). “Breastfeeding may protect against chronic pain after Caesarean section.” ScienceDaily. ScienceDaily, 4 June 2017. www.sciencedaily.com/releases/2017/06/170604115807.htm

Low-dose aspirin may be powerful cancer fighting tool for women

The use of low-dose aspirin (81 mg) reduces the risk of breast cancer in women, a new study concludes. Researchers saw an overall 16 percent lower risk of breast cancer in women who reported using low-dose aspirin at least three times per week.

A City of Hope-led study found that the use of low-dose aspirin (81mg) reduces the risk of breast cancer in women who are part of the California’s Teacher’s Study. This study — which is the first to suggest that the reduction in risk occurs for low-dose aspirin — was proposed by City of Hope’s Leslie Bernstein, Ph.D., professor and director of the Division of Biomarkers of Early Detection and Prevention, and published online in the journal, Breast Cancer Research.

Bernstein and her colleagues saw an overall 16 percent lower risk of breast cancer in women who reported using low-dose aspirin at least three times per week. Such regular use of low-dose aspirin reduced the risk by 20 percent of estrogen or progesterone receptor positive, HER2 negative breast cancer, which is the most common breast cancer subtype.

“The study found an interesting protective association between low-dose aspirin and breast cancer,” said lead author Christina A. Clarke, Ph.D., M.P.H., from the Cancer Prevention Institute of California. “We did not by and large find associations with the other pain medications like ibuprofen and acetaminophen. We also did not find associations with regular aspirin since this type of medication is taken sporadically for headaches or other pain, and not daily for prevention of cardiovascular disease.”

This study differed from other studies that have looked at aspirin and cancer risk because it focused on the dose levels of the aspirin women had taken and tracked the frequency of the use of low-dose aspirin as opposed to regular aspirin. It was also able to look in detail at subtypes of breast cancer.

“We already knew that aspirin is a weak aromatase inhibitor and we treat women with breast cancer with stronger aromatase inhibitors since they reduce the amount of estrogen postmenopausal women have circulating in their blood,” said Bernstein. “We thought that if aspirin can inhibit aromatase, it ought to reduce the likelihood that breast cancer would develop and it could also be an effective way to improve breast cancer patients’ prognosis once they no longer take the more potent aromatase inhibitors.” Bernstein added, “Aspirin also reduces inflammation, which may be another mechanism by which aspirin taken regularly can lower risk of breast cancer developing or recurring.”

As part of the study, researchers analyzed data recorded in questionnaires submitted by 57,164 women in the California’s Teacher’s Study. In 2005, participants answered questions regarding family history of cancer and other conditions, use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS), menstrual and reproductive history, use of hormones, weight and height, living environment, diet, alcohol use and physical activity. In the ensuing years before 2013, 1,457 of these participants developed invasive breast cancer.

The team of researchers chose to focus on low-dose “baby” aspirin, because not only is it inexpensive and readily available as potential means of prevention, but because there are already a lot of people already taking it for prevention of other diseases such as heart disease and even colon cancer.

Now that we have some data separating low-dose from higher-dose aspirin, more detailed research can be undertaken to understand the full value of low-dose aspirin for breast cancer prevention,” said Clarke.”


Story Source:

Materials provided by City of Hope. Note: Content may be edited for style and length.


Journal Reference:

  1. Christina A. Clarke, Alison J. Canchola, Lisa M. Moy, Susan L. Neuhausen, Nadia T. Chung, James V. Lacey, Leslie Bernstein. Regular and low-dose aspirin, other non-steroidal anti-inflammatory medications and prospective risk of HER2-defined breast cancer: the California Teachers Study. Breast Cancer Research, 2017; 19 (1) DOI: 10.1186/s13058-017-0840-7

 

Read this article on science daily:  “Regular use of aspirin can lower risk of breast cancer for women: A new study identifies low-dose aspirin as a potential cancer prevention tool.” ScienceDaily. ScienceDaily, 1 May 2017. www.sciencedaily.com/releases/2017/05/170501131759.htm.

Study concludes: Grilled meat deadly for breast cancer survivors

Findings published in JNCI: Journal of the National Cancer Institute indicate that higher consumption of grilled, barbecued, and smoked meat may increase the mortality risk among breast cancer survivors. In the study, entitled “Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer,” Humberto Parada, Jr., MPH, and colleagues evaluated the link between grilled/barbecued and smoked meats and the survival time after breast cancer.

High-temperature cooked meat intake is a highly prevalent source of polycyclic aromatic hydrocarbons and other carcinogenic chemicals and has been associated with breast cancer incidence, but this study assessed whether intake is related to survival after breast cancer.

In a study population of 1508 Long Island women with breast cancer, subjects were interviewed and asked about their consumption of four types of grilled, barbecued, and smoked meat. The women were asked about their intake in each decade of life and were asked to specify the seasons in which the foods were most frequently consumed. At the five-year follow-up, participants responded to the same questions, which asked about the time period since the original questionnaire.

Findings include:

  • Among the 1508 case women, 597 deaths were identified, 237 (39.7%) of which were related to breast cancer, after a median duration of follow-up of 17.6 years.
  • Compared with low intake, high intake of grilled/barbecued and smoked meat prior to diagnosis was associated with a 23% increased hazard of all-cause mortality.
  • High vs low intake of smoked beef/lamb/pork intake was associated with a 17% increased hazard of all-cause and a 23% increased hazard of breast cancer-specific mortality.
  • Lifetime grilled/barbecued and smoked meat intake and prediagnosis annual intake of grilled/barbecued beef/lamb/pork and poultry/fish were not associated with mortality.
  • Compared with women with low prediagnosis and low postdiagnosis intake of grilled/barbecued and smoked meat, continued high intake was associated with a 31% increased hazard of all-cause mortality.
  • The increase in risk of death from any cause was similar in magnitude among women who reported high prediagnosis and low postdiagnosis intake of grilled/barbecued and smoked meat.

The study’s findings support the hypothesis that high consumption of grilled, barbecued, and smoked meat may increase mortality after breast cancer.


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Journal Reference:

  1. Humberto Parada, Susan E. Steck, Patrick T. Bradshaw, Lawrence S. Engel, Kathleen Conway, Susan L. Teitelbaum, Alfred I. Neugut, Regina M. Santella, Marilie D. Gammon. Grilled, Barbecued, and Smoked Meat Intake and Survival Following Breast Cancer. Journal of the National Cancer Institute, 2017; 109 (6): djw299 DOI: 10.1093/jnci/djw299

Read this article on ScienceDaily: https://www.sciencedaily.com/releases/2017/01/170105212820.htm

New study takes on age-based mammography cut-off guidelines

As of December 2015, 410 mammography facilities in 39 states across the United States have already registered to be part of the National Mammography Database (NMD).
Credit: Radiological Society of North America

 In the largest-ever study on screening mammography outcomes, researchers found that there is no clear cut-off age to stop breast cancer screening. The findings were presented in November at the annual meeting of the Radiological Society of North America (RSNA). This research adds support for guidelines that encourage screening decisions based on individual patients and their health status.

Mammography is the standard imaging exam for breast cancer screening. Guidelines on what age to stop breast cancer screening have been a source of controversy and confusion in recent years. In 2009, the United States Preventive Services Task Force (USPSTF) released new guidelines which stated there was not enough evidence to assess the balance of benefits and harms of screening mammography in women aged 75 years or older.

“All prior randomized, controlled trials excluded women older than 75, limiting available data to small observational studies,” said Cindy S. Lee, M.D., assistant professor in residence at the University of California, San Francisco. “There has been a lot of controversy, debate and conversation regarding the different breast cancer screening guidelines, even among major national organizations, over the past few years.”

Using data from the National Mammography Database, Dr. Lee and her research team analyzed data from over 5.6 million screening mammograms performed over a 7-year period between January 2008 and December 2014 in 150 facilities across 31 states in the U.S. The research team looked at patient demographics, screening mammography results and biopsy results. Data from over 2.5 million women over age 40 were sorted into patient groups by age in 5-year intervals (40-44, 45-49, etc.).

Four standard performance metrics were calculated to evaluate the performance of screening mammography for each age group: cancer detection rate, recall rate, positive predictive value for biopsy recommended (PPV2) and biopsy performed (PPV3). Recall rate is the percentage of patients called back for follow-up testing after a screening exam. Positive predictive value reflects the percentage of cancers found among exams for which biopsy was recommended or performed. Ideal screening performances would have a higher cancer detection rate, PPV2 and PPV3, and a low recall rate.

Overall, researchers found mean cancer detection rate of 3.74 per 1,000 patients, recall rate of 10 percent, PPV2 of 20 percent and PPV3 of 29 percent. Based on increasing age from 40 to 90 years old, these performance metrics demonstrated a gradual upward trend for cancer detection rate, PPV2 and PPV3, but a downward trend in recall rate.

“The continuing increase of cancer detection rate and positive predictive values in women between the ages of 75 and 90 does not provide evidence for age-based mammography cessation,” Dr. Lee said.

The findings lend support to the argument that the decision whether or not to stop screening should be informed by an individual’s personal health history and preferences.

“We know that the risk of breast cancer increases with age,” Dr. Lee said. “With the uncertainty and controversy about what age to stop breast cancer screening, we want to address this gap in knowledge using a large national database.”


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Materials provided by Radiological Society of North America. Note: Content may be edited for style and length.

Read this article on Science Daily: www.sciencedaily.com/releases/2016/11/161128132213.htm