Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Genetic Research / 19.08.2019

MedicalResearch.com Interview with: Tengteng Wang, PhD, MSPH, MBBS Postdoctoral Research Fellow Department of Epidemiology Harvard T.H. Chan School of Public Health Channing Division of Network Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Chronic inflammation is a key player in the development of multiple cancer types, including breast cancer. Aspirin is one of the major non-steroidal anti-inflammatory drugs (NSAIDs) which clearly has anti-inflammatory properties. Given this, substantial evidence from laboratory and population studies suggests that taking aspirin may reduce the risk of developing breast cancer. However, the association of aspirin use with death outcomes following breast cancer diagnosis remains inconclusive and inconsistent across studies. Therefore, we choose to focus on mortality outcomes in this paper and we hypothesized that the inconsistent results for aspirin in relation to mortality could be due to differences in the association by patients’ biological profiles, specifically DNA methylation profiles here. 
Author Interviews, Breast Cancer, JAMA, UCLA / 12.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50709" align="alignleft" width="200"]Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA Dr. Elmore[/caption] Joann G. Elmore, MD, MPH Professor of Medicine, Director of the UCLA National Clinician Scholars Program David Geffen School of Medicine at UCLA  MedicalResearch.com: What is the background for this study? What are the main findings?
  • A pathologist makes the diagnosis of breast cancer versus non-cancer after reviewing the biopsy specimen. Breast biopsies are performed on millions of women each year and It is critical to get a correct diagnosis so that we can guide patients to the most effective treatments.
  • Our prior work (Elmore et al. 2015 JAMA) found significant levels of disagreement among pathologists when they interpreted the same breast biopsy specimen. We also found that pathologists would disagree with their own interpretations of breast biopsies when they where shown the same biopsy specimen a year later.
  • In this study, 240 breast biopsy images were fed into a computer, training it to recognize patterns associated with several types of breast lesions, ranging from benign (noncancerous) to invasive breast cancer. We compared the computer readings to independent diagnoses made by 87 practicing U.S. pathologists and found that while our artificial intelligence program came close to performing as well as human doctors in differentiating cancer from non-cancer, the AI program outperformed doctors when differentiating ductal carcinoma in situ (DCIS) from atypia, which is considered the greatest diagnostic challenge.
Author Interviews, Breast Cancer, Cancer Research, NIH / 08.08.2019

MedicalResearch.com Interview with: [caption id="attachment_50622" align="alignleft" width="126"]Co-First author: Jamie J. Lo, MPH PhD student, Saw Swee Hock School of Public Health National University of Singapore, Singapore Jamie Lo[/caption] Co-First author: Jamie J. Lo, MPH PhD student, Saw Swee Hock School of Public Health National University of Singapore, Singapore [caption id="attachment_50623" align="alignleft" width="100"]Co-First author & Co-Senior author: Yong-Moon (“Mark”) Park, MD, PhD Dr. Park[/caption] Co-First author & Co-Senior author: Yong-Moon (“Mark”) Park, MD, PhD Postdoctoral fellow, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health [caption id="attachment_50624" align="alignleft" width="100"]Co-First author & Co-Senior author: Yong-Moon (“Mark”) Park, MD, PhD Dr. Sandler[/caption] Senior author: Dale P. Sandler, PhD Chief, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health  MedicalResearch.com: What is the background for this study? Response: We were interested, generally, in the association between meat consumption and breast cancer risk. Epidemiological studies of red meat consumption and risk of breast cancer are still inconsistent, although red meat has been identified as a probable carcinogen. In addition, there is not much evidence on the association between poultry consumption and breast cancer risk. We studied around 42,000 women ages 35-74 from across the US who are enrolled in the Sister Study cohort. Women provided self-reported information on meat consumption at baseline and were followed for 7.6 years on average.
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, Novartis / 03.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49521" align="alignleft" width="170"]Fabrice André, MD, PhD Research director and head of INSERM Unit U981 Professor in the Department of Medical Oncology Institut Gustave Roussy in Villejuif, France Global SOLAR-1 Principal Investigator. Dr. Fabrice André[/caption] Fabrice André, MD, PhD Research director and head of INSERM Unit U981 Professor in the Department of Medical Oncology Institut Gustave Roussy in Villejuif, France Global SOLAR-1 Principal Investigator. MedicalResearch.com: What is the background for this study? How does Piqray®  differ from other treatments for this type of advanced breast cancer? 
  • The US Food and Drug Administration (FDA) approved Piqray® (alpelisib, formerly BYL719) in combination with fulvestrant for the treatment of postmenopausal women, and men, with hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-), PIK3CA-mutated, advanced or metastatic breast cancer, as detected by an FDA-approved test after disease progression following an endocrine-based regimen.
  • Piqray is the first and only combination treatment with fulvestrant specifically for postmenopausal women, and men, with HR+/HER2- advanced or metastatic breast cancer with a PIK3CA mutation following progression on or after an endocrine-based regimen, bringing a biomarker-driven therapy option to this population for the first time.
  • Advanced breast cancer is incurable, and patients with all types need more treatment options. With this approval, physicians can now use an FDA-approved test to determine if their patients’ HR+/HER2- advanced breast cancer has a PIK3CA mutation and may be eligible for treatment with Piqray plus fulvestrant combination therapy. 
ASCO, Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, Radiation Therapy / 03.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49509" align="alignleft" width="130"]Manjeet Chadha, MD, MHA, FACR, FASTRO Prof. Radiation Oncology Director of the Department of Radiation Oncology Mount Sinai Downtown  Prof. Chadha[/caption] Manjeet Chadha, MD, MHA, FACR, FASTRO Prof. Radiation Oncology Director of the Department of Radiation Oncology Mount Sinai Downtown  MedicalResearch.com: What is the background for this study? Response: Largely, the goal of cancer care among the elderly is to de-escalate therapy searching for a modality that is both an effective treatment and also associated with minimal toxicity. Approximately, 30% of new breast cancers diagnosed annually are among women older than 70 years of age. Age-adjusted trends note a relatively higher incidence of stage I breast cancer in women between the ages of 70-74 years. For this group of patients, it is imperative that we take a closer look at the evidence-base for our current practice standards, and evaluate opportunities to improve cancer care delivery in the elderly. Randomized trials have helped arrive at an acceptance of adjuvant endocrine monotherapy in older patients with ER positive, node negative breast cancer. However, in the older patients high rates of non-compliance to tamoxifen secondary to poor tolerance is widely recognized. Emerging data also detail the side effect profile of aromatase inhibitors. Most commonly observed symptoms of arthralgia, reduced bone mineral density, and increased risk of fractures throughout the duration of treatment are important considerations for an older population. At least a quarter of patients on aromatase inhibitors discontinue therapy specifically due to skeletal events and musculoskeletal symptoms. Overall, the side effects of ET contribute to a high rate of non-compliance and negative impact on patients’ quality of life.
AACR, Author Interviews, Breast Cancer, Cancer Research, Surgical Research / 08.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48432" align="alignleft" width="149"]Sharon S. Lum, MD, FACSProfessor in the Department of Surgery-Division of Surgical Oncology Medical Director of the Breast Health CenterLoma Linda University HealthLoma Linda University School of Medicine Dr. Lum[/caption] Sharon S. Lum, MD, FACS, Professor Department of Surgery-Division of Surgical Oncology Medical Director of the Breast Health Center Loma Linda University Health Loma Linda University School of Medicine  MedicalResearch.com: What is the background for this study?   Response: Anecdotally, we observed that many patients with advanced HER2+ breast cancer have had tremendous responses to the new targeted therapies and the oncologists were referring them back to surgeons for consideration of local regional therapy. While traditionally surgeons have avoided operating on metastatic breast cancer patients due to the patient’s likelihood of dying from their metastatic disease, these HER2+ patients seemed to be doing so well that surgery might make sense. In our surgical oncology clinic, we seemed to be operating more on these patients. Since these patients seemed to be living longer, they might survive long enough for their primary tumor to become a problem for them. However, we did not have any data to support doing surgery in these cases. Prior studies have demonstrated mixed results regarding the survival benefit from surgery for stage IV breast cancer patients, but these were completed prior to routine use of anti-HER targeted therapies, so we wanted to further examine the role of surgery in HER2+ stage IV breast cancer patients.
Author Interviews, Breast Cancer, Exercise - Fitness, Heart Disease, JAMA, UCLA / 29.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48187" align="alignleft" width="179"]Christina M. Dieli-Conwright, PhD, MPH, FACSM, CSCSAssistant Professor of ResearchDirector, Integrative Center for Oncology Research in ExerciseDivision of Biokinesiology & Physical Therapy, Ostrow School of DentistryDepartment of Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos Angeles, CA 90033 Dr. Dieli-Conwright[/caption] Christina M. Dieli-Conwright, PhD, MPH, FACSM, CSCS Assistant Professor of Research Director, Integrative Center for Oncology Research in Exercise Division of Biokinesiology & Physical Therapy, Ostrow School of Dentistry Department of Medicine, Keck School of Medicine University of Southern California Los Angeles, CA 90033  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This study was designed to assess the effects of an aerobic and resistance exercise on metabolic dysregulation in sedentary, obese breast cancer survivors, however we further examined the effects on cardiovascular disease risk measured by the Framingham Risk Score, reported here. Our findings indicated that exercise, indeed, reduces the risk of cardiovascular disease in this population. 
Author Interviews, Breast Cancer, Chemotherapy, NEJM / 27.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48191" align="alignleft" width="150"]Rita Mehta, MD, HS Clinical Professor,Chao Family Comprehensive Cancer CenterUniversity of California School of Medicine, Irvine  Dr. Mehta[/caption] Rita Mehta, MD, HS Clinical Professor, Chao Family Comprehensive Cancer Center University of California School of Medicine, Irvine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most patients with HR-positive breast cancer become resistant to hormonal therapies like aromatase inhibitor-anastrozole over time, and downregulating estrogen receptor was identified as a mechanism for overcoming or delaying resistance to hormonal therapy in advanced HR-positive breast cancer. The prospective, randomized phase III S0226 trial, first reported by us in NEJM 2012, showed that the selective estrogen receptor degrader fulvestrant in combination with anastrozole significantly improved progression-free survival in 707 women with HR-positive metastatic breast cancer in first-line setting. Treatment with the selective estrogen receptor degrader (SERD) fulvestrant achieved a clinically significant and meaningful improvement in overall survival in patients with hormone receptor (HR)-positive advanced breast cancer in first-line therapy, according to the final analysis of overall survival results from the S0226 study reported by us (Mehta et al. NEJM 2019)
  • Results showed that median overall survival improved by 7.8 months with anastrozole plus fulvestrant (median overall survival = 49.8 months) compared to anastrozole (median overall survival = 42.0 months).
  • The improvement was even greater in patients with endocrine naive disease, with an absolute improvement in median overall survival of 11.9 months.
  • No new safety signals were observed with longer follow-up. 
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Chemotherapy, NEJM / 24.02.2019

MedicalResearch.com Interview with: [caption id="attachment_47551" align="alignleft" width="135"]Aditya Bardia, MBBS, MPH Director, Precision Medicine, Center for Breast Cancer, Attending Physician, Massachusetts General Hospital Cancer Center Harvard Medical School, Boston, MA 02114 Dr. Bardia[/caption] Aditya Bardia, MBBS, MPH Director, Precision Medicine, Center for Breast Cancer, Attending Physician Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response: Metastatic triple negative breast cancer is associated with aggressive tumor biology, and tends to affect younger patients and African Amerians. The response rate with standard chemotherapy regimens in patients with pre-treated metastatic TNBC ranges from 10-15%, and median progression-free survival ranges from 3-4 months. The median survival of metastatic TNBC is around 12 months and has not changed in the past 20 years. Thus, treatment of metastatic triple negative breast cancer represents an unmet clinical need.  
Author Interviews, Breast Cancer, Cancer Research, JAMA, Leukemia / 21.01.2019

MedicalResearch.com Interview with: medicalresearch.comDr. Marie Joelle Jabagi, PharmD, MPH University of Paris Sud, Paris-Saclay University, Paris Health Product Epidemiology Department French National Agency for Medicines and Health Products Safety Saint-Denis, France MedicalResearch.com: What is the background for this study? Response: Secondary hematologic malignant neoplasms that develop months or years after the diagnosis of breast cancer may be a consequence of genetic predisposition, environmental factors, previous cancer treatments or a combination of all those factors. These secondary malignant neoplasms are increasingly becoming a concern given that the population of breast cancer survivors is growing substantially. However, their frequency in real life has been poorly investigated to date. The aims of our research were to estimate the frequency of various types of hematologic malignant neoplasm following a diagnosis of primary breast cancer among women aged 20 to 85 years in France during the past decade, and to compare it to the corresponding frequency in women of the French general population.
Author Interviews, Breast Cancer, NIH, OBGYNE / 27.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46711" align="alignleft" width="133"]Dale P. Sandler, Ph.D.  Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH Dr. Sandler[/caption] Dale P. Sandler, Ph.D. Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH MedicalResearch.com: What is the background for this study? Response: Not having children is a well-established risk factor for breast cancer, but most of this evidence comes from studies of postmenopausal women since breast cancer before menopause is relatively uncommon. There is growing evidence that some risk factors differ for premenopausal and postmenopausal breast cancer – for example obesity which increases risk for breast cancer after menopause but appears to be protective before menopause. There was some evidence that breast cancer risk increased shortly after pregnancy. It was thought that this risk lasted for 5 to ten years. Studies were unable to fully characterize the duration of this increase in risk or evaluate factors such as breast feeding, age at birth, or family history of breast cancer that could modify the relationship between recent pregnancy and breast cancer risk. Breast cancer before menopause or age 55 is relatively rare, and few individual studies are large enough to answer these questions. To answer these questions, we formed the Breast Cancer Collaborative Group, a pooling project involving 20 prospective cohort studies. We included 890,000 women from 15 of these long-term studies across three continents, including over 18,000 incident breast cancer cases. 
Author Interviews, Breast Cancer, JAMA, Weight Research / 06.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46432" align="alignleft" width="200"]Neil M. Iyengar, MD Breast Medicine Service Department of Medicine Memorial Sloan Kettering Cancer Center Evelyn H. Lauder Breast And Imaging Center New York, NY Dr. Neil Iyengar[/caption] Neil M. Iyengar, MD Breast Medicine Service Department of Medicine Memorial Sloan Kettering Cancer Center Evelyn H. Lauder Breast And Imaging Center New York, NY  MedicalResearch.com: What is the background for this study? Response: Obesity is one of the leading modifiable risk factors for the development of hormone receptor positive breast cancer in postmenopausal women. Traditionally, physicians use a person's body mass index (weight in kilograms divided by height in squared meters, kg/m2) to estimate body fat levels. A BMI of 30 or greater is considered to be obese, and this level of BMI increases the risk of at least 13 different cancers. However, BMI is a crude measure of body fat and can be inaccurate. For example, some normal weight individuals (BMI less than 25) have obesity-related problems like diabetes and high blood pressure. Before our study, it was unknown whether high body fat levels in normal weight women contributes to obesity-related cancers such as breast cancer.
Author Interviews, Breast Cancer, Mammograms / 03.12.2018

MedicalResearch.com Interview with: Stamatia Destounis MD, FACR, FSBI, FAIUM Elizabeth Wende Breast Care Clinical Professor University of Rochester Imaging Sciences Rochester, NY 14620  MedicalResearch.com: What is the background for this study? What are the main findings? Response:  The current breast cancer screening recommendations in the United States are unclear regarding when to stop screening. Several societies with published recommendations conflict in regard to when to discontinue screeningmammography. There is little evidence studying the benefit of annual mammography in the population of women 75 and older. Due to this, we felt that it was a very important and timely topic to investigate, with the goal of providing further guidance on why screening mammography may be beneficial in this older population.
Author Interviews, Breast Cancer, Nature / 10.11.2018

MedicalResearch.com Interview with: "Mammogram" by slgckgc is licensed under CC BY 2.0Prof. Cathrin Brisken MD, PhD ISREC, School of Life Sciences Ecole Polytechnique Fédérale (EPFL) CH-1015 Lausanne, Switzerland  MedicalResearch.com: What is the background for this study? Response: Estrogen receptor signaling has been well characterized in various in vitro models, like breast cancer cell lines.  Understanding estrogen receptor action in complex in vivo context is much more challenging. We obtained elegant mouse models in which either all estrogen receptor function or specifically either the hormone dependent (AF-2) or the hormone independent (AF-1) function were ablated. Using the mammary glands from these mice we performed tissue recombination studies to discern the role of the different aspects of estrogen receptor signaling in the mouse mammary epithelium and its different cell populations.
Author Interviews, Breast Cancer, Cancer Research, JNCI / 09.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45816" align="alignleft" width="132"]Angela Mariotto PhD Chief of the Data Analytics Branch  Surveillance Research Program (SRP) Division of Cancer Control and Population Sciences National Cancer Institute  Dr. Mariotto[/caption] Angela Mariotto PhD Chief of the Data Analytics Branch Surveillance Research Program (SRP) Division of Cancer Control and Population Sciences National Cancer Institute (NCI MedicalResearch.com: What is the background for this study? Response: Progressing to metastatic breast cancer (MBC) is one of the major concerns for women diagnosed with early-stage breast cancer. Before our study there were no reliable numbers on risk of metastatic breast cancer recurrence after a (non-metastatic) breast cancer diagnosis, as registries do not routinely collect this data.
Author Interviews, Breast Cancer, Genetic Research / 10.10.2018

MedicalResearch.com Interview with: "JFK Plaza/ Breast Cancer Awareness" by nakashi is licensed under CC BY 2.0Univ.- Prof. Dr. Wolfgang Schreiner Section Biosimulation and Bioinformatics Center for Medical Statistics, Informatics, and Intelligent Systems Medical University of Vienna General Hospital WIEN / AUSTRIA MedicalResearch.com: What is the background for this study? What are the main findings? Response: The choice of correct individualized therapy for breast cancer depends on correct diagnosis: receptors for estrogen, progesterone and HER2 are determined routinely. However 5-10% of these routine diagnostics are inaccurate and may entail suboptimal therapy. We have paved the way for additional diagnostics from gene expression data so as to increase precision of diagnostics.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Cancer Research, Red Meat / 05.10.2018

MedicalResearch.com Interview with: "bacon&eggs" by ilaria is licensed under CC BY 2.0 Maryam Farvid, Ph.D., Research Scientist   Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior prospective studies on red and processed meat consumption with risk of breast cancer have produced inconsistent results. Current meta-analysis of 15 prospective studies shows that women who eat a high amount of processed meat each day may have a higher risk of breast cancer than those who don't eat or have a low intake in their diet. 
Author Interviews, Breast Cancer, Race/Ethnic Diversity, Social Issues / 30.09.2018

MedicalResearch.com Interview with: [caption id="attachment_31912" align="alignleft" width="145"]Mammogram showing small lesion - Wikipedia Mammogram showing small lesion
- Wikipedia[/caption] Sage J. Kim, PhD Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study examined the rates at which women who received patient navigation in a randomized clinical trial reported barriers to obtaining a screening mammogram. The trial, called the Patient Navigation in Medically Underserved Areas (PNMUA) study, randomly assigned patients to one of two groups: one received a patient navigation support intervention and the other served as a control. Of the 3,754 women who received the patient navigation intervention, only 14 percent identified one or more barriers to care, which led to additional interactions with navigators who helped overcome barriers. Black women, women living in poverty, and women who reported high levels of distrust of the health care system were the least likely to report barriers. Women who reported barriers were more likely to have additional contact with navigators and obtain a subsequent screening mammogram. The extra support could help with early diagnosis and better survival and mortality outcomes.
Author Interviews, Breast Cancer, Surgical Research / 17.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44556" align="alignleft" width="166"]Dr. Emily Albright, MD Surgical Oncology Missouri University Health Care Dr. Albright[/caption] Dr. Emily Albright, MD Surgical Oncology Missouri University Health Care MedicalResearch.com: What is the background for this study? What are the main findings? Response: Traditional medicine had a paternalistic approach but more recent changes have transitioned into shared decision making and a patient centered approach. However, current research has not addressed the mode of communicating bad news to patients. This study was designed to look at trends in modes of communication of a breast cancer diagnosis. This study identified a trend for patients to receive a diagnosis of breast cancer over the telephone in more recent years. Also noted was that of those receiving the diagnosis in person 40% were alone.
Author Interviews, Breast Cancer, Cancer Research, JAMA, MD Anderson / 15.09.2018

MedicalResearch.com Interview with: [caption id="attachment_44522" align="alignleft" width="160"]Kelly K. Hunt, MD Department of Breast Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Dr. Hunt[/caption] Kelly K. Hunt, MD Department of Breast Surgical Oncology The University of Texas MD Anderson Cancer Center Houston MedicalResearch.com: What is the background for this study? What are the main findings? Response: We completed a neoadjuvant trial at MD Anderson Cancer Center and published the results in 2005 demonstrating that trastuzumab delivered in combination with anthracycline and taxane based chemotherapy resulted in pathologic complete response rates of up to 60% in patients with HER-2 positive breast cancer. This was a single institutions study and there was concern about cardiac toxicity when using anthracyclines and trastuzumab concurrently. We therefore worked with the NCI cooperative groups, the American College of surgeons oncology group (ACOSOG), to design the ACOSOG Z1041 trial. This trial compared to different regimens in the neoadjuvant setting, one regimen utilizing concurrent anthracycline and taxanes based chemotherapy with trastuzumab and the other regimen utilizing concurrent taxanes with trastuzumab but the anthracycline was delivered in a sequential fashion. The primary end point of the trial was pathologic complete response rates in the breast. The results from this primary end point were published in the Lancet Oncology in 2013 and showed that the pathologic complete response rates were the same with the 2 different regimens. This was important since patients could be assured of similar efficacy without the potential added toxicity of delivering anthracyclines and trastuzumab together. The current publication is a report of the disease-free and overall survival rates from the Z1041 trial. Several studies have shown an association between pathologic complete response rates and survival. The current study shows that there is no difference in survival rates between the 2 different regimens. So once again there is an association between pathologic complete response and survival and it is not important that the anthracycline and trastuzumab are given concurrently in order to achieve these high pathologic complete response rates and improve survival rates.
Author Interviews, Breast Cancer, Cancer Research, JAMA, Mammograms / 25.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44044" align="alignleft" width="142"]Lisa A Newman, MD Director of the Breast Oncology Program for the multi-hospital  Henry Ford  Health System Dr. Newman[/caption] Lisa A Newman, MD Director of the Breast Oncology Program for the multi-hospital Henry Ford  Health System MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In 2009 the United States Preventive Services Task Force published a guideline recommending that American women at average risk for breast cancer defer undergoing screening mammography until they reach the age of 50 years. Prior to this publication, women were widely-encouraged to initiate annual mammography at age 40 years. Women that have a history of breast cancer are automatically considered to be at increased risk for developing a new breast cancer, and so routine screening mammography guidelines do not apply to them. These women require annual mammography regardless of age, unless they have undergone a bilateral mastectomy. We utilized data from Michigan Blue Cross/Blue Shield to evaluate patterns of mammography utilization among women age 40-49 years, comparing rates before versus after 2009, when the USPSTF guideline was published. We analyzed women that had a prior history of breast cancer separately from those that had no history of breast cancer, and we excluded women that underwent bilateral mastectomy. Disturbingly, we found that mammography utilization rates declined among women with a history of breast cancer as well as among those with no history of breast cancer in the post-2009 timeline. This suggested to us that changes in screening recommendations may have had the unintended consequence of generating confusion and misunderstandings regarding the value of mammography among women that undeniably benefit from this imaging, such as those with a history of breast cancer. 
Author Interviews, Breast Cancer, Cancer Research, Chemotherapy, Radiation Therapy / 22.08.2018

MedicalResearch.com Interview with: [caption id="attachment_44079" align="alignleft" width="200"]Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy)  Stanford University Medical Center Dr. Kathleen Horst[/caption] Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy) Stanford University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We were interested in focusing on young women with breast cancer as this is a high-risk patient population that is not studied on its own in clinical trials. Furthermore, the available data on treating breast cancer with neoadjuvant chemotherapy (NAC) does not include detailed outcomes for women under the age of 40 years. Because most women who are diagnosed with breast cancer in this age group will have aggressive disease, most of them will be treated with NAC followed by surgery. From prospective randomized trials we know that women with breast cancer who attain a pathologic complete response (PCR) to neoadjuvant chemotherapy fare significantly better than those who do not. In addition, existing data suggest that a complete response in the lymph nodes also portends a better prognosis. This is the foundation for the currently ongoing NSABP B-51/RTOG 1304 trial, which is evaluating the role of nodal irradiation in those women who attain a pathologic complete response in the lymph nodes after NAC. We wanted to know whether differences in pathologic response in the breast versus lymph nodes led to different clinical outcomes in this patient group. We evaluated outcomes following neoadjuvant chemotherapy for breast cancer in 155 women age 40 and younger. We focused on pathologic response in the breast and lymph nodes as predictors of disease recurrence and survival. We found that any residual disease in either the breast or lymph nodes lessened the chance of cure significantly. Importantly, women who attained a complete response in the lymph nodes but continued to have residual disease in the breast fared just as poorly as those who remained lymph node positive following neoadjuvant chemotherapy. 
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, JAMA, Ovarian Cancer / 21.08.2018

MedicalResearch.com Interview with: Ambry GeneticsShuwei Li, PhD Principal Statistical Geneticist Ambry Genetics MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breast cancer is the most commonly diagnosed cancer, while ovarian cancer is the fifth leading cause of death due to cancer, in US women. Since the discovery of BRCA1 and BRCA2, multiple genes have been reported as risk factors; however, it is still unclear whether the known findings represent the complete genetic landscape of breast and ovarian cancers. Our team performed exome sequencing on more than 10,000 breast and/or ovarian cancer patients and nearly 4,000 controls. We observed increased risk of breast cancer associated with PALB2, ATM, CHEK2 and MSH6 genes, and increased risk of ovarian cancer associated with MSH6, RAD51C, TP53 and ATM genes.  
Author Interviews, Breast Cancer, JAMA, Radiation Therapy / 14.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43814" align="alignleft" width="200"]Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto Dr. Narod[/caption] Steven Narod, MD, FRCPC, FRSC Senior Scientist, Women’s College Research Institute Director, Familial Breast Cancer Research Unit, Women's College Research Institute Professor, Dalla Lana School of Public Health, University of Toronto Professor, Department of Medicine Tier 1 Canada Research Chair in Breast Cancer University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings?  Response: In the past we have shown that about 3 percent of women with ductal carcinoma in situ (DCIS) will die of breast cancer within 20  years of diagnosis.   In the current study, we took a very close look at how the different treatments impact on the risk of dying of breast cancer. Women with DCIS are at risk for  both a new cancer within the breast and dying of breast cancer from cells that spread beyond the breast (lung, liver, brain and bone).   About 20% of DCIS patients will get a new breast cancer within the breast at 20 years.
  • We show here that it is not necessary to develop a new cancer within the breast to die of breast cancer,  in some cases the DCIS spreads directly in the absence of local recurrence.
  • We show that radiotherapy can prevent 25% of the deaths from breast cancer after DCIS. And this has nothing to do with local recurrence.
  • We show that mastectomy reduces the chance of a getting a new cancer (local recurrence) but  doesn’t reduce the chance of dying of breast cancer.
So, if the goal is to prevent new cancers in the breast -   then mastectomy is the best treatment If the goal is to prevent the woman from dying of breast cancer - then radiotherapy is the best treatment. 
AACR, Author Interviews, Breast Cancer, Cancer Research, Lung Cancer / 01.08.2018

MedicalResearch.com Interview with: “smoking” by shira gal is licensed under CC BY 2.0Dr. Jose M. Martín-Sánchez IP of this study Grupo de Evaluación de Determinantes de Salud y Políticas Sanitarias Universitat Internacional de Catalunya Sant Cugat del Vallès Spain MedicalResearch.com: What is the background for this study? Response: Breast cancer has been the first cause of death from cancer among women. However, the mortality rates of breast cancer have been decreased in the last years. This downward trend can be attributed to treatment and screening programs. On the other hand, smoking has been increased among women during the last century and the main cause of lung cancer is smoking behavior. Based on this data, we hypothesized that the lung cancer mortality could outweigh the breast cancer mortality in the next years and the main purpose of this study was to project the mortality rates of lung cancer and breast cancer in women worldwide, based in previous data and using Bayesian methods, in order to identify potential strategies of public health to reduce the impact of lung cancer. Moreover, previous works described the lung and breast cancer mortality or projected one of them in a single country. For example, we have published two articles with data of Spain one of them with the description of lung cancer mortality trend in men and women and other with the projection of lung and breast cancer among women. The information of this study provides an overall point view around the word of this problem of public health.
Author Interviews, Breast Cancer, Cost of Health Care, Mammograms, Medical Imaging / 29.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43571" align="alignleft" width="133"]Michal Horný PhD Assistant Professor Emory University School of Medicine, Department of Radiology and Imaging Sciences Emory University Rollins School of Public Health Department of Health Policy and Management Atlanta, GA 30322 Dr. Horný[/caption] Michal Horný PhD Assistant Professor Emory University School of Medicine, Department of Radiology and Imaging Sciences Emory University Rollins School of Public Health Department of Health Policy and Management Atlanta, GA 30322 MedicalResearch.com: What is the background for this study? Response: Increased breast tissue density is a common finding at screening mammography. Approximately 30-50% of women have so-called “dense breasts” but many of them are not aware of it. The problem is that the increased tissue density can potentially mask early cancers. In other words, if there is cancer hiding in dense breast tissue, it could be difficult to spot it. To improve the awareness of breast tissue density, a patient group called Are You Dense Advocacy, Inc., started lobbying state and federal policymakers to pass laws mandating health care providers to notify women about their breast density assessments. As a result, 31 states have already enacted some form of legislation regarding dense breast tissue.
Author Interviews, Breast Cancer, Cancer Research, Genetic Research, Nature / 23.07.2018

MedicalResearch.com Interview with: [caption id="attachment_43390" align="alignleft" width="199"]Luca Magnani, Ph.D CRUK Fellow/Senior Research Fellow Department of Surgery and Cancer Imperial Centre for Translational and Experimental Medicine Room 140 1st floor ICTEM building Imperial College Hammersmith London, UK Dr. Magnani[/caption] Luca Magnani, Ph.D CRUK Fellow/Senior Research Fellow Department of Surgery and Cancer Imperial Centre for Translational and Experimental Medicine Room 140 1st floor ICTEM building Imperial College Hammersmith London, UK MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by the Yin Yang1 molecule? Response: This study was designed to investigate the evidence of non-genetic mechanisms that could contribute to breast cancer biology. Specifically, we developed a map of regulatory regions from luminal breast cancer patients. Regulatory regions are pieces of DNA that are not transcribed into protein-coding genes but they provide information about where and how much each gene should be activated. It is worth highlighting that cancer is not only the consequence of gene mutations but also the result of the wrong genes expressed at the wrong time.  To catalogue regulatory regions we looked for specific modifications that are strongly associated with their activity (epigenetic modifications). Doing so we developed the first extensive catalogue  of non-coding DNA regions that might play an essential role in regulating how breast cancer cell behaves. Regulatory regions do their job by interacting with specific molecules called transcription factors. These molecules can read the information stored in these regulatory regions and contribute to regulate gene expression. Yin Yang 1 is one of such molecules and was previously thought as a ambiguous player capable of activating or repressing gene activity.  
Author Interviews, Breast Cancer, Cancer Research, Cost of Health Care, JAMA / 06.07.2018

MedicalResearch.com Interview with:

[caption id="attachment_42920" align="alignleft" width="150"]Dr Nora Pashayan PhD Clinical Reader in Applied Health Research University College London Dept of Applied Health Research London  Dr. Pashayan[/caption]

Dr Nora Pashayan PhD

Clinical Reader in Applied Health Research

University College London

Dept of Applied Health Research

London 

MedicalResearch.com:  What is the background for this study?

Response: Not all women have the same risk of developing breast cancer and not all women have the same potential to benefit from screening.

 

If the screening programme takes into account the individual variation in risk, then evidence from different studies indicate that this could improve the efficiency of the screening programme. However, questions remain on what is the best risk-stratified screening strategy, does risk-stratified screening add value for money, and what are benefit and harm trade-offs.

Author Interviews, Breast Cancer, Cancer Research, PLoS, Vitamin D / 22.06.2018

MedicalResearch.com Interview with: [caption id="attachment_42650" align="alignleft" width="130"]Cedric F. Garland, Dr.P.H., F.A.C.E. Adjunct Professor Division of Epidemiology Department of Family Medicine and Public Health University of California San Diego La Jolla, California 92093-0620 Dr. Garland[/caption] Cedric F. Garland, Dr.P.H., F.A.C.E. Adjunct Professor Division of Epidemiology Department of Family Medicine and Public Health University of California San Diego La Jolla, California 92093-0620 MedicalResearch.com: What is the background for this study? Response: Studies mapping death rates from female breast cancer in the US, the former USSR and Canada by Drs. Edward Gorham, and Frank and Cedric Garland revealed for the first time in history that death rates from breast cancer tracked latitude where people lived. The rates were highest in the least sunny northern tier of states, lowest in the sunny southwest. This led these scientists to be the first to theorize that vitamin D prevents breast cancer” said study first author Sharon McDonnell.