Author Interviews, Breast Cancer / 25.07.2014

Rajkumar Lakshmanaswamy, PhD Research Director of the Center of Excellence in Cancer Research The Paul L. Foster School of Medicine Texas Tech University Health Sciences CenterMedicalResearch.com Interview with: Rajkumar Lakshmanaswamy, PhD Basic Science Research Director of the Center of Excellence in Cancer Research. The Paul L. Foster School of Medicine Texas Tech University Health Sciences Center Medical Research: What are the main findings of the study? Dr. Lakshmanaswamy: Our study supports a growing body of research suggesting a safe and effective role for natural steroid hormones in treating postmenopausal breast cancer, with fewer detrimental side effects and an improved health profile than with standard anti-hormone therapies. Using a mouse model mimicking human breast cancer after menopause, we found that treatment with estrogen, progesterone, and testosterone was associated with greater physical activity, improved cognition, and better cardiovascular and bone health, which demonstrates the potential significance of hormone treatment in postmenopausal women. (more…)
Author Interviews, Breast Cancer, Diabetes, Genetic Research, Nature, Vanderbilt / 23.07.2014

MedicalResearch.com Interview with: Qiuyin Cai, M.D., Ph.D. Associate Professor of Medicine Vanderbilt University Medical Research: What are the main findings of the study? Dr. Cai: We conducted a genome-wide association study in East Asians to search for additional genetic changes that are linked to breast cancer development. The study was conducted as part of the Asia Breast Cancer Consortium, which includes 22,780 women with breast cancer and 24,181 control subjects. We found DNA sequence changes in two genes, PRC1 and ZC3H11A, and a change near the ARRDC3 gene were associated with breast cancer risk. These results were also replicated in a large consortium, including 16,003 breast cancer cases and 41,335 control subjects of European ancestry. (more…)
Author Interviews, Breast Cancer, Genetic Research, Nature / 23.07.2014

MedicalResearch.com Interview with Dr Lim Weng Khong Research Fellow, National Cancer Centre Singapore. Medical Research: What are the main findings of the study? Dr Lim Weng Khong: This study uncovered the genetic cause fibroadenomas, which are very common benign breast tumours in women. The team from National Cancer Centre Singapore, Singapore General Hospital and Duke-NUS Graduate Medical School identified a critical gene called MED12 that has frequent durations in a remarkable 60 per cent of fibroadenomas studied. Their findings have been published in the top-ranked journal Nature Genetics. (more…)
Author Interviews, Breast Cancer, Cognitive Issues / 17.07.2014

Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands MedicalResearch.com Interview with: Florien Boel MSc VU University Medical Center Department of Medical Psychology Amsterdam, The Netherlands Medical Research: What are the main findings of the study? Answer: In postmenopausal breast cancer patients, endocrine therapy is widely used, and often for many years on end. Endocrine therapy is thought to have an effect on cognitive functioning, but previous studies have not yet accounted for the possible influence of the diagnosis of cancer and subsequent anxiety, depression or fatigue on cognitive performance. In addition, the cognitive effects of endocrine therapy after long-term use are still mostly unknown. Therefore, we compared cognitive functioning of postmenopausal breast cancer patients who underwent surgery and/or radiotherapy (N=43) with the cognitive performance of women who also received adjuvant endocrine therapy (tamoxifen) (N=20) and a group of healthy matched individuals (N=44). In accordance with the literature, we found that especially cognitive domains that rely heavily on verbal abilities (verbal memory and fluency) seem to be at risk for deterioration during long-term treatment (~2.5 years) with tamoxifen. (more…)
Author Interviews, Breast Cancer, NEJM / 10.07.2014

Dr. Olivia Pagani Institute of Oncology of Southern Switzerland Ospedale San Giovanni, Switzerland MedicalResearch.com Interview with:  Dr. Olivia Pagani Clinical Director of the Breast Unit of Southern Switzerland Ospedale San Giovanni, Switzerland Medical Research: What are the main findings of the study? Dr. Pagani: The study showed that the aromatase inhibitor Exemestane is superior to Tamoxifen (both given together with ovarian function suppression) in preventing breast cancer recurrence in premenopausal women with oestrogen receptor positive early breast cancer. (more…)
Breast Cancer, Lipids / 07.07.2014

Dr. Rahul Potluri Honorary Clinical Lecturer in Cardiology School of Medical Sciences, Aston University Birmingham UK;MedicalResearch.com Interview with: Dr. Rahul Potluri Honorary Clinical Lecturer in Cardiology School of Medical Sciences, Aston University Birmingham UK; Medical Research: What are the main findings of the study? Dr. Potluri: Study was conducted by a retrospective analysis of more than 1 million anonymous patient records across the UK between 2000 and 2013 using the Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) protocol. There were 664,159 women and of these, 22 938 had hyperlipidaemia and 9 312 had breast cancer. Some 530 women with hyperlipidaemia developed breast cancer. A statistical model to study the association between hyperlipidaemia and breast cancer. They found that having hyperlipidaemia increased the risk of breast cancer by 1.64 times (95% confidence interval 1.50-1.79). (more…)
Author Interviews, Breast Cancer / 03.07.2014

Dr. Katja Pinker MD Department of Radiology Medical University of Vienna · MedicalResearch.com Interview with: Dr. Katja Pinker MD Department of Radiology Medical University of Vienna · MedicalResearch.com: What are the main findings of the study? Dr. Pinker: We hypothesized that by imaging multiple key processes involved in cancer development and growth with multiparametric PET/MRI an improved non-invasive diagnosis of breast tumors is possible. To test this hypothesis, we conducted this first clinical feasibility study. Mutliparametric PET/MRI allows an improved non-invasive differentiation of benign and mailgnant breast tumors than currently used contrast-enhanced MRI alone. By its use unnecessary breast biopsies in benign tumors can be avoided without missing cancer. (more…)
Author Interviews, Breast Cancer, JNCI, MD Anderson, Weight Research / 02.07.2014

Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas  77230-1402MedicalResearch.com Interview with Sai-Ching Jim Yeung, MD, PhD, FACP Professor of Medicine The University of Texas MD Anderson Cancer Center Department of Emergency Medicine Department of Endocrine Neoplasia & Hormonal Disorders Houston, Texas  77230-1402 MedicalResearch: What are the main findings of the study? Dr. Yeung: We believe that this study has bridged a significant gap in knowledge between epidemiological data (the association of obesity and poor breast cancer prognosis) and biological mechanisms mediating the impact of obesity on cancer. This study provides an important mechanistic insight into the causal relationship between obesity and breast cancer growth.
  1. Direct evidence for the links between obesity-associated changes in the biological processes and hallmarks of cancer in human estrogen receptor-positive (ER+) breast cancer. 
It is well known that obesity is associated epidemiologicaly with decreased survival in ER+ breast cancer patients. Although a body of experimental literature exists to suggest important roles for estrogen, insulin/IGF-1 and adipokine signaling and inflammation in the mechanisms mediating the impact of obesity on cancer, direct evidence for these mechanisms and their importance relative to one another is lacking in cancers from obese humans. Functional transcriptomic analysis of a prospective observation cohort with treatment-naïve ER+ breast cancer samples identified the insulin/PI3K signaling and secretion of cytokines among the top biological processes involved. Many of the obesity-associated changes in biological processes can be linked to cancer hallmarks.  Upstream regulator analysis identified estrogen (?-estradiol), insulin (INS1), insulin-like growth factor-1 (IGF1), and adipokines [vascular endothelial growth factor A (VEGFA), tissue necrosis factor (TNF), interleukin-6 (IL6), oncostatin-M (OSM), chemokine ligand 5 (CCL5), leptin (LEP), leukemia inhibitory factor (LIF), C-reactive protein (CRP), adiponectin (ADIPOQ), and interleukin-10 (IL10)] in mediating the impact of obesity on human ER+ breast cancer.
  1. Experimental evidence that obesity causes accelerated oncogene-driven ER+ breast cancer carcinogenesis.
While it is not possible to conduct a human experiment to prospectively examine the causal relationship between obesity and breast cancer, we created a transgenic mouse model with genetically induced obesity and oncogene-driven breast cancer.  With this model we found strong in vivo evidence using both longitudinal experiments and cross-sectional experiments that obesity accelerated oncogene-driven breast carcinogenesis. (more…)
Breast Cancer / 25.06.2014

Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ  08901MedicalResearch.com Interview With Dorothy N. Pierce, DNP, MSN, RN, NP-C, CRN, OCN, CBCN Advanced Practice Nurse Rutgers Cancer Institute of New Jersey Rutgers, The State University of New Jersey New Brunswick, NJ  08901 MedicalResearch: What are the main findings of the study? Answer: The main findings from the study were:
  1. Nineteen patients out of 24 (79%) reported lymphedema (LE) symptoms. Majority reporting symptoms received chemotherapy and were 50 years of age and older.
  2. The most commonly reported symptoms were limb tenderness (n=10), swelling (n=9), firmness/tightness (n=8), numbness (n=6), heaviness (n=5), impaired movement of the shoulder (n=5), and finger (n=4).
  3. Overall, the participants had low to moderate lymphedema knowledge. The mean knowledge score was 11.9 with a range from zero to 20.
  4. Patients beginning radiation therapy for breast cancer often had not received any lymphedema information from health care providers prior to therapy; Lymphedema knowledge is moderate to weak.
(more…)
Author Interviews, Breast Cancer, JAMA, MD Anderson, Race/Ethnic Diversity / 20.06.2014

Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, HoustonMedicalResearch.com Interview with: Dalliah Black, MD F.A.C.S. Department of Surgical Oncology The University of Texas MD Anderson Cancer Center, Houston   MedicalResearch: What are the main findings of the study? Dr. Black: This is a retrospective study from 2002 - 2007 using the SEER/Medicare database of over 31,000 women with node negative breast cancer evaluating the utilization of sentinel node biopsy (SNB) as it transitioned from an optional method for axillary staging to the standard of care instead of complete axillary lymph node dissection (ALND).  We found that SNB use increased each year in both white and black breast cancer patients throughout the study period.  However, SNB was less often performed in black patients (62.4%)compared to white patients (73.7%) and this disparity persisted through 2007 with a 12% difference.  Appropriate black patients more often had an ALND instead of the minimally invasive sentinel node biopsy which resulted in worse patient outcomes with higher lymphedema rates in black patients.  However, when black patients received the minimally invasive SNB, their rates of lymphedema were low and comparable to white patients who received SNB. (more…)
Author Interviews, Breast Cancer / 17.06.2014

Jack Cuzick PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University of London, London UKMedicalResearch.com Interview with: Jack Cuzick PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University of London, London UK Dr. Cuzick offers the manuscript below to put the results of the Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial in focus for MedicalResearch.com.

The Prevention of Breast Cancer

The first human evidence that drug treatment might reduce the incidence of breast cancer was reported in 19851, where it was found that use of tamoxifen in a trial of women with breast cancer to reduce recurrence of existing tumours also had a major impact on new tumours in the opposite breast, reducing them from 10 to 3. That observation has subsequently been confirmed in several other adjuvant trials and an overview of all such trials indicates that after an average of about 8 years of follow up, 5 years of tamoxifen reduced new contralateral tumours by 39%, with similar effects in years 0-5 and 5-10 in women with oestrogen receptor positive or unknown primary tumours2. These observations and positive results from animal studies3, led to the evaluation of 5 years of tamoxifen in women without breast cancer, but at high risk in 4 large trials. A recent overview4 indicates a 33% reduction in all breast cancer after a 10 years follow up, with a larger reduction in years 0-5 (48%), when treatment was given, and a continuing (22%) effect in years 5-10. Reductions were seen for oestrogen receptor positive invasive cancer (44%) and DCIS (28%), but no effect was seen for both oestrogen receptor negative invasive cancer, where in fact a non-significant 13% (P=0.4) increase was observed. Somewhat larger effects were seen for these other selective estrogen receptor modulators (SERMs) – raloxifene, lasofoxifene and arzoxifene – in trials of osteoporotic women, where the primary endpoint was fracture reduction4. A subsequent head-to-head trial of raloxifene vs tamoxifen, showed tamoxifen to be about 20% more effective, but raloxifene had fewer side effects5. Lasofoxifene not only showed benefits for breast cancer reduction but also reduced fracture rates and heart disease6, and this multi-dimensional set of benefits makes it an attractive candidate for prevention. (more…)
Author Interviews, Breast Cancer, MD Anderson, Surgical Research / 11.06.2014

Dr. Benjamin D. Smith MD Associate Professor Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch.com Interview with: Dr. Benjamin D. Smith MD Associate Professor Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, TX 77030 MedicalResearch: What are the main findings of the study? Dr. Smith: Although use of needle biopsy to diagnose breast cancer increased during the time period we studied, it remained lower than targeted benchmarks. The patient’s surgeon seemed to exert a major influence on use of needle biopsy. (more…)
Author Interviews, BMJ, Breast Cancer, Brigham & Women's - Harvard, Nutrition / 11.06.2014

MedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate ArofessorMedicalResearch.com Interview with Dr. Maryam Farvid MSc, Ph.D. Takemi fellow, and Associate Arofessor Senior author: Prof Walter Willett Department of Nutrition, Harvard School of Public Health, Boston, MA, MedicalResearch: What are the main findings of the study? Dr. Farvid: Compared to women who had one serving per week red meat, those who consumed 1.5 serving per day red meat had a 22 percent higher risk of breast cancer. Red meat intake is associated with breast cancer risk in a dose-response manner. Each additional serving/day increase in total red meat was associated with a 13% increase in risk of breast cancer. Furthermore, each additional serving/day of poultry was associated with a 25% lower risk of postmenopausal breast cancer. Substituting one serving/day of legumes for one serving/day of red meat was associated with a 15% lower risk of breast cancer, substituting one serving/day of poultry for one serving/day of red meat was associated with a 17% lower risk of breast cancer overall, and substituting one serving/day of combined legumes, nuts, poultry, and fish for one serving/day of red meat was associated with a 14% lower risk of breast cancer. (more…)
Breast Cancer, Mayo Clinic / 08.06.2014

Dr. Barbara Pockaj, MD Professor of Surgery Mayo Clinic, ArizonaMedicalResearch.com Interview Invitation Dr. Barbara Pockaj, MD Professor of Surgery Mayo Clinic, Arizona   MedicalResearch: What are the main findings of the study? Dr. Pockaj: The study analyzed 515 triple negative breast cancer samples using a multi-platform approach including whole genome mRNA expression, protein expression, gene copy number changes and gene sequencing for immune markers. The study found that a cohort of the triple negative breast cancer patients had high expression of PD-L1 (program death ligand) and other immune regulators such as CTLA-4 (Cytotoxic T-lymphocyte Antigen) and IDO-1 (indoleamine 2,3-dioxygenase).  High PD-L1 expression was found in patients whose tumors were triple negative and androgen receptor negative.  High PD-L1 expression was related to DNA repair gene abnormalities including BRCA1. (more…)
Author Interviews, Breast Cancer, NEJM / 05.06.2014

Dr. Olivia Pagani  Institute of Oncology of Southern Switzerland Ospedale San Giovanni, SwitzerlandMedicalResearch.com Interview with: Dr. Olivia Pagani  Institute of Oncology of Southern Switzerland Ospedale San Giovanni, Switzerland   MedicalResearch: What are the main findings of the study? Dr. Pagani: The studies show that also in premenopausal women (as already proven in postmenopausal women), aromatase inhibitors (AIs) (in this case Exemestane) given as adjuvant treatment are more effective than Tamoxifen in women with hormone receptor positive early breast cancer who are given concomitantly ovarian suppression to lower estrogen production. The 28% improvement in disease free survival is comparable to that seen in postmenopausal women. In particular, outcomes in women who did not receive chemotherapy (43% of the entire population, 29% of whom with node positive disease) were strikingly good (<97% were breast cancer free at 5 years). (more…)
Author Interviews, Breast Cancer, General Medicine / 29.05.2014

Alai Tan, MD, PhD Assistant Professor Institute for Translational Science Dept. of Preventive Medicine & Community Health University of Texas Medical BranchMedicalResearch.com Interview with: Alai Tan, MD, PhD Assistant Professor Institute for Translational Science Dept. of Preventive Medicine & Community Health University of Texas Medical Branch MedicalResearch: What are the main findings of the study? Dr. Tan: We found that substantial proportions of women with limited life expectancy receive screening mammography. The screening rates were higher among women who saw more than one generalist physician and who had more visits to generalist physicians. The screening rates were higher among U.S. hospital referral regions with more primary care physicians, mammography facilities and radiologists. (more…)
Author Interviews, Breast Cancer, JAMA / 25.05.2014

Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & DevelopmentMedicalResearch.com Interview with: Dr. Sarah Hawley PhD MPH Associate Professor in the Division of General Medicine University of Michigan Research Investigator, Ann Arbor VA Center of Excellence in Health Services Research & Development   MedicalResearch: What are the main findings of the study? Dr. Hawley: There are a couple of main findings.
  • First, we found that nearly 20% of women in our population based sample of breast cancer patients reported strongly considering having contralateral prophylactic mastectomy (CPM, which means they had their unaffected breast removed at the same time as the breast with cancer), and about 8% received it. Of those who did receive contralateral prophylactic mastectomy, most (about 70%) did not have a clinical indication for it, which included a positive genetic mutation of BRCA1 or BRCA2 or a strong family history of breast or ovarian cancer.
  • However, most women (90%) who received it reported having a strong amount of worry about the cancer coming back (also called worry about recurrence).
  • We also found that when women had an MRI as part of their diagnostic work-up for breast cancer, they more often received contralateral prophylactic mastectomy than when they did not have an MRI.
(more…)
Author Interviews, Breast Cancer, Race/Ethnic Diversity / 14.05.2014

dr_Helmneh SineshawMedicalResearch.com Interview with: Helmneh Sineshaw, MD, MPH Senior Epidemiologist, Health Services Researcher American Cancer Society MedicalResearch: What are the main findings of the study? Dr. Sineshaw: We found that non-Hispanic black women had nearly twofold higher odds of being diagnosed with triple-negative (TN) breast cancer subtype than did their white counterparts, regardless of their socioeconomic group. We also found higher odds of presenting with human epidermal growth factor receptor 2(HER2)-overexpressing breast cancer in Asian/Pacific Islander women compared with white women at every level of socioeconomic status. (more…)
Breast Cancer, Mayo Clinic, Weight Research / 08.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Rates of bilateral mastectomy are higher in hospitals with immediate breast reconstruction available. Bilateral mastectomy rates were highest in hospitals with high volumes of immediate breast reconstruction. Large, teaching, urban, and Northeastern hospitals were more likely to have higher immediate breast reconstruction volumes. (more…)
Breast Cancer, Mayo Clinic, Pain Research, Pharmacology / 06.05.2014

Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn.MedicalResearch.com Interview with: Judy C. Boughey, MD Chair, Division of Surgery Research Mayo Clinic, Rochester, Minn. MedicalResearch.com: What are the main findings of the study? Dr. Boughey: Use of paravertebral block (a form of regional anesthesia) in women undergoing mastectomy results in less need for opioid medications and less frequent use of anti-nausea medication after surgery. (more…)
Author Interviews, Breast Cancer, Mayo Clinic, Surgical Research, Weight Research / 02.05.2014

Tina Hieken, M.D. Associate Professor of Surgery Mayo Clinic,Rochester, MinnMedicalResearch.com Interview with: Tina Hieken, M.D. Associate Professor of Surgery Mayo Clinic,Rochester, Minn   MedicalResearch.com: What are the main findings of the study? Dr. Hieken: Among more than 1,300 newly diagnosed invasive breast cancer patients, 36 percent of whom were obese (BMI ≥ 30), preoperative axillary ultrasound with fine needle aspiration biopsy of suspicious lymph nodes identified metastasis to the lymph nodes in 36 percent of patients found to be node-positive at operation.  For all BMI categories (normal, overweight, obese) axillary ultrasound was predictive of pathologic nodal status (p<0.0001).  The sensitivity of axillary ultrasound did not differ across BMI categories while specificity and accuracy were better for overweight and obese patients, respectively, than for normal weight patients.  Furthermore, patients across all BMI categories who had suspicious axillary lymph nodes on ultrasound and had a positive fine needle aspiration biopsy had significantly more positive lymph nodes at operation, an average of five metastatic nodes, and an overall higher nodal disease burden at operation. (more…)
Author Interviews, Breast Cancer, Genetic Research / 29.04.2014

Dr. Yvonne Bombard, PhD Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital Assistant Professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of TorontoMedicalResearch.com Interview with: Dr. Yvonne Bombard, PhD Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital Assistant Professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto MedicalResearch.com: What are the main findings of the study? Dr. Bombard: The main finding of the study is that gene expression profiling tests play a critical role when women with early-stage breast cancer decide whether to have chemotherapy, but many of them do not fully understand what some of the test results mean. For many the gene expression profiling test was the main factor in their treatment decision. The women we interviewed understood the test would indicate whether chemotherapy would be beneficial to them. But many thought the test reflected their unique circumstances and did not understand that their test result was based on larger population statistics. Patients often viewed their gene expression profiling results as providing information that was more scientifically valid, uniquely personalized and emotionally significant than any other information they had received. For many, the test was a transformational element that empowered them, allowed them to feel confident in their decisions and may even have rescued them from unnecessary chemotherapy. Patients described emotionally and socially complex reasons why they valued gene expression profiling testing in making their treatment decisions. Patients valued the test because it provided them with certainty amidst confusion, with options and a sense of empowerment, and with personalized, authoritative information. (more…)
Author Interviews, Breast Cancer, JNCI, Nutrition / 11.04.2014

dr_sabina-sieriMedicalResearch.com Interview with: Sabina Sieri, PhD Epidemiology and Prevention Unit Department of Preventive & Predictive Medicine Fondazione IRCCS Istituto Nazionale dei Tumori 20133 Milan – Italy MedicalResearch.com: What are the main findings of this study? Dr. Sieri: In our study we found that there was an increased risk of developing breast cancer from high saturated fat intake. High total and saturated fat intake were associated with greater risk of ER PR positive breast cancer. High saturated fat intake was also associated with a greater risk of HER2 negative disease. So, a high-fat diet increases breast cancer risk and, most conspicuously, a high saturated fat intake increases the risk of developing hormone-sensitive diseases, suggesting saturated fat involvement in the etiology of hormone-sensitive breast cancer. (more…)
Author Interviews, Breast Cancer, Mayo Clinic / 10.04.2014

Dr. Judy C. Boughey MD Professor of Surgery Mayo Clinic, Rochester MNMedicalResearch.com Interview with Dr. Judy C. Boughey MD Professor of Surgery Mayo Clinic, Rochester MN MedicalResearch.com: What are the main findings of the study?   Dr. Boughey: This study showed that the rate of reoperation after lumpectomy for breast cancer was significantly lower at Mayo Clinic in Rochester compared to national data. Mayo Clinic in Rochester uses frozen section analysis of margins at time of lumpectomy to direct any margin re-excisions during the surgery and therefore has a significantly lower rate of need for a second operation to ensure clean margins. The rate of reoperation was four times higher in the national data set than in the Mayo Clinic data set. (more…)
Breast Cancer, JAMA, Outcomes & Safety / 03.04.2014

Dr. Lydia  Pace, MD, MPH Division of Women’s Health, Brigham and Women’s Hospital Boston, MassachusettsMedicalResearch.com Interview with: Dr. Lydia  Pace, MD, MPH Division of Women’s Health, Brigham and Women’s Hospital Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Pace: We reviewed the existing literature about the benefits and harms of mammography, focusing on the reduction of breast cancer deaths associated with mammography, as well as the two most often-discussed harms: false positive results and overdiagnosis. We also reviewed the literature about interventions to help patients make informed decisions. We found that the literature suggests that routine screening mammography does reduce mortality associated with breast cancer, across all age groups. However, it is also associated with high rates of false positive results, and considerable rates of overdiagnosis. Overdiagnosis is the most concerning potential risk of mammography screening. Overdiagnosis is the detection of a tumor through screening that would never have caused problems for a patient. It occurs either because of a very slow-growing tumor, or because a woman has medical problems (or is old enough) such that she will likely die of another cause before the cancer became apparent. Overdiagnosis is concerning because we cannot know when a cancer is overdiagnosed, and thus a patient who is overdiagnosed will receive unnecessary treatment for cancer. The scientific literature on mammography is complex, and there are important limitations to the studies both of mammography’s benefits and harms. However, we feel that the best available data suggest that among 10,000 50 year old women undergoing annual mammography for 10 years, 5 deaths will be averted through screening mammography, while about 6130 women will experience at least one positive result. Furthermore, there is about a 19% chance that, if that woman is diagnosed with cancer detected by a mammogram, that cancer is one that would never have caused her problems. Lastly, our review showed that we need more studies to guide us in how an individual woman’s risk should dictate her mammography decisions, and how to support women in making those decisions. However, we know that most women with higher risk for breast cancer will experience higher benefit from mammography screening. (more…)
Aging, Author Interviews, Breast Cancer, Chemotherapy, JNCI / 30.03.2014

Hanna Sanoff MD, MPH Lineberger Comprehensive Cancer Center Department of Medicine University of North Carolina, Chapel Hill, NCMedicalResearch.com Interview with: Hanna Sanoff MD, MPH Lineberger Comprehensive Cancer Center Department of Medicine University of North Carolina, Chapel Hill, NC MedicalResearch.com: What are the main findings of the study? Dr. Sanoff: We measured p16, a protein that increases with cellular aging, in blood cells of women receiving chemotherapy for breast cancer. We found that a standard course of chemotherapy led to an increase in p16 expression equivalent to what we have previous seen in people over the course of 10-15 years of chronological aging. This increase persisted in cancer survivors an average of three and half years after treatment. (more…)
Author Interviews, Breast Cancer, Cancer, NIH / 26.03.2014

Yun Gong, M.D. Associate Professor Department of Pathology, Unit 53 M D Anderson Cancer Center Houston, TX 77030MedicalResearch.com Interview with: Yun Gong, M.D. Associate Professor Department of Pathology, Unit 53 M D Anderson Cancer Center Houston, TX 77030 MedicalResearch.com: What are the main findings of the study? Dr. Gong:  Androgen receptor (AR) was positive in 39% of the inflammatory breast cancer (IBC) tumors, approximately one-third of estrogen receptor (ER)-negative and progesterone receptor (PR)-negative tumors and 42.6% triple-negative tumors. AR positivity was significantly associated with lymphovascular invasion but not with other clinicopathologic parameters. There was a trend toward association between AR expression and PR expression. Univariate survival analysis indicated that patients with AR-negative/ER-negative tumors had significantly worse overall survival and disease-specific survival than the patients with tumors showing other combinations of AR/ER status (i.e., AR-negative/ER-positive, AR-positive/ER-negative,  or AR-positive/ER-positive). Notably, the study was performed using post-neoadjuvant IBC surgical specimens. (more…)
Breast Cancer, Exercise - Fitness / 20.03.2014

Professor Mathieu Boniol PhD International Prevention Research Institute Lyon, FranceMedicalResearch.com Interview with: Professor Mathieu Boniol PhD International Prevention Research Institute Lyon, France MedicalResearch.com: What are the main findings of the study? Prof. Boniol: We conducted a meta-analysis of all prospective epidemiological studies on physical activity and risk of breast cancer. It includes 37 studies, so covers more than 4 million women among which more than 100,000 breast cancer were diagnosed. We showed that when comparing the most active women (about 20% of the population) to least active women (another 20% of the population), vigorous physical activity reduce the risk of breast cancer by 11%. And the good news is that this decline is irrespective of age, BMI, menopausal status, country,... It is also true for the most aggressive breast cancer (ER-/PR-). However, we also showed that this decline is not observed for women taking hormonal replacement therapies, as if these treatments (which are already infamous for poor efficacy and increasing the risk of breast cancer) would nullify any benefit from physical activity. (more…)
Author Interviews, Breast Cancer, PLoS / 22.02.2014

Bodour Salhia, PhD Assistant Professor Integrated Cancer Genomics Division Translational Genomics Research Institute Phoenix, Arizona, 85004MedicalResearch.com Interview with: Bodour Salhia, PhD Assistant Professor Integrated Cancer Genomics Division Translational Genomics Research Institute Phoenix, Arizona, 85004 MedicalResearch.com: What are the main findings of the study? Dr. Salhia: Our study identified novel rare genomic and epigenomic events underlying breast cancer metastasis to brain. We demonstrated that we could molecularly subtype breast cancer brain metastasis the same way we can subtype primary breast cancer. From this analysis we found that the Luminal B subtype was the most common subtype in our cohort, followed by Her2+/ER- enriched tumors and Basal-like tumors. Each of these subtypes displayed genetic and epigenetic features reminiscent of primary breast cancer. We demonstrated that these tumors have a strong predilection to grow by activating pathways involved in G2/M cell cycle progression, whereas, many genes involved in cell migration were epigenetically silenced. Broad amplification of chromosome 8q was common, which resulted in the upregulation of important genes. (more…)
Author Interviews, BMJ, Breast Cancer, Mammograms / 13.02.2014

Anthony Miller, MD Director, Canadian National Breast Screening Study Professor Emeritus, Dalla Lana School of Public Health University of TorontoMedicalResearch.com Interview with: Anthony Miller, MD Director, Canadian National Breast Screening Study Professor Emeritus, Dalla Lana School of Public Health University of Toronto MedicalResearch.com: What are the main findings of the study? Prof. Miller:  The study involved 89,835 women aged 40 to 59. All underwent an annual physical breast examination, while half were randomly assigned to undergo annual mammograms for five years, beginning in 1980. During the five-year screening period, 666 invasive breast cancers were diagnosed in the mammography arm and 524 in the controls.  Over the 25 year follow-up 180 women in the mammography arm and 171 women in the control arm died of breast cancer.  The overall hazard ratio for death from breast cancer diagnosed during the screening period associated with mammography was 1.05 (95% CI: 0.85 – 1.30).  The findings for women aged 40-49 and aged 50-59 were almost identical. After 15 years of follow-up an excess of 106 cancers was observed in the mammography arm, attributable to over-diagnosis, i.e. 22% of screen-detected invasive breast cancers, half of those detected by mammography alone. This represents one over-diagnosed breast cancer for every 424 women screened by mammography. By 2005, 3,250 of the 44,925 women in the mammography arm of the study were diagnosed with breast cancer, and 500 had died of it. The control group of 44,910 women had 3,133 breast cancer diagnoses and 505 breast cancer deaths. We conclude that annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. (more…)