Author Interviews, Breast Cancer, Chemotherapy, Genetic Research, JAMA, NEJM / 26.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27366" align="alignleft" width="150"]Prof. Laura van ’t Veer, PhD Leader, Breast Oncology Program, and Director, Applied Genomics, UCSF Helen Diller Family Comprehensive Cancer Center Angela and Shu Kai Chan Endowed Chair in Cancer Research UCSF Helen Diller Family Comprehensive Cancer Center Dr. Laura Van't Leer[/caption] Prof. Laura van ’t Veer, PhD Leader, Breast Oncology Program, and Director, Applied Genomics, UCSF Helen Diller Family Comprehensive Cancer Center Angela and Shu Kai Chan Endowed Chair in Cancer Research UCSF Helen Diller Family Comprehensive Cancer Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: MINDACT was designed to involve only patients with node negative and 1 to 3 positive lymph node breast cancer. Node negative breast cancer is a cancer that has not spread to the surrounding lymph nodes and therefore has a lower risk of recurrence. Scientists have also demonstrated that breast cancer which has spread to 1 to 3 lymph nodes may behave like node negative breast cancer. Patients with either node negative cancer or with a cancer that involves 1-3 lymph nodes are often prescribed chemotherapy, although physicians believe that approximately 15% of them do not require such treatment. MINDACT provides the highest level of evidence to show that using MammaPrint® can substantially reduce the use of chemotherapy in patients with node-negative and 1-to-3 node positive breast cancer – in other words, it can identify patients with these types of breast cancer who can safely be spared a treatment that may cause significant side effects, and will offer no to very little benefit.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Chemotherapy, Nature / 25.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27306" align="alignleft" width="125"]Shyamala Maheswaran, PhD Associate Professor of Surgery Harvard Medical School Assistant Molecular Biologist Center for Cancer Research Dr. Shyamala Maheswaran[/caption] Shyamala Maheswaran, PhD Associate Professor of Surgery Harvard Medical School Assistant Molecular Biologist Center for Cancer Research MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 85% hormone receptor positive HER2 negative metastatic breast cancer patients show that cancer cells acquire HER2 expression during disease progression. These HER2 positive cells coexist with HER2 negative cancer cells, and these two populations are able to spontaneously oscillate between these two states; in culture and in cancers established in mice. Both HER2 positive and HER2 negative cells form tumors when injected into mice, but HER2 positive cancer cells form tumors more rapidly than HER2 negative tumors. At a molecular level, several growth factor pathways are activated in HER2 positive cancer cells, while activation of the Notch pathway, an embryonic signaling event, is observed in HER2 negative cells. Thus the HER2 positive and HER2 negative cancer cells exhibit differential sensitive to drugs: the HER2 positive cells, which are more proliferative and non-responsive to HER2-targeting agents, are responsive to chemotherapy drugs whereas the HER2 negative tumor cells are sensitive to Notch inhibitors. A combination of chemotherapeutic drugs and notch inhibitors effectively eliminate tumors formed by a mixture of these two population of cancer cells compared to either drug alone. These findings highlight the importance of tumor heterogeneity in cancer progression and drug responses and suggest that targeting all the different populations within cancers is necessary to effectively manage cancer progression.
Author Interviews, Breast Cancer, Cancer Research, Cost of Health Care, Sloan Kettering, Surgical Research / 18.08.2016

MedicalResearch.com Interview with: [caption id="attachment_27055" align="alignleft" width="275"]Monica Morrow, MD, FACS Chief, Breast Service, Department of Surgery Anne Burnett Windfohr Chair of Clinical Oncology Dr. Monica Morrow[/caption] Monica Morrow, MD, FACS Chief, Breast Service Department of Surgery Anne Burnett Windfohr Chair of Clinical Oncology Memorial Sloan-Kettering Cancer Center MedicalResearch.com: What is the background for this study? Response: DCIS, ductal carcinoma in situ, intraductal cancer or Stage 0 cancer refers to what some people call the earliest form of cancer we can find and others term “precancerous”. This difference in terms is due to the fact that DCIS lacks the ability to spread to other parts of the body, a fundamental characteristic of cancer. The goal of treatment in DCIS is to prevent progression to invasive cancer which has the ability to spread. DCIS accounted for only 2-3 % of breast cancers seen in the pre-screening mammography era, but it comprises 25-30% of the malignancies detected in screening mammography programs. For this reason it is uncommon in women under age 40, and more commonly seen in women over 50 years of age. Approximately 70% of the women in the US diagnosed with DCIS are treated with lumpectomy (removal of the DCIS and a margin of surrounding normal breast tissue), and additional surgeries to obtain clear, or more widely clear, margins are done in approximately 30% of women. For this reason, the Society of Surgical Oncology, the American Society for Therapeutic Radiation Oncology, and the American Society of Clinical Oncology undertook the development of an evidence based guideline to determine the optimal clear margin for women with DCIS treated with lumpectomy and whole breast radiotherapy.
Author Interviews, Breast Cancer, Cost of Health Care, Johns Hopkins / 11.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26928" align="alignleft" width="170"]Pedram Argani, M.D. Professor of Pathology and Principal consultant of the Breast Pathology Service Johns Hopkins Medicine Dr. Pedram Argani[/caption] Pedram Argani, M.D. Professor of Pathology and Principal consultant of the Breast Pathology Service Johns Hopkins Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Most pathology laboratories, at the request if clinicians, automatically (reflexively) test needle core biopsies containing ductal carcinoma in situ (DCIS) for estrogen receptor (ER) and progesterone receptor (PR). The logic for testing DCIS for these hormone receptors is that, for patients who have pure DCIS that is ER positive after surgical excision, treatment with estrogen blockers like Tamoxifen can decrease the recurrence of DCIS by a small amount, though overall survival (which is excellent) is not impacted. However, there are several factors which suggest that this reflex testing unnecessarily increases costs. • First, the ER/PR results on core needle biopsy do not impact the next step in therapy; namely, surgical excision. • Second, a subset of excisions performed for DCIS diagnosed on core needle biopsy will harbor invasive breast carcinoma, which would than need to be retested for ER/PR. • Third, because ER and PR labeling is often variable in DCIS, negative results for ER/PR in a small core biopsy specimen should logically be repeated in a surgical excision specimen with larger amounts of DICS to be sure that the result is truly negative. • Fourth, many patients with pure DCIS which is ER/PR positive after surgical excision will decline hormone therapy, so any ER/PR testing of their DCIS is unnecessary. • Fifth, PR status in DCIS has no independent value. We reviewed the Johns Hopkins experience with reflex ER/PR testing of DCIS on core needle biopsies over 2 years. We found that reflex core needle biopsy specimen testing unnecessarily increased costs by approximately $140.00 per patient. We found that ER/PR testing in the excision impacted management in only approximately one third of cases, creating an unnecessary increased cost of approximately $440.00 per patient. Extrapolating the increased cost of reflex ER/PR testing of DCIS to the 60,000 new cases of DCIS in the United States each year, reflex core needle biopsy ER/PR testing unnecessarily increased costs by approximately 35 million dollars.
Author Interviews, Breast Cancer, MRI, PLoS / 02.08.2016

MedicalResearch.com Interview with: [caption id="attachment_26671" align="alignleft" width="75"]Barbara Bennani-Baiti, MD, MS Dr. Bennani-Baiti[/caption] Barbara Bennani-Baiti, MD, MS and [caption id="attachment_26672" align="alignleft" width="69"]Pascal Andreas Baltzer MD Dr. P. Baltzer[/caption] Pascal Andreas Baltzer MD Departement of Biomedical Imaging and Nuclear Medicine Medical University of Vienna Vienna, Austria MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breast MRI ist the most sensitive method for detecting breast cancer. It is currently routinely used in the screening of high-risk patients and as an additional imaging technique in case of inconclusive conventional imaging (mammography and ultrasound). Besides its high sensitivity for detection of breast cancer, breast MRI further provides functional information about normal breast tissue perfusion. Background parenchymal enhancement (BPE) reflects the perfusion or vascularization of the breast and is generally higher in active breast tissue. High-risk patients harbor breast tissue that is at an elevated risk for breast cancer due to several factors (i.e. mutations such as BRCA1, high familial risk, previous radiation of the chest wall, etc.). After a connection between increased breast cancer odds and elevated BPE has been shown in high-risk patients, the community has since assumed that an elevated background enhancement at breast MRI equates an elevated risk for breast cancer for all women. We have shown that this not true for women that are not considered high-risk. In fact, the only risk factor for women undergoing breast MRI without additional risk factors is age.
Author Interviews, Breast Cancer, JAMA, Technology / 29.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26499" align="alignleft" width="150"]Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology University of Michigan Ann Arbor, MI Dr. Lauren Wallner[/caption] Lauren P. Wallner, PhD, MPH Assistant Professor, Departments of Medicine and Epidemiology University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? What are the main findings? Response: Online communication tools like email and social media could be used to support patients through their cancer treatment decision making and ongoing care. Yet, we know very little about whether and how newly diagnosed cancer patients use these tools and whether using online communication influences patients appraisals of their treatment decision making process. We surveyed 2,460 women with newly diagnosed breast cancer as part of the iCanCare Study about their use of email, texting, social media and web-based support groups following their diagnosis. Our findings suggest that women who more often used these online communication tools deliberated more about their surgical treatment and were more satisfied with their treatment decision. However, the use of social media in this diverse population was lower than we expected (12%), and was less common in older women, those with less education, and Black and Latina women.
Author Interviews, Breast Cancer, Fertility, JAMA, OBGYNE / 20.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26343" align="alignleft" width="174"]Alexandra W. van den Belt-Dusebout, PhD Department of Epidemiology The Netherlands Cancer Institute The Netherlands Dr. Alexandra van den Belt-Dusebout[/caption] Alexandra W. van den Belt-Dusebout, PhD Department of Epidemiology The Netherlands Cancer Institute The Netherlands MedicalResearch.com: What is the background for this study? Response: In vitro fertilization (IVF) is commonly used, but because of the relatively recent use of IVF, long-term breast cancer risk is not yet known. Female sex hormones have been shown to affect breast cancer risk. Because sex hormone levels during hormonal stimulation of the ovaries for IVF are up to 10 times higher than in natural cycles, IVF was expected to increase breast cancer risk.
Annals Internal Medicine, Author Interviews, Breast Cancer, Mammograms / 19.07.2016

MedicalResearch.com Interview with: Dr-Brian-SpragueBrian L. Sprague, PhD Assistant Professor Department of Surgery Assistant Professor Department of Biochemistry University of Vermont MedicalResearch.com: What is the background for this study? Response: Having dense breasts makes mammography more difficult to interpret and is also an independent risk factor for developing breast cancer. About half of all U.S. states require that information on the density of a woman's breasts be made available to her after a mammogram, and in some states the report must also inform such women that there are additional tests, such as breast magnetic resonance imaging (MRI), that may detect breast cancer in women who have dense breasts and normal mammograms. Such laws are controversial because of the large number of women affected (around 40% of women aged 40-74) and due to a lack of consensus in the medical community regarding the benefits and harms of supplemental screening strategies. An additional concern is the subjective nature of breast density assessment, which is based on the Breast Imaging Reporting and Data System (BI-RADS) that provides four possible categories for breast density.
Author Interviews, Breast Cancer, CMAJ, Pain Research / 13.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25902" align="alignleft" width="150"]Jason Busse PhD Department of Anesthesia Department of Clinical Epidemiology & Biostatistics McMaster University Hamilton, ON Dr. Jason Busse[/caption] Jason Busse PhD Department of Anesthesia Department of Clinical Epidemiology & Biostatistics McMaster University Hamilton, ON MedicalResearch.com: What is the background for this study? What are the main findings? Response: Persistent pain after breast cancer surgery affects up to 60% of patients. Early identification of those at higher risk could help inform optimal management. We conducted a systematic review and meta-analysis of observational studies to explore factors associated with persistent pain among women who have undergone surgery for breast cancer. We found that development of persistent pain after breast cancer surgery was associated with younger age, radiotherapy, axillary lymph node dissection, greater acute postoperative pain and preoperative pain. Axillary lymph node dissection increases the absolute risk of persistent pain by 21%, and provides the only high yield target for a modifiable risk factor to prevent the development of persistent pain after breast cancer surgery.
Author Interviews, Breast Cancer, Genetic Research / 12.07.2016

MedicalResearch.com Interview with: [caption id="attachment_26042" align="alignleft" width="150"]Ana I. Vazquez PhD Department of Epidemiology and Biostatistics Michigan State University East Lansing, Michigan Dr. Ana I. Vazquez[/caption] Ana I. Vazquez PhD Department of Epidemiology and Biostatistics Michigan State University East Lansing, Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Precise predictions of whether a tumor is likely to spread would help clinicians and patients choose the best course of treatment. But current methods fall short of the precision needed. We tested whether breast cancer survival predictions could be improved by profiling primary tumor samples with genomic technologies. We found that predictions based on clinical information, such as cancer stage and subtype, improve when they incorporate comprehensive data on which genes are active in tumor samples compared to non-cancerous tissues from the same patient. This is also true for genome-wide methylation data, which maps the parts of the DNA that carry molecular "tags" that influence gene activation. If developed for use in the clinic, our approach could spare some patients from unneeded chemotherapy.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Endocrinology, JAMA / 04.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25685" align="alignleft" width="108"]Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA Dr. Aditya Bardia[/caption] Aditya Bardia, MD, MPH Massachusetts General Hospital Cancer Center Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While endocrine therapy is the recommended therapy for Estrogen Receptor positive (ER+) breast cancer, the role of endocrine therapy in neoadjuvant (pre-surgical) setting is unclear. We performed this systematic review and meta-analysis to comprehensively evaluate the efficacy of neoadjuvant endocrine therapy, both alone and in combination with other therapies, compared to neoadjuvant chemotherapy for localized ER+ breast cancer. We found no statistically significant differences between the two treatments in regards to clinical response, imaging response, rates of breast conservation therapy, and achievement of pathologic complete response.
Author Interviews, Breast Cancer, Mammograms / 01.07.2016

MedicalResearch.com Interview with: [caption id="attachment_25725" align="alignleft" width="196"]Rachel Brem, MD Professor of Radiology and Director of Breast Imaging and Intervention George Washington University School of Medicine. Dr. Rachel Brem[/caption] Rachel Brem, MD Professor of Radiology and Director of Breast Imaging and Intervention George Washington University School of Medicine. MedicalResearch.com Editor’s note: Many states now have laws regarding patient notification of breast density after mammography screening. Dr. Brem discusses the background and implications of the new mandatory notification laws. MedicalResearch.com: What is meant by 'breast density?’ Is breast density a risk factor for breast cancer? Is breast cancer more difficult to detect in dense breasts? Dr. Brem: Breast density is a measure used to describe the proportion of fat versus breast tissue, which includes fibrous and glandular tissue. Dense breasts contain more fibrous and glandular tissue and less fatty tissue. This is important because on a mammogram dense breast tissue is white and breast cancer is white. The lack of contrast can make detecting cancer more difficult. You can only tell if your breasts are dense from the mammogram. You can’t feel dense breast tissue or see it. An estimated 40 percent of women have dense breast tissue that may mask the presence of cancerous tissue in standard mammography. Dense breast tissue decreases with age, but remains important throughout life. Over 75 percent of women in their 40s have dense breast tissue but over a third of women in their 70s have dense breast tissue. As breast density increases, mammography sensitivity decreases. This is significant, but we must consider the increased risk of breast cancer in women with dense breast tissue. Women with dense breast tissue have up to a four-fold increased risk of developing breast cancer. So, breast density is essentially the “perfect storm” where the ability to detect cancer decreases while the risk for breast cancer increases. Therefore, optimal approaches to individualized breast cancer screening are needed.
Author Interviews, Breast Cancer, Microbiome / 26.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25539" align="alignleft" width="123"]Gregor Reid, B.Sc. Hons., Ph.D., MBA, ARM, CCM, Dr. HS, FCAHS Director, Canadian Centre for Human Microbiome and Probiotic Research Lawson Health Research Institute London, Ontario, Canada Dr. Gregory Reid[/caption] Gregor Reid, B.Sc. Hons., Ph.D., MBA, ARM, CCM, Dr. HS, FCAHS Director, Canadian Centre for Human Microbiome and Probiotic Research Lawson Health Research Institute London, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Women who breast feed have reduced risk of breast cancer. Human milk has bacteria passed on to the child. These bacteria reach the breast through the nipple and from the gut via the blood. Lactobacilli and Bifidobacteria, beneficial bacteria, grow well in milk. So, I wondered what if women never lactate or breast feed, could bacteria be there? Could bacteria be in the tissue itself and influence whether you got or did not get cancer. Proving there are bacteria in the actual breast tissue itself was an interesting discovery defying previous beliefs.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, MRI, Surgical Research / 24.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25507" align="alignleft" width="120"]Eva C. Gombos, MD Assistant Professor, Radiology Harvard Medical School Brigham and Women’s Hospital Dr. Eva Gombos[/caption] Eva C. Gombos, MD Assistant Professor, Radiology Harvard Medical School Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? Response: Treatment of early stage breast cancer, breast-conserving therapy (BCT), which consists of lumpectomy followed by whole-breast irradiation, requires re-excision 20 %–40% of patients due to positive margins. Breast MR is the imaging modality with the highest sensitivity to detect breast cancer. However, patients who undergo breast MR imaging have not experienced reduced re-excision or improved survival rates. Our hypothesis is that supine (performed with patient lying on her back) MR imaging within the operating room can be used to plan the extent of resection, to detect residual tumor immediately after the first attempt at definitive surgery, and to provide feedback to the surgeon within the surgical suite. The aim of this study was to use intraoperative supine MR imaging to quantify breast tumor deformation and displacement secondary to the change in patient positioning from imaging (prone performed the patient lying on her stomach) to surgery (supine) and to evaluate the residual tumor immediately after BCT.
ASCO, Author Interviews, Breast Cancer, Genetic Research, Journal Clinical Oncology, NIH / 14.06.2016

MedicalResearch.com Interview with: [caption id="attachment_25171" align="alignleft" width="160"]Valentina Petkov, MD, MPH Health Scientist/Program Officer NIH/NCI/DCCPS/Surveillance Research Program Dr. Petkov[/caption] Valentina Petkov, MD, MPH Health Scientist/Program Officer NIH/NCI/DCCPS/Surveillance Research Program MedicalResearch.com: What is the background for this study? Dr. Petkov: The number of breast cancer diagnoses is increasing in older patients because of increasing life expectancy and changing population demographics. Despite high incidence, little is known about breast cancer biology and outcomes in patients older than 70, which are often under-represented in clinical trials. The 21-gene Oncotype DX Breast Recurrence Score assay has been used in clinical practice to predict distant recurrence risk and chemotherapy benefit in lymph node negative, hormonal receptor positive (estrogen and/or progesterone receptor positive) invasive breast cancer since 2004. The goal of our study was to evaluate the role of the 21 gene assay in older patients at population level. We used Surveillance Epidemiology and End Results (SEER) data. We included in the analysis 40,134 patients who were diagnosed with invasive breast cancer between 2004 and 2011, had negative nodes and their tumors were hormonal receptor positive and HER2 negative. Breast Cancer Specific Mortality (BCSM) was assessed at 5 years after diagnosis in patients with low risk (Recurrence Score <18), intermediate risk (Recurrence Score 18-30) and high risk (Recurrence Score >30).
Author Interviews, Breast Cancer, Lipids, MRI, NYU / 09.06.2016

MedicalResearch.com Interview with: Sungheon G. Kim, PhD Associate Professor Department of Radiology NYU Langone and Researcher at the Center for Advanced Imaging, Innovation, and Research MedicalResearch.com: What is the background for this study? Dr. Kim: The role of fat in breast cancer development and growth has been studied extensively using body mass index (BMI), a measure of whole body fatness, and dietary fat intake in a number of epidemiological studies. However, there is a paucity of studies to assess the role of breast fat itself in breast cancer due to lack of a non-invasive and fast measurement method. Since breast fibroglandular cells are surrounded by breast fat cells, the characteristics of breast fat may have a stronger relationship with breast cancer development and growth than BMI and/or dietary fat. However, it is not trivial to study the role of breast fat, mainly due to the lack of a non-invasive and fast measurement method sensitive enough to important features of breast fat, such as types of fat.
Anesthesiology, Author Interviews, Breast Cancer, Opiods, Pain Research / 04.06.2016

MedicalResearch.com Interview with: Dr. Sarah Saxena Université Libre de Bruxelles MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Saxena: Opioids are well known analgesics, but like every drug, they do not come without side-effects. Recently, certain studies have been published about an opioid-free approach in bariatric patients. An opioid free approach is possible combining ketamine, lidocaine and clonidine. We studied this type of approach in breast cancer patients and looked at several factors such as patient comfort pain quality after an opioid free approach vs after an opioid approach. The study showed patients requiring less analgesics after an opioid free approach.
Author Interviews, Breast Cancer, Genetic Research, Ovarian Cancer / 26.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24691" align="alignleft" width="115"]Sibaji Sarkar Ph.D Instructor of medicine Boston University School of Medicine Boston Dr. Sibaji Sarkar[/caption] Sibaji Sarkar Ph.D Instructor of medicine Boston University School of Medicine Boston MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Sarkar: Although breast and ovarian cancers have different clinical presentations, there are certain molecular events that are conserved between the two types of cancers. For example, mutation in a few genes, such as BRCA1, BRCA2, is an indicator of possible development of both breast and ovarian cancers. ARHI, a pro-apoptotic imprinted gene is epigenetically silenced in both breast and ovarian cancers. A similar pattern was observed in microRNA as well. There are also several genes which are differentially expressed in these two types of cancers but few of these striking resemblances led us to investigate whether they have a common origin. In this paper, we compared genetic and epigenetic events in both breast and ovarian cancers and we hypothesize that they may have similar origin (mechanism of formation of cancer progenitor cells), which should be regulated by epigenetic mechanism.
Author Interviews, Breast Cancer, Leukemia / 22.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24558" align="alignleft" width="80"]Dr. Iris Z Uras Dr. Uras[/caption] Dr. Iris Z Uras and Univ.-Prof. Dr. Veronika Sexl [caption id="attachment_24559" align="alignleft" width="80"]Univ.-Prof. Dr. Veronika Sexl Dr. Sexl[/caption] Institute of Pharmacology and Toxicology University of Veterinary Medicine Vienna MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acute myeloid leukemia (AML) is the most common form of acute leukemia in adults. Patients suffering from AML have poor prognosis and high mortality rate despite considerable advances in chemotherapy and hematopoietic stem cell transplantations. Up to 30% of patients with AML harbor an activating mutation in the FLT3 receptor tyrosine kinase (FLT3-ITD). Such mutations are associated with a high predisposition to relapse after remission. In a simplified way we can say that these tumor cells depend on FLT3: Is FLT3 blocked, cells die. Hence, FLT3 inhibitors are being developed as targeted therapy for FLT3-mutant AML; however, clinical responses are short-lived and their use is complicated by rapid development of resistance. This emphasizes the need for additional therapeutic targets. Our study represents a novel therapeutic window to specifically target and kill AML cells with FLT3-ITD mutations. We found that the tumor-promoting enzyme CDK6 but not its close relative CDK4 directly regulates and initiates the production/transcription of FLT3 and thus lead to disease. The FDA-approved kinase inhibitor Palbociclib not only blocks the activity of CDK6 but in turn impairs FLT3 expression: Mutant AML cells die immediately. The treatment does not affect cells without the mutation. The power of CDK6 inhibition in AML cells goes beyond FLT3: Palbociclib also stops production of the PIM1 kinase and thus overcomes the potential activation of survival pathways counteracting the effects of FLT3 inhibition.
Author Interviews, Breast Cancer, Weight Research, Women's Heart Health / 18.05.2016

MedicalResearch.com Interview with: [caption id="attachment_24457" align="alignleft" width="68"]Julie M. Kapp, MPH, PhD Associate Professor 2014 Baldrige Executive Fellow University of Missouri School of Medicine Department of Health Management and Informatics Columbia, MO 65212 Dr. Kapp[/caption] Julie M. Kapp, MPH, PhD Associate Professor 2014 Baldrige Executive Fellow University of Missouri School of Medicine Department of Health Management and Informatics Columbia, MO 65212 MedicalResearch.com: What is the background for this study? Dr. Kapp: For the past several decades the U.S. has had the highest obesity rate compared to high-income peer countries, and for many years people in the U.S. have had a shorter life expectancy. For female life expectancy at birth, the U.S. ranked second to last. At the same time, the U.S. has the third highest rate of mammography screening among peer countries, and the pink ribbon is one of the most widely recognized symbols in the U.S. While the death rate in females for coronary heart disease is significantly higher than that for breast cancer, at 1 in 7.2 deaths compared to 1 in 30, respectively, women have higher levels of worry for getting breast cancer.
Author Interviews, Breast Cancer, Brigham & Women's - Harvard, Nutrition, Pediatrics / 13.05.2016

[caption id="attachment_21216" align="alignleft" width="144"]Dr. Maryam S. Farvid, PhD Takemi Fellow Harvard T.H. Chan School of Public Health Dr. Maryam Farvid[/caption] MedicalResearch.com Interview with: Maryam Farvid, Ph.D. Visiting Scientist Department of Global Health and Population Harvard T.H. Chan School of Public Health MedicalResearch: What is the background for this study? What are the main findings? Dr. Farvid: Breast cancer is one of the most frequently diagnosed cancers and is the second leading cause of cancer deaths among women in the United States. While we know many breast cancer risk factors, few of them are easily modified. Further, evidence suggests that exposure to carcinogens and anti-carcinogens in early life may play an important role. According to this study, what women eat as teens or young adults could affect their breast cancer risk in the future. Teenage girls who eat a lot of fruits may have a lower risk of breast cancer later in life. The risk of breast cancer among women who reported the highest amount of dietary fruits during high school, about 2.9 servings of fruit a day, was 25 percent lower, compared with those who had eaten the lowest amount, about 0.5 serving of fruit a day. We also analyzed individual fruit and vegetable intake and risk of breast cancer: greater consumption of apple, banana, and grapes during adolescence, as well as oranges and kale for young adult was significantly associated with a reduced risk.
Author Interviews, Breast Cancer, Cost of Health Care, Radiation Therapy / 11.05.2016

MedicalResearch.com Interview with: Jayant S Vaidya MBBS MS DNB FRCS PhD  Professor of Surgery and Oncology,  Scientific Director, Clinical Trials Group, Division of Surgery and Interventional Science, University College London Whittington Health - Clinical Lead for Breast Cancer Royal Free Hospital University College London HospitalJayant S Vaidya MBBS MS DNB FRCS PhD  Professor of Surgery and Oncology, Scientific Director, Clinical Trials Group, Division of Surgery and Interventional Science, University College London Whittington Health - Clinical Lead for Breast Cancer Royal Free Hospital University College London Hospital  MedicalResearch.com: What is the background for this study? What are the main findings? Prof. Vaidya: TARGIT-A randomised clinical trial (ISRCTN34086741) compared giving TARGIT IORT during lumpectomy vs. traditional EBRT given over several weeks after lumpectomy for breast cancer; local-recurrence-free-survival was similar in the two arms of the trial, particularly when TARGIT was given simultaneously with lumpectomy. Also, there were significantly fewer deaths from other causes with TARGIT IORT. This study calculated journeys made by patients with breast cancer to receive their radiotherapy, using the geographic and treatment data from a large randomised trial. The study then assessed the same outcomes (travel distances, travel time and CO2emissions) in two semi-rural breast cancers—the results of this assessment confirm and reinforce the original results: the benefit of the use of TARGIT for patients from two semi=rural breast centres was even larger (753 miles (1212 km), 30 h, 215 kg CO2 per patient).
Author Interviews, Breast Cancer, Mammograms / 06.05.2016

MedicalResearch.com Interview with: Ragnhild Falk PhD Oslo Centre for Biostatistics and Epidemiology Research Support Services Oslo University Hospital and Solveig Hofvind PhD Department of Screening Cancer Registry of Norway and Oslo and Akershus University College of Applied Sciences Oslo, Norway MedicalResearch.com: What is the background for this study? What are the main findings? Response: The issue of overdiagnosis has been heavily debated, and a variety of results have been presented. However, the exact proportion of overdiagnosis is unknown as one do not know what would have happen in the absent of screening. We have split the proportion of overdiagnosis into two parts based on the time at which the death occur; scenario 1 as the proportion of women diagnosed with a screen-detected breast cancer and who died within the lead-time period, and scenario 2 as women detected with slow growing tumors that never would have caused any harm during the women’s life if she had not attended screening. In principle, all screening programs will detect breast cancer among women who die of other causes in the near future since there exist competing risk of death among women targeted by screening. Although the all-cause mortality rates are low, it is inevitable. We wanted to focus on the first scenario and estimated the number of women diagnosed with screen detected breast cancer who died within the estimated lead-time period caused by screening. We estimated his proportion to be less than 4 percent of all screen-detected cases in the given England & Wales and the Norwegian setting.
Author Interviews, Breast Cancer, Chemotherapy, Heart Disease, Kaiser Permanente / 04.05.2016

MedicalResearch.com Interview with: [caption id="attachment_19768" align="alignleft" width="156"]Reina Haque, PhD, MPH Research scientist Department of Research & Evaluation Kaiser Permanente Southern California Pasadena Calif Dr. Reina Haque[/caption] Reina Haque, PhD MPH Research scientist Kaiser Permanente Southern California Department of Research & Evaluation MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Haque: The study fills an important knowledge gap about the long-term association of aromatase inhibitors on cardiovascular disease risk in breast cancer survivors. This was a retrospective cohort study that included a cohort of 13,273 postmenopausal breast cancer survivors who were diagnosed with breast cancer, either estrogen or progesterone receptor positive, from 1991 to 2010. The patients were followed through 2011, or a maximum of 21 years. The study participants were divided into four groups based on the drugs they received: 31.7 percent were treated only with tamoxifen; 28.6 percent only with aromatase inhibitors; 20.2 percent used both; and 19.4 percent did not use any of these drugs. These oral drugs are used to combat breast cancer recurrence, but may have long-term side effects on other organs. The study determined that the risk of cardiac ischemia (which can lead to a heart attack) and stroke were not elevated in patients who only took aromatase inhibitors compared to those who only took tamoxifen. These results provide reassurance that aromatase inhibitors may not increase risk of the potentially fatal cardiovascular outcomes compared to tamoxifen.
Author Interviews, Breast Cancer, Compliance, Genetic Research, Mammograms / 27.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23818" align="alignleft" width="150"]Stamatia Destounis, MD, FSBI, FACR Elizabeth Wende Breast Care, LLC, Clinical Professor of Imaging Sciences University of Rochester School of Medicine and Dentistry  Rochester NY 14620 Dr. Stamatia Destounis[/caption] Stamatia Destounis, MD, FSBI, FACR Elizabeth Wende Breast Care, LLC, Clinical Professor of Imaging Sciences University of Rochester School of Medicine and Dentistry  Rochester NY 14620  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Destounis: Identification of women who have an increased risk of breast cancer is important, as they are often eligible for additional screening methods, such as breast MRI. One criterion for eligibility for screening breast MRI is >20% lifetime risk of breast cancer, as determined by risk assessment models through genetic counseling. At my facility, we have incorporated a genetics program. Through the program we are flagging and identifying a large volume of patients who are potentially eligible for additional services. This study was conducted to determine the value of screening MRI in the patient subgroup who have undergone genetic counseling at my facility. In this group we found 50% of patients who were referred for counseling were also recommended to have screening MRI. However, only 21.3% of those recommended actually pursued the exam. Of those patients who did have a screening MRI, 4 were diagnosed with breast cancer, all of which were invasive and node negative. We ultimately had a 10% biopsy rate and 50% cancer detection rate in this subgroup.
Author Interviews, Breast Cancer, JAMA, Mammograms / 27.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23815" align="alignleft" width="250"]Elizabeth A. Rafferty, MD Department of Radiology, Massachusetts General Hospital, Boston  Now with L&M Radiology, West Acton,  Massachusetts Dr. Elizabeth Rafferty[/caption] Elizabeth A. Rafferty, MD Department of Radiology, Massachusetts General Hospital, Boston Now with L&M Radiology, West Acton, Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Rafferty: Breast tomosynthesis has been approved for mammographic screening in the United States for just over 5 years, and many single center studies have demonstrated its improved performance for screening outcomes over digital mammography alone. Our previously published multi-center analysis, (JAMA 2014;311(24), the largest study on this topic to date, demonstrated significantly improved cancer detection and reduced recall rates for women undergoing tomosynthesis compared with digital mammography alone.  In the current issue of JAMA we evaluate the differential screening performance after implementation of breast tomosynthesis as a function of breast density. While tomosynthesis continues to be increasingly available, questions remained about which women should be imaged with this technique. In particular, does this technology offer additional benefit for all women, or only for women with dense breasts. The size of the database compiled by the centers participating in this study allowed us to evaluate this important question. The most critical finding of our study was that the use of tomosynthesis for breast cancer screening significantly improved invasive cancer detection rates while simultaneously significantly reducing recall rates both for women with dense and non-dense breast tissue. Having said that, the magnitude of the benefit was largest for women with heterogeneously dense breast tissue; for this population, tomosynthesis increased the detection of invasive cancers by 50% while simultaneously reducing the recall rate by 14%.
Author Interviews, Breast Cancer, JAMA / 26.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23778" align="alignleft" width="147"]Ahmad Awada, MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles Bruxelles, Belgium Dr. Ahmad Awada[/caption] Ahmad Awada, MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles Bruxelles, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Dr. AwadaThis Study compared, in a randomized fashion, paclitaxel + trastuzumab to paclitaxel + neratinib in the first line setting of metastatic breast cancer. All outcome endpoints (PFS, OS, ORR) were similar. In addition, paclitaxel + neratinib delayed the appearance and decreased the incidence of central nervous system (CNS) events (secondary end point) MedicalResearch.com: What should clinicians and patients take away from your report? Dr. Awada:  Paclitaxel + neratinib is as effective as paclitaxel + trastuzumab. The data suggested that neratinib could influence the pattern of CNS events in HER2+ metastatic breast cancer. These emerging data on CNS events are under validation in the NALA trial.
AACR, Author Interviews, Breast Cancer, Cancer Research, Pediatrics, Radiation Therapy / 25.04.2016

MedicalResearch.com Interview with: [caption id="attachment_23755" align="alignleft" width="150"]Lindsay M. Morton, PhD Senior investigator in the Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetic National Cancer Institute Bethesda, Maryland Dr. Lindsay Morton[/caption] Lindsay M. Morton, PhD Senior investigator in the Radiation Epidemiology Branch of the Division of Cancer Epidemiology and Genetic National Cancer Institute Bethesda, Maryland MedicalResearch.com: What is the background for this study? Dr. Morton: We know that childhood cancer survivors, particularly those who received radiotherapy to the chest, have strongly increased risk of developing breast cancer. We studied about 3,000 female survivors of childhood cancer to identify whether inherited genetic susceptibility may influence which survivors go on to develop breast cancer. MedicalResearch.com: What are the main findings? Dr. Morton: In this discovery study, we found that specific variants in two regions of the genome were associated with increased risk of breast cancer after childhood cancer among survivors who received 10 or more gray of chest radiotherapy. A variant at position q41 on chromosome 1 was associated with nearly two-fold increased risk and one at position q23 on chromosome 11 was associated with a more than three-fold increased risk for each copy of the risk alleles. However, the variant alleles didn’t appear to have an effect among survivors who did not receive chest radiotherapy.
Author Interviews, Breast Cancer, JAMA / 25.04.2016

MedicalResearch.com Interview with: Sherene Loi, MBBS(Hons), FRACP, PhD Associate Professor, University of Melbourne Consultant Medical Oncologist, Breast Unit Head, Translatonal Breast Cancer Genomics and Therapeutics Lab Cancer Council Victoria John Colebatch Fellow Peter MacCallum Cancer Centre, East Melbourne Victoria, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Loi: Even though HER2 amplification/overexpression is such a strong oncogenic driver in breast cancer, clinical and biological heterogeneity is still evident. Our study was performed to investigate the hypothesis that a subgroup of patients with ER-positive, HER2-positive primary breast cancers seem to have lower responses to anti-HER2 therapy, in this case trastuzumab (trade name Herceptin), and we could better identify this group using both ER and HER2 levels. Our study was designed to try to better define this group so we could potentially evaluate the efficacy of future treatment strategies in this group, particularly as combination anti-HER2 therapy (i.e. trastuzumab and pertuzumab) is currently being investigated in the adjuvant setting.