Could Keloids Suggest Increased Risk of Breast Cancer?

MedicalResearch.com Interview with:

Lamont R. Jones, MD, MBA Vice Chair Department of Otolaryngology HNS Henry Ford Hospital Facial Plastic and Reconstructive Surgery Director Cleft and Craniofacial Clinic Otolaryngology Service Chief Henry Ford West Bloomfield Hospital

Dr. Jones

Lamont R. Jones, MD, MBA
Vice Chair
Department of Otolaryngology HNS
Henry Ford Hospital
Facial Plastic and Reconstructive Surgery
Director Cleft and Craniofacial Clinic
Otolaryngology Service Chief
Henry Ford West Bloomfield Hospital

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

Response: The objective of this study was to explore the potential link between keloid development and clinical outcomes of African American women with breast cancer.

MedicalResearch.com: Would you briefly explain what is meant by a keloid?

Response: A keloid is a benign fibrorproliferative tumor of the skin which is more common in African Americans which results from injury such as surgery, ear piercing, burns or infection.

MedicalResearch.com: What are the main findings?

Response: Keloid status of an individual may be indicative of a risk to be diagnosed with early-onset, late staged breast cancer. In addition, it was a distinguishing factor among African American women, which may point to a pathological/molecular pathway that predicates their unique cancer risk.

MedicalResearch.com: What should readers take away from your report?

Response: The research results are preliminary. However, because keloids disproportionately affect African American patients, it may serve as a model to better understand how their tissue microenvironment. Moreover, insights into keloid formation may help to identify ancestry specific biomarkers that may be used as future therapeutic targets to treat cancers in African Americans.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Larger prospective or case control studies may provide more information and better determine the potential correlation of keloid status and breast cancer outcomes. 

Citation:

https://www.henryford.com/news/2019/01/keloids-linked-to-early-onset-and-late-stage-breast-cancer

Jan 30, 2019 @ 2:18 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Breast Cancer Survivors More Likely To Develop Subsequent Blood Cancers

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.

Continue reading

What Causes ‘Chemo Brain’ in Women?

MedicalResearch.com Interview with:

Nicole J. Gervais, Ph.D. Postdoctoral fellow | Einstein lab University of Toronto, Department of Psychology Toronto, ON

Dr. Gervais

Nicole J. Gervais, Ph.D.
Postdoctoral fellow | Einstein lab
University of Toronto, Department of Psychology
Toronto, ON 

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

Response: Aromatase inhibitors (AIs) including letrozole are given as an adjuvant therapy for postmenopausal women with hormone receptor positive breast cancer. Women taking this drug have reported a number of symptoms including hot flashes, memory complaints and mood changes. However, not all studies report memory issues. This might be due to the fact that studies in this population are hampered by confounds, such as chemotherapy/radiotherapy, stress and disease stage, all of which can also adversely impact memory. These confounds make it challenging to observe the independent effects of AIs on memory. By using a non-human primate model, we were able to examine the effects of aromatase inhibition on these symptoms as well as brain function without these confounding effects.

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Breast Cancer Risk Remains Elevated 20-30 years After Childbirth

MedicalResearch.com Interview with:

Dale P. Sandler, Ph.D.  Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH

Dr. Sandler

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.  Continue reading

Canadian Task Force Updates Breast Cancer Screening Guidelines

MedicalResearch.com Interview with:

Dr. Ainsley Moore MD, CFPC, MSc(HB), MSc(CLinEpi) Cand
Associate Professor,McMaster University
Associate Editor,Canadian Medical Education Journal
Vice-Chairof the Canadian Task Force on Preventive Health Care
Dr. Moore

Dr. Ainsley Moore MD, CFPC, MSc(HB), MSc(CLinEpi) Cand
Associate Professor,McMaster University
Associate Editor,Canadian Medical Education Journal
Vice-Chair,  Canadian Task Force on Preventive Health Care

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

Response: The Canadian Task Force for Preventive Health Care has updated its Breast Cancer Screening Guideline. It places an emphasis on shared decision-making between women and their health care provider so that women can make an informed decision based on how they prioritize the benefits and harms of screening with mammography.  

Screening may identify breast cancer earlier and lead to a reduction in breast cancer mortality; however, i talso has known harms such as false positive results, further testing including biopsy, and over diagnosis leading to unnecessary treatment with associated complications.

MedicalResearch.com: What are the main findings?

Response: An updated review of the evidence continues to show a close balance between potential benefits and harms of breast cancer screening; this balance appears to be less favourable for younger women than for women aged 50 to 74 years.

A separate review conducted for this guideline on women’s values and preferences about mammography screening suggests that many women aged 40 to 49 years would choose not to be screened if they were aware of the outcomes for their age group. On the other hand, women aged 50 to 74 years are more likely to choose screening given their more favourable balance of benefits and harms

The recommendations:

  • The TaskForce provides conditional recommendations against screening women age 40 to49 years who are not at increased risk of breast cancer, low certainty evidence shows a small potential reduction in breast cancer death along with higher risk of harms including false positive results, further testing including possible breast biopsy and overdiagnosis leading to unnecessary treatment with associated complications. Recommendations are conditional upon how an individual woman from this age group weighs the benefits and harms of screening
  • The TaskForce provides conditional recommendations in favour of screening women aged 50 to 74 years who are not at increased risk of breast cancer, very low-certainty evidence suggests a modest reduction in risk of breast cancer death and, while the risk of harms of screening are lower than for younger women, it remains a concern.  Recommendations are conditional upon who an individual woman of this age group weighs the benefits and harms of screening

MedicalResearch.com: What should readers take away from your report?

Response: The Task Force provides information on the benefits and harms of breast cancer screening and has developed tools on their website to help guide the discussion between women and their health care provider so that they can make the decision that is best for themFor more details on the Task Force’s findings and recommendations and patient tools, please visit: canadiantaskforce.ca

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: More and better-quality evidence is needed on the impact of breast cancer screening for women of all ages.  Additional studies on Canadian women’s values and preferences for screening that are based on accurate estimates of both benefits and harms conducted in a transparent and easily comparable manner would assist in guiding future recommendations.

MedicalResearch.com: Is there anything else you would like to add?

Response: The Public Health Agency of Canada established theCanadian Task Force for Preventive Health Care to make recommendations forCanadian primary care providers on a broad array of preventive health issues.The members of the Task Force were selected for their expertise in Preventive health care delivered in primary care settings. Task Force members adhere to the highest ethical standards including the avoidance of professional conflicts of interest in order to ensure the scientific credibility of its recommendations.

Citation:

Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer

Scott Klarenbach, Nicki Sims-Jones, Gabriela Lewin, Harminder Singh, Guylène Thériault, Marcello Tonelli, Marion Doull, Susan Courage, Alejandra Jaramillo Garcia and Brett D. Thombs; for the Canadian Task Force on Preventive Health Care

CMAJ December 10,2018 190 (49) E1441-E1451; DOI:https://doi.org/10.1503/cmaj.180463

Dec 11, 2018 @ 8:44 pm

The information onMedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

After Menopause, High Body Fat Associated with Doubled Risk of Estrogen+ Breast Cancer

MedicalResearch.com Interview with:

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

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.

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Women Benefit from Mammography Screening Beyond Age 75 

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.

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Estrogen Receptors More Versatile and Widespread Than Previously Recognized

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.

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About 20% of Women With Earlier Stage Breast Cancer Progress to Metastatic Disease Within 20 Years

MedicalResearch.com Interview with:

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

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.

Continue reading

Breast Cancer: Gene Expression of Receptors on a Chip Can Enhance Precision Diagnosis

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. Continue reading

Modest Post-Menopausal Weight Loss Linked To Lower Breast Cancer Risk

MedicalResearch.com Interview with:

Rowan Chlebowski, MD, PhD Research Professor Department of Medical Oncology & Therapeutics Research City of Hope National Medical Center Duarte, California

Dr. Chlebowski

Rowan Chlebowski, MD, PhD
Research Professor
Department of Medical Oncology & Therapeutics Research
City of Hope National Medical Center
Duarte, California

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

Response: Regarding study background while obesity has been for several decades been well established respect cancer incidence, it has been difficult to provide evidence that weight loss in postmenopausal women would reduce their breast cancer risk.

We address this question by examining short-term, three year weight loss of 5% or more in most menopausal women participating in the Women’s Health Initiative observational study.

Women who lost this moderate amount of weight regardless of their baseline weight experience as statistically significant lower breast cancer incidence.

Continue reading

Cutting Out Bacon, Sausage and Hot Dogs May Reduce Risk of Breast Cancer

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.  Continue reading

Mammograms: Minorities and Poor Less Likely To Report Barriers to Care

MedicalResearch.com Interview with:

Mammogram showing small lesion - Wikipedia

Mammogram showing small lesion
– Wikipedia

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. Continue reading

Most Patients Who Carry BRCA1/2 Pathogenic Variants Are Unaware

MedicalResearch.com Interview with:

Michael F. Murray, MD, FACMG, FACP Director for Clinical Operations in the Center for Genomic Health Yale School of Medicine

Dr. Murray

Michael F. Murray, MD, FACMG, FACP
Director for Clinical Operations in the Center for Genomic Health
Yale School of Medicine

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

Response: Population screening for the cancer risk associated with the BRCA1 and BRCA2 genes has been suggested by some.  We screened a cohort of about 50,000 adult patient volunteers at Geisinger Health System in Pennsylvania for this risk.  Continue reading

Patients Most Often Receive Breast Cancer Diagnosis By Phone

MedicalResearch.com Interview with:

Dr. Emily Albright, MD Surgical Oncology Missouri University Health Care

Dr. Albright

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.

Continue reading

Disease-Free and Overall Survival Among Patients With Operable HER2-Positive Breast Cancer Treated With Sequential vs Concurrent Chemotherapy

MedicalResearch.com Interview with:

Kelly K. Hunt, MD Department of Breast Surgical Oncology The University of Texas MD Anderson Cancer Center Houston

Dr. Hunt

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. Continue reading

Routine Mammography Screening Recommendations Do Not Apply To Women With History of Breast Cancer

MedicalResearch.com Interview with:

Lisa A Newman, MD Director of the Breast Oncology Program for the multi-hospital  Henry Ford  Health System

Dr. Newman

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.  Continue reading

Continued Aggressive Treatment Indicated For Younger Women with Breast Cancer Who Have Incomplete Response to Chemo

MedicalResearch.com Interview with:

Kathleen Horst, MD Associate Professor of Radiation Oncology (Radiation Therapy)  Stanford University Medical Center

Dr. Kathleen Horst

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.  Continue reading

Breast and Ovarian Cancers: More Genes Than BRCA1 and BRCA2

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.   Continue reading

DCIS is a Bona Fide Breast Cancer, Not a Cancer Precursor

MedicalResearch.com Interview with:

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

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.  Continue reading

Coming Soon – More Lung than Breast Cancer in Women

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.

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Yin Yang 1 Regulatory Protein May Help Breast Cancer Evade Treatment

MedicalResearch.com Interview with:

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

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.   Continue reading

Early Dinner May Lower Cancer Risk

MedicalResearch.com Interview with:
“Christmas Roast and Ham Dinner. Had Tamales for Christmas Eve and Christmas morning. #Roast #Ham #ChristmasDinner #Christmas #Champagne #Dinner #Foodstagram” by Yvonne Esperanza is licensed under CC BY 2.0Manolis Kogevinas, MD, PhD

Research Professor
NCDs & Environment Group
Barcelona Institute for Global Health (ISGlobal) – Campus MAR
Barcelona Biomedical Research Park (PRBB) (office 194)
Barcelona, Spain

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

Response: We did the study for two main reasons.

(i) breast and to a less extent prostate cancer are the cancers that have been associated with night shift work and resulting circadian disruption (disruption of the natural day-light cycle);

(ii) experimental studies in animals indicate that timing of diet is important. For example, giving an hypercaloric diet to mice during the day results in obesity, while giving the same diet during the night does not. Mice are nocturnal animals and this means that there normal eating time is the night when they can metabolise what they eat. So, would something similar affect humans? When we eat in late hours at a time when “normally” (normally in the sense of evolution) we would be resting.

In this study we show that adherence to a more diurnal eating pattern and specifically an early supper and a long interval between last meal and sleep are associated with a lower breast and prostate cancer risk. Specifically having super before 9pm and having an interval of 2 hours between the last big meal and sleep, were both associated with an approximately 20% prevention of breast and prostate cancer) compared to those who have supper after 10pm or those who eat and then sleep very close after supper.

Also, the strongest protection was found in “morning types” as compared to “evening types”. Morning types are expected to function worse than evening types in late evening so late suppers may have more adverse effects on them.

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Acupuncture For Pain in Breast Cancer Patients on Aromatase Inhibitors

MedicalResearch.com Interview with:

Dawn Hershman, MD, MS, FASCO Professor of Medicine and Epidemiology Leader, Breast Cancer Program Herbert Irving Comprehensive Cancer Center Columbia University Medical Center

Dr. Hershman

Dawn Hershman, MD, MS, FASCO
Professor of Medicine and Epidemiology
Leader, Breast Cancer Program
Herbert Irving Comprehensive Cancer Center
Columbia University Medical Center

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

Response: Aromatase inhibitors are effective in reducing the risk of recurrence in hormone sensitive breast cancer, however they commonly cause joint pain and stiffness that can lead to early discontinuation of treatment. We know that women who stop early do not get the same benefits as those who continue for the full duration.

Acupuncture has been shown to improve a variety of pain syndromes. We conducted a large multicenter trial among women with joint pain on aromatase inhibitors and randomized patients to true acupuncture, sham acupuncture and a waitlist control arm.

We found that acupuncture resulted in more pain reduction than the other 2 control groups. Measuring pain can be challenging in clinical trials. We now know that a meaningful reduction for a patient is 2 points on a 10 point scale. We found that nearly 60 percent of women in the true acupuncture group experienced at least a 2-point reduction in pain, versus 33 percent of the sham acupuncture group and 31 percent of the controls. These results where highly statistically significant.  Continue reading

Targeting Breast Cancer Screening To Higher Risk Patients Reduces Overdiagnosis, Costs and Side Effects

MedicalResearch.com Interview with:

Dr Nora Pashayan PhD Clinical Reader in Applied Health Research University College London Dept of Applied Health Research London 

Dr. Pashayan

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.

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