Healthsifter by mary desmond pinkowish, since 2003

Breast Cancer Research: The Army of Women Program

This is an interesting find. Breast cancer expert Susan Love, MD, has partnered with Avon to form the Army of Women. Here's their stated goal:

• To recruit one million healthy women of every age and ethnicity, including breast cancer survivors and women at high-risk for the disease, to partner with breast cancer researchers and directly participate in the research that will eradicate breast cancer once and for all.
• To challenge the scientific community to expand its current focus to include breast cancer prevention research conducted on healthy women.

If you sign up, they'll send you information about studies that are recruiting participants. These might be breast cancer treatment studies, or long-term studies on prevention. So regardless of whether you've had breast cancer or not, you can help. Why not?

Migraine may "Prevent" Breast Cancer

Scientists know that falling estrogen levels can lead to migraine in some women. The same decrease in estrogen may lower breast cancer risk. Physician's First Watch reports:

"Researchers pooled data from two studies of postmenopausal women to compare odds ratios among 1900 with breast cancer and 1400 controls. Women with a migraine diagnosis showed reduced risks for ductal and lobular carcinomas — especially hormone-receptor–positive tumors.

The authors speculate that the effect derives from the association between migraine and estrogen. "Low levels of serotonin are clearly associated with increased frequency of migraine, and estrogen positively regulates serotonin," they write."

USA Today covers the angles and includes interviews with some scientists who are not so sure about a causal relationship between migraine and estrogen. Another calls the findings interesting but without much practical application. The original study appears in the journal Cancer Epidemiology, Biomarkers, and Prevention. 

Do Negative "Life Events" Increase Breast Cancer Risk?

This is a bit of a surprise. Israeli researchers found that young women who'd experienced a loss of some kind had a higher risk of breast cancer. Here's part of the write-up in today's ScienceDaily:

"Ronit Peled from the Faculty of Health Sciences at Ben-Gurion University of the Negev, Israel, led a team of researchers who questioned 255 women with breast cancer and 367 healthy controls about their life experiences and evaluated their levels of happiness, optimism, anxiety and depression prior to diagnosis. Peled said, "Young women who have been exposed to a number of negative life events should be considered an 'at-risk' group for breast cancer and should be treated accordingly".

The researchers do point out that women were interviewed after their diagnosis, which may colour their recall of their past emotional state somewhat negatively. However, according to Peled, "We can carefully say that experiencing more than one severe and/or mild to moderate life event is a risk factor for breast cancer among young women. On the other hand, a general feeling of happiness and optimism can play a protective role".

The authors point out that, "The mechanism in which the central nervous, hormonal and immune systems interact and how behaviour and external events modulate these three systems is not fully understood". As such, they suggest that "The relationship between happiness and health should be examined in future studies and relevant preventative initiatives should be developed".

The original study appears in an upcoming issue of the journal BMC Cancer. This is a hot potato.

Breast Cancer? Join a Research Study

From the Society for Women's Health Research comes an invitation:

"...patients are now being recruited for an online study that is measuring cognitive limitations of women breast cancer survivors who return to work. The study is being led by Lt. Lisseth Calvio, M.S., of the U.S. Navy, who is a doctoral student in clinical psychology at the Uniformed Services University of the Health Sciences in Bethesda, Md.

The study is looking for female breast cancer survivors, one to 10 years after primary treatment, such as surgery, radiation or chemotherapy, and women who have never had cancer. The women should be working full time and be between the ages of 18 and 65.

“The study is trying to verify the best way to measure cognitive limitations,” Calvio said. “A lot of breast cancer patients are expressing changes in their cognitive function. First, how do we measure that?  Once that is determined, we can develop strategies to treat or help cancer survivors.”

Autism and Vaccines: Autism One Conference, Chicago

AMEDnews reports evenhandedly on the Autism One conference, which was held in Chicago over the Memorial Day weekend.One of the featured speakers was Dr. Andrew Wakefield, the British physician whose 1998 paper in The Lancet claimed an association between autism and the measles, mumps, and rubella (MMR) vaccine and autism in 12 kids. But this is what's happened since then, quoting from AMEDNews:

"Every so often, a small study such as the one conducted by Dr. Wakefield comes along to buttress that belief. In this case, the momentum has held, even though 10 of the 13 authors on the 1998 paper published a statement inThe Lancet in 2004 retracting the original interpretation that their data indicated a causal link between MMR and autism, and Dr. Wakefield faces significant professional scrutiny."

That is, Dr. Wakefield is in danger of losing his license to practice. In June, the UK health authorities declared that measles is now endemic in that country and confirmed a recent measles-related death. In the US, measles rates are at their highest since 2001. It's more than spots: encephalitis and pneumonia are just two possible complications.

Damage done.

If You're at Risk for Diabetes, You're at Risk for Advanced Breast Cancer, Too

Scientists have known for awhile that women who are overweight and at risk for diabetes are also at elevated risk for breast cancer. Now, a study of 60,000 Swedish women followed since the mid-1980s (a huge, long study), brings even worse news. Being overweight and insulin resistant makes you vulnerable to diabetes and to more clinically advanced breast cancer. The data is being presented this week at a meeting in Brisbane, Australia called the Population Health 2008 conference. The findings are summarized at ScienceDaily. Here's a snippet from an interview with one of the investigators, Dr. Anne Cust:

"Women with insulin resistance or who were overweight were less likely to be diagnosed with stage 1 breast cancers but at greater risk of being diagnosed with stage 2 to 4 tumors -- larger more advanced cancers,'' she said. "We know that being overweight and having insulin resistance is a risk factor for getting cancer but - in the case of breast cancer - our study indicates that the cancer will be more advanced."

Gastric Bypass Weight Loss Surgery Lowers Cancer Risk

This is a hot one: As reported in today's LA Times, In a five-year study, Canadian researchers found that the cancer risk was reduced by 80% in people who had had gastric bypass surgery compared to a control group of obese people who did not have this surgery. Weight loss surgery has been linked to a reduced risk of heart disease and diabetes. Before you scoff at these cancer findings, know that certain types of abdominal fat actually secrete estrogen and other hormones. Estrogen excess may increase the risk of breast cancer, and in this group, the risk of breast cancer was reduced by a huge 85%, colon cancer by 70%. But there are skeptics, rightfully, who are looking at an alternative explanation for these results. Quoting from the LA Times:

But Dr. Edward H. Phillips, a bariatric surgeon at Cedars-Sinai Medical Center, was skeptical about the findings because cancer takes a long time to develop and the patients were studied for only five years.

He noted that it was now common for weight-loss surgery candidates to undergo mammograms, colonoscopies and endoscopies to screen for cancer before the procedure.

"It could be that we are selecting people out of the population who don't have cancer," biasing the results, Phillips said. He believes that losing weight will reduce the incidence of cancer but that it will take longer than five years for the effects to surface.

Christou countered that such screening "is not the standard of care" in Canada, where the subjects lived. Furthermore, many of the patients had undergone surgery as long as 15 years before the start of the study, he said, leaving plenty of time for cancer to develop.

Ultrasound for Breast Cancer Diagnosis

Many radiologists encourage women to have ultrasound exams when their breasts are radiographically dense, or hard to examine on a mammogram. A study in the current issue of JAMA reveals the pluses and minuses of that approach. The investigators enrolled more than 2800 women, all of whom were at a somewhat increased risk of breast cancer and had dense areas in at least one breast. The women then had mammograms and ultrasound exams.

Adding the ultrasound exam increased the number of breast cancer cases detected, and the researchers estimated that for every 1,000 women who had an ultrasound in these circumstances, another 1.1 to 7.2 cancer cases would be detected. Treatment could be started earlier. On the down side, the number of false alarms--that is, the number of "things" that turned up on the screening exam, were biopsied, and found to be noncancerous--quadrupled. Read what the National Cancer Institute had to say.

Digital Mammograms: A Tough Switch for Patients and Doctors

Read this New York Times article about the difficulties doctors and patients are having with the ongoing switch from conventional film mammograms to digital mammograms. Eventually, digital mammograms will
probably be a diagnostic boon. Good stuff.

But during the transition between methods, radiologists haven't always been sure of what they're looking at and often call women back in for a second or third look. Biopsies have been required to make the call in some cases. Scary, nerve-wracking stuff.  To get an idea of how different conventional and digital mammograms look, see the illustration on the second page of this article. There's more than you want to know at the National Cancer Institute Breast Cancer Screening and Testing page.

Looking at Genes and Clinical Characteristics to Find the Best Breast Cancer Treatment

ScienceDaily sums up the paper in the current about using the clinical characteristics of a breast tumor plus its genetic makeup to select the best possible treatment match. This analysis might also say something about prognosis. Quoting:

"Our goal is to treat patients on a more individualized basis, matching the right drugs with the right patients," said Anil Potti, M.D., an oncologist and researcher in the DCCC and the IGSP. "The combination of these two methods, one of which uses the clinical description of patient's breast cancer and the other which looks at gene expression at a molecular level in a patient's tumor, may allow us to do that with unprecedented accuracy. This represents a robust approach to personalizing treatment strategies in patients suffering from breast cancer."

An editorial about the use of these "gene signatures" also appears in JAMA.