Breast cancer blog from bcancer.com

Cancer In Women With Rare Breast Condition

14 Nov 2006 02:49:44 am GMT +0

[imgl]/images/blog/lcis--alh-calcification-61.jpg[/imgl]Women whose mammograms reveal a suspicious lesion need a needle biopsy to confirm or rule out cancer. But if that biopsy reveals only abnormal - not cancerous - cells, is a more extensive evaluation necessary? Yes, suggests a new study by doctors at Washington University School of Medicine in St. Louis. They looked at the medical records of women whose initial core-needle breast biopsies found rare, yet non-cancerous breast conditions: atypical lobular hyperplasia (ALH) or lobular carcinoma-in-situ (LCIS). These lesions are known to increase a woman's risk of breast cancer, but what the researchers found was surprising. Follow-up surgical biopsies in which more breast tissue was removed found that up to 25% of the women actually had cancer in addition to their high-risk breast conditions. Most of the cancers were invasive, meaning the tumors had penetrated normal breast tissue and would require treatment. None of the tumors had spread beyond the breast. "This is very significant," explains lead author Julie A. Margenthaler, M.D., assistant professor of surgery and a breast surgeon at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. "We now know that we can't assume that women with ALH or LCIS are cancer free". The researchers published their study in the recent issue of The American Journal of Surgery. LCIS and ALH are known to increase the risk of breast cancer but neither is considered a precancerous condition. Together, they represent only about one percent of all breast lesions, Margenthaler says. "This seems like a small number but with more than 100,000 core-needle breast biopsies performed in the United States each year, the number of potential cancers missed by not doing a more extensive follow-up biopsy is sizeable". The study included 35 women who received more extensive surgical biopsies after the initial core-needle biopsies showed LCIS or ALH. Core-needle biopsies are performed with local anesthesia and use a hollow needle to remove several small samples of breast tissue that are then examined under a microscope for tell-tale signs of cancer. If the cells are abnormal, a surgical biopsy can be performed immediately. It involves removing the entire suspicious area, along with some of the surrounding, normal tissue, which leaves a small scar. In the study, core-needle biopsies found LCIS in 16 patients, and follow-up surgical biopsies detected cancer in four of these women. Of the 19 patients initially diagnosed with ALH, surgical biopsies found that three of them had cancer. All but one of the seven cancers was invasive. The researchers noted no difference between those with cancer and those without in terms of age, number of children, hormonal status or previous breast biopsies - all risk factors for breast cancer. The cancers detected in the current study are tiny, too small to be felt by a woman or her doctor, says senior author Jill R. Dietz, M.D., assistant professor of surgery and a Washington University breast surgeon. "In patients who were ultimately found to have cancer, it is likely that the core-needle biopsy simply missed the cancer cells and instead extracted the non-cancerous cells". As a comparison, the study also included 61 women whose core-needle biopsies detected a precancerous condition called atypical ductal hyperplasia (ADH). Previous studies have found that many of these women actually have cancer in addition to ADH. Indeed, breast surgeons have for several years routinely recommended that women with ADH routinely undergo more extensive surgical biopsies to look for cancer. That recommendation was confirmed by the current study. The more extensive surgical biopsies found cancer in 31 percent of the women who were initially diagnosed with ADH from the needle biopsy. Based on the current study's results, all patients whose initial breast biopsies show LCIS or ALH at Barnes-Jewish Hospital in St. Louis now routinely receive a follow-up surgical biopsy to confirm or rule out cancer. "This is an important shift in the way we approach these patients," Margenthaler says. "In the past, whether women received a more extensive biopsy was often an arbitrary decision, based on the recommendation of the surgeon or the pathologist". As the number of women getting mammograms continues to increase, and imaging techniques improve, Dietz and Margenthaler say they expect to see a rise in cases of LCIS and ALH. "Knowing that these women should receive more extensive surgical biopsies will have a dramatic effect on our ability to diagnose breast cancer at the earliest stage possible and ensure the women get the treatment they need," Dietz says....

Breast Cancer Survivors Have Higher Suicide Rates

30 Oct 2006 11:26:27 pm GMT +0

[imgl]/images/blog/mask-78900.jpg[/imgl]The burden is not over for breast cancer patients even after the battle with breast cancer is won. A new study suggests that breast cancer survivors have an increased risk committing suicide compared to women in the general population. Survivors of breast cancer have as much as 37 percent increased risk of committing suicide compared to other women and this increased risk of suicide persist for more than 25 years after the diagnosis of breast cancer. These study findings were published in a recent issue of the Journal of the National Cancer Institute. There have been previous studies on this topic but none have undertaken such a long-term study of the subject and none of the studies included women from the United States of America. This conclusion is from analysis of a large pool of data involving 723,810 breast cancer survivors who were diagnosed between 1953 and 2001 and were included in population-based cancer registries in the United States and Scandinavia. The researchers have found that during follow-up through 2002, a total of 836 women committed suicide. Compared with the general population the women with breast cancer had a suicide rate of 4.1 per 100,000 women per year. Even after a period of 25 years, breast cancer survivors still had a 35 percent increased risk of committing suicide. Suicide rates were higher among African American women, with a 2.88-fold elevated risk. Researchers noted that the risk of committing suicide increases with increasing stage of breast cancer. [url=http://breast-cancer-blog.com/blogs/permalinks/10-2006/breast-cancer-survivors.html]Source[/url]...

Cosmetic Outcome Of Lumpectomy

08 Oct 2006 11:03:06 pm GMT +0

[imgl]/images/blog/lumpectomy.jpg[/imgl]Women with breast cancer often undergo a lumpectomy and radiation to save their breasts and avoid the need for additional reconstructive surgery. However, approximately one-third of all patients are unhappy with how their breasts look after undergoing breast conservation treatment and a number of would consider reconstruction, as per a research studypresented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2006 conference in San Francisco. "I have patients walking into my office saying lumpectomy was supposed to save their breast but what's left doesn't look like a breast to them," said Howard Wang, ASPS Member Surgeon and co-author of the study. "Conservation is thought to bean acceptable way of saving a woman's breast. But a number of of these women are coming to plastic surgeons for help, saying it isn't so". In the study, 28 percent of the patients with breast cancer stated they were dissatisfied with the cosmetic result of their lumpectomy. Of those patients, 46 percent stated their physical appearance was worse or much worse after the surgery and were considering reconstruction. Only nine percent of patients who were satisfied with the outcome, however, would consider reconstruction if it were offered. Approximately 26 percent of patients were unhappy with their physical appearance after the lumpectomy but had an improved sense of body image. Plastic surgeons believe this disparity occurred because a number of patients felt relieved to be free of the cancer, leading them to feel better about their bodies even though they were not happy with how their breasts looked. As per the American Cancer Society, almost 213,000 women will be diagnosed with breast cancer this year. Almost 58,000 women underwent breast reconstruction surgery in 2005, as per ASPS. "Patients should know their options and understand that just because they undergo a lumpectomy to save their breast does not mean they will be happy with the cosmetic outcome," said Dr. Wang. "Oncologists need to work with patients to help them understand the potential physical outcomes and refer them to a board-certified plastic surgeon to consider all of their choices"....

Worried About An Abnormal Mammogram?

25 Sep 2006 10:05:59 am GMT +0

[imgl]/images/blog/breast-biopsy-129010.jpg[/imgl]Worried about an abnormal mammogram? Quite understandable, but mammogram abnormality does not mean breast cancer. More important, now what should you do if the mammogram detects an abnormality? Experts in the field indicate that if an abnormality is detected in the mammogram performing a breast biopsy is the best strategy, for follow up of the abnormality even though there are several other options available. Breast biopsy is considered to be the standard approach to mammogram abnormality, and recently a report by the Agency for Healthcare Research and Quality (AHRQ) compared the effectiveness of biopsy, with four other available options. These options includes magnetic resonance imaging (MRI), ultrasound imaging, positron emission tomography (PET) scanning; and scintimammography. The report convincingly concludes that biopsy is the gold standard; when it comes to the long-term follow up an abnormality that is detected in the mammogram. Of course biopsy is more invasive, but is a more accurate test and requires sampling of the breast tissue. The removed tissue is analyzed under the microscope using special stain to determine the presence of malignancy. The four tests mentioned above were not as accurate as a biopsy. These tests missed between 4 percent and 9 percent of breast cancers in women with average risk. The report also suggest that in higher risk women the miss rate would be even higher. AHRQ report states that, use of MRI missed 38 cancers for every 1,000 women; ultrasound missed 50 tumors for every 1,000 women; and PET scans missed 76 per 1,000 women. Scintimammography, which is a nuclear medicine test method, missed 93 tumors for every 1,000 women. So bottom line, the good old breast biopsy is the best test to evaluate for any abnormality that was detected by mammogram....

Detecting Early Metastasis Of Breast Cancer

15 Sep 2006 02:03:52 am GMT +0

[imgl]/images/blog/metastasis-23160.jpg[/imgl]In the U.S., a novel technology soon may be available to detect the spread, or metastasis, of breast cancer earlier than now possible, as per research presented at the first international meeting on Molecular Diagnostics in Cancer Therapeutic Development, organized by the American Association for Cancer Research. Since secondary tumors, ignited by spreading cancerous cells, and not the primary breast cancer tumor, are the primary cause of cancer death, early detection of metastatic spread is crucial to a woman's prognosis. It should enable the patient's doctor to adjust the woman's therapy so that it will target the spreading cancer early, said Winfried H. Albert, Ph.D., chief scientific officer of AdnaGen, the German biotech company that developed the technology. Albert said that the company's diagnostic tool, which is being reviewed in clinical studies at The University of Texas M. D. Anderson Cancer Center in Houston, can spot one cancerous cell in a typical blood sample. A typical sample is 5 milliliters and contains over 2.5 x 1010 cells. As a biomarker for breast cancer metastasis, cancer cells circulating in the blood system have not been easy to detect and analyze because they are a "needle in the haystack" among the millions of cells in the bloodstream. However, Albert said that AdnaGen's technology can detect the "needle" with a specificity of 97 percent (only three "false" positive results in tests of 100 seemingly healthy people). "Metastasis commonly is detected by costly, cumbersome physical methods like computer tomography (CT)," added Albert. "We have seen cases, where our test was positive, when there was still no clinical evidence. But at a careful second look through a Computerized axial tomography scan, small metastatic lesions have been detected." To produce its diagnostic tool, AdnaGen links an antibody-mix to magnetic beads. This antibody-mix is tailored to home in on specific molecular features, or antigens, of the respective cancer cells. When exposed to a blood sample, the magnetic antibody-beads capture tumor cells possessing the specified antigens. A magnetic particle concentrator then removes the tumor cells labeled with the magnetic beads, and the cells are then analyzed to identify several gene products, including potential molecular targets for a specific drug. Using this technology, AdnaGen discovered that the genetic signatures of the breast cancer and its metastases may differ, with the circulating tumor cells reflecting the gene expression profile of the metastases. When a metastases has been diagnosed, therapys "commonly has been chosen as per the features of the primary tumor, neglecting the fact that metastases can differ considerably from them," Albert noted. AdnaGen, which is marketing its breast cancer assay (as well as assays for colon and prostate cancer) in Europe, is awaiting the results of a clinical trial before applying for FDA approval to make the test available in the U.S. [url=http://news.biocompare.com/newsstory.asp?id=151016]Source[/url]...