Breast Cancer

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See What Happens After You Get A Mammogram

(Courtesy: JAMA)

(Courtesy: JAMA)

By Nancy Shute, NPR

Women and their doctors have a hard time figuring out the pluses and minuses of screening mammograms for breast cancer. It doesn’t help that there’s been fierce dissent over the benefits of screening mammography for women under 50 and for older women. Continue reading

Many Older Breast Cancer Patients Receive Unnecessary Radiation Treatment

New evidence on the effectiveness of medical treatments can take a long time to be adopted by doctors.(Getty Images)

New evidence on the effectiveness of medical treatments can take a long time to be adopted by doctors.(Getty Images)

By Patti Neighmond, NPR

Cancer doctors want the best, most effective treatment for their patients. But it turns out many aren’t paying attention to evidence that older women with early-stage breast cancer may be enduring the pain, fatigue and cost of radiation treatment even though it doesn’t increase life expectancy.

Radiation had no impact on survival rates in older women with early-stage cancer.

Researchers from Duke University Medical Center analyzed the impact of a large randomized trial published in 2004 that compared treatment options for women over the age of 70 with early-stage breast cancer. That study compared cancer recurrence and survival rates among women who had surgery, chemotherapy and radiation with that of women who had surgery and chemotherapy only.

While there was a slight decrease in recurrence of cancer in the group who had radiation, there was no difference in survival, thus raising the question of whether radiation treatment for this group of patients is worthwhile. Continue reading

Genetic Variant Linked to Lower Breast Cancer Rates in Latinas

(Getty Images)

(Getty Images)

Researchers have long known that Latina women have lower rates of breast cancer compared to African-American and white women. They have mainly pointed to lifestyle and environmental factors to explain why –- Latinas tend to have more children, breast feed longer, and drink less alcohol, all factors that are associated with lower disease rates.

Now, an international study led by scientists at UC San Francisco shows that a genetic variant unique to Latina women with indigenous ancestry plays a significant role, too.

“When we were accounting for all the non-genetic risk factors in our analysis, it was not enough to explain that women with more indigenous American ancestry tended to have less breast cancer,” says lead author Prof. Laura Fejerman, a member of UCSF’s Institute of Human Genetics. Continue reading

Are Double Mastectomy Rates Driven by ‘Pink-Ribbon Culture Fearmongering’?

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‘The pink ribbon is arguably the most successful marketing tool of the 20th century.’ — Karuna Jaggar, Breast Cancer Action  (Getty Images)

You may have read the other day about the big Stanford study on double mastectomies. Researchers looked at outcomes for every women in California diagnosed with early-stage breast cancer from 1998 to 2011 — — all 189,734 of them — and found, surprisingly, that removing both breasts doesn’t increase breast cancer survival rate.

From NPR:

Women who had breast-conserving surgery had an 83.2 percent survival rate at 10 years, compared with 81.2 percent for those who had a double mastectomy.

“What it means is that women should be aware that if they choose double mastectomy, the chances are that it won’t cause them to live any longer than if they had chosen something else,” said Stanford professor Allison Kurian, lead author of the study.

Perhaps even more surprising than the lack of evidence to recommend double mastectomies is the discovery that, from 1998 to 2011, the procedure had risen among the large population studied from 2 percent to 12 percent. And for women under 40, the rate increased from 3.6 percent to a whopping 33 percent, “even though most of them had stage zero or stage one cancer, a very early, very treatable form,” NPR reports.

Continue reading

Stanford Study: Double Mastectomies Don’t Increase Breast Cancer Survival Rate

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About one-third of women under 40 diagnosed with breast cancer in California choose double mastectomy. (Getty Images)

By Nancy Shute, NPR

More women are choosing to have bilateral mastectomies when they are diagnosed with early-stage breast cancer, even though there’s little evidence that removing both breasts improves their survival compared with more conservative treatments.

Doctors worry that women choose double mastectomy out of the mistaken belief that it eliminates their future risk of cancer.
The biggest study yet on the question has found no survival benefit with bilateral mastectomy compared to breast-conserving surgery with radiation.

The study, published Tuesday in JAMA, the Journal of the American Medical Association, looked at the records of all women in California who were diagnosed with early-stage breast cancer from 1998 to 2011 — 189,734 women, all told. Continue reading

Key Drivers of the Rise in Double Mastectomies: Anxiety and MRIs

(Getty Images)

(Getty Images)

By Nancy Shute, NPR

The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don’t face a higher risk of getting cancer in the other breast.

More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.

That has cancer doctors troubled, because for those women having the other breast removed doesn’t reduce their risk of getting breast cancer again or increase their odds of survival. And they don’t know why women are making this choice.

Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.

Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn’t show more cancer. Continue reading

Exercise Cuts Breast Cancer Risk for All Women, of All Ages, Everywhere

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Women who exercised an hour a day saw the greatest risk reduction, but women who weren’t as active also reduced their risk. (Getty Images)

By Nancy Shute, NPR

This could be the simplest bit of health advice ever: Exercise reduces women’s risk of breast cancer, no matter what kind of exercise they do, how old they are, how much they weigh, or when they get started.

The more active a woman is, the better her odds of avoiding breast cancer. 

Researchers in France looked at studies that involved more than 4 million women around the world who participated in prospective studies from 1987 to 2013. They found that the more active a woman is, the better her odds of avoiding breast cancer. Women who were most active, with more than an hour a day of vigorous activity, got the most benefits, lowering their cancer risk by 12 percent.

But women who weren’t as active saw reduced risk, too, notes Mathieu Boniol, research director at the Strathclyde Institute for Global Public Health in Lyon, France. More activity was better, but anything was better than nothing. He presented the data Thursday at the European Breast Cancer Conference in Glasgow. Continue reading

In Light of the Mammogram Study: Two Thoughts on Breast Cancer

(Getty Images)

(Getty Images)

More evidence is in this week that casts doubt on the value of mammograms. To recap: Canadian researchers followed nearly 90-thousand women since the 1980s. The women were randomly assigned to mammography or physical breast exam. Now 25 years later, the researchers say that roughly equal numbers of women in each group died of breast cancer — mammography, according to this study, is not affecting the death rate at all.

In addition, mammography comes with harms. More than 1 in 5 cancers found in the mammography group were not ones that pose a threat to women’s health, the researchers say. Doctors call this “overdiagnosis.” This is a problem because the treatments for cancer are aggressive — surgery, radiation therapy, chemotherapy — and can cause harms in and of themselves. “There is no question that there is an excess in the diagnosis of tumors that are not going to kill you,” Dr. Laura Esserman, head of the UC San Francisco breast care center, told me, “We all know this phenomenon exists, but this quantifies it.”

Those are the headlines. Thursday morning, KQED’s Forum got into more detail. I was particularly interested in two points the guests made. The first was about new approaches to screening and the second was about screening as distinguished from prevention. Continue reading

The Cost of Mammograms: Is A Picture Worth $7 Billion?

(Getty Images)

(Getty Images)

The issue of how often a woman should be screened for breast cancer has been a topic of hot debate for years. But of the many different issues that are closely examined, cost is rarely among them.

Even mentioning cost typically gets patients somewhat understandably up in arms — no one wants her life to be determined by mere dollars.

But what if those dollars are being spent poorly? The harms of mammograms are well-known — false positives and overtreatment among them. What if reconsidering what we’re doing and how we’re doing it could actually lead to more lives saved?

Into the fray comes an analysis from several researchers, including Dr. Laura Esserman, a breast cancer surgeon with UCSF. They calculated the costs for screening mammography in the U.S. under different scenarios. Continue reading

For Breast Cancer Survivors, Yoga May Help Overcome Fatigue

(Go Interactive Wellness/Flickr)

(Go Interactive Wellness/Flickr)

By Allison Aubrey, NPR

Exercise helps recovery after cancer treatment, but fatigue can make working out hard. Yoga can help reduce fatigue for breast cancer survivors, a study finds. It’s one of a growing number of efforts using randomized controlled trials to see if the ancient practice offers medical benefits.

Women who took a yoga class three hours a week for three months said they experienced 40 percent less fatigue compared to a group of breast cancer survivors who did not do yoga.

“Fatigue is a major and serious problem in survivors,” even years after treatments have ended, Janice Kiecolt-Glaser, a  psychology professor at Ohio State University and lead author of the study, said.

The participants who did yoga also had lower levels of cytokines, which are markers of inflammation, in their blood, Kiecolt-Glaser says. Cytokine levels were reduced up to 20 percent six months after starting yoga. It’s not clear how this may affect their health, she says. Continue reading