April 17, 2008, 4:01 AM CT

lapatinib shrinks breast cancer tumors in6 weeks

A drug that targets the cell surface receptors that play an important role in many types of cancer can bring about significant tumour regression in breast cancer after only six weeks of use, a scientist told the 6th European Breast Cancer Conference (EBCC-6). Dr. Angel Rodriguez, from the Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, USA, said that the work demonstrated for the first time that the tyrosine kinase inhibitor lapatinib could decrease tumour-causing breast cancer stem cells in the primary breast cancers of women receiving neoadjuvant treatment (treatment given before the primary surgery for the disease).

Dr. Rodriguez and colleagues studied 45 patients with locally advanced breast cancer in which the gene HER-2 was over-expressed. The patients received lapatinib for six weeks, followed by a combination of weekly trastuzumab and three-weekly docetaxel, given over 12 weeks, before primary surgery. Biopsies were performed at the time of diagnosis and also after six weeks of lapatinib and cells from the tumours were obtained and analyzed.

We saw significant tumour regression after six weeks of single agent lapatinib, said Dr. Rodriguez. Bi-dimensional tumour measurements showed a median decrease of minus 60.8%. We had previously showed that tumour-causing breast cancer stem cells were resistant to conventional preoperative chemotherapy; indeed, residual cancers that were exposed to such chemotherapy showed an increase in tumour-causing cells and enhanced tumour initiation by the formation of mammospheres, small tumours that form when tumour-causing cells are cultured in a test tube, which reflect the capacity of the cells to self-renew. So we were excited to see that the results with lapatinib were different......... Posted by: Betsy      Read more         Source

April 13, 2008, 9:42 PM CT

MRI 'best' for looking at breast cancer and more

The use of MRI is effective in differentiating the blood supply to medial and lateral breast tumors, which is important in therapy planning and prognosis as per a research studyconducted by scientists at the University of Miami in Miami, FL and the Rabin Medical Center in Petah Tikva, Israel.

Blood supply of medial tumors is mainly through the internal mammary vessels while lateral tumors may be supplied by both the internal or lateral mammary branches.

MRI is currently the best modality enabling us to visualize not only cancer in the breast but the effect it has on the surrounding anatomy, particularly regarding vascular supply and lymphatic drainage, said Ahuva Grubstein, MD, of the Rabin Medical Center and lead author of the study.

The study reviewed 47 tumors (24 medial and 23 lateral) compared to 54 negative and non-malignant cases. Of the 24 medial tumors, 21 predominately received blood from the medial vessel (87%) while 3 predominately received blood from the lateral vessel (13%). Of the 23 lateral tumors, 11 predominately received blood from the medial vessel (47%) while 8 predominately received blood from the lateral vessel (35%). As per the study, 18% of the lateral tumor cases didnt demonstrate any predominant vessel. We dont have enough data regarding aggressiveness of tumors and their blood supply, only that cancerous tumors can change the normal breast blood supply and that this change depends on the tumor location within the breast, said Dr. Grubstein. This change can be used as a marker for malignancy compared to non-malignant findings, he said......... Posted by: Betsy      Read more         Source

March 16, 2008, 9:53 PM CT

Gene Variant Increases Breast Cancer Risk

An international research consortium under the leadership of researchers of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) has shown that a common gene variant increases the risk of developing breast cancer.

In roughly five to ten percent of breast cancer cases there is a family history of breast cancer- i.e., hereditary and, thus, genetic factors play a role here. Alterations in the genes known as BRCAI and BRCAII are a major cause of familial breast cancer - these are responsible for roughly 25 percent of such cases.

"In Gera number of, 75 percent of familial breast cancers are not attributable to mutations in BRCAI and BRCAII. We assume that these cancers are caused in part by rare mutations and in part by unfavorable combinations of risk variants in various genes, which, on their own, have only little effect. Only very few of these have been identified so far - we are searching for the other ones," said Associate Professor Dr. Barbara Burwinkel of the DKFZ.

Members of the AKAP protein family are responsible for transmitting important signals in a cell. Researchers have suspected these proteins to be involved in cancer development. A large international study headed by Barbara Burwinkel has now delivered proof that this is true for breast cancer......... Posted by: Betsy      Read more         Source

March 7, 2008, 5:34 AM CT

High levels of estrogen associated with breast cancer recurrence

Women whose breast cancer came back after therapy had almost twice as much estrogen in their blood than did women who remained cancer-free despite therapy with anti-estrogen drugs in a majority of the women as per scientists as per a research findings reported in the recent issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

The findings suggest that high levels of estrogen contribute to an increased risk of cancer recurrence, just as they lead to the initial development of breast cancer, said the studys lead author, Cheryl L. Rock, Ph.D., a professor in the Department of Family and Preventive Medicine at the University of California, San Diego.

While this makes sense, there have been only a few small studies that have looked at the link between sex hormones in the blood and cancer recurrence, she said. This is the largest study to date and the only one to have included women taking agents such as tamoxifen to reduce estrogens effect on cancer growth.

What the results mean for women who have already been treated for breast cancer is that they should do as much as they can to reduce estrogen in their blood, such as exercising frequently and keeping weight down, she added. Taking anti-estrogen drugs like tamoxifen may not completely wipe out the hormones effect in women who have high levels of estrogen......... Posted by: Betsy      Read more         Source

February 25, 2008, 9:18 PM CT

Test To reduce recurrence of breast cancer

A new test that examines large sections of the sentinel lymph node for genes expressed by breast cancer could reduce the risk of recurrence and multiple surgeries, doctors say.

The GeneSearch Breast Lymph Node Assay, manufactured by Veridex, L.L.C., a Johnson & Johnson company, is being used at the Medical College of Georgia to examine half of the tissue in the sentinel lymph node, the first place breast cancer typically spreads. The sample represents more than 10 times the amount of tissue examined in traditional biopsies.

And because the test examines the tissue with molecular tools, it is more sensitive, says Dr. Zixuan (Zoe) Wang, molecular biologist and scientific director of MCG's Georgia Esoteric and Molecular Diagnostic Labs, L.L.C.

"When we look at the tissue with the GeneSearch test, we are looking for excessive amounts of mamoglobin and cytokeratin 19, both genes that are expressed more in breast cancer tissue," Dr. Wang says. "If those genes are present in excessive amounts, we know the cancer has metastasized."

MCG is the first place in Georgia to offer the test, which Time Magazine named one of the top-10 medical breakthroughs of 2007.

Done during a lumpectomy, the GeneSearch test uses molecular diagnostic methods to examine more tissue than traditional sentinel node biopsies, reducing the chance of false negative results, says Dr. Stephen Peiper, chair of the MCG Department of Pathology and Georgia Cancer Coalition Distinguished Cancer Physician and Scientist......... Posted by: Betsy      Read more         Source

January 31, 2008, 11:01 PM CT

Breast cancer diagnosis comes late

Women who live in Chicago's gentrifying neighborhoods are more apt to receive a late diagnosis of breast cancer than women who live in poverty-stricken neighborhoods, University of Illinois at Chicago scientists have found.

The surprising finding is as per a research findings reported in the recent issue of the Annals of Epidemiology.

"There's been a lot of social change in American cities since 1990, but we know very little about how gentrification impacts health outcomes," said Richard Barrett, researcher at the UIC Institute for Health Research and Policy and lead author of the study. "We know that minority women in Cook County are more likely to be diagnosed with late-stage breast cancer and to die from it compared with white women, but we were interested in how neighborhood change impacts breast cancer diagnosis".

Prior research indicated that places with more people of higher socioeconomic status tend to have lower rates of distant metastasis when diagnosed with breast cancer, Barrett said.

"That would lead one to assume that if an area becomes gentrified, then the proportion of breast cancer cases diagnosed with distant metastases would decline, and patients should have a better chance for survival.

"Our study showed that is not true"......... Posted by: Betsy      Read more         Source

January 28, 2008, 10:40 PM CT

Reducing Symptoms In Breast Cancer Patients

Psychological interventions for cancer patients do more than just ease emotional distress - they directly improve health, new research suggests.

A study of 227 patients with breast cancer observed that those who participated in a psychological intervention program were rated as having better health by a research nurse a full year after the program started.

One especially important result was that patients who exercised received a higher dose of their chemotherapy drug, possibly improving their overall therapy.

"Patients who participated in the program showed fewer and less severe symptoms, and functioned better than those who didn't take part," said Barbara Andersen, co-author of the study and professor of psychology at Ohio State University.

"These were independent health evaluations by nurses who didn't know which patients were participating in the psychological intervention, so we know the effects were real and significant".

The results were reported in recent issues of the Journal of Consulting and Clinical Psychology and Brain, Behavior, and Immunity.

Participants in the study were patients with breast cancer at the Ohio State University Medical Center. All had been diagnosed with Stage II or Stage III breast cancer, had received mastectomies, and underwent chemotherapy during the course of the study......... Posted by: Betsy      Read more         Source

January 17, 2008, 10:19 PM CT

NICE guidelines on breast cancer need urgent revision

The NICE guidelines on follow-up for patients with breast cancer need urgent revision, warn experts in this weeks BMJ.

More than 1.2 million women and men worldwide are diagnosed with breast cancer each year and it is now recognised as a chronic disease that can recur even after 20 -30 years.

Survival continues to improve, so new cancers are now more common in a number of patients than recurrence because the therapys of the first cancer are so effective. However, follow-up protocols still vary widely both within and between countries and are not always evidence based.

The National Institute for Health and Clinical Excellence (NICE) in England and Wales state that the aims of breast cancer follow-up are to detect and treat local recurrence, to deal with adverse effects of therapy and to provide psychological support.

The guidelines suggest that these aims can be met by two to three years of follow-up, and that routine long term follow-up is ineffective and unwarranted. They also claim that the yield from mammography is low.

But Michael Dixon, Consultant Surgeon at Edinburgh Breast Unit and David Montgomery, Clinical Research Fellow at Glasgow Royal Infirmary, argue that the NICE guidelines do not meet their stated aims.

Eventhough true local recurrence after breast conserving surgery falls with time, the development of new cancers in the treated breast increases, so the overall rate of ipsilateral breast events is constant at 0.5 to 1% each year for at least the first 10 years and probably for the rest of the patients life......... Posted by: Betsy      Read more         Source

January 8, 2008, 9:22 PM CT

Choosing overly aggressive treatments for breast cancer

Despite a 1990 consensus recommendation from the National Institutes of Health (NIH) that lumpectomy plus radiation was the therapy of choice for early stage breast cancer, the United States continues to have the highest rate of mastectomy surgery among industrialized countries. Why would a person knowingly undertake a far more severe form of therapy when a lesser one would suffice? A recent survey shows that only 74 percent of women diagnosed with early stage breast cancer (ductal carcinoma in situ or DCIS) chose breast-conserving surgery even though 82 percent of their physicians had recommended the procedure.

To answer this question, we investigate the framing of individual risk understandings by the broader cultural discourses surrounding the disease, explain Nancy Wong and Tracey King (both Georgia Institute of Technology). In-depth interviews. suggest that screening and therapy decisions are influenced by the predilection toward restitution narratives that exists in the United States and other Anglo-western societies. Reflecting culturally structured values toward illness, the dominant narrative of restitution is reinforced by the long-established biomedical model through its emphasis on personal agency, control, and survival.

Due to increases in the availability and sophistication of mammographic screening, DCIS now accounts for approximately 20 percent of all breast cancer cases. The scientists find that womens individual understandings of breast cancer and the risks linked to detection, therapy, and reconstructive surgery are heavily influenced by the ideas of vigilant detection, aggressive therapy, and conformity in maintaining appearances......... Posted by: Betsy      Read more         Source

December 28, 2007, 8:14 AM CT

Taxol with avastin for metastatic breast cancer

The positive results of the first nationwide clinical study showing the benefits of an antiangiogenic agent in breast cancer therapy are reported in the Dec. 27 issue of the New England Journal (NEJM).

The study with Avastin showed the biggest improvement in metastatic breast cancer ever reported in a chemotherapy-based clinical trial. It nearly doubled the time between initiation of chemotherapy for metastatic disease and progression of the breast cancer tumors.

The study was coordinated by the Eastern Cooperative Oncology Group (ECOG) and Kathy Miller, M.D., associate professor of medicine and Sheila D. Ward Scholar at the Indiana University School of Medicine, is the lead author.

Dr. Miller said she found the results exciting because this was the first study to show that an antiangiogenic agent can delay progression of advanced breast cancer. The study looked at Taxol (paclitaxel), which is one of the standard agents for metastatic disease, with and without the addition of Avastin (bevacizumab).

This study not only achieved the longest progression-free survival in advanced disease but the therapy achieved that improvement without adding to the day-to-day treatment burden and with only minor increases in toxicity, said Dr. Miller.

The study enrolled 722 women with metastatic disease from the United States, Canada, Peru and South Africa. Patients were randomized to one of two arms of the phase III study Taxol alone or Taxol with Avastin. The patients, who joined the study from December 2001 through May 2004, represented a balance of age, disease-free interval, estrogen-positive receptors and sites of disease......... Posted by: Betsy      Read more         Source