Archives – December, 2011
Healthcare Prof:
2 (two votes)
A new study published within the November problem of the Journal of the American College of Surgeons shows that breast cancer patients under 40 years old who undergo fertility preservation do not face a substantial delay inside the remedy of their illness when their care is coordinated in a timely fashion.
“Easy access and very good communication amongst surgeons, medical oncologists and reproductive endocrinologists is vital,” stated Lynn Westphal, MD, associate professor, department of obstetrics and gynecology, Stanford University School of Medicine, Stanford, CA.
Frequently, young females who’re diagnosed with breast cancer need to make challenging decisions about surgical treatment options too as chemotherapeutic treatments that could permanently impair their fertility or delay childbearing. Advancements in reproductive medicine like in vitro fertilization have benefited young ladies with breast cancer.
“The burden of facing premature menopause adds to the pressure experienced by young cancer survivors,” said Irene Wapnir, MD, FACS, associate professor, department of surgery, Stanford University School of Medicine. “Fertility preservation through cryopreservation of eggs or fertilized oocytes may possibly be an critical measure to offset these concerns and promote emotional well-being. Our study shows that these procedures, when expedited and appropriately timed, do not delay cancer remedy.”
Researchers used the Stanford Cancer Center tumor registry to retrospectively identify 82 ladies younger than 40 years old who received adjuvant chemotherapy for breast cancer. Of the girls identified, 19 underwent ovarian stimulation and oocyte retrieval, and 63 did not. The timing of fertility preservation, surgical intervention and chemotherapy were compared using the time intervals between diagnosis and remedy inside the patients who didn’t undergo fertility preservation.
The study team identified that the median time from initial diagnosis to chemotherapy in ladies who underwent fertility preservation was 71 days (ranging from 45 days to 161 days) versus 67 days amongst those who did not (ranging from 27 days to 144 days; p<0.22). The median time interval from definitive operation to chemotherapy was similar in the two groups (p<0.79): 30 days for women undergoing fertility preservation (ranging from 14 days to 100 days) and 29 days for women in the control group (ranging from 12 days to 120 days). For women undergoing fertility preservation, the median time from initial diagnosis to a reproductive consultation was 30 days (ranging from 4 days to 133 days) and from referral to fertility preservation was 32 days (ranging from 13 days to 66 days).
The mean age of the females who underwent fertility preservation was 33.7 years, and 84.two percent had not previously given birth. Among females who didn’t undergo fertility remedy, the mean age was 35.2 years, and 25.four percent had not previously given birth. The two groups were dissimilar with respect to stage of illness: 47.three percent of patients within the fertility preservation group had node-negative illness, compared with 25.4 percent in the control group. In addition, 73.7 percent of the fertility preservation group had estrogen-positive tumors, compared with 65.1 percent of the manage group.
Source: Sally Garneski
Weber Shandwick Worldwide
December 30, 2011
4.5 (two votes)
Healthcare Prof:
4 (1 votes)
Nearly half of all breast cancer patients experienced chronic discomfort two to 3 years after remedy and a lot more than half felt discomfort, according to a study by Danish researchers published Tuesday within the Journal of the American Medical Association, the New York Times reports. The study located that females younger than age 40, those who underwent radiation remedy and those who had surgery to eliminate lymph nodes in the armpit are most likely to knowledge lingering pain.
In an accompanying editorial, Loretta Loftus, a senior member of the breast cancer program at the Lee Moffitt Cancer Center, wrote, “This must alert clinicians who’re caring for these patients to pay much more attention to those who are within the high risk groups for pain” (Caryn Rabin, New York Times, 11/10).
Researchers examined a 2009 survey of 3,253 Danish ladies who had breast cancer surgery in 2005 and 2006, Reuters reports. Forty-seven percent of the patients reported discomfort. Inside that group, 13% described the discomfort as severe, 39% described it as moderate and 48% said it was light. Twenty percent of the girls surveyed said they had contacted a physician within the last 3 months relating to their pain (Brown, Reuters, 11/10). Girls of all ages who had mastectomies were more likely to have severe pain than light pain. Discomfort most regularly occurred inside the breast that was operated upon, inside the chest location exactly where tissue was removed, in the upper arm exactly where lymph nodes were removed or along one side of the body, based on U.S. News & World Report‘s “On Ladies.”
“This study isn’t saying to change therapy recommendations based on whether or not a certain therapy is most likely to be associated with discomfort,” Loftus said, adding, “But it’s telling oncologists that they need to be a lot more alert towards the incidence of pain,” she stated (Kotz, “On Females,” U.S. News & World Report, 11/10). The study’s author, Henrik Kehlet of the University of Copenhagen, said a lot more research is needed to determine why some ladies encounter lingering pain and others do not (Szabo, USA Today, 11/11).
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Girls & Families, published by The Advisory Board Company.
? 2009 The Advisory Board Company. All rights reserved.
December 29, 2011
Healthcare Prof:
An analysis conducted by the Finnish Breast Cancer Group and published in the Lancet Oncology shows ladies at intermediate to high-risk of early breast cancer recurrence who received capecitabine as part of their chemotherapy regimen had a 34% reduction within the risk of the illness returning or death, compared with those taking the chemotherapy combination regimen without capecitabine.
The pre-planned three-year interim analysis of a randomised, prospective trial (known as FinXX) compared adjuvant capecitabine in combination with docetaxel and cyclophosphamide plus epirubicin for the remedy of early breast cancer with the standard, non-capecitabine regimen (docetaxel, epirubicin, cyclophosphamide and fluorouracil).[1] The analysis also discovered that patients taking the capecitabine-containing regimen had been significantly less likely to have their cancer spread (distant metastasis) to another part of the body (a 36% reduction in threat was observed). This is the first phase III randomised trial to report efficacy of capecitabine combination therapy in the adjuvant treatment of early breast cancer.
“Capecitabine has already been shown to be effective in patients with advanced breast cancer. In addition, these results from the FinXX study show that using a capecitabine-containing regimen inside the early stages of breast cancer might offer survival benefits for girls, which is a primary goal of treatment,” said Professor Heikki Joensuu, Principal Investigator, Helsinki University Hospital, Finland. “I am encouraged by this analysis, which demonstrates that adding capecitabine towards the chemotherapy regimen within the early stages of breast cancer may prevent the cancer coming back,” he added.
Breast cancer is the second most common cancer within the world and the most common cancer amongst ladies.[2] There are 1.1 million new cases of female breast cancer each year worldwide.[2] Despite recent advances, there is still an unmet need within the remedy and management of early breast cancer with relapse occurring in approximately 30% of patients, depending on individual danger factors, even after chemotherapy.[3]
About the FinXX study
The study, led by the Finnish Breast Cancer Group, was a large open-label, two-arm, randomised multicentre phase III study in girls with early breast cancer. 1,500 patients in Finland and Sweden with no distant metastases who had an intermediate to high danger of recurrence within five years from the time of diagnosis, had been recruited to the study.
The primary objective of the study was to compare the recurrence-free survival of patients receiving single-agent docetaxel (T), followed by cyclophosphamide, epirubicin and 5-FU (CEF) to thos receiving docetaxel with capecitabine (XT), followed by cyclophosphamide, epirubicin and capecitabine (CEX) within the adjuvant treatment of early breast cancer.
— Secondary objectives included the evaluation and comparison among the two treatment arms of:
— Safety profile
— Overall survival
Results to date show that:
— 54 ladies inside the capecitabine-containing arm had their cancer return, or died compared to 80 women in the non-capecitabine containing arm of the study.
— There had been fewer deaths among those taking the capecitabine-containing combination regimen (a 34% reduction in threat of death was observed in this group).
— 43 females inside the capecitabine-containing arm skilled tumour growth in another part of their body compared to 72 ladies in the non-capecitabine arm.
— The study participants need to be followed up for longer in order to assess the effect of capecitabine on survival.
— This analysis is further evidence that capecitabine might have a role in early breast cancer remedy.
About The Finnish Breast Cancer Group
The Finnish Breast Cancer Group is a scientific and educational legitimised society for scientists and specialists who are responsible for breast cancer diagnostics and remedy in Finland. With 260 members The Finnish Breast Cancer Group has carried out several clinical trials on advanced breast cancer and in adjuvant setting on academic basis from 1991.
All trademarks utilised or mentioned in this release are protected by law.
References:
(1) Important improvement in recurrence-free survival (RFS) when capecitabine (X) is integrated into docetaxel (T) 5-FU + epirubicin + cyclophosphamide (CEF) adjuvant therapy for high-risk early breast cancer (BC): interim analysis of the FinXX-trial. Presented in the San Antonio Breast Cancer Symposium, December 2008 (abstract # 82)
(two) Kamanger F et al Patterns of cancer incidence, mortality and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006; 24: 2137 – 2150
(3) Olivotto IA, Bajdik CD, Ravdin PM, Speers CH, Coldman AJ, Norris BD, Davis GJ, Chia SK, Gelmon KA. Population-based validation of the prognostic model ADJUVANT! for early breast cancer. J Clin Oncol 2005;23:2716-25.
Source: The Finnish Breast Cancer Group
December 28, 2011
Healthcare Prof:
5 (1 votes)
Maggie Alexander, Director of Policy at Breakthrough Breast Cancer, stated: “We welcome the commitment within the NHS Constitution that by April 2010 patients will have the legal right to see a cancer specialist inside two weeks of being referred by their GP.
“We hope this won’t further delay the Government’s prior commitment for a maximum two week wait for all breast cancer patients by the end of the year. Females tell us waiting for a diagnosis is extremely distressing regardless of the outcome and Breakthrough would like up-to-date information on how long all breast cancer patients are currently waiting.”
Source
Breakthrough Breast Cancer
December 27, 2011
two (two votes)
Healthcare Prof:
5 (1 votes)
Article Opinions:1 posts
In a new survey of physicians who treat breast cancer patients, only one-third stated they had excellent access to trained medical interpreters or telephone language-interpretation systems when they needed it. Poor access to interpreters can compromise physician-patient communication that is critically crucial in cancer care.
The survey of 348 physicians took place inside the Los Angeles location, exactly where 27 percent of residents – roughly two.five million people – have limited English proficiency (LEP) compared with 9 percent in the rest of the United States. Spanish and Asian languages are the predominant first languages for LEP patients in the LA region, but there are many others, said lead study author Danielle Rose, Ph.D.
Rose worked on the study while at the Cancer Prevention and Manage Investigation in the Jonsson Comprehensive Cancer Center at the University of California, Los Angeles. The study appears online inside the journal Health Services Investigation.
Forty-two percent of respondents stated they utilised a trained medical interpreter, 21 percent utilised a telephone interpreter service (exactly where an interpreter is accessed by phone) and 75 percent reported using untrained interpreters, which could include bilingual office staff or the patient’s friends or family.
“Because of the wide diversity of the Los Angeles population, we had been not surprised that many physicians utilized more than 1 interpreting option,” Rose stated. Physicians at large medical facilities, such as HMOs or large hospitals, were far more likely to have better access to trained interpreters or interpreter services.
One of the recommendations of the study is that Medicare reimburse for interpreter services, Rose said. “This way the doctors’ additional costs would be covered.”
The study stressed the importance of interpreters trained in dealing with medical issues. “Somebody who speaks the language only is not enough. You have to have some medical background to understand the terminology, to explain towards the patient what is happening,” said Georgeen Newland, project manager and health educator with Celebremos la Vida – Clinica Nuestra Salud of the Lombardi Cancer Center at Georgetown University Medical Center.
Although patients and physicians often use family or friends as interpreters, Rose warns of pitfalls. “There is a greater error rate with friends and family or other untrained interpreters,” she stated, and there is risk of the family member advocating for 1 therapy over another or withholding information. Newland, who interprets for Spanish-speaking patients at Lombardi, concurred. “Sometimes the family does not tell the truth to protect the patient. I have witnessed that.”
Health Services Research is the official journal of the AcademyHealth and is published by John Wiley & Sons, Inc. on behalf of the Health Analysis and Educational Trust.
“Use of interpreters by physicians treating Limited English Proficient (LEP) women with breast cancer: results from the provider survey of the Los Angeles Women’s Health Study.”
Rose DE, et al
Health Services Research online, 2009.
Source
Health Behavior News Service
December 26, 2011
Healthcare Prof:
Researchers at Queen’s University have identified a link between two genes involved in cancer formation in humans, by examining the genes in worms. The groundbreaking discovery provides a foundation for how tumor-forming genes interact, and could offer a drug target for cancer therapy.
“When cancer hijacks a healthy system, it can create tumors by causing cells to divide when they shouldn’t,” says Ian Chin-Sang, a developmental biologist at Queen’s and lead researcher on the study. “Certain genes control the normal movement and growth of cells, and by studying how these genes interact, we can understand what is abnormal when cancer is present.”
There is an essential gene in humans called PTEN that acts as a tumor suppressor. When the PTEN gene function is lost, it can lead to cancers. For example, 70-80 per cent of all prostate cancers have lost PTEN function. Another gene family, called Eph receptors, often shows high levels in cancers, but a connection in between PTEN and Eph Receptors in cancer formation has never been shown. The Queen’s study shows the remarkable relationship among these genes in worms.
When the analysis team increased Eph receptor levels in worms, the PTEN levels diminished and the worms died prematurely. When they decreased the Eph receptor level within the worm, the PTEN levels went up and the worm lived longer than normal. The team believes the same principals are applicable to humans.
“Obviously humans and worms look very different,” states Professor Chin-Sang, “but at a molecular level, they are very similar. In some instances, like the ones we are studying, the cellular mechanisms are so similar that the human genes can replace the worm’s gene.”
The next step is to take a closer look at the interaction of these two genes in humans. The findings could lead to exciting breakthroughs in cancer remedy.
“There is a drug used in the treatment of breast cancer that some ladies develop a resistance to,” adds Professor Chin-Sang. “Those same girls have also lost their PTEN. Perhaps their Eph is overactive, and that has made the PTEN go down. The analysis on the worm could therefore provide a useful drug target for therapeutic intervention of breast cancer. In fact, this worm is becoming a bit of a scientific celebrity. Studies on this worm have won researchers 3 Nobel prizes inside the last seven years.”
Professor Chin-Sang’s team includes Sarah Brisbin, Jun Liu, Jeff Boudreau, Jimmy Peng and Marie Evangelista from the Queen’s Biology Department. The analysis was supported by the National Cancer Institute of Canada and Canadian Institutes of Health Investigation. The study is published online within the journal Developmental Cell, and was recently highlighted in Science.
Source: Jeff Drake
Queen’s University
December 25, 2011
Healthcare Prof:
3 (three votes)
An article published Online First and in the December edition of The Lancet Oncology reports that addition of capecitabine to a standard chemotherapy regimen for breast cancer improves recurrence-free survival. On the other hand, therapy with capecitabine is frequently discontinued because of increased adverse events. The article is the work of Professor Heikki Joensuu, Helsinki University Central Hospital, Finland, and colleagues.
A total of 1,500 girls with moderate-to-high risk early breast cancer participated in this randomized controlled trial. They had been assigned to either three cycles of capecitabine and docetaxel followed by three cycles of cyclophosphamide, epirubicin, and capecitabine (capecitabine group, n=753), or to 3 cycles of docetaxel followed by three cycles of cyclophosphamide, epirubicin, and fluorouracil (manage group, n=747). The manage combination was representative of a regimen frequently utilised in Finland and Sweden, and comparable towards the regimen administered in many other countries. The primary endpoint was recurrence-free survival. The authors of this study carried out a planned interim analysis right after three years of median follow-up.
Researchers established that recurrence-free survival at 3 years was better with the capecitabine regimen than with manage (93 percent compared to 89 percent).The capecitabine regimen was associated with much more cases of grade 3 or four diarrhoea (6 percent compared to 3 percent) and hand-foot syndrome(11 percent compared to less than 1 percent). Hand-foot syndrome is a swelling and numbness of the hands and feet that occurs with certain types of chemotherapy. The manage regimen had more occurrences of grade 3 or four neutropenia (98 percent compared to 86 percent) and febrile neutropenia (9 percent compared to four percent). Neutropenia is an abnormally low number of neutrophils which are the most essential type of white blood cell within the blood. Febrile neutropenia is associated fever, often with other signs of infection. Much more patients discontinued planned treatment inside the capecitabine group (24 percent compared to 3 percent in the control arm).
The authors explain: “The capecitabine-containing chemotherapy regimen reduced breast cancer recurrence compared with a control schedule of standard agents. Capecitabine administration was frequently discontinued because of adverse effects… Our results suggest that integration of capecitabine upfront with potentially synergistic chemotherapeutic agents and into several cycles might be an effective remedy strategy.”
They observe: “Integration of capecitabine was associated with frequent discontinuation of planned chemotherapy, but most patients could tolerate all six scheduled cycles. Studies that focus on further refinement of the current chemotherapy regimen are warranted.”
In an associated comment, Dr Ruth M. O’Regan, Emory Winship Cancer Institute, Atlanta, GA, USA, remarks: “Although the findings of this trial are not practice-changing, they are intriguing and could merit further assessment in a larger trial. However, the important toxicity noted using the addition of capecitabine towards the taxane – anthracycline backbone dampens enthusiasm for further studies of this approach. More importantly, it is imperative that we take a a lot more rational approach to the remedy of early-stage breast cancer by tailoring our therapy approaches to molecular phenotypes.”
“Adjuvant capecitabine in combination with docetaxel and cyclophosphamide plus epirubicin for breast cancer: an open-label, randomised controlled trial”
Heikki Joensuu, Pirkko-Liisa Kellokumpu-Lehtinen, Riikka Huovinen, Arja Jukkola-Vuorinen, Minna Tanner, Raija Asola, Riitta Kokko, Johan Ahlgren, P?ivi Auvinen, Akseli Hemminki, Outi Paija, Leena Helle, Lauri Nuortio, Kenneth Villman, Greger Nilsson, Sirpa-Liisa Lahtela, Kaisa Lehti?, Marjo Pajunen, Paula Poikonen, Paul Nyandoto, Vesa Kataja, Petri Bono, Mika Leinonen, Henrik Lindman, on behalf of the FinXX Study Investigators
DOI: 10.1016/S1470-2045(09)70307-9
The Lancet Oncology
Written by Stephanie Brunner (B.A.)
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
December 24, 2011
five (2 votes)
Healthcare Prof:
5 (two votes)
The use of postmenopausal hormone therapy has decreased over time within the United States, which researchers suggest might play a key role inside the declining rate of atypical ductal hyperplasia, a known risk factor for breast cancer.
“Postmenopausal hormone treatment is associated with increased rates of benign breast biopsies, and early and late stages of cancer. Atypical ductal hyperplasia is associated using the use of postmenopausal hormone treatment and its rates have decreased with the decline in use of this remedy,” said researcher Tehillah Menes, M.D., who was the chief of breast service within the Department of Surgery at Elmhurst Hospital Center, New York, when this study was conducted.
Details of these findings are published in Cancer Epidemiology, Biomarkers & Prevention, which is a journal of the American Association for Cancer Investigation.
Atypical ductal hyperplasia is abnormal cells that grow in the milk ducts of the breast. Previous investigation has shown that ladies who’re diagnosed with atypical ductal hyperplasia are at a three- to five-fold increased risk of developing breast cancer.
Using data from the Breast Cancer Surveillance Consortium, Menes and colleagues examined the rates of atypical ductal hyperplasia to determine threat factors and rates for a lot more than 2.4 million mammography studies with and without breast cancer.
Between 1996 and 2005, the researchers identified that postmenopausal hormone therapy use decreased from 35 percent to 11 percent; atypical ductal hyperplasia decreased from 5.five per 10,000 mammograms in 1999 to two.four in 2005. Cases of atypical ductal hyperplasia associated with cancer reached a peak of 4.three per 10,000 mammograms in 2003, but decreased to 3.3 in 2005.
“The rate of atypical hyperplasia declined, which we didn’t expect to see using the increased use of mammography to identify abnormal lesions,” said researcher Karla Kerlikowske, M.D., professor of medicine and epidemiology and biostatistics, University of California, San Francisco. “We did not expect to find a decline in rate of atypical ductal hyperplasia with a decline in postmenopausal hormone therapy use.”
Findings also showed that when atypical ductal hyperplasia is diagnosed with an associated breast cancer, it is usually not an aggressive type of cancer. It is usually associated with low-grade cancers or those at an early stage, providing evidence to support the theory of a separate pathway for development of low-grade and high-grade breast cancers, based on Menes.
“These findings help clarify the different pathways to the development of breast cancer and the role of postmenopausal hormone therapy in increasing the rates of breast cancer,” Menes concluded.
Kerlikowske suggested that future investigation should focus on the influence of exogeneous hormone therapy on benign proliferative lesions of the breast.
Source: Tara Yates
American Association for Cancer Research
December 23, 2011
1 (1 votes)
Healthcare Prof:
5 (1 votes)
A new study finds that girls treated for breast cancer are at higher danger of cancer recurrence if they have dense breasts. Published within the December 15, 2009 problem of Cancer, a peer-reviewed journal of the American Cancer Society, the study’s results indicate that breast cancer patients with dense breasts could benefit from additional therapies following surgery, like radiation.
Previous studies indicate that women with dense breast tissue are at increased threat of breast cancer. Researchers have suspected that high breast density may also increase the threat of cancer recurrence soon after lumpectomy, but this theory has not been thoroughly studied.
Researchers led by Steven A. Narod, MD, of the Women’s College Study Institute in Toronto, reviewed the medical records of 335 patients who had undergone lumpectomy for breast cancer. Investigators monitored the patients for cancer recurrence and compared recurrence with breast density as seen on mammogram, categorized as low density (<25 percent dense tissue), intermediate density (25 percent to 50 percent dense tissue) or high density (>50 percent dense tissue).
The researchers discovered that patients using the highest breast density had a much greater threat of cancer recurrence than did girls using the lowest breast density. Over ten years, women inside the highest breast density category had a 21 percent chance of cancer recurrence, compared with a five percent chance among females inside the lowest category. The difference within the recurrence rates at ten years was even a lot more pronounced for ladies who did not receive radiation. In those females, 40 percent with high-density breast tissue had a recurrence compared with none of the patients with low density.
“The composition of the breast tissue surrounding the breast cancer is critical in predicting whether or not a breast cancer will return following surgery,” concluded Dr. Narod. The authors say their findings indicate that ladies with low breast density, who have a low chance of recurrence following surgery, might not need radiation but that ladies with high breast density could significantly benefit from the additional therapy.
Article: “Mammographic density and the threat of breast cancer recurrence following breast-conserving surgery.” Tulin Cil, Eve Fishell, Wedad Hanna, Ping Sun, Ellen Rawlinson, Steven A. Narod, and David R. McCready. Cancer; Published Online: November 9, 2009 (DOI: 10.1002/cncr.24638); Print Issue Date: December 15, 2009.
Source: David Sampson
American Cancer Society
December 22, 2011
5 (3 votes)
Healthcare Prof:
4.5 (2 votes)
Researchers in the US found that the decline in use of postmenopausal hormone therapy might partly explain the fall in incidence of a known danger factor for breast cancer, atypical ductal hyperplasia. They also stated their findings support the idea that low and high grade breast cancers develop via different pathways and thereby clarify the role that hormone therapy may possibly play in increasing the rates of breast cancer.
The study was the work of first author Dr Tehillah Menes, and colleagues and is published inside the November issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
Menes, who during the study was the chief of breast service inside the Department of Surgery at Elmhurst Hospital Center, New York, told the press that:
“Postmenopausal hormone treatment is associated with increased rates of benign breast biopsies, and early and late stages of cancer.”
“Atypical ductal hyperplasia is associated with the use of postmenopausal hormone remedy and its rates have decreased using the decline in use of this remedy,” she added.
Atypical ductal hyperplasia occurs when abnormal cells start to grow within the milk ducts of the breast and other studies suggest the condition is linked to a three to five-fold increased risk of developing breast cancer.
For this investigation, Menes and colleagues utilised data from more than two.four million mammography studies with and without breast cancer taken in between 1996 and 2005. The data came from the Breast Cancer Surveillance Consortium, which gathers information from a network of seven mammography registries with links to tumor and/or pathology registries in various parts of the US.
Their aim was to examine danger factors and rates of atypical ductal hyperplasia with and without associated breast cancer over time. They also looked at tumor characteristics of breast cancer with and without associated atypical ductal hyperplasia in women previously screened with mammography.
The results showed that:A total of 2,453,483 screening mammograms were linked to 1,064 biopsies with atypical ductal hyperplasia (ADH), 833 breast cancers with ADH, and 8,161 cancers with no ADH.
Postmenopausal hormone therapy use decreased significantly from 35 per cent to 11 per cent over the study period.
Rates of ADH decreased from a peak of five.five per 10,000 mammograms in 1999 to 2.four per 10,000 in 2005.
Rates of cancer with ADH decreased from a peak of four.3 per 10,000 mammograms in 2003 to three.3 per 10,000 in 2005.
ADH and breast cancer were significantly linked to postmenopausal use of hormone therapy.
Cancer linked with ADH was of lower grade and stage and more estrogen receptor positive than cancer without ADH.Menes and colleagues concluded that postmenopausal hormone therapy is linked with an increased risk of ADH with or without cancer, and that:
“Rates of ADH have decreased over the past decade, which may possibly be partially explained by the considerable reduction in use of postmenopausal HT [hormone therapy].”
Co-author Dr Karla Kerlikowske, who is professor of medicine and epidemiology and biostatistics at University of California, San Francisco, stated:
“The rate of atypical hyperplasia declined, which we didn’t expect to see with the increased use of mammography to identify abnormal lesions.”
“We didn’t expect to find a decline in rate of atypical ductal hyperplasia with a decline in postmenopausal hormone remedy use,” she added.
The finding that cancer linked with atypical ductal hyperplasia is usually of lower grade and stage supports the theory that low and high grade cancers develop via separate pathways, said Menes.
“These findings help clarify the different pathways to the development of breast cancer and the role of postmenopausal hormone therapy in increasing the rates of breast cancer,” she concluded.
Kerlikowske suggested future investigation really should concentrate on the effect of hormone therapy on benign proliferative breast lesions.
“Rates of Atypical Ductal Hyperplasia Have Declined with Less Use of Postmenopausal Hormone Remedy: Findings from the Breast Cancer Surveillance Consortium.”
Tehillah S. Menes, Karla Kerlikowske, Shabnam Jaffer, Deborah Seger, and Diana L. Miglioretti.
Cancer Epidemiol Biomarkers Prev, November 2009 18:2822-2828
DOI:10.1158/1055-9965.EPI-09-0745
Source: American Association for Cancer Research.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
December 21, 2011
Previous page