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Breast Cancer Female

  • Depression Common Among Women With Breast Cancer
    October 30, 2014

    Being diagnosed with a potentially deadly disease like breast can come as an emotional shock. And a new study found that women diagnosed with breast cancer had a raised risk for depression.

    A recent Danish study found that many women sought mental health care in the first year after breast cancer diagnosis, and many more started taking antidepressants. This was especially true for women who had other health problems in addition to breast cancer, and for women whose lymph nodes tested positive for the cancer — meaning the disease had spread beyond the breast.

    The study authors said all women diagnosed with breast cancer should be screened for depression.

    Nis P. Suppli, MD, of the Danish Cancer Society Research Center in Denmark, wrote this study with colleagues.

    Past studies on the relationship between breast cancer and lacked important information or only followed women for a short period of time, the authors noted.

    The authors studied almost 2 million women who were cancer-free and did not have a major psychiatric disorder. From this group, 44,494 women developed breast cancer between 1998 and 2011.

    The study authors found that, in the first year after a breast cancer diagnosis, women were 1.7 times more likely to seek treatment for depression and three times more likely to start taking antidepressants than women who did not have breast cancer.

    The researchers followed up with the women who had breast cancer three and eight years after they received the news. Even years after the diagnosis, more of these women started using antidepressants or contacted a hospital for depression treatment than women who did not have breast cancer. However, the number of patients who sought hospital treatment for depression or began taking antidepressants was highest within the first year of diagnosis.

    Factors that may make a woman with breast cancer more likely to be depressed included having other health problems, having cancer that had spread to the lymph nodes, being 70 years old or older, living alone or having limited education, the authors found.

    The study authors suggested that doctors keep these factors in mind when they see patients with breast cancer.

    “In conclusion, women with breast cancer are at long-term risk for depression, and clinicians should be vigilant for signs of this condition,” they wrote.

    This study was published online Oct. 27 in the Journal of Clinical Oncology.

    The Danish Cancer Society and the Health Foundation, Denmark, funded the research. Study author Lars V. Kessing received funding from Lundbeck and AstraZeneca.

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  • Girls Treated for Wilms Tumor May Be at Risk for Breast Cancer
    October 30, 2014

    Sometimes, radiation can be a lifesaving treatment. But radiation may also increase the risk for developing another cancer — and new research suggests this might have happened to some children years after radiation treatment.

    Treatment of Wilms tumor, a rare childhood , can include radiation treatments to the chest. Because radiation is thought to increase the risk for other cancers, a group of researchers studied girls with Wilms tumor to see whether they were more likely to develop breast cancer.

    Girls treated with radiation directed at the chest had a greatly increased risk for breast cancer as young women — compared to those who did not receive radiation.

    Norman E. Breslow, PhD, of the University of Washington and the Fred Hutchinson Cancer Research Center in Seattle, and colleagues wrote a paper on the research findings.

    Advancements in the treatment of Wilms tumor have raised the cure rate to nearly 90 percent, the study authors wrote. Treatments can include radiation to the chest or stomach.

    Dr. Breslow and team reviewed data on 2,492 girls with Wilms tumor. The patients ranged in age from newborn to 19 years old. The study authors noted whether the girls received radiation therapy for their cancer.

    The team continued to collect data on patients who lived past age 15 to see whether they developed breast cancer.

    "I applaud the authors of this important study analyzing the long-term risks of developing a well-known secondary malignancy, breast cancer, in pediatric cancer patients who undergo thoracic radiation," said Brian Lawenda, MD, National Director of Integrative Oncology and Cancer Survivorship, 21st Century Oncology and Founder of Integrative Oncology-Essentials. "For many years, oncologists have been aware of the increased risk of developing breast cancer in adult survivors of pediatric lymphomas who received thoracic radiation therapy as part of their treatment."

    Dr. Breslow and his team found 29 cases of breast cancer among the patients. Twenty-five of the cancers were in women younger than 40.

    The researchers calculated that the risk of getting breast cancer by age 40 for the women in this study was more than 27 times that of the average woman.

    Most of the breast cancer was in women who had chest radiation. Of the 369 patients who received chest radiation, 16 developed breast cancer. 

    "Follow-up guidelines have generally recommended breast imaging (i.e. mammography) starting at the age of 25 years or 8 years after thoracic [chest] radiation therapy in those who received a radiation dose of 20 Gy or higher. Thanks to this study, we now know that thoracic radiation therapy doses as low as 12 Gy are associated with a significant increase in the risk of developing breast cancer in adult survivors of pediatric Wilms tumor," said Dr. Lawenda.

    "Furthermore, any diagnosis of WT appears to increase the risk of developing breast cancer as an adult even without having received prior radiation therapy to the chest. It is believed that this increased risk of breast cancer in those without prior radiation therapy is due to associated chromosomal [genetic] abnormalities often co-existing with a diagnosis of WT that predispose to the eventual development of breast cancer.

    In a related editorial, Jennifer B. Dean, MD, and Jeffrey S. Dome, MD, PhD, of Children's National Health System in Washington, DC, said "The take-home message is that [doctors who treat childhood cancer] should closely evaluate their female survivors of [Wilms tumor] for risk factors for the development of breast cancer."

    Drs. Dean and Dome noted that only about half of cancer survivors at risk for breast cancer are screened as recommended. They urged better education for survivors and health care providers to increase screening.

    "[Dr. Breslow and colleagues] have provided us important information that should prompt changes to the follow-up guidelines for patients with a history of Wilms tumor (with or without prior thoracic radiation therapy to doses less than 20 Gy).  Breast cancer screening should be implemented in all patients in this high-risk population," Dr. Lawenda said.

    This study and editorial were published online Oct. 27 in Cancer.

    The National Institutes of Health funded the research. The authors disclosed no conflicts of interest.

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  • Standard Medication for HER-2 Breast Cancer Remained Top Rx
    October 30, 2014

    The approval of a new medication represents new options for patients. But the new option isn't always the best option. When it comes to treating HER-2 positive breast , the standard medication still appears to beat the newer option.

    A recent study found that, compared with a newer medication called lapatinib (brand name Tykerb), the older trastuzumab (brand name Herceptin) led to fewer disease events in those with HER-2 positive breast cancer when used in addition to standard chemotherapy.

    Disease events are cases of breast cancer recurrence anywhere in the body, a new cancer, or death from any cause.

    HER-2 positive breast cancer is when the cancer makes a protein called human epidermal growth factor receptor 2. This protein is known to promote growth of cancer cells. About one in five people with breast cancer has this type.

    Patients are usually treated for HER-2 positive breast cancer with chemotherapy and a medication that interferes with the HER protein receptor, such as lapatinib or trastuzumab.

    Edith Perez, MD, from the Mayo Clinic in Jacksonville, Florida, conducted this study with colleagues.

    The study, which lasted from 2007 to 2011, included 8,381 people with HER-2 positive breast cancer. These patients received either a combination of lapatinib and trastuzumab or one of the medications alone.

    When both medications were given together, the participants did not live longer disease-free than when taking either medication alone. The combination only led to more harmful effects because of the increased toxicity to their bodies.

    After four and a half years of follow-up, 14 percent of people who were given only trastuzumab had at least one disease event, and 18 percent of those who only took lapatinib had at least one disease event.

    In 2011, early results showed that lapatinib was inferior to trastuzumab. At that point, patients on lapatinib were offered trastuzumab. About 52 percent of people taking lapatinib took at least one dose of trastuzumab.

    In a press release, Dr. Perez said that her team showed that lapatinib was less effective than trastuzumab in stopping the cancer from spreading.

    "There was a trend for additional benefit if those patients were switched to trastuzumab, that cardiac safety was better than predicted, and that the number of brain metastases appeared similar for the patients who received either lapatinib or trastuzumab,” she said.

    The study results were presented at the European Society for Medical Oncology Congress in Madrid at the end of September.

    The study was funded by The Breast Cancer Intergroup of North America , the Breast International Group, the National Cancer Institute and Glaxo SmithKline; the company that makes lapatinib.

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  • Most Breast Cancer Patients Happy with Choice to Remove Non-Cancerous Breast
    October 30, 2014

    When a woman decides to get a cancerous breast removed, she may need to decide if the second, healthy breast should also be removed to reduce her risk of another cancer. In that moment, it can be hard for women to know if they made the right choice.

    A recent study has found that the majority of women who opted to have a mastectomy (surgical removal) of the healthy breast were happy with their decision a decade later.

    Those who had reconstruction — surgery to make the breast mound about the same size and shape as before the mastectomy — were surprisingly less likely to think they made the right decision compared with women who did not have reconstruction. The researchers believe this may be because 39 percent of women who had reconstruction needed another unplanned surgery.

    This study was done by Judy Boughey, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues.

    The researchers learnt how the women felt by sending out more than 600 questionnaires about 10 and 20 years after the women had the non-cancerous breast removed; a procedure called contralateral prophylactic mastectomy (CPM). All were women who had breast in one breast and chose to have a CPM.

    Of the 583 women who answered the first questionnaire about a decade after their surgery, 403 had undergone reconstruction of their breasts.

    Overall, 83 percent were happy with their decision to have a CPM.

    Women who had reconstruction were less satisfied with their decision than women who did not.

    Of the 269 women who answered the questionnaire about 20 years after their surgery, 92 percent said they would choose to have a CPM again.

    Some women who had chosen reconstruction reported more satisfaction with their appearance, higher self-esteem and feeling more feminine than those who did not have reconstructive surgery.

    Still, the vast majority of women were happy with the decision they had made earlier.

    “I think what this study does is adds some literature to the hands of the people counseling patients to say, ‘Whatever decision you make, you’re very likely to be happy with that in the long run, so listen to yourself, and make the decision that’s best for you,’” Dr. Boughey said in a press release.

    The study authors noted that there is mixed data on whether breast cancer patients with CPM live longer than those who do not choose to remove the healthy breast, though most studies show they do not.

    This study appeared in the September issue of the Annals of Surgical Oncology.

    The authors did not disclose any conflicts of interest.

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  • 'Angelina Effect' May Have Boosted Screening for Breast Cancer
    October 30, 2014

    The United Kingdom recently saw a spike in women seeking genetic screening for breast cancer. Researchers think the increase may be tied to a high-profile celebrity endorsement.

    In May 2013, actress Angelina Jolie had genetic screening that determined she was at a heightened risk for breast cancer. The actress then opted to have both of her breasts removed as a preventive measure.

    After Jolie announced her experience, referrals for breast screenings in the UK more than doubled. Researchers are calling this the "Angelina Effect."

    Jolie had a mutation to the gene BRCA1. The BRCA1 and BRCA2 genes produce proteins that fight cancerous tumors. Mutations to these genes are associated with an increased risk of breast and ovarian cancers.

    Dr. Gareth Evans, lead author on a recent study on the spike in cancer screening in the UK, said in a press statement that Jolie’s decision resonated with women “possibly due to her image as a glamorous and strong woman. This may have lessened patients’ fears about a loss of sexual identity post-preventative surgery and encouraged those who had not previously engaged with health services to consider genetic testing.”

    Breast cancer treatments include chemotherapy and radiation. In some cases, doctors perform a mastectomy, which is partial or total removal of one or both breasts.

    Some women, like Jolie, choose to have both breasts removed before cancer develops. That procedure is called an elective double mastectomy.

    Dr. Evans, a geneticist with the Genesis Breast Cancer Prevention Center in Manchester, UK, and colleagues collected data from 21 health centers for 2012 and 2013.

    In those health centers, total referrals for genetic screening went from 12,142 in 2012 to 19,751 in 2013.

    Compared to 2012, referral rates were 17 percent higher from January to April 2013, the study authors found.

    Then, when Jolie made her announcement in May, referrals increased by almost 50 percent.

    Referral rates were 32 percent higher than the previous year in November and December 2013.

    "These high-profile cases often mean that more women are inclined to contact centers … so that they can be tested for the mutation early and take the necessary steps to prevent themselves from developing the disease,” Dr. Evans said.

    In an interview with dailyRx News, Kevin Hughes, MD, Co-Director of Avon Comprehensive Breast Evaluation Center at Massachusettes General Hospital, explained which women are typically recommended for genetic screenings. Screening may be recommended, said Dr. Hughes, if a woman has "a strong family history of breast cancer, multiple relatives with breast or , a family member who had breast or ovarian cancer under the age of 45, a family member who had both breast and ovarian cancer, or a family member with bilateral breast cancer."

    According to Dr. Hughes, these family histories would prompt a physician to recommend a woman to genetic consulation with an expert who conducts genetic screening.

    Dr. Hughes said that if a woman is found to have a BRCA mutation, doctors "tend to give patients the option between close screening with MRI and mammography or profilactic mastectomy [removal of breast to prevent breast cancer]." The close screening, he explained, can detect breast cancer in its early stages, when it's easier to treat.

    The study by Dr. Evans and team was published online Sept. 18 in Breast Cancer Research.

    The Breast Cancer Campaign funded the study. The authors disclosed no conflicts of interest.

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  • Breast Cancer Screening May Be Riskier for Women Over 70
    October 30, 2014

    (dailyRx News) Mammograms can be a lifesaving tool, but older women undergoing this breast screening may be at a higher risk for misdiagnosis.

    A recent study looked at the effects of a breast cancer screening program that began testing women older than 70. The researchers found more early cases of cancer, but the fall in cases of advanced cancer was minimal.

    The authors of the study concluded that testing women older than 70 led to a risk of overdiagnosis and overtreatment. They suggested that women over 70 decide for themselves whether to continue screenings for breast cancer.

    "Talk to your family physician about what cancer screenings you need."

    Gerrit-Jan Liefers, a surgical oncologist at Leiden University Medical Centre, led the study.

    According to the authors, breast cancer is the largest contributor to cancer deaths among women. Current guidelines recommend that women receive regular mammograms to screen for breast cancer.

    This study focused on women in the Netherlands who were 70 or older.

    The Netherlands extended its breast cancer screening program to cover women up to 75 in 1998. Before, the program only covered women up to age 69.

    Researchers tracked cases of breast cancer among these older women from 1995 to 1997, 1998 to 2002 and 2003 to 2011.

    They found that diagnoses of new cases of breast cancer in its early stages rose after the screening expansion began — by about 116 cases per 100,000 women.

    However, diagnoses of advanced breast cancer decreased by 7 cases per 100,000 women.

    The researchers said more screening led to overdiagnosis. Some patients were diagnosed with breast cancer even though they did not have it.

    The authors of the study wrote that overdiagnosis and overtreatment could be costly and result in harmful side effects, especially in older women.

    They concluded that "the harms and benefits of screening should be weighed on a personalized basis."

    "This is a reasonable study where they found the incidence of advanced cancers decreased and the incidence of early cancers increased after the use of screening mammography in the age group 70-75," said Cary Kaufman, MD, FACS, a breast surgeon and specialist at Bellingham Regional Breast Center in Washington state. "That is a valid finding and supports the value of screening mammograms, yet the authors conclusions seem to misinterpret their data."

    Dr. Kaufman explained that screening mammograms find cancers sooner than routine physical exams. "Thus," he said, "mammograms will find a stage 3 cancer when it is stage 2, a stage 2 cancer when it is stage 1 and so on. This study found that larger (stages 2, 3 and 4) breast cancers decreased while smaller (stage 1 and stage 0) breast cancers increased. Their data supports screening mammography in that age group."

    Dr. Kaufman noted, though, that the authors of this study excluded stage 2 cancers — which he called "a very important group of cancers" — from their final statistics. "They excluded the very important finding of a dramatic lowering of stage 2 cancers in their final calculations in this study," he said.

    He explained that before screening, stage 2 cancers were 47 percent of cases. After screening, however, they were only 28 percent of cases. "That is a dramatic effect of down-staging by screening mammography," he said.

    Stage 2 cancers are 2 centimeters to 5 centimeters in size, while stage 1 cancers are less than 2 centimeters. "Essentially, screening mammography found cancers when they were half the size they were previously," Dr. Kaufman told dailyRx News.

    "The effect of screening created a 60 percent decrease in the number of stage 2 patients accompanied by a 70 percent increase in stage 1 patients. Changing from stage 2 to stage 1 increases the survival rate of these patients according to national survival statistics comparing stage 1 and stage 2," he said.

    "It is unfortunate that the authors didn't provide interpretations using all the data. The assumption that the 60 percent decrease in stage 2 patients was not worth including in the calculations and discussion seems erroneous," he said.

    This study was published Sept. 15 in The BMJ.

    The Alpe d'HuZes Foundation funded the research. The authors declared no conflicts of interest.

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    September 17, 2014
    October 30, 2014
    dailyrx.com

  • New Breast Cancer Vaccine Tested
    October 30, 2014

    (dailyRx News) Efforts to fight include both treatment and prevention. And researchers recently tested a vaccine to prevent breast cancer recurrence.

    Results of a clinical trial of a breast cancer vaccine showed that, when women who had breast cancer were vaccinated, the cancer came back less often.

    The researchers also found that the vaccine was safe and well-tolerated in patients.

    "Ask your primary care physician about screening for breast cancer."

    Even with treatment, breast cancer returns in about 20 percent of cases.

    Targeting proteins on tumor cells has been the objective of drug therapy and vaccine development. One such protein is HER2. Trastuzumab (brand name Herceptin) is a type of immunotherapy medicine known as a monoclonal antibody that was developed to target HER2, a protein found in abundance in some breast cancers.

    Elizabeth Mittendorf, MD, PhD, from the M.D. Anderson Cancer Center, led a clinical trial of a new vaccine against GP2, a protein on tumor cells.

    Vaccines work differently than chemotherapy or immunotherapy. They do not kill cancer cells directly. The GP2 vaccine was developed to prime the immune system to look for the recurrence of any HER2 protein and destroy it.

    Dr. Mittendorf presented her team's research results Sept. 6 at the 2014 American Society of Clinical Oncology’s Breast Cancer Symposium in San Francisco.

    The researchers gave 89 breast cancer patients the vaccine combined with an agent to increase its effectiveness by stimulating the immune system (GM-CSF). Ninety-one women were given the GM-CSF alone.

    All the women in the study had HER2 protein on their breast tumors in different amounts.

    The patients received injections once a month for six months. From 12 to 36 months, they received boosters every six months. The researchers collected data on the women for up to five years.

    The main goal of this Phase II study was to find out if the vaccine was safe. The vaccine was found to be as safe as the GM-CSF alone. The women also tolerated the vaccine well.

    The researchers found that breast cancer recurrence decreased by 57 percent in women who got the GP2 vaccine, compared to those who received GM-CSF alone.

    Some of the women in the study had also been previously treated with trastuzumab. In this smaller group of women, those who also received the vaccine did not experience a recurrence of their breast cancer during the study.

    “This is an important and different avenue in immunotherapy research, in that we are investigating ways to prevent cancer recurrence by stimulating the immune system to treat cancer,” Dr. Mittendorf said in a press release.

    Galena Biopharma, Antigen Express and Norwell sponsored the clinical trials. M.D. Anderson receives funds when patients are enrolled in the studies.

    George Peoples, MD, a study author, had inventor rights to the GP2 vaccine.

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  • Call for Genetic Screening to Become New Norm
    October 30, 2014

    (dailyRx News) Gene mutations associated with higher rates of breast and may pose a serious risk to Ashkenazi Jewish (AJ) women, even those without a family history of cancer. This prompted a call for more genetic screening.

    As it stands now, genetic screening is usually only recommended to patients with a family history of cancer. In fact, the US Preventive Services Task Force recommended against population screening of the two genes.

    "Talk to an oncologist about cancer screening methods."

    Efrat Gabai-Kapara, a professor at the Hebrew University Medical School in Jerusalem, led a recent study of 8,195 AJ men.

    The authors focused on three mutations of the genes BRCA1 and BRCA2. These two genes produce a protein that helps the body fight cancer. Mutations, or changes, to the gene may increase the risk of breast or ovarian cancer.

    Of the patients, 91 had a BRCA1 mutation, 81 had a BRCA2 mutation and three had changes to both genes.

    The changes are equally common in men and women. Both mothers and fathers can pass them down.

    The authors first tested AJ men for the genetic mutations. From there, they screened female relatives of the men who had the mutated genes.

    For AJ women who carried the BRCA1 mutation, the combined risk of either breast or ovarian cancer was 60 percent by age 60 and 83 percent by age 80.

    For those with BRCA2 mutations, the risk was 33 percent by age 60 and 76 percent by age 80.

    Applied to all AJs in Israel, 11 percent of breast cancer and 40 percent of ovarian cancer cases could be due to the gene mutations, the authors found.

    Of the 167 families studied, 51 percent had little or no family history of cancer.

    The authors wrote that screening efforts should focus on "clearly damaging mutations" like BRCA1 and BRCA2 — not just family history.

    "We suggest that the time has come to apply our knowledge of these genes to consideration of a general screening program, with the aim of reducing the burden of breast and ovarian cancer," the authors wrote.

    "It is almost paradoxical that, as there is a major effort underway to reduce access for women to mammography for breast cancer screening, there are calls for more genetic screening," said Daniel B. Kopans, MD, Professor of Radiology at Harvard Medical School and Senior Radiologist of the Breast Imaging Division at Massachusetts General Hospital.

    "I certainly support anyone's decision to be tested to see if they have a BRCA1 or 2 gene mutation that carries a very high lifetime risk of developing breast cancer, but we should not lose sight of the fact that genetic mutations only account for approximately 10 percent of breast cancers," he said. "This may increase slightly as we find that there are more women (and men) who develop breast cancer who have unsuspected mutations, but the fact remains that most breast cancer occurs among women who have no known predisposition and none of the known risk factors."

    According to Dr. Kopans, "Mammography is not the ultimate answer, but no one has any idea how to safely prevent or cure all breast cancers. Early detection offers a lifesaving benefit for thousands of women."

    In an editorial about the study published Sept. 8 in JAMA, Mary-Claire King, PhD, and co-authors echoed that call for widespread screenings of the BRCA1 and BRCA2 genes.

    “It is time to offer genetic screening of these genes to every woman, at about age 30, in the course of routine medical care,” they wrote.

    Dr. King noted the limitations of using the study group to make general statements about a much larger group.

    She wrote that the study “has implications for public health and prevention strategies in the United States,” in part because “large-scale population screening for BRCA1 and BRCA2 mutations was feasible.”

    The study was published online Sept. 5 in PNAS.

    The Breast Cancer Research Foundation, National Institutes of Health, Israel Cancer Association and Israel National Institute for Health Policy Research funded the study. The authors disclosed no conflicts of interest.

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  • Wearing a Bra Not Linked to Breast Cancer
    October 27, 2014

    (dailyRx News) Some believe breast is more common in developed countries because more women wear bras. But new research may debunk that idea.

    Wearing a bra did not lead to breast cancer, according to Seattle researchers who interviewed breast cancer patients about bra use in a recent study.

    "Get screened for breast cancer regularly."

    Lu Chen, MPH, and colleagues tested the concern that breast cancer may be more common in women who wear bras.

    “Our study found no evidence that wearing a bra increases a woman’s risk for breast cancer,” Chen said. “The risk was similar no matter how many hours per day women wore a bra, whether they wore a bra with an underwire, or at what age they first began wearing a bra.”

    With the help of colleagues, Chen, a researcher in the Public Health Sciences Division at Fred Hutchinson Cancer Research Center, recruited 1,044 patients for the study.

    Of those, 454 had invasive ductal carcinoma and 590 had invasive lobular carcinoma — the two most common types of breast cancer. All were postmenopausal and between the ages of 55 and 74.

    Breast cancer screenings include regular mammograms, which are X-ray images used to detect cancer. Treatments include radiation, chemotherapy, and surgical removal of one or both breasts, called a mastectomy.

    The study authors interviewed the patients to find out lifetime patterns of bra use. They found no associations between wearing a bra and breast cancer.

    “The findings provided reassurance to women that wearing a bra does not appear to increase the risk for the most common histologic types of postmenopausal breast cancer,” the study authors wrote.

    The study was published online Sept. 5 in Cancer Epidemiology, Biomarkers & Prevention.

    The National Cancer Institute funded the study. The authors disclosed no conflicts of interest.

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  • Call for Genetic Screening to Become New Norm
    October 22, 2014

    (dailyRx News) Gene mutations associated with higher rates of breast and may pose a serious risk to Ashkenazi Jewish (AJ) women, even those without a family history of cancer. This prompted a call for more genetic screening.

    As it stands now, genetic screening is usually only recommended to patients with a family history of cancer. In fact, the US Preventive Services Task Force recommended against population screening of the two genes.

    "Talk to an oncologist about cancer screening methods."

    Efrat Gabai-Kapara, a professor at the Hebrew University Medical School in Jerusalem, led a recent study of 8,195 AJ men.

    The authors focused on three mutations of the genes BRCA1 and BRCA2. These two genes produce a protein that helps the body fight cancer. Mutations, or changes, to the gene may increase the risk of breast or ovarian cancer.

    Of the patients, 91 had a BRCA1 mutation, 81 had a BRCA2 mutation and three had changes to both genes.

    The changes are equally common in men and women. Both mothers and fathers can pass them down.

    The authors first tested AJ men for the genetic mutations. From there, they screened female relatives of the men who had the mutated genes.

    For AJ women who carried the BRCA1 mutation, the combined risk of either breast or ovarian cancer was 60 percent by age 60 and 83 percent by age 80.

    For those with BRCA2 mutations, the risk was 33 percent by age 60 and 76 percent by age 80.

    Applied to all AJs in Israel, 11 percent of breast cancer and 40 percent of ovarian cancer cases could be due to the gene mutations, the authors found.

    Of the 167 families studied, 51 percent had little or no family history of cancer.

    The authors wrote that screening efforts should focus on "clearly damaging mutations" like BRCA1 and BRCA2 — not just family history.

    "We suggest that the time has come to apply our knowledge of these genes to consideration of a general screening program, with the aim of reducing the burden of breast and ovarian cancer," the authors wrote.

    "It is almost paradoxical that, as there is a major effort underway to reduce access for women to mammography for breast cancer screening, there are calls for more genetic screening," said Daniel B. Kopans, MD, Professor of Radiology at Harvard Medical School and Senior Radiologist of the Breast Imaging Division at Massachusetts General Hospital.

    "I certainly support anyone's decision to be tested to see if they have a BRCA1 or 2 gene mutation that carries a very high lifetime risk of developing breast cancer, but we should not lose sight of the fact that genetic mutations only account for approximately 10 percent of breast cancers," he said. "This may increase slightly as we find that there are more women (and men) who develop breast cancer who have unsuspected mutations, but the fact remains that most breast cancer occurs among women who have no known predisposition and none of the known risk factors."

    According to Dr. Kopans, "Mammography is not the ultimate answer, but no one has any idea how to safely prevent or cure all breast cancers. Early detection offers a lifesaving benefit for thousands of women."

    In an editorial about the study published Sept. 8 in JAMA, Mary-Claire King, PhD, and co-authors echoed that call for widespread screenings of the BRCA1 and BRCA2 genes.

    “It is time to offer genetic screening of these genes to every woman, at about age 30, in the course of routine medical care,” they wrote.

    Dr. King noted the limitations of using the study group to make general statements about a much larger group.

    She wrote that the study “has implications for public health and prevention strategies in the United States,” in part because “large-scale population screening for BRCA1 and BRCA2 mutations was feasible.”

    The study was published online Sept. 5 in PNAS.

    The Breast Cancer Research Foundation, National Institutes of Health, Israel Cancer Association and Israel National Institute for Health Policy Research funded the study. The authors disclosed no conflicts of interest.

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