Research has shown that tamoxifen (Nolvadex) can protect against breast cancer but can have side effects including hot flashes, weight gain, abnormal menstrual periods and nausea.
To investigate those women who can most benefit from tamoxifen as a cancer preventive drug, US researchers analysed 4 randomised, placebo-controlled trials and assessed the effects that tamoxifen would have on breast cancer risk 10 years after the treatment.
Investigators used a mathematical model and found that in post-menopausal women under 55 who have an increased risk of developing breast cancer, the benefits of using tamoxifen to prevent cancer are sufficiently outweigh its side effects, it also saves costs.
Source: Cost-effectiveness of chemoprevention of breast cancer using tamoxifen in a postmenopausal US population. Cancer, 2011; published online 14 March 2011
Showing posts with label breast cancer. Show all posts
Showing posts with label breast cancer. Show all posts
Tuesday, March 15, 2011
Wednesday, September 22, 2010
Less invasive cancer surgery is safe and effective
In most cancer patients, axillary-lymph-node dissection (ALND) involves the removal of most of the lymph nodes in the underarm region to improve the chances of survuval, but sometimes it causes damages to the patients' arm and shoulder.
American scientists found that sentinel-lymph-node surgery (SLN), a less invasive technique that only removes the sentinel nodes, the ones closest to the breast, is safe and effective.
5,611 American women whose breast cancer did not appear to have spread to their lymph nodes were recruited to assess their differences in survival rates between the 2 types of surgery. Half of the patients had ALND surgery to remove all of the lymph nodes in the underarm area, while the other half had SLN surgery to remove the sentinel lymph nodes only. Patients were tracked over the next eight years.
The researchers found no significant differences in the patients' survival rates between the two groups. Patients who underwent the SLN procedure were less likely to experience arm problems or lymphoedema (chronic swelling of the arm). The authors concluded that "SLN surgery alone with no further ALND is an appropriate, safe, and effective therapy for breast cancer patients with clinically negative lymph nodes" and that SLN surgery "represents the next major step in reducing the extent of surgical procedures to treat breast cancer".
An accompanying comment said that the paper "vindicates contemporary practice of SLN biopsy and provides support for a reduction in extent of axillary surgery for most patients with breast cancer".
Source: Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncology, 11(10):927 - 933. Published Online: 21 September 2010 (f/t via Athens)
American scientists found that sentinel-lymph-node surgery (SLN), a less invasive technique that only removes the sentinel nodes, the ones closest to the breast, is safe and effective.
5,611 American women whose breast cancer did not appear to have spread to their lymph nodes were recruited to assess their differences in survival rates between the 2 types of surgery. Half of the patients had ALND surgery to remove all of the lymph nodes in the underarm area, while the other half had SLN surgery to remove the sentinel lymph nodes only. Patients were tracked over the next eight years.
The researchers found no significant differences in the patients' survival rates between the two groups. Patients who underwent the SLN procedure were less likely to experience arm problems or lymphoedema (chronic swelling of the arm). The authors concluded that "SLN surgery alone with no further ALND is an appropriate, safe, and effective therapy for breast cancer patients with clinically negative lymph nodes" and that SLN surgery "represents the next major step in reducing the extent of surgical procedures to treat breast cancer".
An accompanying comment said that the paper "vindicates contemporary practice of SLN biopsy and provides support for a reduction in extent of axillary surgery for most patients with breast cancer".
Source: Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncology, 11(10):927 - 933. Published Online: 21 September 2010 (f/t via Athens)
Tuesday, April 20, 2010
Do multivitamin tablets increase breast cancer risk?
Multivitamin supplements are widely used, but a large study involving 35,000 Swedish women aged 49 to 83 found that those who regularly took multivitamins had a higher risk of breast cancer than women who did not.
Based on self-reported questionnaire data, the researchers analysed the women's use of multivitamins as well as details about their health and lifestyle, followed up for 9.5 years until December 2007 to assess the cancer risk. They found that women who took multivitamins were 19% more likely to develop breast cancer than non-users. They also found that women who had taken these supplements for 3 years or more and those who took 7 or more pills a week were at increased risk of breast cancer than non-users, however the increase was very small.
Based on self-reported questionnaire data, the researchers analysed the women's use of multivitamins as well as details about their health and lifestyle, followed up for 9.5 years until December 2007 to assess the cancer risk. They found that women who took multivitamins were 19% more likely to develop breast cancer than non-users. They also found that women who had taken these supplements for 3 years or more and those who took 7 or more pills a week were at increased risk of breast cancer than non-users, however the increase was very small.
The researchers concluded that "multivitamin use is associated with an increased risk of breast cancer" but they noted that other studies have had conflicting results. The authors said that this study carries an important public health message and recommend women to eat healthy diet instead of using supplements.
Critics say that this study was based on self-reported data that could affect the results. Further research is needed, it is not possible to say which of the supplements may contribute to breast cancer risk.
Source: "Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women". American Journal of Clinical Nutrition, March 24 2010 (full text via Athens)
Tuesday, February 23, 2010
Can aspirin reduce breast cancer recurrence?
According to a new study published online in the Journal of Clinical Oncology, there was an association between frequent use of aspirin and lower risk of dying from cancer.
Researchers used survey data from US Nurses' Health Study to examine the effect of aspirin on breast cancer recurrence and survival including over 4000 nurses between 1980 and 2006. They found that women who took aspirin after finishing breast cancer treatment were half as likely to die from the disease compared with those who did not use aspirin regularly. However, the researchers pointed out that the participants were all nurses, the results may not be applied to the general population and they called for a randomised controlled trial to establish whether aspirin really caused the reduced risks they had found.
Previous studies on aspirin's anticancer effects have come to mixed conclusions, experts warned that patients should not start taking aspirin as there are risks associated with taking aspirin including bleeding and gastrointestinal complications.
Source: Holmes MD, Chen WY, Li L, et al. "Aspirin Intake and Survival After Breast Cancer". Journal of Clinical Oncology 2010 ( f/t via Athens)
Researchers used survey data from US Nurses' Health Study to examine the effect of aspirin on breast cancer recurrence and survival including over 4000 nurses between 1980 and 2006. They found that women who took aspirin after finishing breast cancer treatment were half as likely to die from the disease compared with those who did not use aspirin regularly. However, the researchers pointed out that the participants were all nurses, the results may not be applied to the general population and they called for a randomised controlled trial to establish whether aspirin really caused the reduced risks they had found.
Previous studies on aspirin's anticancer effects have come to mixed conclusions, experts warned that patients should not start taking aspirin as there are risks associated with taking aspirin including bleeding and gastrointestinal complications.
Source: Holmes MD, Chen WY, Li L, et al. "Aspirin Intake and Survival After Breast Cancer". Journal of Clinical Oncology 2010 ( f/t via Athens)
Tuesday, October 27, 2009
To screen or not to screen for cancer ?
For decades, people always believe cancer screening saves lives, but a study published in JAMA last week expressed concerns about the harm caused on patients who undergo breast and prostate cancer screening.
Dr Laura Esserman and colleagues who carried out the study found that screening often finds harmless or non-life-threatening tumors that could have gone unnoticed, this has led to huge increase in cancer diagnosis and unnecessary and aggressive treatment for patients while the most lethal, fast-growing cancers are often missed.
They reported 40% increase in breast cancer diagnosis but only 10% decline in late stage cancers. The rate of breast cancer overdiagnosis is as high as 1 in 3 for non-invasive cancers. Similarly, diagnosis in prostate cancer rocketed with the PSA test introduced in the 1980s, but most men with high PSA level turn out not to have cancer. Patients diagnosed with these cancers are often aggressivley and overtreated with radiation and surgery leading to long term harm.
The authors pointed out that the dilemma for breast and prostate cancer is that it is difficult to distingush dangerous cancers from harmless ones and the idea that some cancers are not dangerous and might go away on their own is not always accepted.
Although routine screening has identified more early stage cancers, it has not led to a corresponding reduction in mortality rate in breast and prostate cancer. The study concluded that "screening has value but we need to undertsand what it can and cannot do......., less screening is not necessarily a bad thing" and urged clinicians to rethink the use of breast and prostate cancer screening.
The American Cancer Society (ACS), as a result of the findings of this study, has acknowledged that the benefits of early screening has been overstated.
Source: "Rethinking screening for breast cancer and prostate cancer" JAMA. 2009;302(15): 1685-1692. (f/t via Athens)
Dr Laura Esserman and colleagues who carried out the study found that screening often finds harmless or non-life-threatening tumors that could have gone unnoticed, this has led to huge increase in cancer diagnosis and unnecessary and aggressive treatment for patients while the most lethal, fast-growing cancers are often missed.
They reported 40% increase in breast cancer diagnosis but only 10% decline in late stage cancers. The rate of breast cancer overdiagnosis is as high as 1 in 3 for non-invasive cancers. Similarly, diagnosis in prostate cancer rocketed with the PSA test introduced in the 1980s, but most men with high PSA level turn out not to have cancer. Patients diagnosed with these cancers are often aggressivley and overtreated with radiation and surgery leading to long term harm.
The authors pointed out that the dilemma for breast and prostate cancer is that it is difficult to distingush dangerous cancers from harmless ones and the idea that some cancers are not dangerous and might go away on their own is not always accepted.
Although routine screening has identified more early stage cancers, it has not led to a corresponding reduction in mortality rate in breast and prostate cancer. The study concluded that "screening has value but we need to undertsand what it can and cannot do......., less screening is not necessarily a bad thing" and urged clinicians to rethink the use of breast and prostate cancer screening.
The American Cancer Society (ACS), as a result of the findings of this study, has acknowledged that the benefits of early screening has been overstated.
Source: "Rethinking screening for breast cancer and prostate cancer" JAMA. 2009;302(15): 1685-1692. (f/t via Athens)
Friday, November 14, 2008
Calcium and vitamin D do not prevent breast cancer
Previous studies have reported vitamin D supplements may reduce breast cancer risk but a new study, published online in the Journal of the National Cancer Institute, found that calcium and vitamin-D supplements do not reduce breast cancer incidence in postmenopausal women.
More than 36,000 postmenopaused women were randomly assigned to take 1000 mg of calcium plus 400 IU of vitamin D daily or placebo. Researchers found that the incidence of breast cancer was similar in the supplement ( 528) and placebo ( 546) groups. The authors concluded that " the main findings do not support a causal realtionship between calcium and vitamin D supplement use and reduced breast cancer incidence".
In an accompanying editorial "Breast Cancer Prevention Using Calcium and Vitamin D: A Bright Future?" ( free f/t), the authors say that the study results may have been affected by multiple "important confounders" and that vitamin D and calcium may still have a "bright future" in breast cancer prevention and further studies will be needed.
Source: "Calcium Plus Vitamin D Supplementation and the Risk of Breast Cancer" Journal of the National Cancer Institute. Advance Access published online on November 11, 2008 JNCI, doi:10.1093/jnci/djn360
More than 36,000 postmenopaused women were randomly assigned to take 1000 mg of calcium plus 400 IU of vitamin D daily or placebo. Researchers found that the incidence of breast cancer was similar in the supplement ( 528) and placebo ( 546) groups. The authors concluded that " the main findings do not support a causal realtionship between calcium and vitamin D supplement use and reduced breast cancer incidence".
In an accompanying editorial "Breast Cancer Prevention Using Calcium and Vitamin D: A Bright Future?" ( free f/t), the authors say that the study results may have been affected by multiple "important confounders" and that vitamin D and calcium may still have a "bright future" in breast cancer prevention and further studies will be needed.
Source: "Calcium Plus Vitamin D Supplementation and the Risk of Breast Cancer" Journal of the National Cancer Institute. Advance Access published online on November 11, 2008 JNCI, doi:10.1093/jnci/djn360
Friday, October 10, 2008
Painkillers reduces breast cancer risk
Researchers carried out a meta-analysis of 38 relevant studies carried out in 5 different countries and involving 2.7 million women to examine the association between NSAID use and breast cancer.
The combining results from all 38 studies show that the use of NSAIDs was associated with a 12% reduction in risk of breast cancer. Analysis of all studies examining aspirin use only found a 13% reduction in the risk while the ibuprofen analysis found a 21% reduction in the risk of breast cancer. The authors conclude that there was an overall decreased risk of breast cancer with NSAID use.
Critics say that the use of aspirin and ibuprofen is not without risk in themselves and warn that long-term use of these painkillers would have serious side effects.
Source: Takkouche B, Regueira-Méndez C, Etminan M. Breast Cancer and Use of Nonsteroidal Anti-inflammatory Drugs: A Meta-analysis. Journal of the National Cancer Institute 2008; Oct 7 [Epub ahead of print]
The combining results from all 38 studies show that the use of NSAIDs was associated with a 12% reduction in risk of breast cancer. Analysis of all studies examining aspirin use only found a 13% reduction in the risk while the ibuprofen analysis found a 21% reduction in the risk of breast cancer. The authors conclude that there was an overall decreased risk of breast cancer with NSAID use.
Critics say that the use of aspirin and ibuprofen is not without risk in themselves and warn that long-term use of these painkillers would have serious side effects.
Source: Takkouche B, Regueira-Méndez C, Etminan M. Breast Cancer and Use of Nonsteroidal Anti-inflammatory Drugs: A Meta-analysis. Journal of the National Cancer Institute 2008; Oct 7 [Epub ahead of print]
Friday, July 18, 2008
Breast self-examinations questioned?
According to a new Cochrane review, breast self-examination by itself does not increase survival. The finding is based on 2 studies of 120,000 Russian women and 266,000 Chinese women in 2003 and 2002 respectively.
Both suggest that self-examination actually increase benign biopsies but does not get the patient into earlier treatment. However, the study does not say women should not do self-examinations, but researchers wrote "screening by self-examination or physical examination cannot be recommended".
Source: "Regular self-examination or clinical examination for early detection of breast cancer." The Cochrane Database of Systematic Reviews 2008 Issue 3 ( full text via Athens from Cochrane Library)
Both suggest that self-examination actually increase benign biopsies but does not get the patient into earlier treatment. However, the study does not say women should not do self-examinations, but researchers wrote "screening by self-examination or physical examination cannot be recommended".
Source: "Regular self-examination or clinical examination for early detection of breast cancer." The Cochrane Database of Systematic Reviews 2008 Issue 3 ( full text via Athens from Cochrane Library)
Thursday, May 15, 2008
Aspirin daily reduces breast cancer risk
News sources reported a new study that found women who took aspirin, known as non-steroidal anti-inflammatory drugs (NSAIDs) daily were 16% less likely to develop breast cancer.
Researchers studied the questionnaire responses from a previous study conducted in 2003 and used the answers to relate the use of NSAIDs to the chance of developing breast cancer. They concluded that "breast cancer risk was not significantly associated with NSAID use, but daily aspirin use was associated with a modest reduction in oestrogen-receptor (ER)-positive breast cancer." However they suggested further research is required as other studies have shown conflicting results.
Source: "Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health–AARP Diet and Health Study" Breast Cancer Research 2008, 10:R38doi:10.1186/bcr2089 ( free f/t)
Researchers studied the questionnaire responses from a previous study conducted in 2003 and used the answers to relate the use of NSAIDs to the chance of developing breast cancer. They concluded that "breast cancer risk was not significantly associated with NSAID use, but daily aspirin use was associated with a modest reduction in oestrogen-receptor (ER)-positive breast cancer." However they suggested further research is required as other studies have shown conflicting results.
Source: "Nonsteroidal anti-inflammatory drugs and breast cancer risk in the National Institutes of Health–AARP Diet and Health Study" Breast Cancer Research 2008, 10:R38doi:10.1186/bcr2089 ( free f/t)
Thursday, April 17, 2008
Yellow mushrooms could fight breast cancer
Scientists found that Phellinus Linteus (PL) – a mushroom occurring in tropical regions and used in Oriental medicine since ancient times has antitumour effects on highly invasive breast cancer cells grown in the laboratory, Daily Mail reported.
The researchers found that the effects of the mushroom extract on the growth of cancers was achieved by inhibiting the enzyme AKT in the breast cancer cells and said the results suggest that PL extract could be beneficial as a natural compound in treating invasive breast cancer. However they warned people not to buy the extract until it has been proved safe and effective.
Source: "Phellinus linteus suppresses growth, angiogenesis and invasive behaviour of breast cancer cells through the inhibition of AKT signalling" British Journal of Cancer 2008:98, 1348-1356
The researchers found that the effects of the mushroom extract on the growth of cancers was achieved by inhibiting the enzyme AKT in the breast cancer cells and said the results suggest that PL extract could be beneficial as a natural compound in treating invasive breast cancer. However they warned people not to buy the extract until it has been proved safe and effective.
Source: "Phellinus linteus suppresses growth, angiogenesis and invasive behaviour of breast cancer cells through the inhibition of AKT signalling" British Journal of Cancer 2008:98, 1348-1356
Thursday, March 27, 2008
Fewer doses of radiation could benefit women with breast cancer
A major study suggests giving higher doses of radiotherapy but fewer exposure provides results that are 'at least as good' as the standard regime. The findings were published in Lancet Oncology and The Lancet.
The findings came after two trials START A and B involving nearly 4,500 women with early breast cancer. About half the women received the international standard of radiotherapy which involves 25 treatments, five times a week over five weeks. The rest received 20 % lower dose of radiation on 13 different occasions in either three or five weeks. There was a reduced rate of side effects and lower rate of 'late adverse effects' in women receiving shorter treatments.
The results suggest that a high total dose given in small treatments is no better than simpler schedules using fewer exposures to a lower total dose. Researchers said women with breast cancer 'could benefit from shorter bursts of radiotherapy' , but critics say the study failed to recognise the harm done to breast cancer patients by high doses of radiotherapy.
Source: "The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial" The Lancet Oncology, Current Issue, Volume 9, Number 4
The findings came after two trials START A and B involving nearly 4,500 women with early breast cancer. About half the women received the international standard of radiotherapy which involves 25 treatments, five times a week over five weeks. The rest received 20 % lower dose of radiation on 13 different occasions in either three or five weeks. There was a reduced rate of side effects and lower rate of 'late adverse effects' in women receiving shorter treatments.
The results suggest that a high total dose given in small treatments is no better than simpler schedules using fewer exposures to a lower total dose. Researchers said women with breast cancer 'could benefit from shorter bursts of radiotherapy' , but critics say the study failed to recognise the harm done to breast cancer patients by high doses of radiotherapy.
Source: "The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial" The Lancet Oncology, Current Issue, Volume 9, Number 4
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