Increased risk for DCIS patients
A study from the Fred Hutcheon Cancer Research Center of Seattle, Washington this month demonstrated an increase risk of recurrence in certain groups of women treated with breast conservation for DCIS. The risk of recurrence within the first 5 years of diagnosis was approximatley 15% and 31% in women within 10 years of diagnosis. The risk was elevated for women with tumors larger than 1.5 cm or of the comedo subtype. Premenopausal women had a 2 fold increase risk of recurrence as well as did women who were overweight. Post-menopausal women who were on estrogen for at least 2 years after their diagnosis were also approximately twice the relative risk of development of recurrence. The study stresses the importance of the hormonal influence on ductal carcinoma in situ recurrence and risk associated with breast conservation procedures.
Effects of Hormone Replacement on Breast Cancer
This month in Radiology, scientists from the University of Michigan examined 115 cases of breast cancer in women from 55 to 66 and determined no significant differences in abilities to detect breast cancer or false mammograms in women on hormonal replacement. This is very reassuring since it appears that if women are screened annually by mammography, hormonal replacement therapy does not significantly impact their chance of having a missed breast cancer. It appears from this study that approximately 75% of all woman can be diagnosed whenthe tumors are duct carcinoma in situ or node negative invasive breast cancers less than2 cm. Both of these groups, Stage 0 and Stage 1 breast cancer, have an excellent prognosis. Remember if you are on hormonal replacement have an annual mammogram and clinical breast exam. This is great protection for you against this disease.
Ultra-sound Guided Core Biopsy
Ultasound core biopsy - cheaper. Researchers from Memorial Sloan Kettering in New York published this month in Radiology a study of ultra-sound core biopsies and compared it with the other two common biopsy methods -stereotatic core and surgical. They found that their were substantial cost savings. For ultrasound visiable tumors, 85% of women could avoid surgery and the core biopsy could obtain a diagnosis at 56% of the cost of surgical biopsy. Ultrasound biopsy was also proven to be cheaper than mammographic stereotatic core biopsy. This is yet another success for the evolving technology of diagnosing all breast cancers through simple office needle procedures and eliminating traumatic surgical procedures for diagnosis of breast cancer.
Breast Cancer and Prostate Cancer
The American Cancer Society researchers have reported an increased risk in fatal prostate cancer in patients with a strong family history of breast cancer. This risk is highest among men younger than age 65 whose relatives had breast cancer prior to age 50. Also the risk is higher amongst Ashkenazi Jewish men. A family history of prostate cancer was not necessary to impart that increased risk of prostate cancer. A family history of breast cancer was adequate to increase the risk in these male relatives. This is important information to share with the men in your family if you have had breast cancer at a young age.
How So You Measure Tumor Size When There are Multiple Cancers
In the past research form the 1950's and 1960's has indicated that survival of breast cancer is determined not by the number of breast cancers but by the size of the 1 largest cancer. This old conclusion has been reanalyzed recently by researchers at the University of Toronto and in reviewing a large series of more than 600 patients with breast cancer they were able to identify patients with multiple tumors. Patients with multiple tumors had a greater risk of node positivity and a worse survivor outcome than patient who had single tumors. This challenges our old thought and may indicate something important about the biology of breast cancer. Stay tuned - there are sure to be many more studies on this controversial area.
What's the Ideal Follow-up of Patients with Breast Cancer
Researchers from the Moffett Cancer Center of Tampa, Florida have reviewed data from over 1800 breast cancer patients. Their study showed that there was no value to any routine labs, CT scans or bone scans in the detection of recurrence of breast cancer. The only measures shown to be effective were physical exam, mammography, and careful listening by physicians to all other symptoms.
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