Blog

Breast Cancer Drug Avastin Increases Risk of Blood Clots

Family History of Breast Cancer Substantially Increases Your Risk

The findings suggest there are other genetic mutations that play a role in breast cancer.  Women with a strong family history might consider more frequent screening, including breast MRI.  Also, these women should use anti-cancer drugs such as tamoxifen to prevent getting breast cancer.

For information about breast cancer, see the breast cancer malpractice lawyers of Pennsylvania, headquartered in Pittsburgh, PA.

Migraines Linked to Breast Cancer

The relationship between migraine and breast cancer was dependent on the estrogen receptor (ER) and progesterone receptor (PR) status of the tumor.  Women with no history of migraine were at significantly reduced risk of ER+/PR+ ductal carcinoma, ER+/PR- ductal carcinom, and ER+/PR+ lobular carcinoma.  The risk of ER-/PR- ductal carcinoma and ER+/PR- lobular carcinoma did not differ significantly between migraineurs and women without migraine.

This study tells us that by altering exposure to hormones during premenopausal years, we can reduce the risk of developing breast cancer in the postmenopausal years.

More information about breast cancer is available at the breast cancer attorneys of Pennsylvania.

Breast Cancer Doctor is Hired as New Director of Pittsburgh Cancer Institute

There is a new director of UPMC's University of Pittsburgh Cancer Institute (UPCI):  Dr. Nancy E. Davidson.   She will begin in March, 2009.  She is a leading breast cancer researcher at the Johns Hopkins University medical school in Baltimore.  She currently heads the breast cancer research program at the Johns Hopkins Kimmel Cancer Center, and recently served as president of the American Society of Clinical Oncology.  She will replace Dr. Ronald Herberman, the founding director of the Pitt cancer institute, who plans to devote more time to cancer research.

Dr. Davidson received a bachelor's degree from Wellesley College and earned her medical degree at Harvard Medical School in 1979. She has been involved in breast cancer research for nearly 25 years, and has been at Johns Hopkins since 1986.

Her research focuses partly on the breast cancer cases that do not respond to estrogen-blocking therapy because the women's tissues lack receptors for the female hormone.  She has worked on ways to resensitize women to those treatments, and on substances designed to slow growth and spread of cancer cells.

UPCI receives $174 million in research grants and is ranked 10th nationally in the funding by the National Cancer Institute.

This appointment reflects UPMC's desire to be a national player in breast cancer research and treatment.

For more information about breast cancer, see the breast cancer attorneys of Pennsylvania.

British Scientists Discover Why Tamoxifen Does Not Work In Some Women With Breast Cancer

Doppler Ultrasound Helps Identify Breast Cancer Without Biopsy

The basis for distinction between malignant and benign is that 3-D power Doppler ultrasound can detect the  higher flow velocities in the malignant tumor-feeding vessels have higher flow velocities when seen on Doppler and benign breast masses have slower flow velocities.

More information about breast cancer can be found at the breast cancer malpractice lawyers of Pennsylvania, serving Pittsburgh, Greensburg, Erie, Uniontown, Beaver and Washington PA.

Breast Cancer Featured in New York Times

Insomnia In Breast Cancer May Be Predicted By Respiratory Rhythms

Mammograms Remain Best Way to Spot Breast Cancer

"Mammography remains the most effective screening test for the early detection of breast cancer available to women today," Dr. Otis W. Brawley, the ACS's chief medical officer, said in a society news release. "Women are strongly urged to schedule their mammograms yearly and to talk to their doctor regularly about their risk for breast cancer."

Early detection by mammography screening and improvements in treatment have contributed to a decline in the breast cancer death rate in the United States since 1990. However, recent evidence suggests that many women are getting mammograms at a later age, not scheduling them yearly, or aren't receiving appropriate and timely follow-up after positive breast cancer screening results.

Along with recommending yearly mammograms and clinical breast examinations for women over age 40, the ACS says that women ages 20 to 39 should undergo clinical breast examination at least once every three years. All women should be familiar with their breasts and immediately report any changes to their health care provider.

Women at high risk for breast cancer (greater than a 20 percent lifetime risk) should have an annual MRI and mammogram, and women at moderate risk (15 percent to 20 percent lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram, the ACS recommends.

If Breast Cancer Recurs, Get Mastectomy

Coffee Not Linked to Breast Cancer

A new study shows that coffee is not linked with breast cancer.  More information about this study is available here.

For information about breast cancer and the missed or misdiagnosis of breast cancer, see the Pittsburgh, Pennsylvania breast cancer lawyers.

Young Women Who Receive Radiation for Breast Cancer at Risk of Cancer in Other Breast

According to the study, women diagnosed with breast cancer in one breast have three to four times the risk of developing a new cancer in the other breast.
The risk of contralateral breast cancer was also greatest when three or more family members had a history of breast cancer, indicating that some of the women in the study might have the risk-raising BRCA1 or 2 genetic mutations. These mutations weren't tested for in the study.

Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. suggested that this study was not very relevant because it examined old radiation techniques.

Athor Maartje J. Hooning, at Erasmus Medical Center Daniel den Hoed Cancer Center in Rotterdam, Netherlands, said that even though radiation techniques have a lower dose to the contralateral breast than the techniques in the study, doctors should be aware of the dose-response relationship for risk of contralateral breast cancer. Especially in young women, the radiation dose to the opposite breast should be kept as low as possible.

Computers help docs see breast cancer on X-ray

Like spell-checkers looking for mistakes, the computers flag suspicious areas on X-rays for a closer look by a radiologist. Mammograms are used to screen women for early signs of breast cancer but the tests aren't perfect. In the U.S., the X-rays are read by a single radiologist and cancers are sometimes missed.

Computer-aided detection, or CAD, was developed to help radiologists pick up more cancers. Approved a decade ago, these computer programs are now used for about a third of the nation's mammograms. But the value and accuracy of the technology has continued to be debated.

Now, British researchers are reporting results from a randomized study of 31,000 women. Mammograms in Britain are routinely checked by two radiologists or technicians, which is thought to be better than a single review. Researchers wanted to know if a single expert aided by a computer could do as well as two pairs of eyes.

They found that computer-aided detection spotted nearly the same number of cancers, 198 out of 227, compared to 199 for the two readers.

Single reading standard in U.S.
In places like the United States, "Where single reading is standard practice, computer-aided detection has the potential to improve cancer-detection rates to the level achieved by double reading," the researchers said. Their findings were published online Wednesday by the New England Journal of Medicine,

The study was done at three centers in England that do a large number of routine mammograms. Most of the women in the study were assigned to have their mammograms reviewed twice — once by a pair of experts and a second time by a single reviewer aided by a computer.

"What we demonstrated was that one reader using CAD could pick up as many cancers as the two readers could," said radiologist Fiona J. Gilbert of the University of Aberdeen, lead author of the study.

She said computer-aided detection could be used to expand screening by Britain's national health service, which now offers the test every three years to women 50 to 70. The cost-effectiveness will have to be determined first, she said.

The new findings are encouraging, said Dr. Carol H. Lee, a radiologist at Memorial Sloan-Kettering Cancer Center in New York.

"In the United States, it's just not practical in most practices to do double readings by physicians," said Lee, who is head of the American College of Radiology's Breast Imaging Commission. "These results are reassuring to me that single reading with CAD can achieve that same sensitivity.

Most insurers won't pay for second radiologist
The U.S. government recommends mammograms every one or two years starting at age 40. Experts said there aren't enough radiologists to give mammograms two readings, and insurers don't pay for a second look. Medicare does pay an additional $15 for computer-aided detection.

That extra money helped spur the adoption of the computer checks, said Dr. Ferris M. Hall, a radiologist at Boston's Beth Israel Deaconess Medical Center, where computers are used. He expects more places to use them as they switch to digital images from film X-rays, which eliminates a step in the process.

The research was funded by the British government and Cancer Research UK, a charity. Two of the researchers have received fees from the maker of a computer system and served as unpaid consultants to another.

For more information about breast cancer, or if you believe you may have had a delay in diagnosis of breast cancer, or misdiagnosed, please contact the attorneys at Berger Lagnese for a free consultation.

After breast cancer, weight stakes are higher

It’s common knowledge that keeping fit and maintaining an optimal weight are great ways to achieve overall health. But for breast-cancer survivors, the stakes are much higher.

Research indicates that excess weight can lead to increased levels of the hormone estrogen — and estrogen has been tied to the development of breast cancer in women.

Dr. Duc Vuong, a weight-loss surgeon in Houston, spells out the issue plainly.

“Overweight women have larger breasts,” he says. “These women have more exposure to estrogen, which we think increases their risk of several different cancers, including breast and uterine cancer.”

Vuong says more women are beginning to recognize the connection between excess weight and cancer, and that’s prompting them to take action.

Women on the move
After her second breast-cancer diagnosis two years ago, Ilya Sloan, who was then in her mid-60s, realized that the 200 pounds she carried on her short frame could have played a role in her getting the disease. Her oncologist told her about a clinical research weight-loss study at the Arizona Cancer Center, where Sloan works as a community events coordinator.

By the time she completed the six-month study, Sloan had lost 40 pounds on a low-carbohydrate and low-calorie diet. (The study also included participants who followed low-fat and low-calorie dietary regimes.) As part of her goal to drop more pounds, Sloan does water aerobics several times a week.

Sloan says she’s thrilled that her results are “concrete, something you can see.”

Tawny Rohrbaugh, 45, of Ashland, Ohio, didn’t learn about the connection between excess weight and breast cancer until after her diagnosis in August 2007. As soon as she grasped the seriousness of the situation, she made a decision.

“No more messing around,” Rohrbaugh remembers thinking. “It could mean my life if I don’t lose weight.”

Before her diagnosis, Rohrbaugh had already lost 60 pounds as part of a weight-loss plan — and then chemotherapy caused her to gain back half that amount. But after making a self-directed lifestyle change — which she describes as “cooking healthy food” with lots of fresh fruit and vegetables and regularly doing Pilates-based workouts — Rohrbaugh has lost that weight and continues to drop between 2 and 3 pounds a month.

Rohrbaugh says her motivation is strong: “I don’t want to go through cancer a second time.”

Sheri Morris, a registered nurse with a family history of breast cancer, decided to take an extreme step to lose excess weight. About a year and a half ago, Morris, then in her late 30s, went on a liquid meal replacement plan and lost 35 pounds. Now she tries to hit the gym two or three times a week.

Morris works for Vuong, the Houston surgeon who specializes in laparoscopic adjustable gastric banding, or lap-band surgery. She notes that even women who have had weight-loss surgery must be vigilant.

“Weight-loss surgery’s a tool, but women must still make healthy choices,” she says.

Not the easiest time to lose weight
Dr. Susan Love, a former breast-cancer surgeon who is now president of the Dr. Susan Love Research Foundation, says pre-menopausal women who have had breast cancer and are obese have a higher risk for recurrence. Post-menopausal women are at risk as well.

“We do not know exactly why, but one hypothesis is that fat is capable of making estrogen post-menopausally,” says Love, who notes that it’s simple math — lower the amount of fat and body weight, and you lower the amount of estrogen circulating in the body.

While most women would agree that losing weight is tough under any circumstances, those fighting breast cancer have a different and overwhelming priority — to get through their treatment. Being pushed to lose weight during this critical time is often jarring. “It’s adding insult to injury,” says Sloan, the woman who lost 40 pounds in the weight-loss study.

Love agrees this is a sensitive issue. “It’s not the best thing, as a woman leaves the hospital, to yell, ‘Lose weight!’” she says.

Other challenges can emerge for women at this time, says Emily Nardi, a registered dietitian who counseled participants in the Arizona Cancer Center’s weight-loss study. The study used a screening process to determine patients’ “state of readiness” to lose weight as a condition for enrollment.

Nardi explains that many women expect to become thin and gaunt if they have cancer, but medical treatment can actually promote weight gain in some women, as happened with Rohrbaugh. Depression also can become a debilitating problem for some breast-cancer patients — including young women thrown into sudden menopause. And, Nardi adds, the hormonal shift during menopause also can contribute to unexpected weight gain.

“During and after treatment, women are often inactive and they want to be nurtured and comforted,” Nardi says. “And comfort can often be found in food.”

Overcoming obstacles
How can a woman with breast cancer make it past these hurdles?

Love stresses that empowerment is key. In her lectures, she underscores “losing weight and exercising are actions that each woman can take” to lessen the chances of recurrence.

Sloan says it’s important to be held accountable — a reference to the weigh-in periods that were part of her weight-loss study and that women also can do at home.

The fear of a recurrence never goes away, Sloan says — but she gains strength knowing that, by losing weight, she’s increasing her odds of survival.

If you believe you may have been misdiagnosed, or had a delay in diagnosis of  breast cancer, please contact the attorneys at Berger & Lagnese for a free consultation.

Tamoxifen Speeds Diagnosis of ER-Negative Breast Cancer

Tamoxifen previously had been shown to reduce the risk of estrogen receptor (ER) positive breast cancer in women at high risk of the disease, but not to affect the chance of developing ER-negative disease.

However, the study by researchers at the University of Texas M.D. Anderson Cancer Center in Houston found that the treatment helped doctors diagnosis women who later developed estrogen receptor (ER) negative breast cancer an average of one year sooner than the same at-risk patients who instead took a placebo.

For the study, 13,388 women at high risk of breast cancer participated in the trial; 174 women were diagnosed with ER-positive tumors and 69 women with ER-negative tumors. The median time to diagnosis for ER-negative disease was 36 months in the placebo group but only 24 months in the tamoxifen group.

The median time to diagnosis for ER-positive disease was similar in the placebo and tamoxifen groups at 43 and 51 months, respectively, which is not statistically different.

It's not clear why the diagnosis time of ER-negative tumors is so different, but the authors hypothesized that the drug may make the tumors more detectable. No evidence was found that tamoxifen altered the growth rate of ER-negative disease.

The study was published online Oct. 7 in the Journal of the National Cancer Institute.

The findings should be investigated further, the researchers concluded.

New Breast Cancer Gene Test Offered

Breast Cancer Mammograms, Detection Aided by Computers

It is well established that two persons reading a mammogram find more breast cancers than a single reader.  The New England Journal of Medicine just published a study to determine whether the performance of a single  person reading a mammogram  using a computer-aided detection system would match the performance achieved by two readers. 

In this study, the researchers randomly assigned more than 31,000 women undergoing routine mammography to double reading, single reading with computer-aided detection, or both double reading and single reading with computer-aided detection

For double reading 87.7% of cancers weredetected and for single reading single reading with computer-aided detection 87.2% were detected .  The researchers concluded, therefore, that single reading with computer-aided detection could be an alternative to double reading and could improve the rate of detection of cancer.

For more information about breast cancer, see the medical malpractice lawyers of Pennsylvania.

Acupuncture Offers Relief for Breast Cancer Patients

Treatments for breast cancer can lead to unpleasant side effects for most women, including hot flashes, sweating and lack of energy.  New research suggests relief can come from an unconventional therapy — acupuncture.

Research from the Henry Ford Hospital in Detroit, presented this week at the American Society for Therapeutic Radiology and Oncology’s annual meeting in Boston, studied acupuncture use among 47 women who were receiving anti-estrogen treatments, including tamoxifen or anastrozole (Arimidex). The drugs are known to lower the risk of breast cancer recurrence, but they can trigger menopause-like symptoms, including hot flashes and night sweats. Half the women were given the antidepressant Effexor, which has been shown to reduce hot flashes in breast cancer patients. The other half received acupuncture therapy once or twice a week during the 12-week study.

The acupuncture worked just as well as the antidepressant Effexor to curb hot flashes. Women who received acupuncture also reported fewer side effects and more energy, and some reported an increased sex drive, compared to women who used Effexor, the study showed.

Dr. Eleanor M. Walker, director of breast radiation oncology at the Henry Ford Hospital in Detroit, said that while she expected to see some benefits from acupuncture, the results were surprising.

“I was surprised by the duration of the effect,” Dr. Walker said. “I didn’t realize it would last so long or result in an increase in sex drive and energy. That was a surprise.”

Last year, a report in The Journal of Clinical Oncology suggested a benefit of acupuncture compared to a “sham” acupuncture treatment, but the results didn’t reach statistical significance.

Because the most recent study lasted only three months, it’s not clear how long the benefit of acupuncture lasts. The study authors said that more research is needed to find out if regular “booster” sessions after the initial treatment period will continue to relieve a woman’s symptoms.

Birth Size Linked to Breast Cancer Risk

"These researchers have documented in unequivocal terms that larger birth size is associated with increased breast cancer risk several decades later," said Dr. Dimitrios Trichopoulos, the Vincent L. Gregory Professor of Cancer Prevention at Harvard University School of Public Health Department of Epidemiology and author of an accompanying journal editorial.

Birth size reflects, to a considerable extent, the effects of the intrauterine environment on the fetus, Trichopoulos noted. "To this day, they had not been sufficiently appreciated by the scientific community, because each individual study could not provide conclusive evidence. We are facing now a new reality: that breast cancer has its origins several decades before its clinical appearance," he said.

For the study, a research team led by Dr. Isabel dos Santos Silva, a professor of epidemiology at the London School of Hygiene and Tropical Medicine, collected data on more than 600,000 women, 22,058 of whom had breast cancer. The data came from 32 studies.

The researchers found that women who were heavier and longer at birth had increased risk for breast cancer as adults. An analysis of birth records, among these women, found that for every 17.6 ounces of birth weight, the risk for breast cancer increased 7 percent.

In addition, birth length and head circumference were also associated with an increased risk of breast cancer. The strongest association between size at birth and an increased risk for breast cancer was seen for birth length, the researchers reported.

"Recognition of early life influences are critical in the etiology of breast cancer and helps to explain why several adult life primary prevention practices -- as distinct to secondary prevention ones focusing on early detection -- have been of limited effectiveness," Trichopoulos said.

"Prevention of breast cancer needs to take into account the very long natural history of the disease," he added.

Expert reaction to the new research was fairly guarded.

"There's good evidence for these findings, but there is really no clinical relevance for them," said Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society.

"There is nothing that women should do differently to try to have smaller babies, or women who were born with a longer length or larger head circumference should do anything differently when they grow up or get screened differently, or consider themselves at high risk -- it's really just a research issue," Saslow said.

"Free" Mammograms are Not Without Costs to Low Income Women

In the U.S., a federally funded project called the National Breast and Cervical Cancer Early Detection Program covers the costs of breast cancer and cervical cancer screening tests for women who are at or below 250 percent of the federal poverty line.

However, research indicates that only 13 percent of women who are eligible for mammograms under the program actually get one -- a shortfall that is likely contributing to the ongoing mammography gap between insured and uninsured U.S. women.

One potential reason that eligible women are not getting mammograms under the federal program is that despite the fact that the test is free, women still incur personal costs, including the costs of transportation or child care, as well as lost wages from taking time off from work.

In the new study, researchers at the Centers for Disease Control and Prevention tried to estimate what those costs might be for the typical low-income woman.

Using survey data from 1,870 women who participated in the screening program, the researchers found that for women with an annual income of less than $10,000, the personal cost of one mammogram was $17, on average. The cost of 10 screenings over the years would be about $108, while 25 screenings would amount to $262.

Those figures were all higher for women earning between $10,000 and $20,000 per year -- with a one-time screening costing $31 and 25 screenings costing $475.

These numbers might seem modest, but for a low-income woman, they "could be substantial," Dr. Donatus U. Ekwueme and colleagues write in the journal Cancer.

Policymakers are considering expanding the cancer screening program. But as they do, Ekwueme's team writes, "they should also develop strategies to offset personal costs incurred participants."

In general, experts recommend that women have a mammogram every one to two years, beginning at the age of 40.

For free information about mammograms, medical malpractice, or breast cancer, contact us.  Our lawyers specialize in medical malpractice cases in Pennsylvania.

Early Stage Breast Cancer Not More Likely to Recur in Young Women

Hypnosis Helps Breast Cancer Survivors

Randomized Trial of a Hypnosis Intervention for Treatment of Hot Flashes Among Breast Cancer Survivors

From the Department of Psychology and Neuroscience, Baylor University, Waco; Scott and White Memorial Hospital and Clinic, Department of Psychiatry and Behavioral Sciences, Temple; Cancer Treatment and Research Center, San Antonio; and University of Texas at Austin, TX; University of Arizona, Tucson, AZ; and the Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.

^* To whom correspondence should be addressed. E-mail: Gary_Elkins@baylor.edu

Purpose: Hot flashes are a significant problem for many breast cancer survivors. Hot flashes can cause discomfort, disrupted sleep, anxiety, and decreased quality of life. A well-tolerated and effective mind-body treatment for hot flashes would be of great value. On the basis of previous case studies, this study was developed to evaluate the effect of a hypnosis intervention for hot flashes.

Patients and Methods: Sixty female breast cancer survivors with hot flashes were randomly assigned to receive hypnosis intervention (five weekly sessions) or no treatment. Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least 1 month. The major outcome measure was a bivariate construct that represented hot flash frequency and hot flash score, which was analyzed by a classic sums and differences comparison. Secondary outcome measures were self-reports of interference of hot flashes on daily activities.

Results: Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency x average severity) decreased 68% from baseline to end point in the hypnosis arm (P < .001). Significant improvements in self-reported anxiety, depression, interference of hot flashes on daily activities, and sleep were observed for patients who received the hypnosis intervention (P < .005) in comparison to the no treatment control group.

Conclusion: Hypnosis appears to reduce perceived hot flashes in breast cancer survivors and may have additional benefits such as reduced anxiety and depression, and improved sleep.

If your breast cancer was missed or misdiagnosed, and you would like more information about this, contact the breast cancer malpractice lawyers.  Our attorneys only work on significant malpractice cases in Pennsylvania, including Pittsburgh, Erie, Washington PA, Beaver, Greensburg, and Uniontown.

Parents Getting Breast Cancer Gene Test for Kids

New Vaccine for HER2-Positive Breast Cancer has Promising Results in Mice