Women should be aware that all cancers detected during breast cancer screenings are not necessarily lethal. More intensive screening tends to reveal even cancers that may lie dormant or cause no harm. A recent study in the British Medical Journal shows that nearly 52% of mammograms in areas offering organized screening are over-diagnosed, with one in three overdiagnosed overall. The danger lies in the health problems that may result from unnecessary treatment (such as chemotherapy, radiation or surgery).
A mammogram uses x-rays to detect masses in the breast tissue, allowing doctors to detect breast cancer in its early stages when it’s most likely to be cured. Women over the age of forty are encouraged to get a mammogram every 1-2 years. Although a mammogram is beneficial when lethal cancers are detected, it may be harmful when perceiving those that are not.

It is estimated that one in three breast cancer mammography screenings are overdiagnosed. Overdiagnosis occurs when the patient dies before cancer complications occur, whether it's because the cancer grows too slowly or simply remains dormant.

Because it is impossible to discriminate between types of cancers that will not cause death or symptoms and those that will, all types of cancer are treated. In fact, 37% of women age 40-54 who died from causes other than breast cancer had invasive or non-invasive cancer legions at autopsy, half of which were visible on radiography.

Researcher Karl Julh Jørgensen, co-author and researcher of the study, wrote “The increase in incidence of breast cancer was closely related to the introduction of screening and little of this was compensated for by a drop in incidence of breast cancer in previously screened women.”

Jørgensen, along with director Peter C Gøtzsche, both of The Nordic Cochrane Center in Copenhagen, Denmark, gathered information for the review by compiling several studies from Norway, Sweden, Australia, Canada, and the United Kingdom, using data seven years prior to screening and seven years after.

Researchers obtained information from women too young to be screened to use as a control. This information was compared with pre-screening trends of the screened group to establish a background incidence.

The rate of diagnosis for women younger than 50 and greater than 74 remained constant, but when the post-screening trend in women age 50-69 was examined, breast cancer diagnosis was almost 42% higher than expected.  This was followed by a 15% decline in diagnosis for women over the age of 70. Over-diagnosis for breast cancer alone was 35%, which jumped to 52% when carcinoma in situ (at its original site) was included.

Although factors such as the use of hormone replacement therapy (associated with an increased risk of breast cancer) and incidence of ductal carcinoma in situ (DCIS) may play a factor in the statistics, researchers still attribute much of this change in diagnosis to organized and more frequent screening.

Other deviations due to the nature of different types of cancer must still be accounted for, but the study’s findings do stress taking precautions in breast cancer screening.

Digital mammography readings, for example, in lieu of traditional mammograms (that tend to detect a higher rate of false positives due to poorer image quality) may be the best procedure, but knowing the facts about breast cancer’s risks can help prevent complications as a result of overdiagnosis.

Visit our Breast Cancer Community.

A follow-up study in Washington shows that although migraines are a real pain, they may spell relief for women at risk for developing breast cancer.

Dr. Christopher I. Li, M.D., Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle, Wash. originally conducted this study with colleagues in 2008. Their original study linked clinically diagnosed migraines with a lower risk for both invasive ductal and invasive lobular breast cancer.

Breast cancer and migraines are both hormonally related conditions—migraines often resulting from unstable or changing hormone levels, especially estrogen. For women, who are 2-3 times more likely to experience migraines than men, this time is typically during the early days of menstruation.

The study found that postmenopausal women with a history of migraines had 32-33% reduced chance of developing breast cancer. These statistics proved to be even more consistent in subtypes of breast cancer that are estrogen-receptor and progesterone-receptor positive.

When the original study results were released last fall, the sample group consisted of roughly 3,500 postmenopausal Seattle women between the ages of 55-74. This time, however, Dr. Li and his colleagues were able to paint a much better picture. “Having a larger and more diverse study in its underlying population helps in replicating the findings,” Li says.

By more than doubling the sample size, expanding testing to women of different menopausal stages  (this time including ages 35-64), and adding four locations in Detroit, Los Angeles, Atlanta, and Philadelphia, researchers were able to define breast cancer’s connection to migraines more clearly.

In addition to age and menopausal status, many breast cancer risk factors also trigger migraines. Such factors include smoking, alcohol consumption and use of exogenous hormones (such as birth control). These risk factors, however, did not increase the likelihood of women with a history of migraines.

According to the second study, rates among the control and case groups were relatively unchanged, despite differences in use of prescription migraine medications and age at migraine diagnosis. Even among those who did not avoid these triggers, women with a history of migraines were still 26% less likely to develop breast cancer than those without.

It is not clear how migraines “protect” against breast cancer, but researchers hope to further examine the role of hormones, NSAIDs (nonsteroidal anti-inflammatory drugs) and other medications in the development of breast cancer.

The best way to reduce breast cancer risk is to check regularly. For more information on breast cancer and how to do a self-examination, visit NationalBreastCancer.org.

You can also check out Helia's  Breast Cancer Community!

 

Want more information about migraines? Click here .

British researchers reported Tuesday that women who consume low to moderate amounts of alcohol face an increased risk of several types of cancers. Based on their data, they conclude that alcohol may account for nearly 13 percent of all cancers of the breast, liver, rectum, and upper digestive tract combined in the UK.

Researchers at the University of Oxford examined the relationship between alcohol consumption and several types of cancer among nearly 1.3 million middle-aged women enrolled in the UK’s Million Women Study. About a quarter of the women in the study reported abstaining from alcohol, but among the other three-quarters, the average alcohol consumption was one drink per day; very few reported having more than three drinks per day.

In the study that appears in the February 24^th online edition of the Journal of the National Cancer Institute, researchers compared the lightest drinkers – those who consumed two or fewer drink per week – with those who drank more. After an average follow-up time of seven years, they found that each additional alcoholic drink regularly consumed per day was associated with 11 additional breast cancers per 1000 women up to age 75; one additional cancer of the oral cavity and pharynx; one additional cancer of the rectum; and an increase of 0.7 each for esophageal, laryngeal, and liver cancers. The background rate for all of these cancers combined is about 118 cases per 1,000 women. The type of alcohol consumed (wine, beer, or liquor) did not matter.

While the cancer risk to individuals conferred by drinking alcohol is not large, the researchers stress that given the prevalence of alcohol consumption in most Westernized countries, it likely results in a large number of cancers that are otherwise preventable, accounting for perhaps 13 percent of all cancers in the UK.

Previous studies have suggested that moderate alcohol consumption can benefit heart health and may reduce the chances of heart disease. While the present study did not address heart disease risk, the results call into question the health benefits of moderate alcohol consumption. However, heart disease is the leading cause of death for both women and men, ahead of all types of cancers combined, so there may still be an overall health benefit from moderate alcohol consumption.

Further research will hopefully shed light on who, if anyone, may benefit from moderate alcohol consumption and what is the "safest" amount to drink. Whether there is any overall health benefit to you from drinking alcohol may depend on your personal history and risk factors (e.g. family history of cancer or heart disease, cholesterol levels). Talk to your doctor about your risk factors and your alcohol consumption to find out if you should change your drinking habits.

For more information about breast cancer prevention, see How can I prevent breast cancer? in the Healia Health Guides. If you have a question about your alcohol consumption, ask the Healia Health Community on Alcohol or Ask the Experts at Healia Health Communities.

_{Photo: rolands.lakis, Flickr, Creative Commons}

The risk of breast cancer doubles in women who take hormone replacement therapy for five years, according to newly released results from the Women’s Health Initiative. This largest-of-its-kind study also made news in 2002 when the main part of the study was stopped after finding that hormone replacement was associated with higher risks of heart problems and breast cancer.

The new results confirm that taking the hormones estrogen and progestin after menopause increases the risk of breast cancer and demonstrates that risk increases with each year the hormones are taken. Taking the hormones for just two years increased the risk of breast cancer significantly, and after five years of hormones the risk of breast cancer is twice that of women who did not use hormone replacement.

The study also finds that after stopping hormone treatment, breast cancer risk falls as quickly as it rises. Roughly two years after stopping hormone treatment, the risk of breast cancer returns to normal levels. This is in stark contrast to other cancer risk factors such as smoking, which may take 10 to 15 years or more after quitting for cancer risk to return to normal.

This likely explains why breast cancer rates have plummeted in recent years. Following the original findings of the study, many women stopped taking hormone replacement therapy or decided not to start it: in the general population, use of hormone replacement has dropped 70 percent since the initial results were announced.

Some researchers have suggested that the decrease may not be due to fewer people taking hormones but instead because fewer women were getting mammograms. This would mean that fewer cancers were being detected, not necessarily that fewer were occurring.

However, the new study shows conclusively that mammography rates were virtually the same among those taking hormones and those not, putting to rest the idea that cancers are being missed due to reduced screening.

Doctors now caution women to consider using hormones only if their menopause symptoms are severe. The finding that breast cancer risk doubles with five years of hormone replacement is likely to reinforce the advice that only women who really need the treatment should use it. In addition, the fact that breast cancer risk seems to increase the longer the treatment is used will likely lead doctors to counsel their patients to limit hormone therapy treatment to the shortest possible course.

Despite the increased cancer risk, most women will not get breast cancer by taking hormones short-term. The increased cancer risk from a couple of years of hormone use translates to a few extra cases of breast cancer a year for every 1,000 women on hormones.

For some women, the transition to menopause can be very difficult, accompanied by severe hot flashes, memory problems, and difficulty sleeping. If these symptoms are interfering with your daily life, consider talking to your doctor about hormone replacement. While most women with mild symptoms should avoid hormone replacement, if your symptoms are severe, the increased cancer risk may be preferable to you in order to get some relief.

To find out more about hormone replacement, breast cancer screening and prevention, see the Healia Health Guide of Breast Cancer. If you have questions about hormone replacement, ask the experts on Healia Health Communities or share your experience at the Healia Health Community for Hormone Replacement Therapy.

 

_{Photo: merfam, Flickr, Creative Commons}

The rate of new cancer cases in the U.S. appears to be dropping for the first time, according to a report released this week in the Journal of the National Cancer Institute. In addition, cancer death rates continue to fall steadily as they have for several years thanks to improvements in both cancer detection and treatment.

The annual "Report to the Nation" on cancer shows that the rate of new cancer diagnoses among men dropped 1.8 percent a year between 2001 and 2005, while the rate for women dropped just over half a percent a year. The drop was seen across all racial groups examined. Also, the cancer death rate among men and women continued to drop, by an average of 1.8 percent a year through 2005. However, cancer remains the second leading cause of death for Americans with only heart disease claiming more lives.

Much of the gains were made in the rates of some leading cancers including breast, prostate, and colorectal cancers. The declines are largely due to increases in cancer screening, and for breast cancer, to a decrease in the use of hormone replacement therapy. Lung cancer rates also decreased but only for men, likely because smoking rates fell for men before they did for women, which allowed men to reap the benefits sooner. In contrast, the rates of lung cancer in women, kidney cancer, melanoma, and several others cancer types continue to rise.

While the declines in cancer rates were small, most between one and four percent, the fact that death rates continue to fall as well suggests that the improvements are real, rather than caused by, for example, people skipping screening appointments, allowing existing cancers to go undetected.

Experts question whether the gains can be maintained in the face of the economic downturn. Declining budgets for cancer research and decreased adherence to cancer screening and surveillance programs threaten to reverse the trend, just as the milestone of a decline in overall cancer rate is finally being attained.

If you are concerned about your cancer risk, talk to your doctor about what you can be doing to decrease your risk. Read the American Cancer Society guidelines for the early detection of cancer at the American Cancer Society’s Website. To get personalized answers to your questions about cancer, ask the experts on Healia Health Communities or join the Healia Health Community for Cancers.

 

_{Photo: DefMo, Flickr, Creative Commons}

Migraine headaches are painful and debilitating but they may have a silver lining for women. A recent study reports that women who have a history of migraines have a 30% lower risk of developing breast cancer. The study, conducted at the Fred Hutchinson Cancer Research Center in Seattle, was the first to examine a link between the two disorders and appears in the November Issue of the journal Cancer Epidemiology, Biomarkers and Prevention.

Migraine history appeared to reduce the risk of the most common types of breast cancer: those that have receptors for the female sex hormones estrogen and/or progesterone on the surface of their cells. The presence of such receptors renders these types of tumors susceptible to hormone-blocking drug treatments.

Researchers are not sure why migraines reduce breast cancer risk but the answer may have to do with the levels of female sex hormones in the blood. Migraines are more common in women than men and they tend to occur more frequently when levels of female sex hormones are low, such as during menstruation.

Conversely, many women who have migraines experience fewer episodes during pregnancy, a time when the levels of these hormones are high. Sex hormones are known to stimulate the growth of some types of breast cancer, so perhaps lower overall levels of this hormone lead to both an increase in migraines and a decrease in the growth of breast tumors.

If you are a women with migraines, this does not mean you are protected from getting breast cancer, only that your risk may be somewhat reduced. You should continue to have regularly scheduled mammograms as recommended by your health care provider. If you take medication for your migraines, you should continue to do so, as the study does not address whether migraine treatments have any effect on breast cancer risk.

For more about migraines, join the Healia Health Communities for Migraines. Find out more about breast cancer in the Healia’s breast cancer health guide.

 

_{Photo: Patrick Denker, Flickr, Creative Commons}

Researchers at the University of Texas M.D. Anderson Cancer Center released a report last week stating that high-dose chemotherapy (followed by a stem-cell transplant to rebuild the immune system) after surgery may not extend the lives of breast cancer patients. Experts discovered that women who received this aggressive treatment had a few extra cancer-free months, but that they ultimately did not survive any longer than women who never underwent this surgery.

These results confounded many researchers, including Donald Berry, chair of biostatistics and study leader at the University of Texas M.D. Anderson Cancer Center:       

I was surprised by the results. I was expecting some subsets of women to show some survival benefit. Many studies had been suggesting that there were some patients, such as young patients and women with triple negative cancer (cancer cells that lack receptors for estrogen, progesterone or HER2, which makes them difficult to treat with drugs) that would benefit. But our analysis shows that's not true, said Berry. 

 

The therapy involves multiple steps beginning with the extraction of bone-marrow stem cells from the patient prior to surgery. After the tumor has been removed, the patient is given very high doses of chemotherapy, and then re-infused with their stem cells, which restore immune cells destroyed by the chemotherapy. According to the study, these ultra-high doses of chemo are extremely toxic. Many of the 20,000 women who have received the treatment in the U.S. have died from the toxicity.

The study consisted of 15 trials (6,200 patients) and included women with all types of breast cancer at the beginning stages of disease. Each woman had tested positive for cancer in lymph nodes upon surgery. None of the women in the study had been diagnosed with cancer that had metastasized (spread) to anywhere else in the body.

High-dose chemotherapy was very popular in the 1980s and 1990s when many doctors believed that high doses of chemotherapy was better following cancer surgery. Although it was painful for patients, oncologists believed that high chemo levels would ultimately benefit patients by destroying any cancer cells that could still be in the body.

When making a decision on a particular cancer therapy, the American Cancer Society recommends learning what types of treatment are available, their risks and benefits, the possible side effects, and how to manage them. Learning about your options and discussing them with your doctor can help you with these important decisions. For more information on breast cancer treatment, visit healia.com.

high dose chemotherapy breast cancer breast cancer treatment

October is Breast Cancer Awareness Month and you may be helping in fundraising efforts for this worthwhile cause. So far, the month has been full of races, walks, pink ribbons, cancer survivor stories, and education. But one question comes to mind amongst all of these efforts…

Is everything we are doing making a difference? And just where does all of this fundraising money go?

According to the Susan G. Komen Breast Cancer Foundation, they have invested $1 billion to date in breast cancer research, education, and health services.

A minimum of twenty-five percent of the net income from each domestic Affiliate Race supports the Komen for the Cure Award and Research Grant Programs. These programs fund groundbreaking breast cancer research, meritorious awards, and educational and scientific conferences around the world.

And up to seventy-five percent of the net income from each domestic Affiliate Race stays in the local community to fund breast health education and breast cancer screening and treatment projects.

The American Cancer Society states that since 1993, 3.5 million walkers across the country have raised more than $230 million through their Making Strides Against Breast Cancer events.

The money raised through Making Strides events helps the American Cancer Society fight breast cancer by offering the nation’s only 24-hour cancer hotline, providing free email mammogram reminders, and funding cutting-edge research leading to the discovery of lifesaving treatments like Tamoxifen and Herceptin.

Based on rates from the National Cancer Institute, 12% (or 1 of 8) women born today will be diagnosed with breast cancer at some time during their lifetime.

So, participate in that walk, make that donation, and help breast cancer fundraising efforts… one in eight women will be thankful that you did.

For more information on breast cancer prevention and treatment, visit Healia.com.

 

breast cancer breast cancer awareness month

Robin Roberts, anchor of ABC’s Good Morning America show, announced she has breast cancer on Tuesday's show. She discovered this after following her own advice about the importance of early detection for cancer.

Roberts had done a story about her former colleague Joel Siegel, who tragically died of colon cancer in June. After the story, she examined her breasts that night and found a lump. Follow-up tests revealed news she didn't want to hear: that she has breast cancer.

The good news, however, is that Robin discovered her cancer before it moved beyond its early stages. Early detection is critical to breast cancer survival. This story illustrates how important it is for women to be familiar with how to do breast self-exams and other screening methods for breast cancer.

breast cancer detection screening methods Robin Roberts Joel Siegel