Breastcancer.org Research News

A Common Plastic Chemical, BPA, Is Shown to Affect Breast Development in Fetal Monkeys

Fri May 11 18:12:27 -0400 2012

BPA is the commonly used designation for bisphenol A, a chemical found in many rigid plastic products, food and formula can linings, dental sealants, and on the shiny side of paper cashier receipts (to stabilize the ink). The structure of BPA resembles estrogen, and as a result, exposure to it can affect how estrogen and other hormones act in the body, by mimicking or blocking them. This can disrupt the body's hormonal balance.

Many women choose to limit their exposure to BPA and other estrogen-like chemicals because it is known that estrogen can make hormone-receptor-positive breast cancer develop and grow. Some experts have expressed concern that BPA exposure in early life may lead to an increased breast cancer risk later in life.

A recent study found that breast tissue development in primates exposed prenatally to BPA was more advanced compared to breast tissue development in those not exposed to BPA, a finding that could be linked to increased breast cancer risk later in life. The study was published online May 7, 2012, in the journal Proceedings of the National Academy of Sciences of the United States of America (PNAS). Read the abstract of Bisphenol A alters the development of the rhesus monkey mammary gland.

The researchers gave some pregnant monkeys BPA in their diet, resulting in their blood levels of BPA being comparable to those typically found in U.S. women. Other pregnant monkeys were not given BPA. After the baby monkeys were born, the researchers biopsied the breast tissue of baby monkeys, and then they compared the biopsy findings for the baby monkeys exposed to BPA to the findings for those not exposed to BPA.

They found that the babies who had been exposed to BPA while in their mother’s uterus showed signs of more advanced breast tissue development. This advanced development of breast tissue during fetal and early life could set the stage for an increased risk of being diagnosed with breast cancer later in life.

In the Breastcancer.org Lower Your Risk section you can learn much more about what we know about breast cancer risk factors, and what you can do to minimize your personal risk. For more specific information on risks from plastics, and what you can do about those risks, visit the Breastcancer.org Exposure to Chemicals in Plastic pages.

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Aggressive Screening Plan Not Needed After Benign Biopsy Results

Tue May 08 12:31:52 -0400 2012

Many times, a suspicious area in the breast found by a mammogram or other screening test is biopsied and found to be a benign (not cancer) abnormal area. When this happens, doctors often recommend a more aggressive breast cancer screening plan because they’re concerned that the benign abnormal area may be linked to a higher risk of breast cancer. The National Comprehensive Cancer Network supports this approach, recommending that screenings be done every 6 to 12 months for 1 or 2 years in women who’ve had a benign abnormal area that’s been biopsied.

But a new study suggests that more aggressive breast cancer screening may not make sense after a benign abnormality is biopsied; following standard breast cancer screening guidelines for women with average breast cancer risk is appropriate.

The study was published in the May 2012 issue of the American Journal of Roentgenology. Read the abstract of Short-Term Follow-Up of Patients With Benign Breast Biopsies: Is It Really Worth It? (scroll down to the second abstract).

Researchers reviewed the medical records of 388 women who had a breast biopsy with benign results. The women were 18 to 88 years old. Looking at the breast cancer screening tests (mostly mammograms) done after the biopsy, the researchers found:

at 6 months, 40 women had a follow-up screening test; none were diagnosed with breast cancer
at 1 year, 345 women had a follow-up screening test; none were diagnosed with breast cancer
at 2 years, 197 women had a follow-up screening test; two women were diagnosed with breast cancer

Both of the women diagnosed with breast cancer were older than 40 and would have been screened for breast cancer (based on current screening guidelines) even if they hadn’t had an earlier benign breast biopsy.

Because of the extra breast cancer screenings that were done, 6% of the women had a second breast biopsy with benign results.

So the researchers concluded that a more aggressive breast cancer screening plan after a benign abnormal area is found in the breast may not be warranted. For most women, following the current breast cancer screening guidelines is fine.

If you’ve been diagnosed with a benign abnormal area in your breast, this study should be reassuring. As you develop a breast cancer screening plan with your doctor, you might want to bring up this study. Together, you can create a screening plan that makes the most sense for your specific situation.

For more information on mammograms and other tests to detect breast cancer, visit the Breastcancer.org Breast Cancer Tests: Screening, Diagnosis, and Monitoring pages.

Lymphedema Risk Seems to be Lowered by Physiotherapy

Fri May 04 09:54:21 -0400 2012

Lymphedema is swelling of the arm, hand, or chest wall caused by a build up of lymph fluid in those tissues after breast cancer surgery, especially surgery that removes underarm (axillary) lymph nodes. (Edema is the medical term for swelling.)

A small study found that a special massage technique called physiotherapy can stop lymphedema from developing in some women when done after surgery.

Between 10% and 90% of women develop some level of lymphedema after breast cancer surgery. Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or damaged during surgery, lymph fluid may not drain properly and can collect in the tissues near the surgical site. Radiation therapy and chemotherapy can increase the risk of lymphedema.

Physiotherapy to prevent or treat lymphedema also is called decongestive manual lymphatic drainage or complex decongestive physiotherapy. During physiotherapy, a specially trained therapist gently massages the skin and soft tissues of the arm where lymphedema could develop or has developed after surgery. Each physiotherapist may use different techniques. A typical regimen might include an hour-long massage once a day, 3 to 5 days a week. Many therapists wrap the arm with bandages or gauze after the massage and the bandages stay on for the other 23 hours per day.

Physiotherapy is very different from traditional massage therapy, which focuses on muscles and deep tissues and can be quite forceful. Traditional massage therapy can sometimes make lymphedema worse rather than better.

This Spanish study split 120 women who had breast cancer surgery that removed some of the axillary lymph nodes into two groups. Half of the women received physiotherapy to the arm and surgical scar tissue that also included shoulder exercises; they also were given educational materials about the exercises. The other group only received educational materials about shoulder exercises that could help minimize their risk of developing lymphedema. The women were followed for 1 year.

Overall, 16% of the women developed lymphedema: 25% of the women who didn't get physiotherapy and 7% of the women who got physiotherapy. This means that the women who had physiotherapy were 72% less likely to develop lymphedema compared to women who didn't have physiotherapy.

This study was small and the different physiotherapists used different techniques. Also, there were many differences among the women that could have affected whether lymphedema developed, including:

weight
number of lymph nodes removed
surgical complications

So these results are considered preliminary. More research is needed to better understand which physiotherapy techniques work the best, how useful physiotherapy can be in reducing lymphedema risk, and which women physiotherapy can help the most.

For some women who do develop lymphedema, the swelling is mild and goes away over time with treatment. For other women, the swelling is severe and can be an ongoing problem. Other research has shown that decongestive physiotherapy can help reduce the swelling, discomfort, and stiffness of lymphedema that developed after breast cancer surgery.

You can learn more about the risks for lymphedema, steps you can take to minimize that risk, and tips for managing lymphedema in the Breastcancer.org Lymphedema section.

Careful Weight Lifting Doesn’t Increase Lymphedema Risk

Fri May 04 09:53:56 -0400 2012

Lymphedema is swelling of the arm, hand, chest wall, back, or other body part caused by lymph fluid collecting in tissue after surgery, especially breast cancer surgery that removes underarm (axillary) lymph nodes. Edema is the medical term for swelling, so swelling caused by lymph fluid is "lymphedema."

Many doctors believe that lifting heavy objects with an arm at risk for lymphedema may cause lymphedema to develop. If lymphedema has already developed, many doctors also believe that lifting heavy objects may worsen it. A study suggests that a careful weight lifting program that starts with light weights and gradually increases after breast cancer surgery doesn't increase lymphedema risk and could possibly lower the risk of developing lymphedema. The results were presented at the 2010 San Antonio Breast Cancer Symposium (SABCS).

Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or damaged during surgery, the lymph fluid may not drain properly and can collect in the tissues near the surgery site. The more lymph nodes that are removed, the greater the risk of lymphedema. Some research suggests that the risk of lymphedema is higher and any lymphedema that does develop is more severe in women who are overweight or obese. Radiation therapy and chemotherapy can increase the risk of lymphedema.

All of the women in this study, called the Physical Activity and Lymphedema (PAL) trial, had surgery to remove early-stage breast cancer and all the women had at least two lymph nodes removed. Because of the surgery, all the women were at risk for lymphedema or had already developed lymphedema in the arm on the side where the breast cancer was removed.

In this analysis, the researchers looked at 154 women in the PAL trial who didn't have lymphedema when the trial started. Half of the women made no changes to how they cared for their arms after surgery. The other half of the women took part in a weight lifting program made up of:

membership at a gym (mostly local YMCAs) working with trainers who took a special class on how to weight train the women
13 weeks of weight lifting classes designed specifically for women with lymphedema or at risk for it; the women started with very light weights (1 to 2 pounds) and gradually increased
a custom-fitted compression garment (a wrap that gently compresses the arm and hand) that was worn while weight lifting

After 1 year, the 134 women who completed the weight lifting program and follow-up were no more likely to develop lymphedema than the women who didn't participate in the weight lifting program.

Overall, 11% of the women who lifted weights developed lymphedema compared to 17% of the women who didn't lift weights.

This study looked at whether weight lifting would increase the risk of developing lymphedema. This study didn't look at whether weight lifting could reduce the risk of developing lymphedema after breast cancer surgery. Still, women who were at the highest risk of developing lymphedema (they had five or more lymph nodes removed) and lifted weights were 70% less likely to develop lymphedema compared to women at the highest risk who didn't lift weights:

About 7% of high-risk women who lifted weights developed lymphedema compared to 22% of high-risk women who didn't lift weights.

On average, women who lifted weights increased their body strength and decreased their body fat.

The same researchers who did this study did an earlier analysis of women in the PAL trial who were diagnosed with lymphedema when they started the study. They found that the women who lifted weights were more likely to have some easing of the lymphedema and less likely to have the lymphedema get worse compared to women who didn't lift weights. So contrary to popular belief, lifting weights didn't make existing lymphedema worse.

More research should be done with larger groups of women to see if gradually increasing weight lifting after breast cancer surgery can actually lower the risk of developing lymphedema.

These results suggest that the common recommendation to avoid strenuous use of an arm at risk for lymphedema after breast cancer surgery may not always make sense. Still, until we know more, it's probably good to be cautious. If you're scheduled for breast cancer surgery, be sure to ask your doctor about your risk of lymphedema and any steps you can take to lower that risk. After surgery, talk to your doctor about exercises and any activity restrictions that make the most sense for your unique situation. If you'd like to do strength training after surgery, you might want to ask your doctor about this study and ask for the name of a physical therapist who works with women who have lymphedema or are at risk for lymphedema.

Stay tuned to Breastcancer.org for the latest information on lymphedema and its treatment.

Research Says Lymphedema Risk Is Ongoing

Fri May 04 09:53:36 -0400 2012

Lymphedema is swelling of the arm, hand, or chest wall caused by a build-up of lymph fluid in tissue after surgery, especially surgery that removes underarm (axillary) lymph nodes. (Edema is the medical term for swelling.) A study suggests that lymphedema may be more common and last longer than generally thought. The study also suggests that the risk of lymphedema can last 5 years or more after breast cancer treatment ends.

Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or damaged during surgery, lymph fluid may not drain properly and can collect in the tissues near the surgery site. The more lymph nodes that are removed, the greater the risk of lymphedema. Some research suggests that the risk of lymphedema is higher and any lymphedema that does develop is more severe in women who are overweight or obese. Radiation therapy and chemotherapy can increase the risk of lymphedema.

The researchers monitored 211 breast cancer survivors for 5 years, looking for symptoms of lymphedema. They used four ways to decide if a woman had lymphedema.

Five years after surgery, 43% to 94% were judged to have lymphedema. The percentages varied because the four methods of diagnosing lymphedema had different criteria. Still, this range is much higher than the 15% to 20% risk that is considered average lymphedema risk.

The percentage of women with lymphedema was:

94% based on arm circumference (anywhere on the arm) change of more than 2 cm. (about 0.75 inches)
83% based on three-dimensional arm volume increase of 200 ml (6.5 ounces) or more; this increase is called limb volume change (LVC)
55% based on LVC increase of 10% or more
43% based on a woman reporting lymphedema symptoms; in addition to swelling of the soft tissues of the arm or hand, other lymphedema symptoms are numbness, a feeling of heaviness in the limb, or pain

Many women first developed lymphedema more than a year after surgery; some women developed lymphedema 5 years after surgery. The results contradict conventional wisdom that lymphedema generally develops during the first year after surgery. The researchers are continuing to analyze the results, hoping to identify the factors linked to lymphedema development long after surgery.

These results suggest that lymphedema after breast cancer surgery is more common than doctors realize and that lymphedema can happen years after treatment.

If you're getting ready to have breast cancer surgery, be sure to ask your doctor about your risk of lymphedema and the steps you can take to lower that risk. If you've already had surgery and now have lymphedema, you probably already know ways to help manage lymphedema, including:

elastic sleeves and/or gloves to gently compress tissue and move out excess fluid
decongestive therapy, in which a specially trained therapist gently massages the affected skin and tissue; the arm is usually bandaged between the massages

You can learn more about how to minimize the risk of lymphedema as well as other ways manage it in the Breastcancer.org Lymphedema section.

Decongestive Therapy Helps Remove More Fluid from Arm with Lymphedema Than Compression Sleeve

Fri May 04 09:53:14 -0400 2012

Lymphedema is swelling of the arm, hand, or chest wall caused by a build up of lymph fluid in those tissues after breast cancer surgery. (Edema is the medical term for swelling.)

Many women wear elastic compression sleeves and/or gloves to gently compress the tissues and move excess fluid out of the arm area and ease lymphedema. Another treatment for lymphedema is decongestive therapy. During decongestive therapy, a specially trained therapist gently massages the skin and soft tissues affected by lymphedema. The affected arm usually is massaged for an hour once a day, 3 to 5 days a week, and then bandaged for the other 23 hours.

A study found that women with lymphedema who had decongestive therapy had slightly less excess fluid in their arms compared to women who only wore a compression sleeve. Decongestive therapy seemed to offer more benefits for women who had had lymphedema for more than a year.

Between 5% and 25% of women develop some level of lymphedema after breast cancer surgery. Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or damaged during surgery, lymph fluid may not drain properly and can collect in the tissues near the surgical site. Radiation therapy and chemotherapy can increase the risk of lymphedema.

Decongestive therapy also is known as manual lymphatic drainage or complex decongestive physiotherapy and is typically done once a day, 3 to 5 days a week, for several weeks depending on how swollen the arm or hand is. At the end of every massage session, the therapist wraps the arm or hand in customized bandages to keep excess fluid out of the arm and shape the arm to look less swollen. The therapist usually prescribes exercises to do while wearing the bandages.

Decongestive therapy is very different from traditional massage therapy, which focuses on muscles and deep tissues and can be quite forceful. Traditional massage therapy can sometimes make lymphedema worse rather than better.

In this study, 95 women who developed lymphedema after breast cancer surgery were randomly assigned to receive either decongestive therapy or wear a compression sleeve to treat the lymphedema. The women's affected arms were about 27% larger than their unaffected arms.

The 56 women treated with decongestive therapy had an hour-long massage once a day for 4 weeks. After the massage, they wore gauze and bandages on the affected arm for the other 23 hours. After the 4 weeks of decongestive therapy, the women wore compression sleeves and gloves 12 hours a day. The women also received general advice on skin care, exercise, and diet.

The other 39 women wore compression sleeves and gloves 12 hours a day. They also received general advice on skin care, exercise, and diet.

A year after lymphedema treatment ended, the arms of the women who received decongestive therapy were 29.3% smaller, compared a 22.6% reduction in arm size for women who used only compression sleeves and gloves. This difference in arm size was small enough (less than 7%) that it could have been due to chance and not because of the different treatments.

Still, when the researchers looked at the actual amount of fluid removed (rather than the percentage reduction in arm size), they said the difference between the two treatments was important. On average, the women who received decongestive therapy had more than 8 ounces of fluid removed from their arms, compared to less than 5 ounces for women who used only compression sleeves and gloves.

For some women who develop lymphedema, the swelling is mild and goes away over time with treatment. For other women, the swelling is severe and can be an ongoing problem. If you've developed symptoms of lymphedema after surgery, whether mild or severe, you may want to consider decongestive therapy. In addition to reducing the amount of excess fluid, many women find that decongestive therapy relieves some of the pain and stiffness associated with lymphedema. Many therapists feel that decongestive therapy helps ease lymphedema. Always check with your doctor to make sure that decongestive therapy makes sense for your specific situation.

You can learn more about the risks for lymphedema, steps you can take to minimize that risk, and tips for managing lymphedema in the Breastcancer.org Lymphedema section.

Strength Training Doesn’t Worsen Lymphedema, May Actually Help

Fri May 04 09:52:52 -0400 2012

Women who have had breast cancer surgery usually are told to avoid strength training -- also called resistance training or weight lifting -- to avoid worsening any lymphedema (pronounced LIMF-eh-DEE-ma) that might develop after surgery.

A study seems to disprove this advice. The researchers found that strength training doesn't worsen lymphedema after breast cancer surgery and actually can help reduce the symptoms associated with lymphedema as well as the risk of lymphedema flare-ups.

Between 5% and 25% of women develop some lymphedema after breast cancer surgery. Lymphedema is a build-up of lymph fluid in the arm, which causes swelling. (Edema is the medical term for swelling.) Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or damaged during surgery, lymph fluid doesn't drain properly and collects in the tissue near the surgery site. Lymphedema can cause other symptoms such as tingling, numbness, stiffness, and weakness. Still, those problems can happen after breast cancer surgery even without lymphedema.

In this study, 141 women who developed lymphedema after breast cancer surgery were split into two groups. About half the women kept doing whatever exercise they were doing before the study started. The other women started doing whole-body (including arms) resistance exercises using weights 2 times per week. When the study started, the women's lymphedema was stable (not getting better or worse). The women were monitored for 1 year.

The women who started whole-body resistance exercises using weights:

had better upper body strength
were no more likely to have the lymphedema get worse
were more likely to have lymphedema improve
were less likely to have occasional lymphedema flare-ups

compared to women who didn't do resistance exercises.

Resistance training can improve arm and shoulder strength. Stronger arms and shoulders can help women get back to work and other personal activities that be might difficult after breast cancer surgery, especially if lymphedema develops. Still, the researchers caution that all women with lymphedema must be careful not to injure the arm during any exercise because bruises and scrapes can make lymphedema worse and cause complications, such as infection.

While these results are encouraging, it's important to note that this is only one small study. Some doctors may not want to change their recommendation to avoid resistance exercise after breast cancer surgery if lymphedema develops until more research is done. Still, if resistance training was part of your exercise routine before surgery, or if you're looking to build strength after surgery, you might want to talk to your doctor about the results of this study. Depending on your unique situation, you may want to ask your doctor if a referral to a physical or occupational therapy specialist with experience treating breast cancer surgery side effects makes sense. These specialists have experience with specific treatments and exercises that may improve your situation.

For more information on managing and avoiding lymphedema, visit the Breastcancer.org Lymphedema pages.

Controversial Microsurgery May Ease Lymphedema, but Long-Term Results aren’t Certain

Fri May 04 09:52:29 -0400 2012

Lymphedema is swelling of the arm, hand, or chest wall caused by a build-up of lymph fluid in those tissues after breast cancer surgery. Radiation therapy and chemotherapy can add to the risk of lymphedema.

An uncommon type of surgery, called lymphaticovenular bypass, sometimes is done to treat lymphedema. A very small study found that lymphaticovenular bypass can ease lymphedema in some women, but it's unclear how long the benefits last. Besides the uncertainty about how long the results last, lymphaticonvenular bypass is controversial because it may make lymphedema worse if not done by a specially trained, very experienced surgeon.

As blood flows through the body's tissues, a small amount of clear fluid -- lymph fluid -- naturally forms and bathes the tissues. Lymph fluid moves through tissues via a network of channels called lymphatic vessels. Normal muscle action helps keep lymph fluid levels balanced by moving the fluid through the lymphatic vessels and back into the bloodstream so fluid doesn't build up and cause swelling. Lymph nodes, such as the ones in your armpit, act like relay stations in the lymphatic vessel network.

During surgery to remove breast cancer, some of the lymphatic vessels in the chest wall and armpit area may have to be cut. (Lymphatic vessels are more likely to be cut if lymph nodes are removed.) If some lymph vessels are cut, there may be fewer channels to drain the lymph fluid from nearby tissues. Lymph fluid then can build up in the arm, hand, or chest wall area.

About 40% of women develop some degree of lymphedema after breast cancer surgery. Lymphedema can improve slowly or even go away over time. Still, lymphedema is more likely to be a problem for women who've had more extensive surgery and had lymph nodes removed. A number of non-surgical techniques can help reduce the risk of lymphedema, including compression garments and massage.

In this very small study, researchers looked at the results of 20 women who chose to have lymphaticovenular bypass surgery to treat lymphedema that had lasted for an average of about 5 years after breast cancer surgery. The surgery was done at the M.D. Anderson Cancer Center in Houston. During lymphaticovenular bypass, which is considered microsurgery, three or four lymphatic vessels in the arm are connected directly to veins (blood vessels that move blood to the heart). The goal of this rerouting is to increase the flow of lymphatic fluid out of the arm and ease the lymphedema. This surgical treatment for lymphedema is rare, but is more common in Asia and Europe than it is in the United States.

Researchers assessed lymphedema improvement by measuring the size (volume) of the affected arm before and after lymphaticovenular bypass. They also asked the women how the arm felt -- whether it felt lighter or softer, for example.

After lymphaticovenular bypass, the women's arms were smaller, but by the end of the first year after surgery, some of the benefits seemed to be lost. Affected arm size decreased:

29% 1 month after surgery
33% 3 months after surgery
39% 6 months after surgery
25% 1 year after surgery

Many of the women reported that their arms felt lighter and softer after the microsurgery and none of the women had significant complications or had the lymphedema get worse.

Lymphaticovenular bypass surgery is difficult to do and requires special surgical training. This may be one reason why it's not a common lymphedema treatment. While the women in this study did receive some benefit from the surgery, the decrease in arm size didn't last and none of the women were considered cured of lymphedema. More, larger studies are needed to see if the results last over time, as well to figure out if the surgery works for a variety of women.

If you have severe lymphedema and non-surgical treatments haven't helped, you may be considering lymphaticovenular bypass surgery. Make sure that the surgeon doing the surgery (usually a plastic surgeon) has a lot of experience and has had good success with the procedure.

You can learn more about lymphedema and the non-surgical steps you can take to avoid, minimize, and manage it in the Breastcancer.org Lymphedema section.

Flying Doesn’t Seem to Increase Risk of Lymphedema

Fri May 04 09:52:02 -0400 2012

Some doctors believe that the pressure changes the body goes through while flying on an airplane could trigger lymphedema in people who've had breast cancer surgery. A small study found that only about 5% of women who had had breast cancer surgery developed persistent arm lymphedema after flying on an airplane. The results were presented at the 2008 San Antonio Breast Cancer Symposium.

Arm lymphedema is the swelling of the arm or hand because lymph fluid has accumulated there. A network of lymph channels and lymph nodes in the body, along with the normal flexing and contraction of muscles, helps move the fluid out of the body's soft tissues and back into the bloodstream. Breast cancer surgery can disrupt the lymph channels and lymph nodes and change the way the chest wall muscle works. These changes can cause lymphedema to develop on the side where the cancer was removed. Numbness, discomfort, and infection (sometimes) can happen along with the swelling. Lymphedema isn't life threatening, but it can be annoying and can last for a while.

Lymphedema is more likely to happen when the underarm (axillary) lymph nodes are removed during mastectomy or lumpectomy. The risk of lymphedema is also higher when:

a large amount of tissue is removed during surgery
radiation therapy is given to the underarm lymph nodes
chemotherapy is part of the treatment plan

About 5% to 10% of women treated for breast cancer develop lymphedema during or after treatment.

The 75 women who participated in this study were all training for dragon boat racing. All of them had surgery to remove early-stage breast cancer. In the 2 weeks before a long distance flight, the women had a special test -- called whole arm bioimpedance -- that measured the level of soft tissue fluid in the arm on the side where the breast cancer was removed. The same test was done 3 hours after the women landed and again 2 months after the flight.

The results:

15 of the 75 women had what was considered a significant increase in arm fluid right after the flight; most of these women (14 of them) had made the longest flights compared to the rest of the group. Most of these women (12 of them) had had more tissue removed during breast cancer surgery (mastectomy and complete underarm lymph node removal) compared to the rest of the group.
Only 8 of the 75 women had a large enough increase in arm fluid after the flight to be called true lymphedema.
Some of the women who had lymphedema right after the flight already had been diagnosed with lymphedema before the flight. Only 2 of the 75 women developed lymphedema for the first time after the flight.
Of the 8 women who had true lymphedema after the flight, 7 were tested 2 months later. The lymphedema had resolved in 4 of these 7 women.

Based on these results, the researchers concluded that flying on an airplane is unlike to cause or worsen lymphedema for most people who have had surgery to remove early-stage breast cancer. The researchers also pointed out that though some doctors tell people not to exercise and avoid heavy lifting to reduce the risk of lymphedema after breast cancer surgery, the women in this study were accomplished athletes (which involves exercise and lifting) and most were untroubled by lymphedema.

In the Breastcancer.org Lymphedema section you can learn more about minimizing your own risk of lymphedema after surgery.

Online Tool May Help Predict Lymphedema Risk

Fri May 04 09:51:03 -0400 2012

Lymphedema is swelling of the arm, hand, trunk, or breast caused by a build-up of lymph fluid in those tissues after breast cancer surgery. Edema is the medical term for swelling. Lymphedema can develop very soon after surgery or months, or even years, later.

Results from a study presented at the Multidisciplinary Breast Cancer Symposium in September 2011 suggest that an online tool does a good job of predicting the risk of lymphedema after surgery to remove breast cancer. The tool analyzes a number of lymphedema risk factors, including age and number of lymph nodes removed. When the tool was used before surgery, more than 70% of the women it predicted would develop lymphedema did develop the condition. When the tool was used after surgery, it also helped predict whether lymphedema would develop.

Lymph fluid normally drains from body tissues through the lymph nodes and lymph channels. If some lymph nodes and channels are removed or cut during surgery, lymph fluid may not drain properly and can collect in the tissues near the surgery site. The more lymph nodes that are removed, the greater the risk of lymphedema. Some research suggests that the risk of lymphedema is higher and any lymphedema that does develop is more severe in women who are overweight or obese. Radiation therapy and chemotherapy can increase the risk of lymphedema.

In this study, 1,054 Brazilian women diagnosed with early-stage breast cancer had surgery and axillary (underarm) lymph node dissection. The researchers used the online lymphedema risk tool:

before surgery
6 months after surgery
more than 6 months after surgery

with all the women to predict whether they would develop lymphedema and then followed the women for 5 years. At the end of 5 years, 30.3% of the women developed lymphedema.

The tool, developed in collaboration with The Cleveland Clinic, considers a number of factors including:

age
body mass index (BMI), which includes both weight and height
the number of cycles of chemotherapy administered through the arm on the same side as the breast surgery
the number of lymph nodes removed during surgery
the extent of radiation therapy

Both before and after surgery, when the tool predicted that lymphedema would develop, it did more than 70% of the time.

Experts think that the tool could help doctors identify and better advise women who are much more likely to develop lymphedema after breast cancer surgery. These women could be given more information on what to do to minimize the risk of lymphedema developing, as well as to minimize the severity if lymphedema does develop.

After the researchers publish their findings in a medical journal, doctors and patients will be able to access the online tool at www.lymphedemarisk.com.

If you're going to have breast cancer surgery, be sure to ask your doctor about your risk of lymphedema and the steps you can take to lower that risk. Ask your doctor if using the online tool makes sense for you. If you've already had surgery and have been diagnosed with lymphedema, visit the Breastcancer.org section on Lymphedema for more information.

Screening Mammograms Offer Benefits for Women Age 40 to 49

Thu May 03 17:25:07 -0400 2012

A study looking at the value of screening mammograms for women age 40 to 49 found two important benefits:

The screening mammograms were more likely to find lesions that weren’t invasive cancer but are linked to a higher risk of breast cancer (called high-risk lesions).
If the screening mammogram found invasive breast cancer, the cancer was more likely to be at an earlier stage and smaller when diagnosed.

The results were published in the May 2012 issue of the American Journal of Roentgenology. Read the abstract of Neglecting to Screen Women Between the Ages of 40 and 49 Years With Mammography: What Is the Impact on Breast Cancer Diagnosis.

The researchers looked at 108 breast cancers found by biopsy in women age 40 to 49:

71 of the cancers were diagnosed in women who had been getting regular screening mammograms; biopsies in these women were mostly done because of suspicious mammogram findings.
37 of the cancers were diagnosed in women who got no breast cancer screening; biopsies in these women were done because of breast symptoms, such as a lump felt by a woman or her doctor.

The cancers were either DCIS (ductal carcinoma in situ) or invasive cancer. DCIS isn't invasive cancer. DCIS can be large or small, but stays inside the breast milk duct. It doesn't spread into surrounding normal breast tissue or into the lymph nodes or other organs. DCIS is also called stage 0 breast cancer.

DCIS was much more likely to be diagnosed in the women who were getting regular screening mammograms. This is important since women diagnosed with DCIS have a higher risk of being diagnosed in the future with invasive breast cancer in the same breast compared to women who haven’t been diagnosed with DCIS. Women with DCIS usually have surgery to remove the DCIS and sometimes get other treatments to reduce the risk of being diagnosed with invasive cancer later.

The invasive cancers diagnosed in the women who were getting regular screening mammograms were, on average, at an earlier stage and smaller than the invasive cancers diagnosed in the women who weren’t getting regular screening. This is important because in most cases the earlier the stage and the smaller the cancer, the better the prognosis.

Other studies have shown that regular screening mammograms starting at age 40 means better prognoses for women diagnosed -- and lives saved. Still, despite current guidelines and evidence, many women age 40 to 49 don't get regular screening mammograms.

If you're 40 or older and have an average risk of breast cancer, yearly screening mammograms should be part of your healthcare. If your breast cancer risk is higher than average, you may want to talk to your doctor about a more aggressive breast cancer screening plan that makes the most sense for your particular situation.

There's only one of you and you deserve the best care possible. Don't let any obstacles get in the way of regular screening mammograms:

If you're worried about cost, talk to your doctor, a local hospital social worker, or staff members at a mammogram center. Ask about free programs in your area.
If you're having problems scheduling a mammogram, call the National Cancer Institute (800-4-CANCER) or the American College of Radiology (800-227-5463) to find certified mammogram providers near you.
If you find mammograms painful, ask the mammography center staff members how the experience can be as easy and as comfortable as possible for you.

For more information on mammograms and other tests to detect breast cancer, visit the Breastcancer.org Breast Cancer Tests: Screening, Diagnosis, and Monitoring pages.

Brachytherapy More Likely to Cause Complications, Need for Mastectomy in Older Women

Wed May 02 17:49:38 -0400 2012

Women diagnosed with early-stage breast cancer who have lumpectomy usually have radiation therapy after surgery. Radiation therapy after lumpectomy lowers the risk of the breast cancer coming back (recurrence) and makes lumpectomy as effective as mastectomy.

There are two basic ways to deliver radiation. The traditional way is to irradiate the entire breast (whole-breast irradiation) with radiation from an external source. Newer methods deliver radiation internally, or externally in precisely focused three dimensions, to just the area of the breast where the cancer was (partial-breast irradiation). A number of studies are being done to see if the benefits and risks of partial-breast irradiation are similar to whole-breast irradiation.

A study comparing one type of partial-breast irradiation -- multi-catheter internal radiation (also called interstitial needle-catheter brachytherapy, or just brachytherapy) -- to whole-breast irradiation after lumpectomy in older women found that women who had brachytherapy were more likely to have treatment complications and more likely to need a mastectomy in the 5 years after lumpectomy compared to women who had whole-breast irradiation.

The results were published in the May 2, 2012 issue of the Journal of the American Medical Association. Read the abstract of Association Between Treatment With Brachytherapy vs. Whole-Breast Irradiation and Subsequent Mastectomy, Complications, and Survival Among Older Women With Invasive Breast Cancer.

Researchers looked at the records of 92,735 women age 67 or older who were diagnosed with early-stage breast cancer between 2003 and 2007. All the women had lumpectomy to remove the cancer and all had some type of radiation therapy after surgery:

6,952 had brachytherapy
85,783 had whole breast irradiation

Compared to women who got whole-breast irradiation, women who got brachytherapy were:

more likely to have complications right after surgery:
- 16.2% of women who got brachytherapy had an infection in the breast area after surgery compared to 10.3% of women who got whole-breast irradiation
- 16.25% of women who got brachytherapy had other complications after surgery compared to 9.0% of women who got whole-breast irradiation
more likely to have other complications in the 5 years after surgery:
- 14.6% of women who got brachytherapy had breast pain compared to 11.9% of women who got whole-breast irradiation
- 8.3% of women who got brachytherapy had fat necrosis (breakdown of fat in the breast tissue) compared to 4.1% of women who got whole-breast irradiation
- 4.5% of women who got brachytherapy had a broken rib compared to 3.6% of women who got whole-breast irradiation
more likely to need a mastectomy in the 5 years after lumpectomy:
- 4.0% of women who got brachytherapy had a mastectomy compared to 2.2% of women who got whole-breast irradiation

Still, both groups of women (brachytherapy vs. whole-breast irradiation) had the same overall survival 5 years after diagnosis:

87.7% of women who got brachytherapy were projected to be alive 5 years after diagnosis compared to 87.0% of women who got whole-breast irradiation

This study suggests that brachytherapy probably is a worse option than whole-breast irradiation for older women.

The drawbacks of traditional whole-breast irradiation include daily trips to the hospital for treatment -- usually 5 days a week for 4 to 6 weeks -- and accidentally exposing nearby healthy tissue (the lungs or heart, for example) to radiation.

To overcome these drawbacks, doctors developed partial-breast irradiation techniques. The new techniques deliver more focused and intense radiation therapy over a shorter period of time. Because the radiation is more focused, the hope is that the newer techniques will cause fewer or milder side effects than traditional radiation therapy with the same benefit.

Doctors are looking forward to the results of a very large, ongoing study called NSABP B-39/RTOG 0413 that is looking at the effectiveness and safety of three types of partial-breast irradiation and comparing them to whole-breast irradiation in both younger and older women.

The three partial-breast irradiation techniques being studied in NSABP B-39/RTOG 0413 study are:

multi-catheter internal radiation or interstitial needle-catheter brachytherapy (the same type evaluated in the study reported on above)
balloon internal radiation, known by the brand name MammoSite
3-D conformal external beam radiation (3DCRT)

Brachytherapy uses radioactive "seeds" to deliver radiation directly to the area where the cancer was. The seeds are placed in very small tubes (catheters) that are stitched into place under the skin. The seeds are left in the tubes for a few hours or a few days. You remain in the hospital during treatment. Once the treatment is completed, the seeds, tubes, and stitches are removed and you go home.

The MammoSite system places a special tube with a balloon on one end in the breast where the cancer was. The tube comes out of the skin through a small hole. The tube and balloon are placed either during lumpectomy or afterward in a surgeon's office. During each treatment, a machine places a radioactive seed into the center of the balloon for 5 to 10 minutes -- just long enough to deliver the required dose of radiation. After the seed is removed, you may leave the treatment center. A total of 10 treatments are usually given over 5 days. That means 2 treatments per day, about 6 hours apart. When the final treatment is done, the balloon and tube are removed through the small hole in the skin.

3DCRT radiation starts with a planning session (simulation). A special MRI or CAT scan of the breast is done and is used to map out small treatment fields for the area at risk. The type and distribution of radiation is designed to maximize the dose to the area that needs to be treated and avoid or minimize radiation to tissue near the area. The radiation is delivered with a linear accelerator, the same machine used in traditional external radiation, twice a day for 1 week.

Until more results are published, partial-breast irradiation should be considered a promising experimental approach that hasn’t yet been shown to have the same benefits and risks as whole-breast irradiation. We hope that the NSABP B-39/RTOG 0413 study will give doctors more information.

If you've been diagnosed with early-stage breast cancer and lumpectomy followed by radiation therapy will be part of your treatment, ask your doctor about the radiation therapy options that make the most sense for your unique situation. You and your doctor will consider a number of factors, including:

the characteristics of the cancer (size, location, lymph node involvement)
your personal preferences (how important is having a shorter total radiation therapy treatment time?)
the experience level and results of the doctors who will give your radiation therapy

Together you and your doctor will make the best choice for YOU. Visit the Breastcancer.org Radiation Therapy section to learn more about radiation therapy techniques and possible side effects.

May 2012 Research News

Wed May 02 11:03:07 -0400 2012

Screening Mammograms Offer Benefits for Women Age 40 to 49
May 3, 2012
A study looking at the value of screening mammograms for women age 40 to 49 found two important benefits. Read more...

Brachytherapy More Likely to Cause Complications, Need for Mastectomy in Older Women
May 2, 2012
A study found that women who had brachytherapy after lumpectomy were more likely to have treatment complications and more likely to need a mastectomy in the 5 years after surgery compared to women who had whole-breast irradiation after lumpectomy. Read more...

New Guidelines on Exercise and Nutrition During and After Cancer Treatment Released
May 2, 2012
The American Cancer Society has released new guidelines on diet and exercise during and after cancer treatment. Read more...

New Guidelines on Exercise and Nutrition During and After Cancer Treatment Released

Wed May 02 10:54:54 -0400 2012

Many studies have found that a healthy diet and regular exercise can improve a woman’s overall health and well-being during and after breast cancer treatment. Benefits can include:

faster recovery from treatment
lower risk of the cancer coming back (recurrence)
better survival rates
improved mood, stamina, and overall sense of wellness

The American Cancer Society asked a group of experts to review the available information and develop new guidelines on diet and exercise during and after cancer treatment. The guidelines were published online April 26, 2012 in CA: A Cancer Journal for Clinicians. Read Nutrition and Physical Activity Guidelines for Cancer Survivors.

While not specific to breast cancer, the guidelines focus on a number of topics, including the role of diet and exercise for people:

undergoing cancer treatment
recovering from treatment
diagnosed with recurrent or advanced-stage cancer
who are long-term cancer survivors

The guidelines urge cancer survivors to get to and maintain a healthy weight and exercise regularly. Specific recommendations include:

limit high-calorie foods and beverages and increase physical activity to promote weight loss if overweight or obese
avoid being inactive and return to normal daily activities as soon as possible after diagnosis
aim to exercise at least 150 minutes per week
include strength training exercises at least 2 days per week
eat a diet full of vegetables, fruits, and whole grains

The guidelines also suggest specific exercise goals for cancer survivors.

Adults age 18 to 64 should do moderate aerobic exercise at least 150 minutes per week or vigorous aerobic exercise for 75 minutes per week. An equal combination of moderate and vigorous aerobic exercise is OK, too. So maybe you do an hour and 15 minutes of moderate exercise and 35 minutes of vigorous exercise per week. Exercise for at least 10 minutes at a time and try to exercise throughout the week rather than cramming it all in on one day. Strength training for all major muscle groups also should be done at least 2 days per week.

Adults older than 65 should follow the same recommendations for people age 18 to 64 if possible. Still, if chronic conditions limit your activity, try to be as active as you can and avoid being inactive for long periods of time.

The experts encouraged people to take part in a structured exercise program (through a cancer support program, for example) because many people find it hard to stick with an exercise program after cancer treatment.

The guidelines offer examples of moderate and vigorous aerobic exercise.

Moderate exercise (you can talk, but not sing) is:

ballroom and line dancing
biking on level ground or with few hills
canoeing
general gardening (raking, trimming shrubs)
sports where you catch and throw (baseball, softball, volleyball)
doubles tennis
using a manual wheelchair
using a hand cycle (also called an ergometer)
brisk walking
water aerobics

Vigorous exercise (you can say only a few words before having to stop to catch your breath) is:

aerobic dancing
biking faster than 10 miles per hour
fast dancing
heavy gardening (digging, hoeing)
hiking uphill
jumping rope
martial arts (karate, for example)
race walking, jogging, or running
sports with a lot of running or movement (basketball, hockey, soccer)
swimming fast or swimming laps
singles tennis

If you're being treated or have been treated for breast cancer, it’s a good idea to make exercise and a healthy diet part of your daily routine. Think of exercise and a healthy diet as important parts of your overall treatment plan that help you recover and stay healthy. Talk to your doctor about how much and how often you should exercise. Ask around and see if any breast cancer support groups near you have organized exercise classes. If you can't find an exercise class through a breast cancer support group, consider joining another exercise class or start walking with a friend. There's a good chance that exercising with other people will give you the motivation and support to make regular exercise part of your recovery. Find the right exercise routine for YOU and then do your best to stick with it! It can make a difference both physically and mentally, today and tomorrow.

If you’d like more information and resources, visit the Breastcancer.org Nutrition and Exercise sections.

In the Nutrition section, you can learn about:

healthy eating during and after treatment
dietary supplements
online nutrition resources

In the Exercise section, you can learn about:

benefits of exercise
types of exercise
when you can and can't exercise during treatment
tips on finding a trainer

More Exercise and Stress Management Improves Quality of Life During and After Treatment

Wed Apr 25 10:08:22 -0400 2012

Much research has shown that exercise, a healthy diet, and counseling can help women feel better, both physically and emotionally, during and after breast cancer treatment.

A study has found that doing more exercise and being in a stress management program after breast cancer surgery improved women’s mood, quality of life, and resistance to fatigue during and after breast cancer treatment.

The study was funded by the National Institutes of Health and done by the University of Miami Department of Psychology. Read the summary of Benefits of Physical Activity on Depression and Functional Quality of Life During Treatment for Breast Cancer: Psychosocial Mechanisms.

240 women diagnosed with early-stage breast cancer started in the study from 4 to 10 weeks after breast cancer surgery. Other treatments (chemotherapy or radiation therapy, for example) were ongoing for many of the women while they were in the study.

The researchers kept track of the women’s physical activity levels. Half the women also participated in a 10-week stress management group (called cognitive behavioral stress management or CBSM). The other half participated in a one-day self-help education program.

All the women felt fatigue related to the breast cancer diagnosis and treatment. But during their first 3 months in the study, both doing more physical activity and participating in the CBSM program were linked to:

better mood
more resistance to fatigue, meaning fatigue didn’t disrupt a woman’s everyday activities
overall better quality of life

If you're currently being treated for breast cancer, the stress of your situation can add to the effects of breast cancer treatment. Consider getting help to manage your stress -- either individually or in a group. You also might want to consider trying one or more complementary and holistic medicine techniques to help you manage stress. In the Breastcancer.org Complementary and Holistic Medicine pages, you can learn about 16 therapies, including:

what to expect
how to find a qualified practitioner
important things to consider before trying a technique

During and after treatment you should also try to make exercise and a healthy diet part of your daily routine. Think of exercise and a healthy diet as another important part of your overall treatment plan that helps you recover and stay healthy. Talk to your doctor about how much and how often you should exercise. Ask around and see if any breast cancer support groups near you have organized exercise classes. If you can't find an exercise class through a breast cancer group, consider joining another exercise class or start walking with a friend. There's a good chance that exercising with other people will give you the motivation and support to make regular exercise part of your recovery. Find the right exercise routine for YOU and then do your best to stick with it! It can make a difference both physically and mentally, today and tomorrow.

In the Breastcancer.org Exercise pages you can learn about:

the benefits of exercise
types of exercise
when you can and can't exercise during treatment
tips on finding a trainer

Researchers Identify 10 Genetic Error Patterns in Breast Cancer

Mon Apr 23 15:32:11 -0400 2012

One or more errors in a cell’s genetic code or gene behavior can turn a normal cell into a cancer cell -- a cell that grows, divides, and spreads in an uncontrolled way.

Researchers have linked a number of particular genetic errors to cancer development and behavior. As more research is done, it’s become clear that genetic errors are usually different from cancer to cancer, even between two people who’ve been diagnosed with the same type of cancer. It’s also becoming clear that different combinations of genetic errors affect how a cancer behaves and responds to treatment.

A new study did a detailed genetic analysis of nearly 2,000 breast cancers. The researchers found 10 patterns of genetic errors that were linked to the cancers’ prognosis and how they responded to treatment.

The research was published online April 18, 2012 in the journal Nature. Read the abstract of The genomic and transcriptomic architecture of 2,000 breast tumours reveals novel subgroups.

The breast cancers were analyzed using automated, computerized gene analysis. The analysis looked for three types of genetic errors that have been linked to cancer development and behavior:

gene mutations: mistakes in the genetic code
gene over-expression: normal genes that are overactive, or there are too many copies of them; for example HER2-positive breast cancer has too many HER2 genes
gene under-expression: normal genes that are underactive or turned off

The researchers then looked at the outcomes of each woman in the study and compared a woman’s outcome to the genetic profile of the cancer she had been diagnosed with. The researchers found 10 groups of genetic errors that were linked to different outcomes:

aggressiveness of the cancer
response to treatment
risk of recurrence
tendency to spread
overall prognosis

Each group of genetic errors was named and numbered (IntClust-1, IntClust-2, etc., through IntClust-10).

The results suggest that detailed genetic analysis to identify a breast cancer’s specific group of genetic errors could give doctors a more precise and predictable way to estimate prognosis and plan treatment.

While the results are interesting, detailed genetic analysis like the testing done in this study isn’t commonly done. Also, doctors won’t be able to apply this information to breast cancer diagnosis and treatment for several years.

Stay tuned to Breastcancer.org Research News for the latest information on newer, better ways to diagnose and treat breast cancer.

Large Review Study Confirms Herceptin’s Benefits

Sat Apr 21 11:08:38 -0400 2012

Herceptin (chemical name: trastuzumab) is a targeted therapy medicine used to treat HER2-positive breast cancer.

Findings from a large review study found that women diagnosed with HER2-positive breast cancer that was treated with Herceptin were less likely to have the cancer come back (recur) and more likely to survive compared to women who didn't get Herceptin.

The findings were published online on April 18, 2012 in The Cochrane Library. The Cochrane Library catalogues information from The Cochrane Collaboration, a highly respected program that helps doctors and patients decide on the best treatment approaches based on careful analysis of available research. Read the abstract and plain language summary of Trastuzumab containing regimens for early breast cancer.

HER2-positive breast cancers make too much of the HER2 protein. The HER2 protein sits on the surface of cancer cells and receives signals that tell the cancer to grow and spread. About one out of every four breast cancers is HER2-positive. HER2-positive breast cancers tend to be more aggressive and harder to treat than HER2-negative breast cancers.

Herceptin works by attaching to the HER2 protein and blocking it from receiving growth signals. Herceptin, which is given intravenously, is approved by the U.S. Food and Drug Administration to:

treat advanced-stage, HER2-positive breast cancers
lower the risk of recurrence (the cancer coming back) of early-stage, HER2-positive breast cancers with a high risk of recurrence

This study was a meta-analysis. A meta-analysis combines and analyzes the results of a number of earlier studies. In this case, results from eight studies looking at the benefits and risks of Herceptin were in the meta-analysis. Nearly 12,000 women were in the studies. All the women had been diagnosed with either early-stage or locally-advanced HER2-positive breast cancer. Besides surgery, treatments included chemotherapy and hormonal therapy (if the cancer was hormone-receptor-positive). Some of the women got Herceptin and others didn’t. The women were followed for about 3 years after they were diagnosed.

Compared to women who didn’t get Herceptin, women who did:

were 36% less likely to have the cancer come back
were 40% less likely to die from breast cancer

Women who got Herceptin for a full year got the most benefits.

Herceptin may cause side effects, including:

high blood pressure
joint and back pain
hot flashes
headache
diarrhea

Some women getting Herceptin will have decreased heart function during treatment. In rare cases, heart failure can develop. Other studies have shown that heart problems caused by Herceptin are more likely to happen in older women, women with diabetes, and women with preexisting risk factors such as high blood pressure, high cholesterol, and obesity. Heart function can recover when Herceptin treatment stops.

In this study, women who got Herceptin were five times more likely (2.6% vs. 0.5%) than women who didn't get Herceptin to develop heart problems during and after treatment. All the women had normal heart function before starting Herceptin treatment.

To better understand a study’s results, it sometimes helps to look at them in terms of large groups of people. So based on this study, if 1,000 women got standard breast cancer treatments but not Herceptin:

about 900 would survive
about 645 would have no recurrence
about five would have a heart problem during or after treatment

If 1,000 women got Herceptin for 1 year and other standard breast cancer treatments:

about 933 would survive (33 more than women who didn’t get Herceptin)
about 740 would have no recurrence (95 more than women who didn’t get Herceptin)
about 26 would have a heart problem during or after treatment (21 more than women who didn’t get Herceptin)

While Herceptin has risks, this large review clearly shows that Herceptin can improve prognosis in women diagnosed with HER2-positive breast cancer. If Herceptin is or will be part of your breast cancer treatment plan, you may want to ask your doctor about your personal risk of Herceptin-related heart problems and how your heart function will be evaluated before, during, and after Herceptin treatment.

In the Breastcancer.org Herceptin pages, you can learn more about how Herceptin works, when it's used, and what to expect during treatment.

Adolescent Drinking Boosts Benign Breast Disease Risk

Wed Apr 18 14:59:07 -0400 2012

While results vary, many studies have found a link between drinking alcohol and increased breast cancer risk.

New results from the very large and ongoing Nurses’ Health Study II (NHS II) found a strong link between drinking alcohol during adolescence and the risk of being diagnosed with BENIGN (not cancer) breast disease. The link is important because being diagnosed with benign breast disease -- called proliferative benign breast disease -- is linked to a higher risk of breast cancer in the future.

The results were published online April 9, 2012 in Pediatrics. Read the abstract of Intakes of Alcohol and Folate During Adolescence and Risk of Proliferative Benign Breast Disease.

The NHS II aims to find links between personal health and lifestyle factors and a variety of health risks. More than 116,670 female nurses between age 25 and 44 completed a comprehensive questionnaire about their health and lifestyle when they enrolled in the NHS II in 1989. Since then, the women have regularly provided updated information on their health, diets, and lifestyles.

In this study, researchers used NHS II information and looked for links between drinking alcohol in adolescence and being diagnosed later in life with proliferative benign breast disease. Compared to women who reported little or no drinking during adolescence, women who drank during adolescence had a higher risk of proliferative benign breast disease later in life. The more the women drank during adolescence, the higher the risk.

The risk of proliferative benign breast disease was:

11% higher in light drinkers (one-half to one drink per day)
36% higher in modest drinkers (one to two drinks per day)
35% higher in heavy drinkers (two or more drinks per day)

In 2010, the Growing Up Today study looked for links between alcohol drinking and benign breast disease in daughters of the women in NHS II. It also found a strong link between alcohol drinking in adolescence and benign breast disease.

These studies looked at benign breast disease, not breast cancer. Still, the results suggest that drinking alcohol at a young age may harm breast tissue. Because proliferative benign breast disease is by definition benign, the increased risk may not seem important. But it is.

Proliferative benign breast disease can cause breast cancer screening to have a false positive result. A false positive happens when a mammogram finds an abnormal area that looks like a cancer but turns out to be normal. Ultimately the news is good: no breast cancer. But the suspicious result usually means follow-up with one or more doctors and extra tests and procedures (more imaging studies, possibly a biopsy). There are psychological, physical, and economic costs related to false positives.

Also, women diagnosed with proliferative benign breast disease have a higher risk of being diagnosed with breast cancer in their future.

Limiting or avoiding alcohol is a good idea for every girl and woman who wants to do all she can to lower her risk of breast disease, including breast cancer. You may want to talk to the daughters, granddaughters, and other young women in your life about the effects alcohol can have on health, especially breast health.

Breastcancer.org president and founder Dr. Marisa Weiss and her daughter, Isabel, have written the book Taking Care of Your "Girls:" A Breast Health Guide for Girls, Teens, and In-Betweens. They talk candidly about breast development and breast health -- separating myths from facts and detailing steps everyone can take to improve breast health and reduce breast cancer risk over a lifetime.

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Automated Ultrasound for Women with Dense Breasts Approved by FDA Panel

Mon Apr 16 15:13:09 -0400 2012

On April 11, 2012 a U.S. Food and Drug Administration (FDA) expert panel recommended that an automated ultrasound device be approved for breast cancer screening in women with dense breasts.

The automated ultrasound device is called somo*v automated breast ultrasound system (ABUS) and was specifically designed to detect cancer in women with dense breasts.

Research has shown that dense breasts:

can be six times more likely to develop cancer
can be harder for mammograms to detect cancer in; breast cancers (which aren't fatty) are easier to see on a mammogram when they're surrounded by fatty tissue

Research also has shown that adding ultrasound to annual mammograms improves breast cancer detection in women with dense breasts. Ultrasound technology designed to find breast cancer in dense breasts could improve the usefulness of ultrasound for this type of screening.

The soma*v ABUS ultrasound device already is FDA-approved to help diagnose cancer in women with a breast abnormality that's suspected to be breast cancer. The FDA expert panel has now recommended expanding soma*v ABUS' use to include screening (along with mammograms).

The FDA panel did caution that this ultrasound should probably only be used to screen women with dense breasts who haven't had a breast biopsy or breast cancer surgery. Soma*v ABUS ultrasound already is approved in Europe and Canada for breast cancer screening (along with screening mammograms) in women with dense breasts.

The FDA doesn't have to follow the recommendation of the panel, but it usually does.

Stay tuned to Breastcancer.org Research News for updates on the approval process of soma*v ABUS for breast cancer screening in women with dense breasts.

Research News

Mon Apr 16 13:23:42 -0400 2012

Our experts routinely examine breast cancer research for important advances, updates, and changes in how breast cancer is treated and diagnosed. Breastcancer.org strives to bring you updates on the latest breast cancer research through its Research News program. Medical experts at Breastcancer.org provide easy-to-understand summaries of what the research means for YOU.