In 2012, it’s estimated that approximately 230,000 American women and 2,200 American men will be diagnosed with breast cancer, according to the American Cancer Society. Behind the scenes, researchers are steadily working toward conquering this potential killer. Here, we report on advances in screening, treatment and prevention.
The Screening Arena
Doctors are constantly refining methods for identifying those at risk for the disease and for detecting breast cancer in its earliest stages. Here, some findings from the past decade:
- A mathematical equation derived from the ongoing National Surgical Adjuvant Breast and Bowel Project can help calculate a woman’s lifetime risk for an invasive form of breast cancer. The formula estimates risk based on factors such as age at first menstruation, childbirth history and family history of the disease. This method can be useful for women considering preventive therapies, offer peace of mind to those who overestimate their risk and help women and their doctors develop an effective screening schedule.
- Scientists have found that mutations in the BRCA1 and BRCA2 genes—which can be detected through a blood test—increase a woman’s risk for breast cancers. Less than 10 percent of the new cases diagnosed each year can be attributed to heredity.
- Magnetic resonance imaging (MRI) is being used in addition to standard mammography to enhance diagnosis. MRI has proven useful in detecting and staging invasive lobular breast cancer, a form that is difficult to diagnose with mammography. It is used to supplement mammography in screening women at very high risk for breast cancer, such as those with the BRCA1 and BRCA2 genes. MRI is also used to find tumors in the opposite (contralateral) breast of women newly diagnosed with the disease.
- Sentinel node biopsy can give women important information about the extent of their cancer while sparing them from major surgery. Traditionally, all the lymph nodes near the affected breast are removed to test for the spread of cancer cells. This can lead to complications. But in sentinel node biopsy, only the nodes that would be first affected are removed for analysis.
Certain chemotherapy drugs appear to launch a more effective attack against cancer cells than traditional chemotherapy. Some work on the body’s immune system, while others interfere with the functioning of the cancer cells.
In 1998, the FDA approved tamoxifen, a drug long used to treat breast cancer, for use in preventing the disease in women at high risk. The drug works by disrupting estrogen’s effect on breast tissue. The nationwide Study of Tamoxifen and Raloxifene (STAR) compares raloxifene’s breast cancer-fighting abilities to those of tamoxifen. Raloxifene also appears to reduce the incidence of invasive breast cancer. In addition, results from several studies suggest lifestyle steps that may lower breast cancer risk.
- Seven hours of moderate exercise per week reduced breast-cancer risk by nearly 20 percent in women ages 30 to 55, according to the Nurses’ Health Study.
- Mayo Clinic researchers warn that women who consistently eat very-well-done red meat may raise their risk of breast cancer. They speculate that cooking protein at high temperatures creates a chemical that can directly mutate DNA.
- Women who have more than one alcoholic drink a day may increase their breast cancer risk by as much as 25 percent.
A certain type of breast cancer called triple-negative breast cancer (TNBC) is very difficult to treat because it is not sensitive to the hormone and immune therapies that are used for other forms of breast cancer. This cancer mostly occurs in young women and accounts for about 10-20% of all breast cancer cases. While this cancer can often be treated with chemotherapy, the tumors are more aggressive and more likely to recur. Researchers from Memorial Sloan-Kettering Cancer Center in New York City have found that a vaccine made from a virus from the smallpox family can be used to treat this type of breast cancer.
The study findings, presented on October 1st at the 2012 Annual Clinical Congress of the American College of Surgeons, showed that the vaccine virus was able to enter cells and cause destruction of the tumor in mice. It also prevented blood vessel growth in the tumors, resulting in significant tumor destruction. Since the small pox vaccine has already been given to millions of people, it is thought to be a safer option for treatment. Clinical trials would be necessary to evaluate its effectiveness in humans.
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