2003 ARCHIVE

Smoking Can be Lethal to Breast Cancer Patients
An Alternative to Mammograms
Sugars Linked to Spread of Cancer
Research on Environmental Links to Breast Cancer
Breast Cancer Treatment Cuts Recurrence After Tamoxifen
CBCC/F Board Member Receives Award
Deadlne to File for Taxol Settlement
Hormone Therapy Cutting Death Rate
Obesity Not Associated with Efficacy of Tamoxifen
Estrogen Link between Obesity & Breast Cancer
Personality Doesn’t Influence Cancer Risk
CBCC/F Loses One of Its Greatest Advocates
Sonography for Detecting Breast Cancer in Young Women
Blood Test for Breast Cancer
Black Cohosh More Toxic
Patient Privacy Rule Takes Effect
NEWS 2006 ARCHIVE
NEWS 2005 ARCHIVE
NEWS 2004 ARCHIVE

SMOKING CAN BE LETHAL TO BREAST CANCER PATIENTS

Kicking the smoking habit can extend the lives of breast cancer patients who've been treated with lumpectomies and radiation, says a study by researchers at Fox Chase Cancer Center in Philadelphia.

The study included 1,039 breast cancer patients, smokers and nonsmokers, treated with lumpectomies and radiation at Fox Chase from March 1970 to December 2002. Median follow-up of the patients was 67 months.

The researchers compared overall survival rates and deaths from breast cancer among the smokers and nonsmokers.

“This analysis shows that smoking, either past or present, was associated with increases in distant metastases and deaths from breast cancer,” Fox Chase radiation oncologist Dr. Khanh H. Nguyen said.

“Even after we adjusted for different prognostic factors, those who continued to smoke during treatment did not live as long as those who had stopped. Our study suggests that smoking cessation remains an integral component in the comprehensive management of breast cancer,” Nguyen says.

AN ALTERNATIVE TO MAMMOGRAMS
Ray Hardman, WNPR

HARTFORD, CT (2003-10-07) The UConn Health Center is one of the test sites for Homologous Electrical Difference Analysis. Researchers are hoping HEDA will be a more comfortable and maybe a more accurate breast cancer screening method.

Listen to the broadcast. (Link opens in a new window and requires RealPlayer, which you can download for free here.)

SUGARS LINKED TO SPREAD OF CANCER
Diane Orson, WNPR

NEW HAVEN, CT (2003-10-02) Scientists at Yale University have found that abnormal sugars in cancer cells may help tumors to spread to other parts of the body.

Listen to the broadcast. (Link opens in a new window and requires RealPlayer, which you can download for free here.)

NIH-FUNDED CENTERS TO RESEARCH POSSIBLE ENVIRONMENTAL LINKS TO BREAST CANCER

National Institutes of Health Director Elias A. Zerhouni, M.D., announced the funding of four new Breast Cancer and the Environment Research Centers to study the prenatal-to-adult environmental exposures that may predispose a woman to breast cancer. Announcing the four centers at a press conference, NIEHS Director Kenneth Olden gave credit and thanks to the National Breast Cancer Coalition for the instrumental role played in establishing the model for these centers.

The centers are funded jointly by the National Institute of Environmental Health Sciences and the National Cancer Institute, both agencies of the National Institutes of Health, at a total of $5 million a year over seven years, or $35 million.

NIH Director Zerhouni said, “If we can understand the early events that can set the stage for breast cancer, we can do more to prevent this disease.”

The new centers are the University of Cincinnati; Fox Chase Cancer Center, Philadelphia, PA; University of California, San Francisco; and Michigan State University, East Lansing.

All the centers will work with advocacy groups to add their insight and experience to the research effort. These breast cancer and other advocates also will play a part in outreach activities to translate the results of the research into improved understanding, diagnosis and prevention of breast cancer. These partnerships are unique in breast cancer research.

BREAST CANCER TREATMENT CUTS RECURRENCE AFTER TAMOXIFEN

Breast cancer patients who follow up Tamoxifen treatment with Letrozole, an estrogen suppressor commonly called femara, cut risk of recurrence by nearly half, according to a study published on-line by the New England Journal of Medicine.

The study of more than 5,000 women with the most common form of breast cancer was suspended halfway through its planned five-year timespan because of the surprisingly strong results. The Journal also moved up publication of the study, which will appear in the November 6 issue, because of the importance of the findings.

Cutting the study off early prevented more substantive longterm findings but gave all its participants the option of immediately starting Letrozole treatment, according to the Journal article and two accompanying editorials. Other breast cancer patients also could start on Letrozole when they finish Tamoxifen treatment.

“It is likely that in the coming months there will be much debate over whether the data and safety monitoring committee made the best decision in halting the study,” said one of the editorials, titled Letrozole after Tamoxifen for Breast Cancer – What is the Price of Success? by Dr. Norman Wolmark.

“At a minimum, suitable patients must be apprised of these important observations and must be given the opportunity to receive Letrozole, with an understanding of the limitations of the data,” it concluded.

The study found that women with estrogen-sensitive breast cancer who had completed five years of Tamoxifen treatment and then took Letrozole were about 40 percent less likely to have the cancer return or get a new tumor in the other breast than those who received a dummy pill after Tamoxifen.

In addition, when breast cancer returns and spreads, Tamoxifen is the top treatment to stall tumor growth and buy women some time. It prevents estrogen from linking up to a receptor on the surface of cancer cells. An earlier study showed Tamoxifen’s effectiveness ended after five years of use.

The study was conducted by 18 doctors from various Canadian, U.S. and European hospitals, universities and cancer centers.

MONDAY, OCTOBER 27, 2003: CBCC/F BOARD MEMBER RECEIVES AWARD

The Connecticut Breast Cancer Coalition/Foundation is pleased to announce that Shwana Brathwaite, a member of the Connecticut Breast Cancer Coalition Board of Directors, has been awarded Representative John Larson’s Nancy Pilver Breast Cancer Heroine Award. The award will be given on Monday, October 27 at 11:00 AM at Hartford Hospital.

For the fourth year, Representative Larson is recognizing the efforts of a person in his district who is going above and beyond to help women who have breast cancer. Each heroine is making a difference on the frontlines in the fight against this awful disease. The award is named for Nancy Pilver, the late Legislative Chair of the Connecticut Breast Cancer Coalition, who set a high standard for advocacy and accomplishment that was noted by Representative Larson.

For Shwana, helping women with breast cancer is more than a job. In addition to her paid work for the American Cancer Society, she is a community leader who freely gives her own time to local hospitals, women’s health groups and church groups in addition to her work on the Board of the Connecticut Breast Cancer Coalition. Feeling a passionate obligation to do whatever she can to find a cure, Shwana makes a difference in the future of all women with breast cancer. Her relationship with the Connecticut Breast Cancer Coalition is just one of the powerful ways she helps others. She runs conferences and health fairs, and coordinates activities that educate the women of her district and beyond.

The CBCC/F would like to congratulate Shwana on this important award and to thank her on behalf of myself [Susan Davis], the Board of Directors, and community for her commitment and outstanding contributions.

NOVEMBER 14, 2003: DEADLINE TO FILE FOR TAXOL SETTLEMENT

There is a Taxol financial settlement that has been negoatiated because of overcharging for the drug. If you paid for the drug, you may be entitled to join the claim.

If you were treated with Taxol or its generic equivalent, Paclitaxel, from January 1, 1999 through February 28, 2003 you may be entitled to a cash recovery.

To get more information, call 1-800-659-7609 or visit www.taxolsettlement.com (link opens in new window).

HORMONE THERAPY CUTTING DEATH RATE FROM BREAST CANCER IN EUROPE

“Hormone therapy combined with earlier detection is dramatically cutting the death rates from breast cancer in Europe,” a British researcher said at ECCO-12, The European Cancer Conference. “The decreases in mortality parallel those seen in the United States,” said Professor Richard Peto, Ph.D., Oxford University, United Kingdom, reporting on an analysis of a host of studies carried out over the past 40 years.

“Until the 1990s,” Dr. Peto said, “the death rate for breast cancer was rising slowly in Europe and the United States, but then it started to decrease and continues to decrease. If the trend continues, by the year 2010, the breast cancer death rate in developed countries will be only half what it would have been without the treatment advances of the 1980s and 1990s, due particularly to hormone treatment.”

“For instance, treatment with Tamoxifen for 5 years gives a survival advantage over nontreated controls,” he continued. “After 15 years of follow-up on 10,000 women, the cancer death rate among controls was 34.8%, compared to 25.6% in the treated group.”

“Back in the early 80s, there was a widespread belief that hormonal treatment just didn’t work for breast cancer, that it was palliative, but had no effect on survival,” Dr. Peto said. “It’s just not true.”

STUDY FINDS OBESITY NOT ASSOCIATED WITH EFFICACY OF TAMOXIFEN FOR EARLY-STAGE BREAST CANCER

Obesity is not associated with an increased risk of recurrence among women with early-stage, hormone-responsive breast cancer and does not appear to decrease the effectiveness of the drug Tamoxifen, according to a study in the October 1 issue of the Journal of the National Cancer Institute.

Earlier studies had suggested an increased risk of recurrence and death among obese women compared with lean women. However, these studies included women with different stages of breast cancer, note study leader James J. Dignam, Ph.D., of the University of Chicago, and his colleagues. Obesity is associated with a more advanced stage of disease, and this could account for the observed increase in risk of recurrence and death among obese women, the researchers say.

In this study, Dignam and his colleagues looked at women with early-stage, hormone-responsive disease. The study involved 3,385 women enrolled in a randomized, placebo-controlled study to evaluate the effectiveness of Tamoxifen after surgery. The authors examined the association between obesity (defined as having a body mass index of 30.0 kg/m2 or higher) and risks of breast cancer recurrence, of contralateral (opposite) breast tumors, of other new primary cancers, and of overall mortality.

After a median follow-up time of 166 months (13.8 years), obese women had no higher risk of recurrence or deaths attributable to breast cancer than lean women. However, obesity was associated with increased risks of cancer in the contralateral breast, of other primary cancers, and of all-cause mortality. Tamoxifen reduced breast cancer recurrence and mortality to a similar degree, regardless of body mass index.

The authors point out that their study did not consider weight or obesity at different periods of life, including adolescence and early adulthood. And they did not have information about socioeconomic measures, dietary history, and other factors that may have contributed to obesity.

The findings suggest that obesity does not decrease the effectiveness of Tamoxifen for breast cancer recurrence and mortality, the authors conclude, adding that the results support the use of Tamoxifen in breast cancer patients of all body types. However, because obesity increases the risk for second cancers and mortality, it may affect the long-term welfare of breast cancer survivors, the authors say.

ESTROGEN MAY BE LINK BETWEEN OBESITY AND BREAST CANCER

According to the Journal of the National Cancer Institute, obesity increases the risk of breast cancer in postmenopausal women by increasing the amount of estrogens in the blood. High levels of estrogen have been linked as a causative factor for breast cancer.

The finding was reported by the Endogenous Hormones and Breast Cancer Collaborative Group. Joanne F. Dorgan, M.P.H, Ph.D., an epidemiologist at Fox Chase Cancer Center, is the lead investigator of one of eight cohorts included in the analysis.

“We’ve known that postmenopausal women who are overweight have an increased risk of breast cancer, and the risk also is higher in women who have higher levels of estrogens in their blood,” said Dorgan. “Our results suggest that obesity increases breast cancer risk in postmenopausal women by increasing serum concentrations of estrogens.”

For the study, researchers analyzed the blood donated by women in the U.S., Europe and Asia. All the women were cancer-free and were not using hormone replacement therapy when the blood was collected. The women were followed for 2 to 12 years and 624 women developed breast cancer. Hormones in their blood were compared with the hormones from 1,640 cancer-free women who were the same age when blood was donated as the women who developed breast cancer. Obesity was measured by body mass index (BMI), a measure of weight that is adjusted for height.

Most of the established risk factors for breast cancer are either fixed (family history and genotype) or not amenable to modification (age at menarche, number of and ages at pregnancy, age at menopause).

“This is an example of a risk factor that a woman can control,” Dorgan said. “The effect of obesity on breast cancer risk is important because the prevalence of obesity is high and increasing.” According to Dorgan, the estimated prevalence of obesity in U.S. women aged 60 to 74 increased from 29 percent between 1988 and 1994 to 40 percent in 1999-2000.

SOURCES:
- Journal of the National Cancer Institute
- Fox Chase Cancer Center (http://www.fccc.edu)

JUNE 3, 2003: PERSONALITY DOESN’T INFLUENCE CANCER RISK

Despite old beliefs, melancholy cannot lead to cancer. Research released Tuesday, June 3, 2003, suggests that your personality has no influence on whether or not you develop the disease.

Japanese researchers discovered that people who fit certain personality type—as in people who were especially extraverted, neurotic, tough-minded or prone to lying—were no more likely than others to develop cancer over a seven-year period. The researchers asked 3027 residents in Japan to complete personality tests and describe their health behaviors, then followed those residents for seven years to determine who developed cancer.

The researchers focused on certain personality traits: extraversion, neuroticism and psychoticism—described as liveliness, emotional instability and coldness, respectively—as well as a trait marked by lying and social conformity. Overall, people who had strong tendencies toward each of the four personality types were no more likely than others to develop any type of cancer, nor did they show higher risks for individual cancers—namely, cancer of the stomach, lung, colorectum and breast.

Writing in the Journal of the National Cancer Institute the authors suggest that people’s neuroticism may be a result of a cancer diagnosis, rather than the cause.

Early cancer may have caused some people to become more neurotic, they note, and people whose cancer was diagnosed during the first years of the study may have already had symptoms of the disease when the study began. These early symptoms, even without a diagnosis, could also have caused people to become more neurotic over time, the authors write.

MAY 10, 2003: THE CBCC/F LOSES ONE OF ITS GREATEST ADVOCATES

Nancy Pilver, the State Legislative Chair for the Connecticut Breast Cancer Coalition/Foundation, passed away Saturday, May 10, after a long and courageous battle with breast cancer. Nancy was a very active member of her community in Manchester, and volunteered to help and serve on committees and as an officer for many church, civic, political and charitable organizations. She was an active member of the Center Congregational Church and was involved in the Manchester Historical Society, the Pride-in-Manchester Week Committee, Heritage Day Committee, the Manchester Library Board, the Republican Town Committee and the Republican Women’s Club. She volunteered with the American Cancer Society, Manchester Memorial Hospital Women’s Auxiliary, and, most importantly, was very involved with breast cancer research organizations. Nancy was instrumental in starting state legislation for the check-off box for breast cancer contributions on income tax forms, “Drive-Thru-Mastectomies” breast cancer insurance coverage, and introduced legislation for a breast cancer automobile license plate. Part of the proceeds from the Breast Cancer License Plate Drive will benefit the newly established Nancy Pilver Research Fund, which will be used solely to pay for breast cancer research in Connecticut.

On a personal note: I knew Nancy and she was literally a bundle of energy. She accomplished more in a day than some people do in a month. She never let her illness get in the way of fighting for breast cancer research and legislation. Though it was not her responsibility and she already had a full plate, Nancy was responsible for keeping me apprised of updates on this web site. Her friend, who spoke with her two days before she died, told me that Nancy was still giving orders and organizing things from her bed. She kept up the fight to the very end. Let her be an inspiration to us all to never give up, regardless of how bleak a situation may seem. Her loss will be felt by many, but she will be present always in our hearts.

JDG

MAY 2003: SONOGRAPHY FOR DETECTING BREAST CANCER IN YOUNG WOMEN

Results of a new study show that breast sonography is more accurate than mammography in symptomatic women 45 years old or younger, and may be an appropriate initial imaging test in investigating these women, says Nehmat Houssami, MD, Ph.D., and lead author of the study. The study, published in the American Journal of Roentgenology, “is the first published study to examine the comparative sensitivity and specificity of mammography and sonography in relation to age in young women with breast symptoms, where the two tests were interpreted independently of each other and where almost all subjects had undergone both tests,” says Houssami. To conduct the study, Houssami and other researchers at the School of Public Health at the University of Sydney, the MBF Sydney-Square Breast Clinic, and Northern Sydney and Central Coast BreastScreen in Australia, used sonography and mammography to examine 480 women between the ages of 25 and 55.

Results of the study indicate that sonography correctly identified 84.9 percent of breast cancers in symptomatic women 45 years old and younger, whereas mammography correctly identified 71.7 percent of breast cancers in this group. Results also show that both mammography and sonography accurately identify 79.1 percent of breast cancers in women 46-55 years old. Based on their findings, Houssami, suggests, “If a woman has breast symptoms (or changes) or is found to have a lump (or swelling) on examination, then we recommend that women 45 years and younger should be investigated with sonography as the main imaging test, and those older than 45 years should be investigated with mammography as the main imaging test.”

This idea is contrary to current recommendations or standards, which suggest age 35 as the age to decide which test to use as the primary imaging in women with symptoms of breast cancer, says Houssami. However, Houssami warns, “Research evidence is intended to guide, and not to replace, clinical decision-making which takes into consideration the individual woman’s situation, such as her risk of having breast cancer and her preferences, as well as the specific clinical findings.”

Houssami cautions, “This study is not about screening—it is about diagnosis of women who are referred for testing because they are experiencing breast symptoms. There is a critical difference, our study has nothing to do with screening; mammography is the only proven screening test for breast cancer.”

APRIL 21, 2003: BLOOD TEST FOR BREAST CANCER

Using an innovative technique, researchers at Eastern Virginia Medical School have identified specific serum protein profiles that may enhance the detection of breast cancer. In early testing, the biomarker profiles have shown a specificity and sensitivity that approaches that of mammography.

The technique used, called protein chip mass spectrometry, searches for multiple proteins that are differentially expressed in blood to create a unique profile. Samples were collected from 139 women, including both breast cancer patients and healthy women. The age range of participants was 21 to 91. Patients were classified as either normal/benign or cancer.

Results of the screening identified 80% of the breast cancer patients as ductal carcinoma in situ or stages I or II. Only 13% were stage III and 7% were stage IV. These results need to be validated in larger samples and by outside institutions. However, these findings are encouraging for the future of finding a blood test for the detection of breast cancer.

APRIL 2003: BLACK COHOSH MAY MAKE BREAST CANCER DRUG MORE TOXIC

Women with breast cancer who are undergoing chemotherapy may want to avoid black cohosh, the herbal remedy often used to treat menopausal symptoms such as hot flashes, according to Connecticut researchers. In a new study of laboratory-grown breast cancer cells, the herb seemed to increase the toxicity of the commonly used chemotherapy drugs doxorubicin (Adriamycin) and docetaxel (Taxotere), but not a third, cisplatin. “We saw this with three different commercial black cohosh extracts,” said Dr. Sara Rockwell of Yale University School of Medicine in New Haven, Connecticut.

The suggestion that black cohosh may make these anticancer drugs more potent than they already are could be “a good thing or a bad thing,” Rockwell said. “If this were an effect just on the tumor cells, that would be a good thing because it would mean you get more antitumor effect for a person on black cohosh,” she said. “On the other hand, Adriamycin is used in doses that are nearly toxic—it wipes out the bone marrow and is very close to the limit of heart toxicity. A substantial number of patients treated with Adriamycin show serious heart injury after treatment and if black cohosh increased that it could make this drug lethal.”

More research is needed to determine if this is true for patients—results in laboratory cells may not mimic what happens in the body, a much more complex situation compared with a carefully controlled experiment.

APRIL 2003: NEW PATIENT PRIVACY RULE TAKES EFFECT

You may have read that new provisions to the Health Insurance Portability and Accountability Act took effect last week. These provisions may impact you. So, to help you understand, here’s a basic look at the new provisions from Health and Human Services. For more information, check out the FAQ and other links at: http://www.hhs.gov/ocr/hipaa/ (link opens in new window).

The New Provisions
Most health plans and health care providers that are covered by the new rule must comply with the new requirements by April 14, 2003.

The HIPAA Privacy Rule for the first time creates national standards to protect individuals’ medical records and other personal health information.

• It gives patients more control over their health information.
• It sets boundaries on the use and release of health records.
• It establishes appropriate safeguards that health care providers and others must achieve to protect the privacy of health information.
• It holds violators accountable, with civil and criminal penalties that can be imposed if they violate patients’ privacy rights.
• And it strikes a balance when public responsibility supports disclosure of some forms of data—for example, to protect public health.

For patients, it means being able to make informed choices when seeking care and reimbursement for care based on how personal health information may be used.

• It enables patients to find out how their information may be used, and about certain disclosures of their information that have been made.
• It generally limits release of information to the minimum reasonably needed for the purpose of the disclosure.
• It generally gives patients the right to examine and obtain a copy of their own health records and request corrections.
• It empowers individuals to control certain uses and disclosures of their health information.

About Us Programs Legislation News BC Emergency Fund Donate Now Calendar
Membership Events License Plate Resources Support Our Work Get in Touch Home

© 2000—2007 Connecticut Breast Cancer Coalition/Foundation. All rights reserved. Disclaimer