MRI vs. mammography for detecting DCIS. A comparison was made between mammography and breast magnetic resonance imaging (MRI) to detect ductal carcinoma in situ. The subjects were 7,319 British women, of whom 193 had a tissue diagnosis of DCIS and 167 had been tested using both methods. MRI was more effective in detecting DCIS, picking up 92% of cases as compared to 56% by mammography. The results look solid but the researchers are calling for confirmation in a randomized trial because MRIs are so much more expensive than standard mammography. (Lancet 2007; 370:485-492).
Tamoxifen and aromatase inhibitors. Tamoxifen for a period of five years used to be the treatment of choice following surgery for breast cancer. It has now been established that, for breast cancer that is hormone receptor positive, either anastrozole (Arimidex) or exemestane (Aromasin), if prescribed after two to three years of tamoxifen, improve disease-free survival significantly. Another third-generation aromatase inhibitor is letrozole (Femara). Any of these three may be prescribed to improve outcome after some years of tamoxifen or, alternatively, as a second-line treatment for advanced breast cancer. (Ann Oncol 2008:19(1): 16-27)
A related study looked at the tendency of women to forget or ignore prescriptions for an aromatase inhibitor. A research team in Boston identified more than 12,000 women who had received prescriptions for Arimidex over a period of two years. Of these, anywhere from a fifth to a quarter of women stopped buying the medication during the first year. The research team warns that this tendency can significantly affect the success of treatment. (J Clin Oncol 2008; 26:552-562)
HRT linked to ovarian cancer. The Million Women Study, a U. K. trial of postmenopausal women, has determined that those women receiving hormone replacement therapy (HRT) were, on average, 20% more likely to develop and die from ovarian cancer as compared to women who never received therapy. www.medscape.com/viewarticle/555597? src=mp&spon=17&uac=30649BV
Chemicals from Teflon, Scotchgard found in human breast milk. Researchers have detected perfluorinated compounds, used to make Teflon, Scotchgard and grease-resistant food packaging, in human milk samples from 45 nursing mothers in Massachusetts. This is the first study to document levels of these suspected carcinogens in breast milk. www.newswise.com/articles/view/540271/?sc=swtr
Mammograms should continue to 75 years of age. Two large studies of mammography screening for breast cancer conclude that it is beneficial for women aged 70 to 75 and that a three-year interval between mammograms is sufficient. One study took place in the Netherlands where the upper age limit was extended from age 69 to age 75 in 1998. The three-year interval was recommended after a longitudinal U. K. study. The data were reported at the 6th European Breast Cancer Conference in Berlin, Germany, April 2008.
Treatment for hot flashes. A 20 mg dose of the progestin, megestrol acetate (Megace), significantly reduces hot flashes in women with breast cancer, according to the results of a trial published this Spring. The women were required to have completed surgery, chemotherapy and four months of tamoxifen (if prescribed) and also had to complete daily logs showing at least five severe or ten milder hot flashes per day. The study randomized 286 women to receive either a 20 mg dose, a 40 mg dose or a placebo. Over two-thirds of the women on the 20 mg dose of Megace reported a reduction in hot flashes. (J Clin Oncol 2008; 26:1650-1656)
New course in ecohealth available. An 11-day ecohealth course is to be offered annually and rotate among three universities – the University of Guelph, the University of British Columbia (UBC) and the Université du Québec à Montréal (UQAM). The initiative is backed by a $1 million grant from the International Development Research Centre and will accept 25 graduate students and 5 professionals for this year's course, August 5 to 15 at UBC. The course will be offered in Guelph in 2009 and in Montreal in 2010. (Canadian Press, April 16, 2008)
Nipple aspirate may predict breast cancer. Women with epithelial cells present in nipple aspirate fluid face a high risk of breast cancer. This report follows from analysis of nipple aspirate fluid from 946 women seen in a breast cancer clinic between 1970 and 1991. When the fluid contained epithelial cells, the woman was 1.9 times more likely to develop breast cancer. It is hoped that this kind of analysis might enhance current predictions of risk of breast cancer. (BMC [BioMed Central] Cancer 2008; 8:75)