Drug Combination Approved for Breast Cancer-(Cancer Info-12/09/2001)

The Food and Drug Administration today approved the combination of two existing drugs for use in women whose advanced breast cancer has not responded to standard medication. Used together, Xeloda and Taxotere increased survival about 25 percent compared with Taxotere alone, according to a study of 511 women with advanced breast cancer for whom first-line drugs had failed.

Breast cancer is the No. 2 cancer killer of women in the United States. "It's a small development but an important one," because the drug combination likely will help some women with no other options, said Joann Schellenbach, spokeswoman for the American Cancer Society.

Taxotere is administered intravenously every three weeks. Xeloda, a pill taken daily, won accelerated approval from the FDA in April 1998 because doctors had little to offer women whose breast cancer had spread despite surgery, radiation and treatment with standard breast cancer medications. At the time, the FDA directed that the two drugs be tested together.

Xeloda interferes with a crucial step in cell division, while Taxotere disrupts "machinery" in cells that enables division. Cancer cells, which divide more rapidly than healthy ones, are more susceptible to such an attack. Xeloda's maker, the Roche Group, parent of Hoffmann-La Roche Inc., funded the study. It found the increased median survival of the patients ranged from 11 1/2 months for those getting Taxotere alone to 14 1/2 months for patients receiving both drugs. Taxotere is made by the French drug company Aventis SA. Nearly 192,000 American women are diagnosed with breast cancer each year, and about 40,000 are expected to die from it this year, according to the cancer society.

Like other cancer treatments, the new combination can cause serious side effects. According to the FDA, those include fatigue, nausea, vomiting, diarrhoea, painful swelling of the hands and feet, and suppression of bone marrow, which makes all the cells in blood. The drugs also must be used cautiously in women using blood-thinning medications.

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Estrogen therapy helps elderly –(Times of India Online-15/08/2001)

Estrogen replacement therapy significantly improved bone density in frail, elderly women, according to a study that suggests beginning the treatment even late in life may be beneficial. The findings are encouraging, though more research is needed to determine whether the improved bone density helps prevent fractures in elderly women, said Dr. Dennis Villareal, the study's lead author and a professor of geriatrics and gerontology at Washington University School of Medicine in St. Louis.

There were questions about whether estrogen could improve bone density in frail, elderly women — and whether they could tolerate it. The study found that few of the women experienced side effects from the estrogen. It also found similar and possibly even greater effects on bone density in older women compared to younger women.

Patients and their doctors must weigh the potential benefits of estrogen therapy with the risks, which include a slightly elevated chance of breast cancer, Villareal said.

In the study, 67 women age 75 and older who had mild to moderate physical frailty were randomly assigned to receive estrogen or a placebo for nine months. None had received estrogen previously. At the end of the study, bone density in the lumbar spine had increased an average of 4.3 percent among women who received estrogen — similar to or higher than increases noted among younger women in previous studies. Bone density in the women's hips increased an average of 1.7 percent, and among the women who adhered most closely to the hormone replacement therapy, femoral neck bone density increased 2.5 percent

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Breast-conserving therapy the preferred treatment for DCIS-(Cancer Page-06/08/2001)

Except for women with a moderate risk of local recurrence, breast-conserving therapy is the preferred treatment for ductal carcinoma in situ (DCIS), according to researchers from the University of Toronto. Dr. Eileen Rakovitch and colleagues used a decision analysis model to determine which of four treatment options is optimal for women who have undergone a wide local excision for DCIS:  mastectomy, irradiation, irradiation plus tamoxifen or observation.

The appropriate treatment option depended heavily on a woman's risk of local recurrence and her attitude toward mastectomy, the researchers note. Observation was the optimal option for women with a local recurrence risk of < 15% at 10 years. Mastectomy was the preferred treatment for women with a risk between 15% and 38%, but only if it did not severely diminish the quality of life, the authors note. The addition of tamoxifen to breast-conserving therapy was the preferred approach for women with a >38% risk of recurrence or a >6% risk of cancer in the contralateral breast.

"The clinical decision-making process in the management of DCIS remains complex because of the biologic heterogeneity of DCIS, its predilection to be diagnosed in relatively young and otherwise healthy women, and its excellent long-term prognosis," the investigators comment.

The current analysis "does not facilitate prediction of an individual's risk of local recurrence after an initial wide local excision for DCIS," they point out. "However, it does provide insight into the most relevant parameters and their critical threshold values weighed in the decision-making process."

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Slovakia now accepts cancer-(Times of India Online-31/07/2001)

Thirty years ago, Veronika Hubacova had to convince her friends and colleagues that her breast cancer wasn't like leprosy -- that they could shake her hand without getting sick.
Hubacova says she'll never forget the terror that gripped her husband and children, who believed her illness was contagious and her diagnosis was a death sentence. Such ignorance was commonplace in Slovakia and other East European countries under communism, where cancer was so taboo that few patients dared to disclose they had it.
"Women would rather die than admit it," said Hubacova, who lost one breast but survived to become a relatively healthy 72-year-old retiree. "Back then, it was like living in the Stone Age."

Today, 11 years after the peaceful collapse of communism, change is in the air. Slovaks now talk openly about cancer, unraveling the many myths that misled them for so long. As in the West, people are donating money to research foundations and support groups.
Before democracy began taking hold, Slovak authorities were more preoccupied with keeping their people in check than with keeping them informed. There were no leaflets, let alone books, to educate people about cancer, their outlook or their treatment options.
Even some doctors were ill-informed: Their advice boiled down to telling their patients to get their affairs in order and prepare to die.

All that began to change soon after communism ended in 1989. Within a year, the League Against Cancer was founded on a pledge to "remove taboo, myths and misleading information about cancer." It was the League, a non-governmental organisation, which came up with the idea of the "Day of Daffodils". Volunteers spend every April 6 collecting donations in the streets to help with the prevention, early diagnosis, treatment and research of cancer. Five years ago, hesitant Slovaks gave just $9,130. This year, the League collected about $207,000.

Yet despite the new approach, old ghosts remain. In rural areas, people are still reluctant to go to a doctor when they sense a health problem. Cancer itself is widespread, particularly cancer of the lung; as elsewhere in Eastern Europe, many Slovaks smoke. Colon and intestinal cancer are among the top killers. Nearly one in four Slovak men dies of cancer, and the incidence of cancer among women isn't far behind. Siracka is frustrated that so many women who have obvious problems with their breasts refuse to see a doctor until the disease is more advanced. Hubacova told of a young woman who was terrified of seeing an oncologist because "the whole village would find out about it" and she would become a source of gossip.

But cases like this are becoming the exception amid a stream of booklets, books, magazines, media reports and school programs. A new high school textbook sums up the new approach: "Remove the taboo, change the attitude to lifestyle and stress the importance of prevention."

Peter K., who lost his wife to cancer 15 years ago, wishes he had access to that kind of information when she first got sick. "If I could read about it and find how I could have helped my wife during that time, we both could have had a better life," he said, speaking only on condition of anonymity.

Hubacova prefers to look forward, not back. She and a few other breast cancer survivors have set up "Venusa," or Venus, a support group where women can learn about healthier lifestyles and the government benefits they're entitled to, and share their stories with one another. Even though it lacks a permanent office, a telephone line and a fax, the group has managed to attract about 300 women in the capital, Bratislava. Following its example, women in 14 other cities and towns have set up similar organizations. "At first, they're scared to come," Hubacova said. "But then some of them decide to call me at home and I tell them my story, which helps them to overcome their fear."

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Japanese find gene link in breast cancer –(Times of India Online-)

In a finding that could lead to better diagnosis, treatment and possibly prevention of breast cancer, Japanese scientists said they had found a genetic link between breast and bowel cancer. Researchers at the Yamagata School of Medicine in Japan, have discovered that a gene called adenomatous polyposis coli (APC) that is mutated in more than half of all cases of bowel cancer also does not work properly in over a third of women suffering from breast cancers.

"We already knew the APC gene was important in bowel cancer, but to find that it's switched off in so many breast cancers is really exciting. This gene could now be a valuable target for breast cancer drugs of the future," Dr Gen Tamura said in a statement.

The research is published in the latest edition of the British Journal of Cancer.

APC is a tumour suppressor gene that stops a cancer from developing. Two copies of the gene, one from each parent, are needed to protect an individual from getting cancer. The gene could either be mutated or switched off in a chemical process called methylation. It is deformed in only about six per cent of breast cancer patients but switched off in many other cases.

Tamura and his team studied the status of the gene in 50 breast tumours. In 18 tumours at least one APC gene was turned off but in 21 healthy samples of breast tissues both APC genes were working properly. "The fact that we only found inactivation of APC genes in breast tumours, and not in normal tissue, suggests these changes are specific to the disease and may be important to its development."

Breast and bowel are two of the most common cancers. Breast cancer affects about one in 10 women sometime during their lifetime and kills hundreds of thousands worldwide each year. In developed countries excluding Japan, bowel cancer kills one in 50 people. It can occur in younger people but is most common in people over 50 years of age.

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Study defends preventive mastectomies –(Times of India Online-20/07/2001)

Removing the healthy breasts of women with genetic mutations that often trigger breast cancer can save their lives, Dutch researchers found in the strongest study yet to show that the controversial strategy works. In the study, none of the women who chose to undergo preventive, or prophylactic, mastectomies developed the often-deadly cancer. In a comparison group of women who also had the mutant genes and opted only for regular checkups, one-eighth got breast cancer and one woman died.

Scientists had questioned whether the extreme approach really prevents breast cancer because some breast tissue remains after surgery and the dangerous mutant genes are in every cell in the body. "We can say to our patients that this method of prevention is nearly 100 per cent effective and that they can sleep without fear of getting breast cancer," said Dr Jan Klijn, chairman of the Rotterdam Family Cancer Clinic, part of Erasmus University Medical Center, where the research was done.

Other experts, however, cautioned that the women, many in their 20s and 30s, were followed for only three years on average. "My guess is that some small number of women might" later develop breast cancer despite the mastectomy, said Dr Marvin Schwalb, director of the Center for Human and Molecular Genetics at the University of Medicine and Dentistry of New Jersey.

The research was reported in the New England Journal of Medicine.

From 1992 on, Klijn and colleagues studied 139 women after they were determined by DNA testing to have a dangerous mutation on either of the breast cancer susceptibility genes, BRCA1 and BRCA2. The mutations carry a lifetime breast cancer risk of up to 85 per cent.

More than half of the women 76 chose to have a prophylactic mastectomy, with most later having breast reconstruction. The 63 other women chose regular follow-up: annual mammograms or MRI screenings, examination by a doctor every six months and monthly breast self-exams. Eight developed breast cancer during the study, with half detecting it themselves between screenings.

"It's a really fine study," said Dr Lynn Hartmann, a cancer specialist at the Mayo Clinic in Rochester, Minnesota. "Three or four years ago, women were doing this with no proof at all that it worked." Hartmann and colleagues reported in 1999 that prophylactic mastectomies cut the risk of developing breast cancer at least 90 per cent. They reviewed medical records of 639 women who underwent the procedure from 1960 through 1993. But such retrospective studies are valued less by researchers than prospective ones, where each patient group gets exactly the same care. The women in the Mayo Clinic study sought prophylactic mastectomies because they had relatives with breast cancer and feared getting it. DNA testing for the mutant genes was not possible at the time. Subsequent testing found 16 of them had the mutant genes, but none have developed breast cancer in 12 years of follow-up, Hartmann said.

In an editorial in the journal, Dr Barbara L Weber of the University of Pennsylvania and Dr Andrea Eisen of McMaster University in Canada said that the studies by Klijn and Hartmann suggest that prophylactic mastectomy, while extreme, is the most effective prevention strategy. They urged support for research to find better breast cancer screening methods and medications that can prevent the disease.

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Chemotherapy causes rapid bone loss in women-study-(Times of India Online-14/07/2001)

Chemotherapy given to women with early-stage breast cancer causes their bone density to decline at a faster rate than previously known, increasing the risk of osteoporosis, researchers said. Scientists led by Dr. Charles Shapiro at Ohio State University said they were surprised to find that 35 pre-menopausal women treated with chemotherapy experienced up to an 8 percent loss in bone density after 12 months of treatment. The median age of the women was 42. The bone loss in the patients treated with chemotherapy was so significant, the researchers said, that the study was halted to allow the women to seek care from their primary physician.

"We were surprised that (bone loss) occurred so early because other studies had begun to evaluate patients at 12 months" after chemotherapy commenced, said Shapiro. "An independent committee met, and they concluded that these 35 women have lost so much bone, 8 percent, in the spine that it was unethical in view of that to treat them with placebo."

The study appears in the Journal of Clinical Oncology.

Chemotherapy causes a woman's ovaries to shut down prematurely, stopping the production of the female hormone estrogen. The vital hormone is used by the body for reproduction, but it also protects bones from deteriorating. Women naturally stop producing estrogen when menopause begins, but the decline in the hormone, and resulting drop in bone density, occurs at a faster rate when chemotherapy is administered. Post-menopausal women average a decline of about 1 percent to 2 percent in bone mineral density per year.

The sample size included 49 patients suffering from early-stage breast cancer, with 35 entering into early menopause after one year of the chemotherapy treatment. Researchers had later planned to randomly divide seven patients to test the effects of a nasal spray on slowing bone loss -- four would receive the spray and three a placebo, or dummy medication. Researchers cautioned that women who experience rapid bone loss are prone to osteoporosis, an incurable disease that causes bones in the hip, spine and wrist to become fragile and break.

"We focus on the side-effects of chemotherapy, but we don't focus as much as we should ... on early menopause leading to rapid bone loss," Shapiro said. "The results of this study support a role for bone density scans in those women who develop chemotherapy induced ovarian failure." Osteoporosis can be slowed with a balanced diet rich in calcium and vitamin D, exercise and tests to measure bone density, according to experts.

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Ageism in breast cancer shortens lives: Study-(Times of India Online-10/07/2001)

Elderly women with breast cancer are not being offered life-prolonging surgery because of discrimination and ageism in healthcare services, British researchers said. Women in their 70s in Britain and elsewhere are often only given the drug tamoxifen for breast cancer, while their younger counterparts have surgery as well as the hormone therapy. But a new study, dubbed the Golden Oldies Trial, shows that surgery and tamoxifen, the gold standard of care for breast cancer, would also benefit elderly women and add years to their lives.

"Surgery had a significant influence on survival. The older women having what we would consider conventional treatment for younger women were living longer," said Professor Michael Baum of University College in London. Baum said ageism was the reason why older women with operable breast cancer did not routinely have their tumour removed. They might not be considered fit enough for surgery or doctors might want to spare them the discomfort of an invasive procedure. He and his colleagues compared the two treatment options on 455 women over 70 years old who had been randomly selected to have surgery and tamoxifen or just the drug. After 12 years of follow-up, they found that the women in the dual treatment group lived about three years longer.

Dr June Crown, the head of the advocacy group Age Concern, described withholding surgery for any reason as discrimination. "Breast cancer is a horrific thing for any woman to face, regardless of her age. The prospect of having the fundamental choice of treatment taken away from you on the basis of your age is quite simply age discrimination, whatever the intentions might be."

Tamoxifen, which is sold by Anglo-Swedish drug giant AstraZeneca under the brand name Nolvadex, is a drug used to prevent and treat breast cancer. It works by neutralising the action of the female hormone estrogen, which stimulates breast cancer growth. Studies have shown it is effective for treating early and advanced breast cancer, particularly in women over 50 who are most likely to develop the disease. The US Food and Drug Administration have also approved it for use in preventing breast cancer in women with a high risk of getting the disease.

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Tamoxifen increases risk of aggressive breast cancer –(Times of India Online-06/07/2001)

Breast cancer patients who take tamoxifen lower the overall risk of a tumour recurring. Should a new cancer develop, however, researchers find it is five times more likely to be of an aggressive type. In a study appearing in the journal of the National Cancer Institute, researchers at the Fred Hutchinson Cancer Research Centre said the study clearly shows the benefits of taking tamoxifen to stave off new disease, but it also shows the need to find drugs to treat tumours resistant to tamoxifen.

"Half of the women who take tamoxifen develop resistance, but this resistance is not understood," said Dr Christopher Li of the Hutchinson Centre. The new study, he said, is consistent with theory that tamoxifen supports the growth of breast tumours that are not sensitive to estrogen, the female hormone. This is important because tamoxifen and other drugs work against tumours sensitive to estrogen, but "there are no drugs that target estrogen-negative tumours." The study emphasises the need for finding such drugs.

Dr Sandra Swain of the National Cancer Institute said Li's study had "noteworthy limitations" and was inconsistent, in some respects, with other tamoxifen studies. "The use of tamoxifen should not be changed based on this study," Swain said in an interview. "Tamoxifen has clearly increased survival for thousands of women who have used it."

Li agreed but insisted that his study gives more insight into the effect of tamoxifen resistance among some breast cancer patients.

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Breast Cancer Cases on the Rise Among Young Women-(Bombay Times-20/06/2001)

Annually, 22,837 cases of cancer are reported in Mumbai city. Out of these, breast cancer is ranked number one, with 6629 cases, according to a survey conducted in 1999 by the Indian Cancer Society. There has been an obvious rise in the number of breast cancer cases in the city in recent times, especially among young women between the ages of 24 and 30 years. This is a peculiar trend as no such upswing has been reported in Western countries.

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Radar tests for breast cancer-(Cancer Info-30/06/2001)

Radar technology could soon provide a better and safer test for breast cancer after scientists discovered it can detect tumours in patients. Scientists are hopeful ground penetrating radar - called Atomic Dielectric Resistance - will be able to detect cancer and other diseases, including CJD. Tests on tissue taken in breast cancer biopsies have shown the ADR scanner, which fires short pulses of radio waves into the body, was successful in revealing whether cancer cells were malignant or benign. The early results of a trial of 36 patients from the Western General Hospital, in Edinburgh, have shown it can detect their cancer.

The radio waves change behaviour as they travel through different materials, and produce three-dimensional images on a computer screen. Next week, doctors Colin and Gordon Stove, a father and son team based at Radar World Ltd, will be awarded £50,000 from the National Endowment for Science, Technology and the Arts to develop a prototype "smart scanner" for breast cancer screening. They are currently working with Dr Alastair Kirkpatrick, the former director of the South East Scotland Breast Screening Programme, to analyse the results of body scans of 36 women.

Gordon Stove said he and his father had discovered the potential for medical use of the technology "purely by accident". "We have developed this from ground penetrating radar," he said. "We were mucking about in the lab and I scanned my father’s body and he scanned mine. "We noticed you could pick out the organs, like the heart, and it was purely out of curiosity at that stage. Once we had that breakthrough, we decided to take it further."

Dr Stove said the tests on biopsy tissue from breast cancer patients have shown the scans can distinguish between benign and malignant cancers. "We have a transmitter and a receiver, and we shine a beam that fires at the object," he explained. "The waves penetrate through each layer of the skin and pick up every layer through the human body. It reflects this data to the receiver and shows up as an image on a computer screen. "We can then do further investigation with our software. That’s where we can really distinguish between a malignant and a benign cancer."

Dr Kirkpatrick said the results so far have been encouraging: "It looks as if it will be able to pick up abnormalities." If the technique is successful, patients could be scanned fully clothed, without painful compression of the breast as happens with mammography. The radiation is less than that emitted by a mobile phone. A quicker and more accurate test could also enable women to be screened more often.

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Researchers make cancer advancement-(Times of India Online-29/06/2001)

Scientists have created mice that are immune to some of the most common types of breast cancer, a development they say brings science a step closer to developing drugs to precisely block the spread of breast cancer in humans. The research involves a protein linked to half of all human breast cancers. The bioengineered mice lack that protein, which some tumors need to grow. Though it could take years to develop a drug therapy targeting the protein, the findings are dramatic proof that certain breast cancers can occur only when the protein is present.

The scientists who conducted the research aren't suggesting that humans be bioengineered to resist breast cancers. Instead, they hope their findings will inspire more research to target the protein using drugs. They produced the cancer-resistant mice by building on earlier success in engineering mice that don't express the protein cyclin D1, one of many proteins that regulate cell growth. Because cyclin D1 is found in abnormally high amounts in half of human breast cancers, it has become the focus of much scientific scrutiny.

The wanted to test whether eliminating the protein in mice prone to certain breast cancers could keep them cancer-free. The researchers bred the mice engineered to not express cyclin D1 with four other types of laboratory mice, each prone to different types of breast cancer, and monitored their offspring for signs of cancer. Two of the resulting cross-breeds were immune to the type of breast cancer for which they carried a gene. The findings clearly show two cancer genes called Neu and Ras can only turn normal cells into cancer cells by sending signals through the cyclin D1 protein.

The fact the mice with the two other cancer genes, called Wnt-1 and Myc, developed breast cancers means those cancer genes are capable of signaling through other cell-regulating proteins. Researchers should try to target cyclin D1 using existing cancer-blocking drugs. Drugs that target a protein partner of the cell-regulating proteins that include cyclin D1 with Genentech's breast cancer drug, Herceptin, which aims to block the Neu cancer gene could be paired. That cancer gene has been linked to about 30 percent of human breast cancers.

If there was a way to take out cyclin D1 the cancer gene pathways could be unplugged completely from the cell cycle machinery without compromising the patient's health.

Other scientists said that when more is known about the cellular changes that the Neu and Ras cancer genes induce through cyclin D1, physicians might be able to create molecular profiles of breast cancer patients to target their unique mix of tumors.

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Dense bone may help ID breast cancer –(Times of India Online-21/06/2001)

Bone density in elderly women may offer a new indicator of their risk of breast cancer, researchers say. Researchers report that older women with high bone density were about two times more likely to develop breast tumours. The finding does not mean that high bone density causes breast cancer but that bone density may act as a predictor that would alert patients and clinicians to a higher level of risk of the disease.

This is a surrogate marker for breast cancer risk, which could become part of the clinical equation for evaluating a patient's tendency to develop the disease. The study shows that bone density may be particularly useful predictor for older women with advanced breast tumours.

A bone density test may eventually be important in assessing breast cancer risk, but should not be used now because there are too many unanswered questions about accuracy. Also, the study involved only older women and it is not known how bone density tests could be used for women under 65. Bone density appears to be an indirect measure of levels of hormones, such as testosterone and estrogen, that have been linked both to bone density and to breast cancer.

The study followed the health history of 8,905 women who were 65 or older and initially free of breast cancer. At the start, the researchers measured the bone density in the wrist, forearm and heel of each woman. They were then all monitored for more than six years. During that period, 315 of the 8,905 developed breast cancer. Analysis showed that women in the quarter of the group with the highest bone density in the forearm were about 2.8 times as likely to develop breast cancer as those who were in the lowest bone density quarter of the group. A similar relationship was found for the other bone density tests. A study that was based on the density of the bones in the leg and hip had similar results.

However, the results apply only to older women and more research is needed to determine if bone density tests would also be predictive for breast cancer among younger women.

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Gene variant probed in breast cancer-(Times of India Online-14/06/2001)

Older white women with a genetic variation in a protein that helps regulate cell growth are 60 per cent less likely to get breast cancer, preliminary research suggests. The research bolsters scientists' understanding of the protein and its variations, some of which have been linked to colon cancer in humans and tumours in mice. The inherited variation, found in about 15 per cent of the US population, involves the gene for a naturally occurring protein called transforming growth factor beta-1. The study involves data on 3,075 white women aged 65 and older.

When more is known about the role of variations in this gene and others in determining cancer risk, the knowledge may be combined with other risk factors to better estimate each woman's risk of developing breast cancer. The study was termed exciting but preliminary. Such work could potentially help scientists better understand the causes of breast cancer.

Other genetic variations have been linked to breast cancer, specifically mutations in the BRCA1 and BRCA2 genes, which are linked to a significantly increased risk but are also relatively uncommon and account for a small number of cases.

The gene for transforming growth factor beta-1 shows up in three different ways. The two most common variations were found in 2,617 of the participants and are present in about 85 per cent of the US population. While women in the study with these two variations were about 2 1/2 times more likely to get breast cancer than women with the third variation, only about 6 per cent of them developed breast cancer during 10 years of follow up. About 2 per cent of women with the third variation developed the disease. The risk faced by women with the more common variations likely is similar to the general population's average risk. The average US woman's lifetime risk is about 8 per cent, according to the American Cancer Society.

Because all of the participants were 65 or older when they enrolled in the study, and most of the cancers developed in women after age 70, the results only address the relationship between the protein variations in older women. It is possible that the effects of the polymorphism (variation) differ by age or menopausal status. The study also involved mainly white women, so it's possible the variation would have different effects in women of other races.

Other studies have found that the less common gene variation is associated with higher levels of the protein. Because study participants with this variation faced a decreased cancer risk, the results support the theory that high levels of the protein suppress initial tumour development. More studies of this genetic variation in other populations are needed to establish how useful it will be in the general population.

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Bush says war against cancer can be won-(Times of India Online-02/06/2001)

President George W. Bush welcomed breast cancer survivors to the White House, saying advances in medical research give him "some measure of confidence that the war on cancer is winnable. I hope, I believe and I pray that we are on the verge of great victories against breast cancer," Bush told dozens of women participating in the National Race for the Cure.

Organisers of the race expect 1.3 million people to participate in 112 events nationwide, raising money for research, community programs and free cancer screenings for uninsured women.

First lady Laura Bush, her mother a breast cancer survivor, and Health and Human Services Secretary Tommy Thompson, whose mother-in-law was a breast cancer victim, joined Bush at the East Room event.

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Discrimination against breast cancer survivors-(Times of India-16/05/2001)

Although most women who have survived breast cancer report positive results from talking about their experience with friends and family, a significant number say they have suffered negative consequences in personal and work relationships as a result of disclosing their past illeness.

The team studied 378 women who had been diagnosed with breast cancer an average of 8 years previously and who had been cancer free for at least 2 years. More than 67% had told their family members and friends and about half had told co-workers, supervisors or bosses. While most women said that sharing information led to receiving more support, feeling closer to others and getting advice from others, others reported difficulties in obtaining or continuing life insurance, extended health coverage or private disability insurance.

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Hormone replacement therapy may reduce breast cancer risk-(Cancer info-16/05/2001)

Taking hormone replacements after a diagnosis of breast cancer - once thought to increase the risk of tumors - does not make recurrence more likely and may even lower chances that the cancer will return. Women with breast cancer generally have avoided the therapy, in which post-menopausal women take pills to replace female hormones that diminish with age, because it was known that estrogen was linked to the growth of some tumors. But the new study suggests that breast cancer patients should not fear hormone replacement therapy, or HRT.

The data are reassuring for women who take HRT after a breast cancer diagnosis. HRT need not be ruled out automatically. However the study should not be considered the final answer. It is possible that a larger study will show a proven risk reduction, but it is premature now to show an actual benefit from HRT in this patient population. The numbers in the study are too small to give final statistical evidence of the effects of HRT on breast cancer patients.

Women use hormone replacement therapy to relieve post-menopausal symptoms, such as flushing and hot flashes. It also lowers the risk of heart disease and osteoporosis, the brittle bone disease, after menopause. Some studies have suggested, however, that using HRT for five years or longer can produce a slight increase in the risk of breast cancer.

Uncertainty remains about long-term effects of HRT, opting for it is a highly individual consideration, and there currently is no universal recommendation for the therapy. The new study is an attempt to find answers about effects of HRT for a limited population: women who already have breast cancer.

In the study the authors analyzed data from a group of 2,755 women who had been diagnosed with invasive breast cancer. Within this group were 174 women who began using hormone replacement therapy after the cancer diagnosis. Each of the HRT users was matched by age, disease and year of diagnosis with four randomly selected nonusers. The researchers then compared the long-term outcomes of the two groups. The study found the rate of breast cancer recurrence for the HRT users was 17 per 1,000 person-years, while for nonusers the rate was 30 per 1,000 person-years. A person-year is one year of human life. Death from breast cancer was 5 per 1,000 person-years for HRT users and 15 per 1,000 person-years for nonusers, the study found.

The study found some data that suggested HRT might increase the risk of cancer in the previously unaffected breast. Researchers said the risk of developing tumors in the unaffected breast was 12 per 1,000 person-years for the HRT users and eight per 1,000 person-years for nonusers.

The numbers of HRT users who developed cancer in the opposing breast were felt to be too small for strong statistical conclusions. However, the authors noted that the finding about cancer in the other breast reinforces the need for caution in assessing the overall impact of HRT after breast cancer.

An editorial in the journal also advised caution in interpreting the results. These results must be considered preliminary, the editorial said. Two large studies investigating questions about HRT and breast cancer are under way in Sweden and in Britain.

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New drug to combat breast cancer being developed-(Times of India Online-16/05/2001)

Scientists have proved that a new non-steroidal anti-inflammatory drug (NSAID), Celecoxib, considered less toxic than other NSAIDs, prevents breast cancer in female rats, suggesting that the drug may be used to prevent breast cancer in humans.

Anti-inflammatory effects of the NSAIDs result from blockage of prostaglandin (physiologically active compounds) cascade through inhibition of an enzyme called cyclooxygenase (COX). Two genes - COX-1 and COX-2, control production of cyclooxygensae. Studies show the prostaglandin cascade is linked to the deregulation of biosynthesis of estrogen, a female sex hormone, which plays a role in manifestation of breast cancer. Conversion of the COX-2 gene to its active form results in excess production of prostaglandin and also estrogen biosynthesis.

Aberrant turning on of COX-2 gene can induce mammary cancer by formation of blood vessels in tissues, inducing cell division and by mutation through free radical formation. To study the preventive aspects of Celecoxib, which specifically inhibits COX-2 and has significant anti-inflammatory and analgesic properties but lesser toxicity than Aspirin and Ibuprofen, researchers from the Ohio State University College of Medicine and Searle Monsanto Research and Development fed three groups of mice on simple food, food supplemented with Celecoxib and food supplemented with Ibuprofen separately.

After seven says, each group was given a single intragastric dose of dimethylbenz(a)anthracene (DMBA), a cancer inducing agent, and 28 days later, each animal was examined for appearance of tumors.

Reporting their findings, scientists Randall E Harris, Galal A Alshafie, Hussein Abou-Issa and Karen Seibert said 127 mammary tumors were excised from control animals. From animals receiving Ibuprufen, 61 tumors and from those receiving Celecoxib, 18 tumors were excised. Of the 18 tumors three were non-malignant. Thus, Celecoxib produced striking reductions in the incidence of mammary cancer, tumor burden and tumor volume. In this group, only 13 of the 40 animals developed malignant tumors. Besides, tumors were relatively small, they said. In contrast, 100 per cent of control animals had malignant tumors and majority had multiple large size tumors.

Ibuprofen also produced significant reduction in cancer risk, tumor burden and size, but its effects were of lesser magnitude than those of Celecoxib. The administration of both the NSAIDs also prolonged the latency period of tumor induction as in control animals tumors were detected after about 58 days of DMBA input while in Celecoxib and Ibuprofen treatment groups, tumors were detected after about 95 and 86 days respectively.

Celecoxib or Ibuprofen did not produce any toxic effects like weight loss, gastrointestinal ulceration or bleeding, the scientists said, underscoring the need to investigate efficacy of specific blockade of COX-2 gene as a potentially effective approach to chemoprevention of this disease.

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Women to be warned of abortion-cancer link-(Times of India Online-08/05/2001)

Massachusetts is joining other states in considering legislation that would require doctors to tell women they may be at greater risk for breast cancer if they have an abortion. However, both the American Cancer Society and the National Cancer Institute have concluded that any relationship between abortion and breast cancer is unproven.

Anti-abortion groups support the bills, which they say are intended to provide women with valuable health information, while pro choice advocates say the warning is a scare tactic designed to pressure women to abandon abortions.

"It's important for women to know what abortion is and what it can do to them," said Maryclare Flynn, executive director of Massachusetts Citizens for Life. "It's not an easy procedure. They need to know all the facts."

Flynn and other supporters of so-called "women's right to know" legislation say cells produced during pregnancy can turn cancerous if the pregnancy is ended.

Abortion activists say the bills are assaults on the right to abortion.

"Attempts to link abortion to breast cancer are part of a broader campaign by those who oppose abortion to stigmatise abortion," said Melissa Kogut, executive director of the Massachusetts chapter of the National Abortions Rights Action League.

Some studies investigating possible links have shown a small increase in risk, while others have not shown any risk associated with either induced or spontaneous abortions.

The most common risk factor for breast cancer is age, according to the National Cancer Institute. Other factors include a family history of breast cancer, late age at menopause, late age at the time of the first full-term birth of a child, and certain breast conditions.

Lawmakers in at least 16 states are considering similar bills, according to the National Abortion Rights Action League, which opposes the legislation. Mississippi is the only state with a law in effect, according to the National Conference of State Legislatures.

The Massachusetts bill was set to be heard by a legislative committee Monday, and would require doctors to give women "a written summary of current information linking abortion to breast cancer in certain women."

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Study: Breast implants cancer-safe-(Times of India Online-28/04/01)

Women who have had silicone breast implants do not face an increased risk for most cancers, according to a National Cancer Institute study of 13,500 women who had implant surgery for cosmetic reasons. The findings are generally reassuring and help lay to rest much of the concern about silicone breast implants.

The study compared the incidence of cancer between women who had received cosmetic breast implants and 4,000 other women of similar age who had received other types of plastic surgery. Health histories for the patients covered an average of 13 years, much longer than most of the earlier breast implant health studies.

Early studies had shown that a comparison between breast implant patients and those receiving other cosmetic surgery was the best way to determine the specific effects of the silicon implants. Incidence rates for nearly every cancer were not elevated among the implant patients. This included cancers of the mouth, stomach, large intestine, breast, cervix, uterus, ovary, bladder, thyroid, connective tissues and immune system. There were slightly elevated rates of cancer for the respiratory system and brain, but there is no clear connection between these cancers and the silicon implants. Only the difference in respiratory cancer rates reached "statistical significance" principally because of lung cancers.

There were 33 lung cancers among the implant patients, compared to 13 among the other cosmetic surgery patients, but the connection of this cancer to implants is not clear. The cause of death for these patients was obtained from death certificates and it was not possible to determine the smoking habits of the deceased. Smoking is known to be the leading cause of lung cancer.

Between 1.5 and 2 million women have received breast implants since 1962, about 80 per cent for cosmetic reasons and the rest as breast reconstruction after cancer. The study did not include women who had received implants following breast cancer.

The study follows an earlier study that found no increased risk for breast cancer among patients who received implants. Further analysis of the study data will evaluate risks linked to other causes of death and to the risk of connective tissue disorders among implant patients.

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Mammograms help live longer: Study-(Times of India online-25/04/2001)

Women who get regular mammograms may reduce their risk of dying from breast cancer by more than 60 percent, about twice the amount seen in large formal studies, according to a new analysis by the American Cancer Society. While there is little argument that mammograms are worthwhile, especially for women after menopause, the study suggests they may do substantially more good than most experts had assumed up to now.

Seven landmark studies in North America and Europe have shown that mammograms save lives. Together, they suggest regular screening lowers the risk of breast cancer death by about 30 percent. However, these studies, conducted mostly in the 1970s and 1980s before mammograms became routine, may have underestimated the true benefit.

Some women in the studies who were offered screening refuse to get mammograms, while others in the unscreened comparison groups sought out mammograms on their own. This diluted the difference between those who got mammograms and those who did not. The latest analysis sought to see what happened to those who actually get mammograms. It was conducted in two counties in Sweden where the use of these screening tests is very high.

It found that those who comply with screening recommendations reduce their risk of dying from breast cancer by 63 percent when compared to the early 1970s, when mammograms were not routinely done.

Some have questioned whether improving breast cancer survival results from catching the disease earlier through screening or from better treatments. The data suggest that screening accounts for nearly all the benefit. This is because no significant increase in survival is seen over time in either breast cancer patients who are too young for mammograms or among older women who refuse to get them. The contribution of treatment advances is there. But a large part of the improvement is related to the screening benefit.

The study was based on 6,807 women aged 20 through 69 who were diagnosed with breast cancer over 29 years in the Swedish counties of Dalarna and Ostegotland. Of these, 1,863 died of the disease. The researchers compared mortality rates in three time periods: 1968 to 1977, before mammograms were introduced; 1978 to 1987, when mammograms were offered to half of the women in the two counties in a large study; and 1988 to 1996, when mammograms were available every two years to all women over age 40.

During the most recent period, 85 percent of the women got regular mammograms. By comparison, it is estimated that between 50 percent and 60 percent of U.S. women get mammograms that frequently.

Looking only at women who get screened opens the possibility of what researchers call selection bias. The worry is that those who get mammograms are already healthier than those who do not. It's their good habits, not their mammograms, that make them live longer. However, this is unlikely to have made a big impact on the reduction seen in the study. When the researchers look at all women in the two counties, not just those who got mammograms, the risk of dying from breast cancer has fallen 50 percent since the 1970s.

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New early detection procedure benefits women at high risk of breast cancer-(Cancer Info-25/04/2001)

Magee-Womens Hospital is beginning to offer an innovative test that can identify atypical cells deep in the breast that years later may develop into cancer. Intended only for women at high risk for breast cancer because of family history or other factors, ductal lavage is a new way to collect cells from inside the milk duct, where most breast cancer begins.

Ductal lavage is not a screening tool and should be used only as an adjunct to mammograms and physical breast exams, but high-risk women would be ideal candidates for the procedure. The brief procedure can be done in a doctor's office or outpatient clinic. Lavage is a French term that means "wash" or "rinse". Since the Food and Drug Administration approved the catheter last year, the test has become available at about 70 centers across the US.

Scientists have known that production of fluid in the milk ducts (when women are not pregnant or lactating) can be a warning sign for breast cancer, but until now doctors did not have an effective way to retrieve that fluid. The test has been compared to a Pap smear, in which cells are collected from the cervix to detect early changes that might lead to cervical cancer.

Breast cancer develops over eight to 10 years. If atypical cells are detected, it will give women more time to make better and informed decisions on treatment. You don't have to panic now. Women can reduce the chances of developing invasive breast cancer by 86 percent by finding these atypical cells early.

Most women have six to nine milk ducts in each breast. Each duct has a tiny opening on the surface of the nipple. Milk comes through these openings when a woman breast-feeds. The procedure is performed only on fluid-producing ducts because they are the most likely places to find abnormal cells. In fact, studies show that fluid production indicates a doubled risk for developing breast cancer.

Kim Edeus, 35, of, Murrysville, was one of the first women tested last week at Magee. Her mother died of breast cancer at age 32, when Edeus was only 9. Edeus has had a couple of breast biopsies that so far have showed no sign of cancer. Doctors began by applying an anesthetic cream to numb each nipple area a half-hour before the procedure. Then Edeus massaged her right breast to encourage ductal fluid to move toward the nipple. A little fluid appeared from one of the ducts, which helped doctors locate the opening in the nipple. A suction cup device that looked like a small breast pump to the nipple is placed to draw more fluid from the duct. Then a catheter, a flexible tube about the width of two human hairs, is inserted into the duct. The catheter delivered additional anesthetic to numb the inside of the duct. After the duct was numbed, 2 to 4 teaspoons of saline is sent through the tube to wash out cells along the way. The doctor then pressed on the breast to push saline, now containing thousands of duct cells, back out of the breast. Her left breast yielded no fluid, so the procedure was not performed there. The sample was sent to a laboratory, where results were expected in 48 hours. Edeus winced a bit when the catheter was inserted, but said the sensation was similar to the pinch you feel in your skin when giving a blood sample. Most women say the procedure is not painful. Not all atypical cells will develop into cancer, but studies show that women with atypical cells and a family history of breast cancer face an 11 to 22 times increased risk of developing the disease. If atypical cells are detected, patients may choose to begin treatments of tamoxifen, which blocks the growth of breast tumors that are sensitive to estrogen. If malignant cells are found the patient could opt to have the duct removed, he said. One of the benefits of ductal lavage is that it can be easily repeated, even given annually like a mammogram, to monitor changes in the breast. However, the procedure will not work on all women since there is no guarantee that the cells can be harvested from the breast.

With the new technology, researchers are looking at the possibility of one day delivering medication through the ducts to treat breast conditions.

You can learn more about the procedure at www.ductallavage.com

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Japan approves sale of the breast cancer treatment-(Times of India Online-05/04/2001)

Japan had approved sale of Herceptin, a breast cancer drug produced by the Swiss firm Roche, the company said on Wednesday. Almost 34,000 new cases of breast cancer were diagnosed each year in Japan. International studies showed Herceptin prolonged the lives of women with widespread breast cancer by an average of 24 per cent.

It was discovered and developed by Genentech, a US biotechnology firm controlled by Roche. Herceptin was approved for sale by US drug officials in 1998.

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Treatment at home for cancer patients-(Cancer Info-03/04/2001)

Rural women whose breast cancer has spread to their bones will benefit from a new medication that lets them treat themselves at home instead of going to a hospital. The one-third of breast cancer patients whose cancer has spread to the bone, and is attacking it, have been treated for bone loss via an intravenous drip medicine. This involves a one-day hospital stay each month. But from today sufferers will be able to take an oral medication, Sodium Clodronate, or Bonefos, which could save them hours in travel time away from their families.

Bonefos was developed in Finland but has been tested on hundreds of Australian patients. It comes from the same class of drugs used to treat osteoporosis but is of higher potency. If left untreated cancer cells can cause fractures, intense pain and shrinking and put pressure on the lungs, bowel and kidneys. The most common bone attacked is the vertebrae, pelvis and ribs.

The medication prevents bone loss where cancer has already spread to the bone. It is also being tested by British, Scandanavian and Canadian researchers to determine if it prevents breast cancer spreading to bone in the first place.

The results are said to be promising and will be published in the next few months. Bonefos will be listed on the Pharmaceutical Benefits Scheme next month. Its side-effects are fewer than the previous intravenous treatment, but it still causes constipation and nausea in 5 per cent of patients.

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Five years of tamoxifen after mastectomy is enough-(Times Of India Online-01/04/2001)

Women with breast cancer treatable by surgery need only take the drug tamoxifen for five years to prevent a cancer recurrence. Taking the drug for a longer period of time seems to add no extra benefit in terms of preventing a return of cancer.

The study included 1,323 women with breast cancer who received tamoxifen beginning immediately following mastectomy. Eligible patients in the tamoxifen group who were disease-free at five years were randomly assigned to continue taking tamoxifen or to stop taking it. Followup of these patients revealed that the benefits of tamoxifen therapy lasted for at least 15 years, but it wasn't necessary for women to take the drug for more than five years to get the benefit. Further studies may be able to determine the optimal duration of tamoxifen therapy, but in the meantime prescribing tamoxifen for five years seems reasonable, they say.

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Breast cancer risk often misinterpreted-(Times of India Online-31/03/2001)

Statistics commonly used to describe a woman's lifetime risk of developing breast cancer may be misleading, causing women to feel unnecessarily anxious. Instead, shorter-term projections broken down by race and age may be more valuable.

For instance, many groups have reported that a woman's lifetime risk of developing breast cancer is 1 in 9, but how relevant is this statistic to an individual woman's life?

Lifetime risk is the likelihood that a newborn girl will develop breast cancer sometime during her entire life. The 1-in-9 statistic does not apply to women of all ages.

In an effort to clear up the confusion, the study authors estimated the risk of developing breast cancer within the next 5, 10 or 20 years for women currently aged 30 to 70 years in four major ethnic groups--Asian/Pacific Islanders, Hispanic, African American and Caucasian. The researchers note that they made their calculations based on California statewide data. They found that a 30-year-old woman has a 2 per cent (1 in 50) chance of being diagnosed with breast cancer in the next 20 years, while a 40-year-old has a 4.5 per cent (1 in 20) chance.

The investigators also found that a 50-year-old woman's risk of developing invasive breast cancer-the most serious kind-in the next 5 to 20 years ranged anywhere from 1 in 15 to 1 in 133, depending on her ethnicity.

For women currently aged 50, the estimated risk of developing invasive breast cancer within 5 years varied from 0.8 per cent (1 in 133) among Hispanics to 1.3 per cent (1 in 75) among Caucasians. Within 20 years, estimated risks increased to 6.6 per cent (1 in 15) among Caucasians, 5 per cent (1 in 20) among African Americans, 3.9 per cent (1 in 26) among Asian/Pacific Islanders, and 3.7 per cent (1 in 27) among Hispanics.

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Breast-Cancer Treatment Varies by Age-(Cancer Info-22/03/2001)

Most elderly female breast-cancer patients in the early stages of the disease do not undergo proper treatment, according to a recent study. The research examined 718 women age 67 and older with breast cancer. The study found that only half of the women who chose a lumpectomy over a mastectomy were recommended for radiation treatment, the standard method to keep the disease from coming back after breast conservation surgery. The numbers were even lower for women age 80 and older: Only 38 percent of women in that category were recommended for radiation treatment. With no radiation therapy after a lumpectomy, there is a 40 percent chance among postmenopausal women that the cancer will reoccur within 10 years.

Black women who participated in the study were half as likely to receive radiation treatment after undergoing a lumpectomy. The authors did note that there were not enough black women in the study to make the findings statistically significant, but they referred to other studies with similar findings.

The data are inconclusive as to whether doctors are biased against the elderly women or the women are just not following doctor's orders. It is important for doctors to understand their patients' needs and goals. They should explain to women that if they prefer to have a lumpectomy they need radiation treatment. If a woman doesn't want to have radiation, then she needs a mastectomy.

A study is under way to see whether the use of tamoxifen, a cancer treatment and prevention drug, after a lumpectomy is just as effective as radiation treatment. Many more women would choose the tamoxifen treatment if it proves effective, since radiation can produce fatigue, swollen, heavy breasts and burns on the breast.

Of the annual new cases of breast cancer, 50 percent are in women 65 years or older. Since elderly women are the fastest growing population in the United States, the study's authors recommend that more research focus on the best treatment for those stricken with breast cancer.

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Light may help detect breast cancer-(Times of India Online)

For more than half a century, doctors and scientists have been intrigued with the idea that light might be a better way to detect breast tumors. Researchers are working on a prototype machine that shines invisible laser beams through a woman's breast without ever touching it. This and other projects worldwide have raised hope for an alternative to the squeezing, pressing X-ray mammogram, derided by some women as the "slammogram."

The problem is that light scatters wildly inside breast tissue and the tissue's density poses some unique viewing challenges. The difficulty is to find the wavelength to isolate the cancer. The new machine uses a laser diode that shines infrared light through a breast at 16 different points. A computer analyzes the pattern of photons the quirky part-particle, part-wave building blocks of light to reconstruct an image of the breast's interior.

Out of 10 women in the first clinical trials, the system found five malignant tumors and one that was benign. They were confirmed by biopsies and were as small as 5mm, about the size of an average pinky fingernail. Mammograms usually cannot detect lumps any smaller than 1cm.

In 1929, Dr. Max Cutler was one of the first physicians to shine a light bulb through a woman's breast. But the process, known as translumination, produced faded images and was unsuitable for diagnosis. Translumination was later reborn as diaphanography. Scientists used infrared light to try and see breast cancers, but succeeded only in detecting large tumors near the surface. Today's scientists still use infrared light but now have the added advantage of computer programs that mathematically translate the photon pattern of the breast into an image.

X-ray mammography is the only breast-cancer screening system now approved by the federal Food and Drug Administration. Other methods, ultrasound and magnetic resonance imaging among them are used to follow up if a suspicious lump is detected.

The attraction of a light-based system is to give women, especially younger women with dense breast tissue, a safer, cheaper, noninvasive method. During testing, a patient is face down on a scanning table as laser beams rotate horizontally around the breast and a computer program translates the light pattern into an image.

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Drug combo prolongs breast cancer survival-(Cancer Info-10/12/2000)

For the first time, a combination drug treatment has produced longer survival rates in women in the general population with advanced breast cancer than those taking only Taxotere, the current ``gold standard'' treatment. Women with advanced breast cancer were shown to live an average of 2.6 months longer and with slower progression of the disease when they took a combination of Roche Holding AG's Xeloda and Aventis SA's Taxotere than when they took Taxotere alone, according to the 511-patient trial.

An extra few months of life might not sound like a lot, but it's a giant leap when you consider that 44,000 women die and 195,000 are diagnosed each year with breast cancer in the United States. Patients on the combination therapy not only live longer but report having a better quality of life.

The 16-nation trial recruited women with metastatic breast cancer - cancer that has spread to other parts of the body. All had relapsed or failed to respond to another class of cancer drugs called anthracyclines used as first-line treatment, including adriamyacin.

Half the patients had a series of regimens for over a year that included only Taxotere (docataxel), in 100-milligram injections once every three weeks. The other half received both Taxotere and Xeloda -- one 1250-mg Xeloda pill (capecitabine) twice a day for 14 days, and 75-mg injections of Taxotere once every three weeks. Patients receiving the combination therapy survived a median of 13.7 months, compared with 11.1 months for those taking only Taxotere, a difference that is statistically significant.

Also, the study showed that progression of disease took longer for women on the combination therapy -- 6.1 months compared with 4.2 months for the Taxotere-only group, a result that was also statistically significant. Patients in both groups tolerated their treatments well.

Those on Taxotere alone had side effects typically seen with chemotherapy drugs, including a reduction in white blood cells that puts patients at greater risk of infection, as well as fatigue and hair loss. The group taking both Xeloda and Taxotere had more diarrhea and mouth sores, but reducing dosage of the drugs eased the side effects.

Swiss drugmaker Roche launched Xeloda in the United States in 1998 as the only oral chemotherapy agent for breast cancer.

Taxotere is a member of the taxane family of cancer drugs that also includes Bristol-Myers Squibb Co's Taxol. The Aventis drug is approved for treating breast cancer patients after chemotherapy has failed.

Only one other drug combination, of Taxotere and Genentech Inc.'s monoclonal antibody Herceptin, has been shown superior to Taxotere alone in prolonging lives of women with advanced breast cancer. But that combination is only appropriate for about 25 or 30 percent of patients, the proportion of women in the general population that have an inherited mutation in the so-called ''Her2'' gene. Herceptin is only used to treat women that have been confirmed to have the mutation, which considerably increases the risk of developing breast cancer.

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Flax seed muffins 'fight breast cancer'-(Cancer Info-10/12/2000)

Muffins coated with seeds from the flax plant may be able to hold back the growth of breast tumours. It has been suggested that increasing dietary intake of products containing flax-seed could even prevent the disease. However, his study involved only 25 women eating his flax seed muffins, and he has called for more research to be carried out to prove his theory.

The muffins included 50 grams of ground flax seed - other patients were given normal muffins to compare the results. The women's breast tumours were later removed to see how fast the cancer cells were growing. The group eating the flax seed muffins had tumours, which were growing significantly less than the others. This inhibitory effect had been suggested beforehand by studies using animals. This encourages researchers to believe this is a very significant biological effect in women and that we are heading towards more definitive proof that dietary flax seed may prevent breast cancer. The results are exciting because this is the first time anyone has demonstrated these changes in breast cancer with any dietary component.

The different varieties of flax cultivated commercially are used either to make clothing, or as an edible foodstuff when ground down. Many health claims have been made on behalf of edible flax seed, including protection from heart disease and stroke.

However, it is difficult to draw any certain conclusions from this study alone. In this case further research with larger studies must be carried out before flaxseed is more widely used. The power of the chemical ingredients of flax seed, especially if ground up, has led some doctors to warn against patients supplementing their diets with it unless they have a high cancer risk.

Flax seed contains rich concentrations of the plant version of the human hormone oestrogen. Animals fed large amounts showed abnormalties in prostate glands and ovaries in some experiments, and doctors have warned against taking lots of flax seed during pregnancy.

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Cell Suicide System Out Of Whack In Breast Tumors-(Cancer Info-22/11/2000)

Many breast tumours contain a flaw that derails the body's mechanism for destroying abnormal cells, researchers have found. Normally, the appearance of a cancerous or damaged cell triggers a chain of events that result in the cell's destruction. This process is called apoptosis, or programmed cell death. Now it has been found that the gene TMS-1, which participates in apoptosis, is silent in many breast cancer cells. Investigators found this abnormality in 40% or 11 of 27 breast tumors.

TMS-1 appears to have been shut down because of a mistake in the body's system for tagging genes. Those that should be "off" are tagged with a chemical reaction that adds a methyl group to the gene, a process called methylation. Those that stay "on" have no tag. It was found that TMS-1, which should always be on, is sometimes mistakenly tagged and shut off. The abnormal methylation of the gene may play a role in making cells less able to delete themselves and abnormal could promote tumorigenesis.

The good news is that methylation is reversible and drugs can be used to turn TMS-1 back on. Researchers have been able to do this with breast cancer cells in the laboratory.

The trick in patients will be to find a drug that specifically removes TMS-1 methylation without affecting other genes.

It may be more useful to use TMS-1 to predict whether a person will respond to treatment with chemotherapy or radiation, rather than to find any new type of treatment. Many types of cancer treatment-including chemotherapy-work by inducing apoptosis, and these treatments could be less effective in patients with a genetic flaw that halts this process in its tracks. It is not clear whether the shutdown of TMS-1 causes cancer growth or is a byproduct of this growth.

Methylation is a system for adding information to chromosomes, but it is not a basic part of the genome, so it is not inherited. However, when a cell with an abnormally methylated TMS-1 gene divides, its progeny will have this abnormality as well. The abnormality in TMS-1 results when there is too much of a certain methylating enzyme in the body. This enzyme, DNMT-1, is one of the enzymes responsible for adding methyl tags to genes.

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Study says computers can help detect breast cancer –(Cancer Info-28/11/2000)

Using computers to double-check mammograms can increase the detection of cancers by 20 percent, according to a study. The findings based on mammograms given to nearly 13,000 women suggest the technology can help radiologists find breast cancers earlier while improving their accuracy. Radiologists miss about one in five breast cancers. Since the signs can be extremely subtle, computer-assisted detection helps to recognize those signs, such as minute calcium deposits, or very subtle masses or changes in architecture.

The $200,000 ImageChecker system used in the study was approved by the Food and Drug Administration two years ago based on preliminary research showing success rates similar to Freer's. It is the only such technology with that approval. The system works with the regular X-ray image taken in a mammogram. The film is run through a computer processor that creates a digital image. The computer, "trained to recognize certain subtle patterns," scans the image and marks suspicious-looking areas, which invites the technician to take a closer look.

In the study of 12,860 women screened, 49 unsuspected cancers were detected, including eight picked up by ImageChecker that the radiologist had missed. All eight were in very early stages, when they are most easily treated.
The number of women asked to return to the radiologist for more tests and the biopsy rates also increased by 20 percent. Though some of those were false alarms, the increases were proportional to the increases in cancer detection and were thus considered acceptable. More research is needed before such computer-assisted methods can be recommended as a routine screening tool.

Only about 150 units are used worldwide, but even if other studies find similar results, cost will impede widespread use of computer-assisted detection. Mammograms typically cost between $75 and $150. At large centers, computer-assisted detection could add as little as $15 to the tab. But at smaller centers, costs could be substantially more.

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Urban Lifestyle Primary Cause of Breast Cancer- (Times of India-22/11/2000)

Mumbai has the highest incidence of breast cancer amongst the four metros. 29 out of every 100,000 women suffer from breast cancer. One out of every 32 urban women and one out of every 52 rural Indian women develop breast cancer in their lifetime. Women under 35 are at a lower risk, but the latest observation shows that they too are increasingly suffering from the disease.

In another 20 years, a 200% increase in numbers is expected and India may equal figures in the US where one out of every eight women have breast cancer.

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Life-saving breast cancer drugs underfunded – survey-(Cancer Info-26/10/2000)

One in three health authorities in the UK is not giving hospital cancer units the funding they need to supply potentially life-saving new breast cancer drugs, according to a new survey. Some hospitals are facing a cash crisis and specialists are using their own budgets to ensure patients get the taxane drugs, a cancer conference was told. And spending on other cancer treatments is being cut to fund supplies of the breast cancer drugs.

Despite the establishment of the National Institute for Clinical Excellence (Nice), which was supposed to end postcode prescribing, there are still wide regional variations in the prescribing of expensive drugs. Earlier this year, Nice recommended that taxanes, a new type of expensive but highly effective breast cancer drug, should be made available on the NHS for patients with advanced forms of the disease. But a nationwide audit of NHS cancer services for the Campaign for Effective and Rational Treatment (CERT) found that while individual units were using the drug, there was still uncertainty over health authority funding for taxanes.

It found that one in three health authorities in the UK has still not adequately funded the use of taxanes. Hospital cancer units are prescribing the drugs, but the money has still not filtered down from the health authorities. Around one in nine health authorities may have reduced the budgets or use of treatments for other tumour types in order to fund the use of taxanes in ovarian or breast cancer, the audit found. Drugs for both these cancers will be reviewed by Nice in the next year.

But the Government's "cancer tsar" Professor Mike Richards said: "Everybody who should be treated with taxanes is receiving them. "We have contacted all the NHS trusts and health authorities in the CERT survey. They have all told us that in fact they are not having any problems. The CERT survey is complete rubbish and presents a totally misleading picture." The survey contained inaccuracies and also covered hospitals in Scotland and Northern Ireland not covered by the Nice guidance, Prof Richards said.

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Chances of Breast Cancer Depend on Lifestyle-(Times of India-18/10/2000)

October 9^th was commemorated at Breast Cancer Awareness Day. Tata Memorial Hospital conducted free check-ups for women throughout the month. Around 80,000 new cases of breast cancer are diagnosed each year in India and 30,000 die of the disease. This disease has been the leading cause of death among women in developed countries for decades and the same pattern is being observed in developing countries like our own.

Aging has been cited as the greatest risk factor with over 75% being over 50. Family history also increases the risk. Other women who are at risk are those who began menstruating before the age of 12, those who had no children and those who had their first child after the age of 30. Women who reach menopause after the age of 50 are also at risk. Long term use of the hormone estrogen, especially if without medical supervision can increase risk. Lifestyles like use of alcohol, obesity and even exposure to pesticides are known to increase the risk of breast cancer.

Early detection improves chances of treatment. Women should perform a breast self-examination every month to check for lumps and abnormal changes. They should get examined by a doctor annually or immediately on noticing changes in the breast. Mammograms and X-rays should only be taken on a doctor’s advice.

If a cancer is detected early only the lump must be removed, but in advanced cases, the entire breast may have to be removed. Treatment is by surgical removal of the lump along with regional lymph nodes, followed by radiation and chemotherapy. An anti-estrogenic drug is usually given for a few years to prevent recurrences.

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Second-hand smoke not linked to breast cancer risk-(Times of India-18/10/2000)

A large study of non-smoking women whose husbands were smokers has found no link between exposure to second-hand smoke and death from breast cancer, contradicting previous findings. As expected, exposure to spousal smoking was associated with an increased risk of lung cancer and heart disease.

The researchers examined the medical histories of nearly 150,000 women over a 12-year period during which 669 women died of breast cancer. The investigators assessed breast cancer death rates among women whose husbands smoked and compared them with those seen in women married to men who had never smoked. The strength of the study lies in the fact that it included a very large number of women with breast cancer. Previous studies had used a much smaller number. However, data did show that women exposed to second-hand smoke under the age of 20 may be at increased risk of dying of breast cancer.

Breast cancer is fundamentally a hormonal disease and there is not a single risk factor. This is why screening is so important.

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Older Birth Control Pills Linked to Breast Cancer-(Cancer Info-10/10/2000)

Although birth control pills have been only weakly linked to breast cancer in some studies, new research shows that the hormone-heavy pills used 25 years ago may have significantly increased breast cancer risk among women with a family history of the disease. In a study of 426 families, investigators found that oral contraceptive use tripled breast cancer risk among women with sisters or mothers who had the disease. The risk was confined to women who used the Pill prior to 1975. Since then, birth control pills have evolved to include lower doses of estrogen and progestin, which should make them safer in terms of breast cancer, researchers suggest. There is currently no evidence that these newer formulations increase breast cancer risk.

The link between breast cancer and the Pill was strongest among women with five or more cases of breast or ovarian cancer in their families. In these 35 families, Pill use was linked to an 11-fold increase in breast cancer risk.

The research team looked at both breast and ovarian cancer because the presence of both diseases in a family suggests that women may be genetically predisposed to breast cancer. These findings suggest oral contraceptives may pose a risk for a subset of women who are strongly predisposed to breast cancer.

However, the question of whether high-risk women should use new formulations of the Pill has no 'yes-or-no' answer. For example, women who are genetically susceptible to breast and ovarian cancer face a complex decision because the Pill appears to cut ovarian cancer risk. Ovarian cancer has a poor prognosis because, unlike breast cancer, it is rarely caught early. Moreover, there is no evidence that link an increased breast cancer risk with current formulations of the Pill. What is important is that studies continue to follow high-risk women to make sure the new incarnations of the Pill are indeed safe.

The report notes the complexities surrounding the Pill decision. The Pill should be seen neither as an established way to reduce ovarian cancer risk, nor as a wrong choice for women with a family history of breast cancer. Rather the use of oral contraceptives needs to be considered on an individual basis, taking into account all of a woman's health concerns.

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Breast Reconstruction During Mastectomy Boosts Well-Being-(Cancer Info-03/10/2000)

Women who have a breast reconstructed after a mastectomy gain large improvements in their emotional, social and functional well-being, regardless of the technique or timing they choose for their reconstruction.

But the biggest psychological boost, the study shows, comes to those who opt for reconstruction during the same operation as their mastectomy, rather than those who have reconstructive surgery later. Choosing implants or the patient's own tissue makes only small differences.

The study surveyed 250 mastectomy patients at 12 medical centers in the U.S. and Canada. The surveys were done twice: days before and a year after their reconstructive surgery by one of 23 surgeons. Most of the women - 184 - had breasts made from their own tissue, using one of two variations of an operation called TRAM reconstruction. The rest had artificial tissue expanders or implants filled with saline or silicone. Two thirds, or 161 patients, had reconstruction during mastectomy surgery.

The two hour-long take-home surveys evaluated the women's emotional well-being, vitality, general mental health, social functioning, functional and social well-being, and body image. After reconstruction, they were also asked about their satisfaction with their surgery. The results were compared among the groups that chose different reconstruction approaches and timing.

Results showed that breast reconstruction meets its goals of improving patients' well-being and promoting their recovery.

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Breast cancer risk influenced by estrogen exposure-(Times of India-26/09/2000)

The timing of estrogen exposure during a woman’s life span may affect her risk of breast cancer. An increase in risk is seen if the exposure occurs during the fetal period, pregnancy or menopause. But a childhood exposure decreases breast cancer risk.

The studies conducted on animal models also investigated whether diet including dietary fat and soy during fetal life, childhood and pregnancy increased breast cancer risk.

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Everything happens for the best-(Bombay Times-07/09/2000)

Prayer doesn’t necessarily change things for you. It changes you for things. With her faith pinned to God and her life revolving around the Bible, 47-year-old Dolly Veena Jacob is living life to the hilt and enjoying every bit of it despite being afflicted with cancer.

"Life’s tragedies too have their won lessons to impart. Had it not been for my breast cancer I would probably not have learnt about a positive attitude and a mentally strong outlook towards life. The illness has also taught me to forgive those who have hurt me as well as to submit myself entirely to God.

Certain signs and symptoms of cancer can be a tad depressing. Like the loss of hair in women. Moreover, some women feel it’s a loss of womanhood to lose a breast, but one has to learn to overcome these things.

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Update on Breast Cancer-(Times of India-25/08/2000)

Breast cancer survivors need to be evaluated for osteoporosis. Researchers found that survivors are at increased risk for osteoporosis because they are more likely to undergo early menopause caused by chemotherapy. Postmenopausal patients should seek periodic screening. Such patients cannot take the standard estrogen therapy for prevention and treatment of osteoporosis, but should supplement their diet with calcium and vitamin D and get regular activity that helps to build bones. Other drugs like alendronate, raloxifene and calcitonin may also be considered.

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Potential breast cancer suppressor identified-(Times of India-18/08/2000)

A protein which could potentially suppress the formation of malignant breast tumours in humans has been identified. The SYK enzyme, a substance that promotes chemical change is commonly present in normal human breast tissue and is benign. It is only present at very low levels in a specific type of breast tumour, called an invasive tomour.

The growth of the tumour can be suppressed by reintroduction of SYK into tumour cells, raising the possibility of a new way of treating invasive breast cancer.

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Scientists identify new gene for breast cancer-(Cancer Info-16/08/2000)

Scientists may have identified the gene responsible for up to one in 30 of breast cancers, it was announced yesterday. An international team of doctors is racing to find the exact area of chromosome where the gene is located. Two genes, BRCA1 and BRCA2, are known to have a strong influence on the disease. Most women who inherit the genes will develop breast cancer by 70, they have an 80 per cent chance of getting it. About one in 100 women will get the disease because of their genes, but scientists knew that BRCA1 and BRCA2 accounted for only half the cases.

Scientists have now located what looks like a very good region to search for a third breast cancer susceptibility gene. If these results are confirmed, this new gene could account for up to one third of the hereditary breast cancer cases that cannot be explained by BRCA1 or BRCA2. The finding will help thousands of women suspicious that they are carrying the cancer gene. If they prove positive, they can have mammograms and preventive drugs.

To explain the family-linked cases that did not involve BRCA1 and BRCA2, they examined 37 tumours from breast cancer patients who did not have the known gene mutations. Having the human genome sequence - finished earlier this summer - will help a great deal in homing in on the gene on chromosome 13.

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Update on breast cancer-(Times of India-01/08/2000)

Breast conserving therapy is as good as mastectomy in large tumours. Research has shown that breast tumours that are smaller than 2 cm do not require a modified radical mastectomy and can be effectively treated with "breast conserving therapy", cnsisting of lumpectomy surgery to remove the tumour, radiation and sometimes chemotherapy.

The present study evaluated treatment for tumours as large as 5 cm and found that breast conserving therapy was as effective as radical mastectomies for overall survival. It was noted that patients who had breast-conserving therapy did have larger numbers of cancer recurring in the breast or nearby, but that these recurrences did not cause a difference in overall survival.

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Preventive Mastectomy Often Leads to Long Term Satisfaction -(TOI-28/07/2000)

Women who are at high risk for breast cancer because of family history sometimes seek mastectomy of both breasts before the disease strikes. Such a procedure lowers the risk of breast cancer by about 90%. This study by researchers at the Mayo Clinic questioned more than 500 women who had undergone such a procedure between 1960 and 1993 to learn what psychological effects it had. 70% of the women said they were satisfied with the procedure, 11% were neutral and 19% were dissatisfied.

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Breast cancer patients in US are a happy lot after surgery-(Economic Times-24/07/2000)

A study of 572 women who decided to have a double mastectomy because of a family history of breast cancer has found that most were satisfied with their life afterward.

Most women had a subcutaneous mastectomy in which the nipple is left in place for reconstruction purposes. Today women electing to undergo the preventive mastectomy would have a total mastectomy in which the entire breast is removed. Advances in surgical reconstruction do not require the earlier partil technique which retained perhaps 5% of the original breast tissue.

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Hot Flash Relief-(Time-17/07/2000)

Hormone replacement therapy is designed to make up for the body’s lowered estrogen output during menopause. But many of these women also know that HRT has been linked to an increased risk of breast cancer. There is therefore a great interest in alternative therapies. Unfortunately, there is little hard evidence to support the use of most hot-flash remedies sold in health food stores. In scientific testing, soy isoflavones show as much as 45% reduction in hot flashes, but placebos seems to be equally effective.

Doctors conclude that 80% of women who experience hot flashes are over the hump within 18-24 months. They could get away with taking hormones for that period without increased breast cancer risk.

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Just being upbeat won’t beat cancer-(Times of India-04/07/2000)

Extensive research with late stage breast cancer patients at Sydney’s prestigious Royal North Shore Hospital failed to find any proof that having a sunny outlook on life helped keep death at bay. The research took five years involving 24 women with advanced breast cancer, some of whom had cognitive behaviour therapy sessions to try and cheer them up and some who did not.

This is not to say that the human mind did not have healing power. The central nervous system does have an effect on the central immune system, which is why when we are depressed we seem more susceptible to colds and other illnesses. While researchers did find that some patients lived a lot longer than others, there was no evidence that state of mind was the telling factor. The survey is the fifth to contradict a celebrated 1989 finding by American researcher David Spiegel that women with advanced breast cancer who attended a weekly support group lived longer than those who did not.

Some cancer patients are so despairing that they don’t bother to take their medicines, go for examinations or look after themselves. Certainly, taking a positive attitude could not hasten death.

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Delhi fast becoming India’s breast cancer capital, say doctors-(Times of India-23/06/2000)

Modernity and emancipation may bring along serious problems- some fatal like breast cancer. This problem has already begun to show itself in urban areas like Delhi, which is becoming the city with the highest rate of breast cancer in the country.

At present, one out of 20 or 25 women in Delhi are likely to develop this cancer at some stage in their lives. The rate is still lower than the US or UK, where one of seven women are at risk.

It is fact that breast cancer is an affliction of the well-to-do, modern woman and those living in the metros are at a higher risk than those in semi-urban or rural areas.

This is because women in cities tend to delay their marriages till they are touching 30 and bear children in their mid-thirties. There has also been a marked change in the eating habits of the Indians.

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Breast Cancer Metastasis Suppressor Gene Isolated-(Cancer Info-02/06/2000)

Pennsylvania State University researcher Danny Welch reports in the journal Cancer Research the discovery of the first breast cancer metastasis suppressor gene. This gene, which Welch has named BRMS1, for breast cancer metastasis suppressor 1, maps to a hot spot on human chromosome 11 (11q13) for deletions and rearrangements in late stage breast cancer cells.

Previously, Welch had found that introducing a normal chromosome 11 into a metastatic breast carcinoma cell line suppressed the metastatic potential of the cell line without affecting tumorgencity. In the present study, he set out to identify the genes responsible for this suppression. To assess the function of the gene in vivo, independent metastatic cell lines were transfected with the BRMS1 gene, and those cells were then injected into nude mice to test for tumorigenicity and metastatic potential. One hundred percent of the mice given the control, metastatic cell line developed metastases, while the rate of metastases dropped 50-90% in mice given the cells carrying the putative suppressor gene.

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EU regulators approve Roche breast cancer drug –(Cancer Info-26/05/2000)

European regulators approved Herceptin, a revolutionary treatment for breast cancer developed by Roche.

Herceptin is a targeted treatment designed to kill only cells expressing a gene, called HER2, that is associated with aggressive cancer cell growth. Not all breast cancers express HER2. Unlike traditional chemotherapy, Herceptin does not destroy normal, healthy cells. It is the first of a new "generation" of so called pharmacogenomic treatments that is only given after doctors have used genetic tests to see if patients will benefit from the drug.

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Drug may ease hot flashes in women with breast cancer-(Cancer Info-17/05/00)

Postmenopausal women whose hot flashes are caused by the breast cancer medication tamoxifen may find some relief in a drug normally used to treat high blood pressure, researchers suggested today. In a study of 194 women taking tamoxifen, researchers at the University of Rochester Cancer Center found that the drug clonidine had a "small beneficial effect" in reducing the frequency, duration and severity of hot flashes.

Hot flashes -- sudden spikes in temperature that cause sweating and dizziness -- are the most common side effect of tamoxifen, the treatment of choice for women whose breast cancer tumors are fueled by estrogen. Millions of women take estrogen and other hormones to ease hot flashes brought on by menopause. But doctors are reluctant to prescribe estrogen in conjunction with tamoxifen.

"There's a lot of concern among oncologists that combining two hormones can cause inadvertent side effects. Blood clotting is the most dreaded one," said Dr. Kishan Pandya, who led the study, published in today's Annals of Internal Medicine.

Women taking clonidine suffered a median of 2.2 fewer hot flashes per day, according to the study. Women who received a placebo reported a median of 1.2 fewer hot flashes per day over the course of the eight-week study.

Jennifer Aikin, director of the clinical coordinating center at the National Surgical Adjuvant Breast and Bowel Project in Pittsburgh, said patients have had some success with clonidine. But the drug's side effects include dry mouth and low blood pressure.

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Drugmaker warns doctors of deaths linked to breast cancer drug-(Cancer Info- 05/05/00)*

Pharmaceutical company, Genentech Inc. has warned doctors that the breast cancer drug Herceptin is linked to 15 deaths and 47 other adverse reactions in patients. In a letter to doctors sent Thursday, the company said the adverse effects included allergic shock and extreme respiratory distress. In nine of the 15 deaths, symptoms arose within 24 hours of the time Herceptin was administered. An estimated 23,000 patients have been treated with Herceptin.

Severe reactions to Herceptin had not occurred in clinical trials before the drug gained Food and Drug Administration approval in 1998, but sometimes reactions can't be foreseen in trials. Safety issues may only be seen once the drug gets put into a larger patient population.

Herceptin is used to treat breast cancer patients that have too many copies of the HER2 gene. A healthy version of this gene produces a protein that signals cells to grow and multiply normally. But in women with too much HER2, the breast cells reproduce out of control and spread throughout the body. Herceptin, an antibody, blocks excess HER2, shrinking and eliminating tumors.

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Cranberries Effective Against Breast Cancer In Mice-(Cancer Info-26/04/2000)*

Cranberries could bring breast cancer risk down by at least 40 percent in mice, opening prospects for curing the disease on humans, Canada's National Post reported Saturday.
In their latest study, Canadian researchers at the University of Western Ontario fed a group of mice with dehydrated cranberries and then injected human breast cancer cells into the mammary glands of mice. Compared with another group of mice receiving injections but without eating cranberries, this group of mice prove to be 50 percent lower in risk of suffering from breast cancer.

Drinking cranberry juice was discovered capable, too, of reducing the number of expected tumors in the mice by 40 percent. The cranberry-fed mice also showed a reduction in the spread of tumors to their lungs and lymph nodes.

Najla Guthrie, the study's lead researcher, was quoted as saying that "quercetin is the flavonoid found in cranberry juice, and it's been shown to have activity in colon cancer in a lot of laboratory studies." In their next step, Canadian researchers will determine why cranberries inhibit the development of breast cancer in animals before they can be sure that cranberries have the same effects on humans.

Canada is one of the major cranberry producers in the world. More than 32,000 tons of berries were grown in 1998 to bring in 55 million Canadian dollars (about 37.3 million U.S. dollars), according to the newspaper.

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Bust the Cancer-(Mid-Day-11/04/2000)*

The fear of developing breast cancer stalks all women be it a young woman who may have a small nodule in her breast, a mature woman on hormone replacement therapy or an old lady who has recently seen a dear friend develop it. We need to remove this lurking fear and take positive steps instead, to either rule out or confirm the disease.

Breast cancer is one of the most common cancers among women. It is estimated that one in 12 women may develop breast cancer at some time in their life. It is also the most common single cause of deaths in women aged 35-54 years.

We still do not know the cause of breast cancer, hence the only way to prevent breast cancer is by secondary prevention, early detection and prevention of a cancer from spreading.

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Breast cancer slower in older women-(Times of India-06/04/00)*

Older women who have breast cancer often have a less aggressive version that is less likely to kill them, researchers have said. They said doctors may be justified in treating some older patients-those older than 70-with gentler approaches such as hormone therapy, leaving the most traumatizing chemotherapy, surgery and radiation therapy for younger women whose cancer is more likely to kill them. However, more research is needed before doctors can definitely say breast cancer is a different, slower disease in older women.

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Scientists Link Grilled Meat To Breast Cancer –(Cancer Info-05/04/00)*

Scientists are offering new evidence that grilled, charred and fried meat may pose a risk of breast cancer. The culprit appears to be a compound called PhIP, produced when meat is cooked at high temperatures. Studies have shown that rats fed high doses of PhIP develop tumors in their mammary glands.

Scientists meeting this week for the American Association for Cancer Research conference are hearing about additional evidence from a study of more than 900 women, a third of whom had breast cancer. Those who said they ate lots of charred and grilled meats had a two-fold greater risk of getting breast cancer as women who rarely or never did. Another study by German researchers reported at the conference that PhIP weakly mimics the female hormone estrogen. That could explain why the chemical would do most of its harm in breast tissue.

Scientists recommended braising, stewing or baking meat. If something is to be grilled, she suggested cooking it partially first so that it spends less time exposed to flames

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Studies on to detect, prevent cancer amongst women-(Times of India-27/03/00)*

Two of the world’s largest randomized control studies on early detection of common cancers among women are currently under way in Maharashtra. While one study focuses on screening and early detection of breast and cervical cancer among 1.5 lakh women in ten slum areas of Mumbai, the other concentrates on cervical cancer prevention among 1.6 lakh rural women in Barshi, near Sholapur.

"Cervical cancer is the number one cancer among women in India, while breast cancer is emerging as the leading cancer among urban women," says Dr. K. A. Dinshaw, director of Tata Memorial Hospital, which is conducting both studies. The two studies will look at "the benefits of public screening for cancer as well as scientifically validate appropriate screening methods for India."

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Post-Lumpectomy Chemo Reduces Local Recurrence of Breast Cancer –(Cancer Info-22/03/00) *

One brief course of chemotherapy could greatly reduce the risk of recurrence in some women who have had breast-conserving surgery to treat their breast cancer, according to a new report. In a study published in the March issue of the Journal of Clinical Oncology, researchers from the Netherlands Cancer Institute and the European Organization for Research and Treatment of Cancer found that for women under 43 years old whose breast cancer had not spread to their lymph nodes, one course of chemotherapy immediately after lumpectomy could reduce their risk of local recurrence of the cancer by more than threefold.

Local recurrence is the return of cancer to the site in which it originally occurred after it has been treated. In a local recurrence, there are no signs of cancer in nearby lymph nodes or tissue. The researchers studied 361 premenopausal women with small (less than 3 centimeters), lymph node-negative breast cancer tumors who had been treated with breast-conserving therapy (BCT, or lumpectomy). Following surgery, 179 of the women (the "treatment group") were given a single course of chemotherapy within 36 hours. The other 182 women (the "control group") were not given chemotherapy. All women had radiation therapy within six weeks after surgery.

The investigators compared the local recurrence rates of the two groups, and also studied the effect that other factors - including age, tumor type and size, and estrogen-receptor status (an index of responsivenss to hormonal therapy) - had on the risk of local recurrence.

Young age was found to be the most significant risk factor for local recurrence - patients who were younger than 43 years old had an almost threefold increased risk of local recurrence (23 percent rate) compared with patients who were 43 or older (8 percent rate). Brief post-op chemotherapy was found to significantly reduce the local recurrence risk. Patients who received this added treatment reduced their chances of local recurrence by more than 50 percent. The local recurrence rate after eight years was 20 percent for women who did not receive the chemotherapy, but only 10 percent for those who did.

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Tamoxifen upgraded in cancer guidelines – (Cancer Info–16/03/00) *

Doctors writing guidelines for 17 of the nation's most prestigious cancer treatment hospitals recommended expanding the use of tamoxifen to prevent recurrence of breast cancer. The researchers also removed mention of use of high dose chemotherapy for the treatment of advanced breast cancer, following publication of several studies that didn't find an advantage over conventional treatment. The new guidelines were presented at the annual meeting of the National Comprehensive Cancer Network. Dr. Robert Carlson, professor of medicine at Stanford University, Stanford, Calif., and head of the NCCN's Breast Cancer Guidelines Committee, said new studies have shown that tamoxifen substantially reduces the risk of the spread of the disease to the unaffected-or contralateral- breast.

"Previous guidelines had recommended the use of tamoxifen to prevent recurrence of cancer in the original or ipsalateral breast," Carlson said. "We expanded that recommendation to the contralateral breast."

Carlson explained that new research reported by the National Surgical Adjuvant Breast and Bowel Project showed that tamoxifen treatment after lumpectomy surgery - removal of the cancerous tumor, but not complete removal of the breast - reduced the risk of the spread of cancer to the unaffected breast by about 30 percent.

He said studies also showed that the longer a women takes tamoxifen, the greater the reduction in risk of spread to the other breast - a 13 percent reduction after one year on tamoxifen; 26 percent after two years; 47 percent after five years.

"These studies represent high level evidence that we are very confident of," Carlson said, but the recommendations come with a cautionary note. Tamoxifen treatment can causes some serious side effects, Carlson said, so the low risk of developing contralateral breast cancer has to be weighed against those side effects.

"We are not at present at the point where we are saying that tamoxifen definitely should be used in this setting," he said.

In another decision, the committee which has fine tuned the treatment pathways five times in the 5-year history of the NCCN guidelines deleted mentions of high-dose chemotherapy for treatment of metastatic breast cancer.

Carlson said that in previous guidelines, the use of the controversial high-dose treatment was hinted at as a possible option for patients if performed in a properly designed clinical trial. Carlson said studies during the past year have indicated that there was no particular benefit from the high-dose procedure over conventional chemotherapy regimens.

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Combining hormones? Think twice – (The Week - 12/03/00) *

Adding progestin to estrogen enhances the risk of breast cancer. About one fifth of American women going through menopause take hormone replacement therapy and close to half who have had a hysterectomy take hormones. Estrogen is believed to help prevent heart disease and osteoporosis and increase overall sense of well-being. Studies 25 years ago showed that taking just estrogen increased the risk of endometrial cancer, cancer of the lining of the uterus. Many doctors then began prescribing estrogen with progestin, a synthetic form of the hormone progesterone.

Two recent studies have found an increased risk of breast cancer in women who take combined hormone replacement therapy. Researchers found that for every five years of use, the risk of breast cancer rose 24% among women who were taking combination hormones. For women taking only estrogen, the risk rose by 6%. The risk also appeared to be higher in women who took a cycle of estrogen pills followed by progestin compared with those who took a pill that combined the two. Although these results were not statistically significant, they were very close to being so.

Experts seem to be fairly certain that while any use of hormones confers some risks, the risk of short term use to relieve menopause symptoms, up to 3 years, is probably low. However women taking or thinking of taking hormones for longer periods should carefully discuss the risks and benefits with their doctor.

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Report Finds Widespread Fraud in Cancer Therapy Test- (Washington Post-11/03/00)

A South African study that purports to show benefits of high-dose chemotherapy, followed by stem-cell transplantation in breast cancer patients contains inaccurate information about the patients, the treatment and even their survival or death. The frauds admitted by the lone researcher, "invalidate the study," which should be entirely discounted by breast cancer researchers, a team of scientific auditors said yesterday.

Officials at the University of Witwatersrand, in Johannesburg, announced in February that the study, conducted single-handedly by the chief oncologist at its medical school, was full of mistakes and deceptions. They are catalogued in an article released yesterday by The Lancet, a European medical journal that will publish the report in a future issue.

One of the American auditors, F. Marc Stewart, chief of hematology and oncology, University of Massachusetts Memorial Medical Center, said it appears the study was not even a randomized controlled trial. That means it lacked the basic structure that lent its findings such weight and attention when they were presented at a cancer meeting in the United States last year.

Instead of enrolling patients and randomly assigning half to standard treatment and half to the experimental one, Bezwoda apparently prescribed the experimental treatment to a group of cancer patients and compared them to women who had received various conventional treatments in the past.

The question of whether high-dose chemotherapy for cancer that has spread beyond the breast is better or worse than conventional chemotherapy has been both a scientific and a political controversy in recent years. The treatment consists of chemotherapy given at doses that normally would be lethal, followed by "rescue" transplantation of bone-marrow cells (or, more recently, with stem cells harvested from the bloodstream.) A few non-randomized studies a decade ago suggested this strategy might save more women's lives.

The auditors also found that seven women had relapsed, been referred for end-of-life care and were not tracked for more than two years before a 1999 presentation. That almost certainly meant the number of deaths in women getting high-dose chemotherapy was higher than originally reported. Counting them, mortality in the experimental group was 26 percent, not the 11 percent reported.

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Breast Cancer Screening Aid Cleared for Diagnostic Use-(Cancer-Info-1/2/00)

The war against breast cancer has a new weapon, thanks to an advanced sensor developed at NASA's Jet Propulsion Laboratory (JPL). The device, called the BioScan SystemTM, was developed by OmniCorder Technologies, Inc., Stony Brook, N.Y. OmniCorder received clearance to market the system from the Food and Drug Administration in December 1999.

Studies have determined that cancer cells exude nitric oxide. This causes changes in blood flow in tissue surrounding cancer that can be detected by the sensor. The BioScan SystemTM is sensitive to temperature changes of less than .015 degree Celsius (.027 degree Fahrenheit) and has a speed of more than 200 frames per second. It causes no discomfort to the patient and uses no ionizing radiation.

The sensor, called the Quantum Well Infrared Photodetector (QWIP), was invented by Dr. Sarath Gunapala, principal engineer of JPL's Device Research and Applications Section. The digital sensor detects the infrared energy emitted from the body, thus "seeing" the minute differences associated with blood flow changes.

"It is a great pleasure to see something I invented being used for public benefit," said Gunapala, "especially in medicine and even more so in the early detection of cancer."

The BioScan SystemTM also uses Dynamic Area TelethermometryTM, invented by Dr. Michael Anbar, founding scientist of OmniCorder. The two technologies work together to image the target area and to provide the physician with immediate diagnostic information.

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Cases of breast cancer likely to go up by 200% - (TOI-18/01/00)

Incidence of breast cancer is expected to increase by 200% in the next 20 years, academic coordinator of the Tata Memorial Hospital, Dr. Rajendra Badwe, said on Thursday. The risk of getting breast cancer was increasing with consumption of fatty food and food containing preservatives, the doctor observed. Lack of exercise added to the risk. Further, with the increase in lifespan, breast cancer has become a major threat to women’s health. Breast cancer comprises 25% of total cancer cases in women. According to statistics, breast cancer is the most common cause of death among women in the age group 40-50. In contrast to Western countries where 80% women approach the doctor in the first or second stage, in India, 80% come in the third or fourth stage. Awareness about how to conduct self-examination is needed in this country.

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Britain Defends breast Cancer Screening-(Reuters-12/01/00)

Britain defended its breast cancer screening program in response to a controversial new Danish study that says screening may do more harm than good. The government's Department of Health said the program was worthwhile, detecting more than 8,000 cancers in 1997/98 alone. Figures published in November 1999 showed a 14 percent drop in deaths from breast cancer between 1989 and 1998, it said.

"The NHS (National Health Service) breast screening program is a success and around one million women are screened each year, " the department said in a statement Friday.

The screening program's top official, Dr Muir Grey, went on a media offensive, concerned that the study's findings, published in The Lancet medical journal and given wide publicity Friday, may dissuade women from having mammogram screenings. Mammography uses a series of X-rays to detect abnormalities, such as tumors, in breasts.

The Danish researchers said mammography, long considered the biggest weapon against breast cancer, which kills more British women than any other form of cancer, was a waste of time as it did not reduce the death rate from the disease.

"There is no reliable evidence that screening decreases breast cancer mortality", Dr Peter Gotzsche and Ole Olsen of the Nordic Cochrane Center in Copenhagen said in the latest issue of The Lancet.

The Danish study re-examined major trials of breast cancer screenings in Sweden, Scotland, Canada and the United States that involved 500,000 women.

The researchers found that only two trials -- conducted in Canada and Sweden -- met widely accepted criteria for an adequate randomization process, where women were randomly assigned either for mammographic screening or to an unscreened control group.

"These two trials did not find an effect on breast cancer mortality," Gotzsche said. " We have doubts about whether the benefits that might be there outweigh the harm '', adding that some false alarms led to healthy breasts being removed.

Grey said : " I will be asking our specialist breast cancer group to look at this (the study) in detail. But at the moment this is not something that makes me say I'm going to phone the minister today and say let us change the policy" .

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Lymph Node Number Tied to Risk of Dying from Breast Cancer-(Reuters Health-04/01/00; SOURCE: Cancer 2000;88:108-113)

By counting the number of lymph nodes under a woman's arm after surgery to remove a breast tumor, doctors can predict her risk of dying from breast cancer in the next 5 years, even when there is no evidence that the cancer has spread to the nodes, US researchers report. Their study in the January issue of the journal Cancer is the first to demonstrate the importance of total number of lymph nodes to survival in breast cancer patients.

Doctors currently gauge survival after breast cancer surgery by counting the number of axillary (armpit) lymph nodes to which cancer has spread. However, about 10% to 15% of women will die from the spread of cancer when there appears to be no axillary lymph node involvement.

``In women with no evidence that cancer has spread, a major problem is that we don't have a good indicator of which women will ultimately die of metastatic breast cancer,'' lead author Dr. Robert L. Camp, a post-doctoral fellow in the department of pathology at the Yale University School of Medicine in New Haven, Connecticut, told Reuters Health.

``Our study indicates that a high number of axillary lymph nodes in patients with lymph node negative breast carcinoma is of significant predictive value in determining patient survival,'' the research team concludes.

Camp said there is actually little variation in the total number of lymph nodes between women. However, more aggressive tumors cause lymph nodes to swell, giving the appearance that more exist.

The investigators found that ``the 5-year survival rate for patients with 20 or more tumor-free lymph nodes was 84.7%, compared with 96.3% for patients with fewer than 20 tumor-free lymph nodes.''

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Panel supports digital mammograms (Associated Press-16/12/99)

Digital mammography took a step closer to market Thursday as government advisers recommended approval of the first computerized mammogram. The article says that FDA advisors are unanimous that government should OK device.

American Women undergo some 30 million mammograms every year. The breast X-ray is the gold standard in detecting breast cancer, particularly early tumors. But mammograms are not foolproof. Scientists long have hoped digital mammography - computerized breast X-rays that do not use film - could help improve them. For example, radiologists might enhance computerized images for a better view of a spot that is too light or too dark on a standard mammogram's X-ray film.

However, "In terms of the ability to find cancer earlier, the name of the game in mammography, the feeling is the ultimate benefit of the digital technology has yet to be demonstrated," Schultz said.

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Scientists report marker of increased cancer risk in women with benign breast disease (Cancer Information and Support International-15/12/99)

Women with a benign breast disease whose cells lose the ability "to hear" signals instructing them not to divide are at increased risk of later developing breast cancer, Vanderbilt-Ingram Cancer Center researchers have found. In the Dec. 15 issue of the Journal of the National Cancer Institute, the scientists report that a reduction in expression of a receptor for transforming growth factor beta (TGFb) occurs early in the progression from hyperplasia to malignancy in some women. Hyperplasia is a benign condition that involves an overgrowth of apparently normal cells.

"This is the first time we've found credible evidence of a biologic marker of increased breast cancer risk in women with unequivocally benign breast disease," said William Dupont, Ph.D., professor of Preventive Medicine at Vanderbilt.

A laboratory test to determine levels of expression of this receptor might be used in the future to reassure women at no increased risk or to guide decisions about screening and preventive measures in women whose risk is elevated, Dupont said. In addition, the findings suggest a new angle for scientists to explore in developing prevention strategies.

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Breast cancer:Timing of surgery is vital for survival (TOI-29/11/99)

Premenopausal women with beast cancer may have a better chance of survival if surgery to remove tumours is not done during the first part of their menstrual cycle, a new British study, published in a recent issue of the journal Cancer, suggests. An average menstrual cycle lasts 28 days with the first day of a woman's menstrual period being counted as day 1. Hormone levels are low as the cycle begins. Estrogen levels rise steadily during the first part of the cycle, with progesterone rising more gradually. After ovulation, during the second part of the cycle, progesterone becomes the dominant hormone. It is believed that levels of these hormones may affect the likelihood of tumour cells' spreading at the time of surgery.

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US FDA panel backs new use for Taxol (Medivision- October, 99)

A US Food and Drug Administration panel unanimously recommended expanding the approved uses for leading cancer-drug Taxol to patients with early-stage breast cancer. Taxol has been approved as part of a treatment regimen for patients with node positive breast cancer that had spread to the lymph nodes but no further. The data is not clear on whether the benefits for receptor positive tumours, which are better treated with Tamoxifen, outweigh the drug 's risks. Side effects include neutropenia, a potentially dangerous drop in some white blood cells.

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Breast Cancer: Alternative medicine and an upbeat attitude - (Medivision, September, 99)

Lillie Shockney, R.N., Director of education and outreach for the Johns Hopkins Breast Centre writes that it may surprise us that she is not as skeptical as most health care professionals are about complementary medicine for breast cancer. So long as standard medical care is not neglected, there is nothing wrong with a woman trying acupuncture, herbal remedies, homeopathy, and the like. Anything that fosters a positive attitude can be good medicine. Efforts are made to inject humour into the situation because they believe that it can make a difference in how well a patient does.

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Study: Tamoxifen loses effectiveness-(Medivision, August 1999)

Tamoxifen, a drug that fights breast cancer by blocking the action of the hormone estrogen, eventually loses its effectiveness and then may actually help the cancer to grow. Researchers at Duke University Medical Centre said they found that the reaction of breast cells to tamoxifen changes over time until the drug starts to behave like the hormone it is supposed to block.

Research further showed that tamoxifen resistance could be reversed using certain peptides. This causes tamoxifen to once again have an anti-estrogen effect.

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Altered Perceptions of breast cancer at 2^nd World Conference-(Medivision, August, 1999)

Over 1000 delegates from 50 countries attended the 2^nd World Conference on Breast Cancer in Ottawa which was organised in conjunction with the US-based Women’s Environment and Development Organisation (WEDO).

Among the papers presented was a study on baby teeth collected from children in the US, which revealed that those whose teeth contain a lot of radioactive material live in areas having high breast cancer rates. The study called the ‘Tooth Fairy Project’ proved that women living within 100 miles of a reactor are at the greatest risk of dying of breast cancer.

Studies on pesticides have shown a complex and indirect linkage with breast cancer but there are indications that lactation is an effective way to flush out toxins from breast tissue. The beneficial effect may be due to the achievement of functional maturity combined with the subsequent flush-out of toxins including highly suspect organochlorine and estrogen-mimicking pesticides.

One research paper indicated that diet and genetics could be indicators of the real risk factors of breast cancer and the search for the hidden enemy, the environment, should begin right at the stage of conception into infancy and childhood.

Globally, 900,000 new cases of breast cancer are reported every year, 505,000 in developed countries and 390,000 in developing countries.

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Drug Slashes Breast Cancer Risk, says US Medical Journal – (TOI- 21/6/99)

A drug approved to fight the bone disease osteoporosis significantly decreased the risk of breast cancer among postmenopausal women. Women who took the drug, raloxifene, for three years reduced the risk of breast cancer by 76% compared with those who took a dummy pill, but it is premature to recommend raloxifene to lower the risk of developing breast cancer except in clinical tests.

In treating breast cancer, doctors have long prescribed a related drug, tamoxifen, to block the action of the female hormone, estrogen, on breast tissue, where it can promote the growth of cancer. But tamoxifen has its own hazards, like increasing the risk of cancer of the uterus and formation of blood clots in leg veins that can be fatal if they travel to the lungs. Clots are also an unwanted effect of raloxifene. Scientists believe that raloxifene prevents estrogen-related breast cancers by occupying the same molecular receptor sites on the surface of the cell as the estrogen molecule. Raloxifene blocks estrogen’s cancer promoting effects on breast and endometrial tissue and is safer than tamoxifen. But women taking raloxifene reported hot flashes, influenza like symptoms, cramps and fluid accumulation in the legs.

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