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The Latest Breast Cancer News and Research
FDA Panel Supports Expanded Use of Breast Cancer Drug
A Food and Drug Administration panel recently backed the use of Perjeta, a drug manufactured by Roche and currently used to treat HER2-positive metastatic breast cancer, for women who have been diagnosed but who have not yet had surgery. If approved, it would be the first pharmaceutical option to shrink or eliminate cancerous tumors pre-surgery. In the small study by Roche's Genentech unit, women who received Perjeta as initial treatment were 18% more likely to be cancer-free after 12 weeks than women who received other drugs. Although the FDA panel's vote was unanimous—with one abstention—members expressed concerned the drug might be overused to treat women with relatively small tumors that could be easily removed with surgery and later treated with drug therapy. The panel vote essentially constitutes a recommendation that the FDA approve Perjeta for use in early-stage breast cancer, and though the FDA usually follows the advice of its panels, it isn’t required to. A decision by the FDA is expected by October 31.
New Explanation For Racial Gap in Survival Rates
Despite recent declines in breast cancer deaths, black women are still more likely to die of breast cancer than are white women. Until now, the gap was thought to be caused by differences in screening, existing health problems, socioeconomic status and treatment, but a new study by researchers at the University of Pennsylvania and published in the Journal of the American Medical Association suggests that the low survival rate cannot be explained solely by these factors.
In the study, researchers compared more than 7,000 black women over 65 with similarly aged white women who were matched on criteria such as state of their health upon diagnosis and the state of their tumors. They were also compared by treatment such as surgery, radiation therapy and chemotherapy. All the women were insured by Medicare.
Five-year survival rates were 55.9% for black women and 68.8% for white women, a 12.9 percentage point difference. But when the researchers also accounted for how sick the patients were when first diagnosed, the black-white difference in survival dropped to 4.4%. Looking further at treatment, as well as their condition at the time of diagnosis, dropped the difference to 3.6%. "Therefore, the overall survival disparity is greatly influenced by how sick patients are at diagnosis, but only trivially influenced by differences in treatment," concluded Jeffrey Silber, study author and director of the Center for Outcomes Research at the Children's Hospital of Philadelphia. One reason may be that black women are less likely to seek medical care, even when insured.
New Guidelines on Discussing Preventive Drugs
The American Society of Clinical Oncology (ASCO) has updated its guidelines on interventions to reduce the chance of breast cancer developing in women who have an increased risk of the disease. Current findings indicate that currently only a small percentage of eligible women discuss breast cancer risk reduction options with their doctors or are even aware that there are options.
This latest update, published in the Journal of Clinical Oncology, includes the following key recommendations:
- Tamoxifen (20 mg per day orally for five years) should be discussed as an option to reduce the risk of invasive, estrogen receptor (ER)-positive breast cancer in premenopausal or postmenopausal women.
- Raloxifene (60 mg per day orally for five years) should also be discussed as an option to reduce the risk of invasive, ER-positive breast cancer in postmenopausal women.
- Exemestane (25 mg per day orally for five years) should be discussed as an alternative to reduce the risk of invasive, ER-positive breast cancer in postmenopausal women. Note: while exemestane is approved for the treatment of breast cancer, the FDA has not yet approved its use in breast cancer prevention.
The guidelines suggest that all three agents should be discussed (including risks and benefits) with women aged 35 years of older without a personal history of breast cancer who are at increased risk of developing invasive breast cancer, based on risk factors such as the women's age, race, and medical and reproductive history.
Biomarker May Predict Risk of Breast Cancer Recurrence
Scientists at Boston's Massachusetts General Hospital Cancer Center appear to have discovered a biomarker reflecting expression levels of two genes in tumor tissue, which may predict if the disease will recur. The biomarker can determine whether women treated for estrogen-receptor (ER)-positive breast cancer should undergo a second round of estrogen-blocking medication after completing tamoxifen treatment.
In the study, published in the Journal of the National Cancer Institute, researchers found that the HOXB13/IL17BR ratio can indicate which patients are at risk for cancer recurrence after tamoxifen and which are most likely to benefit from continuing treatment with the aromatase inhibitor letrozole (Femara).
"Most patients with early-stage, ER-positive breast cancer remain cancer-free after five years of tamoxifen treatment, but they remain at risk of recurrence for 15 years or longer after their initial treatment," according to Dennis Sgroi, MD, of the MGH Cancer Center and Department of Pathology, the lead and corresponding author of the report. "Our biomarker identifies the subgroup of patients who continue to be at risk of recurrence after tamoxifen treatment and who will benefit from extended therapy with letrozole."
Paul E. Goss, MD, PhD, director of the Breast Cancer Research Program at the MGH Cancer Center and a co-author of the report, adds, "This discovery means that about 60% of women with the most common kind of breast cancer can be spared unnecessary treatment. But more importantly, the 40% of patients who are at risk of recurrence can now be identified as needing continued therapy with letrozole, and many will be spared death from breast cancer."
Breastfeeding Can Delay The Onset of Breast Cancer by up to a Decade
A new Spanish study appears to support previous findings that suggest women who breastfeed have a reduced risk of developing breast cancer. The results, published in the Journal of Clinical Nursing, looked at 504 female breast cancer patients aged 19 to 91 and discovered that breastfeeding delayed the onset of the disease by 10 years–but only among women who breastfed for more than six months and who did not smoke. On average, non-smoking women who breastfed their baby for at least six months were diagnosed at the age of 68.4, more than a decade later than both non-smokers who had not breastfed (or who had done so for less than three months), who were diagnosed at 58 years, and non-smokers who had breastfed for between three and six months (57 years). Female smokers who breastfed received no benefit in terms of when they were diagnosed with the disease, regardless of how long they fed their child naturally, the results suggest. The findings confirm the results of past studies, which suggest that both breastfeeding and pregnancy help protect women against breast cancer by reducing estrogen levels in the body.
Clinical Trial Explores Broccoli Sprouts
The ongoing quest for nature-based breast cancer treatments has turned to a popular cruciferous vegetable: broccoli, or specifically, the young version known as "broccoli sprouts." These fledgling plants are rich in the organic compound glucoraphanin, a precursor of the molecule sulforaphane, which has been shown in studies to produce anticancer effects. So, researchers at New York's Roswell Park Cancer Institute, in collaboration with the National Cancer Institute, are conducting clinical trials to test their use in treatment scenarios.
For the trial, which began earlier this year and will conclude in 2015, researchers are working with postmenopausal women who have been diagnosed with breast cancer for the first time and have not yet received any chemo- or endocrine therapy. The study is looking at whether broccoli sprout extract, taken for two weeks prior to the start of conventional cancer treatment, alters the biological markers associated with cancer cell growth.
Other studies on broccoli sprouts have shown the plants to possess anticancer effects against prostate and urinary as well as breast cancers; to reduce Helicobacter pylori-induced gastritis; to shield against oxidative stress-induced upper airway disease; and even possibly to protect the skin from UV radiation.
For more information on the trial, visit clinicaltrials.gov and type "broccoli sprouts breast cancer" in the search box.
Oncology Esthetics Provides Safe, Targeted Spa Treatments
People fighting cancer require various types of support: medical, emotional, spiritual and yes, esthetic. Through the trademarked technique called Oncology Esthetics (OE) founded by esthetician, massage therapist, author and educator Morag Currin, spas like Visions Spa Salon in Novi, Michigan, are using their expertise to treat clients when they need it most.
As with numerous spa staffs that learn OE, The Esthetics Team at Visions received extensive training from Touch for Cancer, a leading Oncology Esthetics certification program headed by Currin that works with skincare professionals throughout North America, Australia, New Zealand and the United Kingdom. The team was educated on the effects of cancer, and cancer therapies and medications, on the skin and lymphatic system. Practitioners also learned about the need for optimal sanitation when working on clients with weakened immune systems. Only after receiving this education, in addition to hands-on training on the proper skincare ingredients and protocols to use with this deserving clientele, was the team allowed to receive OE certification. Visions was then able to expand its menu to include specialized skincare services for clients with cancer.
For more information, including a list of products suitable for use on clients with cancer, see October’s issue of DAYSPA magazine.
Nouveau Contour's Intelligent Device Helps Post-Surgery Appearance Return to "Normal"
Women and men who choose to have breast reconstruction following cancer surgery often find that their resulting appearance still falls too short of "normal," particularly when they’re left with altered or missing areolae and/or nipples. In these cases, medical micropigmentation can provide realistic-looking results to help speed up true psychological recovery and a sense of normalcy.
To help practitioners perform this in-demand procedure, Nouveau Contour offers Intelligent, the first computerized permanent cosmetics device with an Intel microprocessor chip. Thanks to software installed within its operating system, the device calculates the best needle frequency needed to achieve optimal pigment retention for each unique area of application, enabling the practitioner to create completely believable reconstructions. Intelligent can also reduce the appearance of radiotherapy marks and diffuse post-procedural scarring. Nouveau Contour Academy offers a variety of advanced training classes for technicians who wish to provide this rewarding service. For information, visit nouveaucontourusa.com.
Janice McCafferty, who underwent the Nouveau Contour procedure following a preventive mastectomy and reconstruction, and who is also the public relations representative for the company, explains, "Nouveau Contour is the completion of the process. There was nothing like this before. After my surgery, I thought they'd just put implants in and call it a day. But the plastic surgeon started telling me about other options, and said, 'We can make you look like a woman again.' I used to have a fear of looking at myself in the mirror. Now, when I do, it’s unbelievable—I really do look normal," she adds. "We've all heard the term, 'look good, feel better'—well, this really is the case!"