Breast screen expansion criticised
THE expansion of free breast cancer screening to Australian women aged up to 74 could prompt a rise in overdiagnosis and unnecessary treatment, an expert believes.
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breast cancer
The following articles have the tag breast cancer
Jolie breast surgery may prompt gene test rush
GPs have been warned to expect a surge of requests for breast cancer gene mutation tests following news of Angelina Jolie’s double mastectomy.
Free breast screens may lead to more overdiagnosis: expert
THE expansion of free breast cancer screening to Australian women aged up to 74 could prompt a rise in overdiagnosis and unnecessary treatment, an expert believes.
Cancer group loses landmark case against gene patent
A CANCER group which fought against the patenting of the BRCA1 gene has lost its landmark case in the Federal Court but may appeal the decision.
Breast cancer risk and sleep
WOMEN who have poor sleep are no more likely to develop breast cancer than those who report sleeping well, an Australian study shows.
Experts back tamoxifen for breast cancer prevention
THE Medical Oncology Group of Australia (MOGA) is campaigning to have tamoxifen PBS funded for the prevention of breast cancer, amid growing evidence of the benefits of the strategy.
Confine breast MRI screen to high-risk women: expert
MRI screening of women at high risk of breast cancer identifies a small number of additional cancers but leads to a substantial number of false positive recalls, Melbourne research shows.
Drug company settles over breast cancer a half century on
FOUR US sisters have reached a settlement with a drug company after claiming their breast cancers were caused by synthetic oestrogen their mother took during her pregnancies in the 1950s.
Lower BreastScreen detection rate drop prompts review
A DROP in breast cancer detection rates in the South Australian screening program has prompted a review of 54,000 digital mammograms conducted between September 2010 and June this year.
Breast cancer linked to lack of sun exposure
LATITUDE may be linked to breast cancer risk with women living in southern regions of Australia almost twice as likely to develop the disease as women further north, research has found.
Australian breast cancer false positives among lowest in the world
DESPITE concerns about overdiagnosis of breast cancer, the rate of false-positive mammograms in Australia is among the lowest in the world and two-thirds lower than in the US, Sydney research shows.
Breast cancer risk higher in postmenopausal women with diabetes
POSTMENOPAUSAL women with type 2 diabetes are 27% more likely to get breast cancer than other women at the same stage of life, a meta-analysis has found.
Mammography halves risk of breast cancer mortality
WOMEN who undergo screening mammography halve their risk of dying from breast cancer, according to the largest study of its kind in Australia.
Cancer in pregnancy on the rise, but researchers unsure why
THE rate of pregnancy-associated cancer is rising, according to a new Australian study.
One in 20 metastasis risk for women with localised breast cancer
Australian researchers have estimated the average risk of metastatic cancer among women with a breast malignancy following a study of 6000 women enrolled on the NSW Central Cancer Register.
Promotion of 3D breast imaging queried by experts
RADIOLOGISTS have queried the promotion of a 3D screening and diagnostic tool for breast cancer detection now available at four sites in Australia.
Behind the news - HRT use and cancer
Has the fall in HRT use affected colorectal or breast cancer rates in women older than 50?
Pregnancy does not alter breast cancer survival
RESEARCHERS have established for the first time that it is safe for women with oestrogen receptor-positive breast cancer to become pregnant.
Oestrogen-only HRT reduces breast cancer risk
WOMEN taking oestrogen-only HRT are less likely than non-HRT users to develop breast cancer or to die from the disease in the long term, US researchers say.
Breast cancer survivors gain relief with group CBT
COGNITIVE behavioural therapy (CBT) is effective at offering relief to women experiencing hot flushes and night sweats after breast cancer treatment, a UK-based study has found.
MRI rebate proposed for faulty breast implants
A MEDICARE rebate could be established to offer subsidised MRI scans to Australian women with potentially faulty PIP (Poly Implant Prothèse) breast implants.
French govt accuses PIP company of ‘massive deception’
A REPORT to the French government on the PIP breast implant scandal accuses the company involved of “massive deception” and points to weaknesses in oversight of medical device makers.
Expert slams anti-breast screening book
A LEADING Australian breast cancer surgeon has hit out at a European research organisation that is ramping up its opposition to mammography screening.
HRT link to breast cancer study questioned
AN INTERNATIONAL team of researchers has questioned the methodology of a landmark study that concluded combined HRT is linked to development of breast cancer.
Get thee to a pharmacy: Nuns need pill, experts say
AUSTRALIAN researchers have called for consideration that Catholic nuns take the oral contraceptive pill to reduce their increased risk of ovarian and uterine cancers.
Experts oppose anti-screening research
MORE than 40 breast cancer screening experts including five Australians have denounced researchers involved with an “anti-screening” campaign that has links to the Cochrane Collaboration.
GP recognised for innovative vision
A FORMER GP leader has been hailed as an “innovator” and handed top honours at the HESTA Primary Health Care Awards this week.
Caution on carotenoids in breast cancer
CAROTENOID supplements have been linked to an increased risk of mortality in women being treated for breast cancer. In the first study suggesting possible harm from a specific antioxidant used by breast cancer patients, US researchers found a twofold increased risk of breast cancer mortality with frequent use of combination carotenoids compared to no use. Researchers followed 2200 women, of whom 81% were taking at least one type of antioxidant supplement, for two years after their cancer diagnosis. They found a protective effect of vitamins C and E against breast cancer recurrence, and noted a trend ...
Breast screening not linked to lower mortality
RECENT reductions in breast cancer mortality are likely due to improved medical management rather than screening programs, experts in preventive health say after an international study. Researchers from France, the UK and Norway investigated the impact of mammography programs by comparing trends in breast cancer mortality among pairs of similar countries where one introduced mammographic screening 10–15 years before the other one. A reduction in breast cancer mortality would be expected to manifest sooner in countries with earlier screening programs, but this was not borne out by the study, they said. ...
Safety alert for breast cancer patients on antidepressants
THE TGA advises caution over prescribing tamoxifen plus the selective serotonin reuptake inhibitor (SSRI) paroxetine in women with breast cancer. A safety alert on the drug interaction was issued after an observational study found an association between concurrent use of tamoxifen and paroxetine and an increased risk of breast cancer mortality. The clinical effect has been attributed to reduced conversion by cytochrome P450 2D6 (CYP2D6) of tamoxifen to a major active metabolite. Although evidence from epidemiological studies was conflicting, the mechanism of the effect was biologically plausible, the TGA said. “Caution is warranted when prescribing ...
Post-traumatic stress strikes women after breast cancer
RISK factors predisposing women with breast cancer to post-traumatic stress have been identified in a new study. Danish researchers found women with post-traumatic stress symptoms after surgery for breast cancer were more likely to have low socioeconomic status, previous physical and mental illness, more than three affected lymph nodes and reduced physical function three months after surgery. More than 3000 women, who answered a questionnaire at three and 15 months after surgery, were included in the study. One-fifth of women had severe post-traumatic stress symptoms at three months and 14.3% at 15 months. With most ...
Breast scan radiation risk outstripped by lives saved
THE risk of radiation-induced breast cancer from digital mammographic screening after age 40 is far outweighed by the expected mortality reduction it brings, experts say. A recent Canadian assessment of radiation-induced breast cancer incidence has concluded the risk should not deter screening of women in this age group. Researchers estimated that, among a cohort of 100,000 women screened annually between the ages of 40 and 55, and biennially thereafter to age 74, there would be 86 cancers and 11 deaths due to radiation-induced breast cancer. This was estimated with the most recent standard screening dose of 3.7 ...
Breast scan radiation risk outstripped by lives saved
E risk of radiation-induced breast cancer from digital mammographic screening after age 40 is far outweighed by the expected mortality reduction it brings, experts say. A recent Canadian assessment of radiation-induced breast cancer incidence has concluded the risk should not deter screening of women in this age group. Researchers estimated that, among a cohort of 100,000 women screened annually between the ages of 40 and 55, and biennially thereafter to age 74, there would be 86 cancers and 11 deaths due to radiation-induced breast cancer. This was estimated with the most recent standard screening dose of 3.7 ...
Rural breast cancer patients choosing more invasive treatment
RURAL women diagnosed with breast cancer may not base their treatment decisions on evidence due to lack of access to health services, a breast cancer expert says. Speaking at the annual Pink Ribbon Breakfast in Sydney this morning, Dr Helen Zorbas, chief executive officer at the National Breast and Ovarian Cancer Centre (NBOCC), said as specialist cancer services were located in metropolitan or major regional areas, many rural women needed to travel away from home. “Of concern is that rural women’s decisions about treatment options may be based on factors such as the availability of health services ...
US FDA considers withdrawing breast cancer drug
EXPERTS have dealt a blow to blockbuster breast cancer drug bevacizumab, after recommending that approval for this indication be withdrawn in the US. A US Food and Drug Administration (FDA) panel voted 12 to one yesterday that the drug’s side-effects outweighed its benefits for treatment of metastatic breast cancer. The FDA, which fast-tracked the approval of bevacizumab in 2008, is expected to make a final decision by 17 September on whether to withdraw the indication. A spokesperson for manufacturers Genentech said the recommendation did not impact usage of the drug in other countries, or usage for ...
Risk of breast cancer death higher in post-partum women
WOMEN diagnosed with breast cancer in the months after giving birth are at significantly higher risk of death than those diagnosed during pregnancy, Australian research shows. Research Assistant Professor Angela Ives said the study of almost 3000 breast cancer patients in Western Australia underlined the need for suspicious lumps found in pregnancy to be promptly investigated. Professor Ives, an epidemiologist from the University of WA’s Cancer and Palliative Care Research and Evaluation Unit, said the study aimed to find out whether the timing of diagnosis in and around pregnancy affected the prognosis. They found women diagnosed with ...
Work exposure to synthetic fibres and solvents raises breast ca risk
WOMEN exposed to certain petroleum products and synthetic fibres in their early working lives are at increased risk of later developing breast cancer. A case control study showed that occupational exposure before the fourth decade of life – while breast cells continue to proliferate – elevated risk. More than 1100 postmenopausal Canadian women – half of whom were diagnosed with breast cancer and half with other cancers – were interviewed for the study. The researchers found that textile workers exposed to acrylic fibres had a seven-fold increased risk of breast cancer and nylon fibre exposure doubled ...
Long-term metformin uselinked to lower breast ca risk
LONG-TERM use of metformin may decrease the risk of breast cancer in women with type 2 diabetes, new research suggests. The UK case-control study found women with type 2 diabetes who used 40 or more metformin prescriptions over five or more years, had a 56% decreased risk of developing breast cancer compared with women not taking metformin. However, short-term metformin use or sulfonylurea usewas not associated with a decreased risk of cancer. The study, involving 22,621 women with type 2 diabetes using sulfonylureas, biguanides, thiazolidinediones, alpha-glucosidase inhibitors or prandial glucose regulators, with and without concomitant insulin, ...
Claim that breast screening is ineffective rejected
A RECENT study suggesting mammography screening has not reduced breast cancer mortality in Denmark has been dismissed as irrelevant by an Australian expert. The study, which was widely reported in the general media, found that breast cancer mortality in regions of Denmark without screening declined at twice the rate of areas that offered screening (2% per year vs 1% per year) in women aged 55 to 74 years. “We were unable to find an effect of the Danish screening program on breast cancer mortality,” the researchers said. However, Australian researcher Professor David Roder, a member of ...
Bisphosphonates linked to lower breast cancer risk for non-obese
THE use of bisphosphonates is associated with a 30% reduction in breast cancer risk, so long as the woman taking them is not obese, a study shows. The case-control study of 6000 US women is the first to suggest that the drugs used to prevent and treat osteoporosis may also prevent breast cancer. But Australian endocrinologist Professor Susan Davis cautioned that low bone mineral density may just be a marker for low production of oestrogen. “This is a provocative study and [the preventive effect] would need to be looked at in a randomised controlled trial,” she ...
Aspirin may lower risk of death after breast cancer
REGULAR aspirin use may protect breast cancer survivors from disease recurrence and death, research shows. But experts have cautioned that encouraging this group to increase their aspirin use would be premature. The research finding, based on responses from 4000 women enrolled in the prospective observational Nurses’ Health Study, is the first to show a clear survival advantage for women with a history of breast cancer who take regular aspirin. Some 732 deaths occurred in the cohort, including 341 attributable to breast cancer, and another 140 had disease recurrence but survived. The risk of breast cancer death ...
Some SSRIs inhibit tamoxifen, experts warn
THE use of a common selective serotonin reuptake inhibitor (SSRI) appears to inhibit the effect of tamoxifen and is associated with an increased risk of mortality from breast cancer. The findings have led to calls for product warnings to be upgraded. Canadian researchers found that among 2430 women treated with tamoxifen and a single SSRI, those concurrently using paroxetine had an increased risk of death. The effect was increased according to length of concurrent use and remained after adjustment for age, duration of tamoxifen treatment and other potential confounders. The authors estimated that use of paroxetine ...
Online risk assessment will help predict female familial cancer risk
A NEW online tool has been developed to assist GPs in identifying women at higher-than-average risk of developing ovarian and breast cancer. Experts at the National Breast and Ovarian Cancer Centre (NBOCC) have developed an algorithm for assessing the probability that a woman may have an inherited mutation and require referral to a family cancer centre. The tool is designed so that a decision can be made based on a maximum of eight questions that collect information about both sides of the patient’s family, NBOCC chief executive officer Dr Helen Zorbas said. The answers might also help ...
Rethink mooted on cancer screening
APPROACHES to breast and prostate cancer screening should be reconsidered, US experts say, in light of 20 years of screening failing to produce a more significant reduction in mortality from these diseases. In a recent commentary, a group of radiologists and urologists said overall cancer rates were higher, many more patients were being treated, and the incidence of aggressive or later-stage disease had not significantly decreased. “Screening has had some effect, but it comes at significant cost, including over-diagnosis, over-treatment and complications of therapy. Additional gains are unlikely with the current approach and may inadequately add to ...
Breast intentions
Proposed changes to breast cancer screening are attracting emotional responses in the media. Kate Woods speaks to the experts to set the record straight. ALMOST 20 years ago, when state and federal health ministers joined together to fund a national mammography screening program, the age-standardised death rate from breast cancer was 30.6 deaths per 100,000 women. 1 For women aged 50-69 years, the rate was even higher: almost 67 deaths per 100,000 women. 1 At the time, estimates were that if the new program – which became known as BreastScreen Australia – was ...
Subsidised MRIs improve breast cancer detection
OFFERING young women at high risk of breast cancer subsidised MRI screening does improve detection of abnormalities. A study involving 72 WA women at high risk of breast cancer found MRI scanning to be the most reliable detection method for potential cancers. Of the 15 lesions detected none were primary invasive cancers but three were significant – including a metastatic papillary cancer in an axillary node, papillomatosis with atypia and a papilloma. Of the remaining lesions, two were seen on mammogram but not on ultrasound and eight were seen on ultrasound but not on mammogram. ...
Expanded breast screening program may save more lives
BROADENING population-based breast screening would likely improve survival rates but would require a major expansion of Australia’s mammogram program, experts say. The BreastScreen Australia Evaluation Final Report , released last week by the Australian Health Ministers’ Advisory Council, has recommended extending the target age range for screening beyond women in their 50s and 60s. Professor John Boyages, director of the NSW Breast Cancer Institute, welcomed wider screening as long as it was linked to good treatment. “If we introduced two-yearly screening from age 45 to 74, we’ve calculated it would increase our screening ...
Breast cancer cases rise, but mortality drops
DESPITE an increase in cases of breast cancer over the past 20 years, mortality is now at an all-time low, due in part to the national breast screening program that began in 1991, researchers say. In 1991, 230 women per 100,000 in the 50-69 years target age group developed breast cancer, and 67 died, according to an Australian Institute of Health and Welfare report. But by 2005, although there were 279 new cases for every 100,000 women, the mortality rate had dropped to 47.5 – the lowest level since the program began. Report co-author Dr Alison ...
Tamoxifen a cancer risk after five years
TREATMENT with tamoxifen for five years reduces the risk of subsequent contralateral breast cancer following a diagnosis of an oestrogen receptor positive (ER+) breast tumour, but treatment exceeding five years could put women at risk of oestrogen receptor negative breast cancer (ER-). A US study has revealed that among 367 women who had used tamoxifen for more than five years, the risk of developing an ER- contralateral breast cancer was more than four times higher than 728 controls who had not used the drug. The authors said while the considerable benefits of adjuvant hormonal therapy for women ...
Study confirms HRT increases ovarian cancer risk
EVIDENCE is mounting that HRT increases the risk of ovarian cancer, in addition to the well-established risk of breast cancer. A Danish cohort study of 909,000 women found those who had used HRT had a 38% increased risk of developing ovarian cancer, compared to never-users, over an eight-year period. They had a 44% greater risk of epithelial ovarian cancer. The association remained regardless of the duration of use, formulation, oestrogen dose, regimen or progestin type, or the route of administration. The absolute risk indicated approximately one extra ovarian cancer for every 8300 women taking hormone therapy ...
Antioxidants commonly used in breast cancer despite risks
ANTIOXIDANT supplements are used widely among breast cancer patients, despite concerns the supplements may interfere with therapeutic interventions. The first study to examine supplement use at different stages of breast cancer treatment found 39% of patients used antioxidants as an adjunct to chemotherapy, 42% during radiation and 62% during tamoxifen therapy. More than 750 patients – members of the US Long Island Breast Cancer Study cohort – were asked about their supplement use six years after treatment. Researchers found antioxidant users tended to be health-conscious before diagnosis, with higher fruit and vegetable intake, and used herbal ...
Eating red meat not a breast cancer risk
POSTMENOPAUSAL women can be reassured of the safety of eating red meat after research shows no link between meat consumption and an increased risk of breast cancer. A large, prospective diet and health study in the US (the NIH-AARP study) found no association between breast cancer diagnosis and intake of total meat, red meat, processed meat or meat cooked at high temperatures. More than 120,000 postmenopausal women were questioned about meat intake and preparation and were followed for eight years, during which 3800 cases of invasive breast cancer occurred. Meat-eating also did not affect breast cancer ...
Fear drives breast cancer surgery
AUSTRALIAN experts have expressed concern over the number of women with breast cancer having potentially unnecessary contralateral prophylactic mastectomies (CPM). Their comments come as a US study of 51,030 women with unilateral ductal carcinoma in situ (DCIS) showed CPM rates rose by 148% from 1998 to 2005. Women younger than 40, recently diagnosed with breast cancer, with lobular carcinoma in situ, a large tumour size or a high tumour grade, were more likely to undergo CPM, they found. Dr Andrew Spillane, associate professor of surgical oncology at Sydney University, said anecdotal evidence suggested CPM rates were ...
Phone alert boosts breast screens
AUTOMATED telephone reminders are the most effective and low-cost method of promoting repeat mammography screening among women, new research shows. The US study of 3547 women due for their next mammogram compared the effectiveness of three reminder types: a standard reminder letter promoting the benefits of mammography, an automated telephone reminder, or a comprehensive reminder letter including contact information for breast cancer screening facilities. Although all reminder types increased repeat mammography rates by 17.8%, women who received automated telephone reminders were 32% more likely to have had a repeat mammography than those receiving printed reminders. Automated ...
Breast outcomes
Oncoplastic surgery, a single procedure to resect and rearrange breast tissue, is generating debate. Rada Rouse explores the risks and benefits. WHEN surgical oncologist Professor Monica Morrow makes a pronouncement, other specialists in the field tend to sit up and take notice. Professor Morrow, chief of the breast service at Memorial Sloan-Kettering Cancer Center, New York, is an executive member of the US Society for Surgical Oncology, and the first surgeon to sit on the US National Cancer Policy Board. But her recent opinion piece for the British Medical Journal seems to ...
Outcomes compromised by less invasive breast surgery
THE current trend towards minimally invasive surgery for breast cancer has improved cosmetic outcomes, but could be compromising cure rates and potentially endangering lives. Experts are warning that newer techniques such as oncoplastic surgery – where removal and reconstruction of breast tissue are performed in one operation, with no use of radiation – have not yet been proven. Professor John Boyages, executive director of the NSW Breast Cancer Institute at Westmead Hospital, Sydney, agreed: “What we’ve learnt over the last 25 years is that good local control saves lives.” Evidence-based therapy was to treat the whole ...
HRT cancer risk less than five years
NEW research is casting doubt on the five-year time frame in which the use of HRT is considered safe, prompting one expert to suggest a shorter period of use may need to be recommended to reduce the risk of breast cancer. Professor Henry Burger, an endocrinologist and consultant to the Jean Hailes Foundation for Women’s Health, was commenting on a US observational study of 67,000 women. It found that oestrogen plus progesterone therapy was associated with a doubling of the risk of lobular cancer within three years of use. The study also found that the risk ...
Migraine may lower breast cancer risk
POSTMENOPAUSAL women with a history of migraines may have a lower risk of developing breast cancer. In the first study of its type, US researchers combined data from two population-based studies to examine the relationship between migraine and the risk of breast cancer among 1938 women who had a ductal or lobular carcinoma. The researchers then compared them with 1474 women without a history of migraine. They found women who self-reported a clinical diagnosis of migraine had a 33% lower risk of ductal carcinoma and a 32% lower risk of lobular carcinoma than did those free ...
Cheeky campaign targets young
SIX per cent of all breast cancers diagnosed in Australia are in women younger than 40. On the face of it, 6% sounds like a relatively small number from an epidemiological perspective, but this number takes on a very different meaning in my role as a breast physician, where I see, week after week, young and vibrant women in their 20s and 30s who are diagnosed and dealing with treatment for this disease. Then the reality of the women behind the statistic becomes quite confronting. This week, the National Breast and Ovarian Cancer Centre launched an awareness ...
The realities of risk perception
IF we accurately perceive our risk of a future problem, then it follows that we would implement behaviours to try to protect ourselves from this risk. For example, if we perceive that wearing a seat belt reduces the risk of serious injury in a car accident, then we are more likely to wear it. Does this translate to other areas of our health? If we perceive that we are at risk of cancer from smoking, do we stop smoking? Not always. WOMEN AND RISK PERCEPTION Research shows that women do not accurately perceive ...
HRT and breast cancer risk
Clarifying the links between hormone replacement therapy and breast cancer. BREAST cancer is a commonly occurring malignancy with a one-in-nine risk of a woman of being diagnosed before the age of 85 years. A possible increase in the risk of breast cancer is the most emotive issue associated with any discussion of HRT for postmenopausal women. BACKGROUND Before 2002, the most significant publication regarding the link was the 1997 Lancet paper of Beral and colleagues ( 350:1047-59 ), which was a collaborative re-analysis of available data, all of which was observational. ...