CaSfA - Cancer Support for All
News from CaSfA's Director

breast cancer

Dealing with Breast Cancer



A CaSfA member recently gave meThe Silver LiningCompanion Guide: A Supportive and Insightful Guide to Breast Cancerby Hollye Jacobs, RN, MS, MSW.  While this was written specifically for the breast cancer survivor, much is relevant to survivors of all cancers. (The companion guide is availablefree to allat: https://www.directrelief.org/silverlining/).  This publication reminded me of a handout I developed a few years ago:

If you are Diagnosed:
Accept feelings-anger, guilt, denial, despair…

Results from the TH3RESA trial


Results from a study presented at the San Antonio Breast Cancer Symposium showed patients with metastatic, HER2-positive breast cancer who received a combination antibody/chemotherapy drug in a phase 3 clinical trial survived longer, on average, than patients receiving other treatments. (http://news.cancerconnect.com/conjugate-drug-extends-survival-in-patients-with-advanced-her2-positive-breast-cancer/ )“The TH3RESA trial, which enrolled more than 600 participants in the U.S. and overseas, compared survival times in patients randomized to treatment with the conjugate drug trastuzumab emtansine (T-DM1) to those randomized to treatment of their physician’s choice. All patients had metastatic breast cancer that tested positive for the human epidermal growth factor receptor 2 (HER2) protein – a feature in about 20 percent of all breast cancers – and had previously been treated with chemotherapy as well as the HER2-targeted drugs trastuzumab and lapatinib. The investigators found that those in the T-DM1 group lived a median of 22.7 months vs. 15.8 months for those in the treatment of physician’s choice group – a 44 percent improvement.”  In addition, serious side effects were lower in the TDM-1 group.

The Updated ACS Guidelines for Breast Cancer Screening

The American Cancer Society (ACS) released its new breast cancer screening guidelines, raising the recommended age for beginning annual screening from 40 to 45, and endorsing biennial screenings beginning at age 55. In addition, the new guidelines suggest physicians should forgo clinical breast exams for women of any age. 

I have an admittedly biased opinion about these recommendations.  My breast cancer was found by a routine annual screening mammogram.  I had a very low risk of developing breast cancer.

The DCIS Controversy

Ductal Carcinoma in Situ is diagnosed by examination of the biopsy of breast tumor.  The cancer cells are within the milk ducts and have not invaded the underlying tissue.  It is classified as Stage 0 breast cancer.  The incidence of DCIS has increased with the widespread use of screening mammography and it now accounts for 20-30% of all newly diagnosed breast cancers.
 
The treatment of DCIS has become controversial.  Even the name is a source of controversy.  Some believe it should not be called cancer at all, since it doesn’t involve tissue invasion.

New Finding in Triple Negative Breast Cancer


Researchers in the UK have found an overactive gene, BCL11A, in 8 out of 10 patients with triple-negative breast cancer.  This type of cancer is especially aggressive. Without estrogen, progesterone and HER2 receptors targeted therapy using tamoxifen, aromatase inhibitors, and Herceptin do not work.  Finding this gene is the first step in developing targeted therapy for this type of breast cancer.  (http://www.telegraph.co.uk/news/science/science-news/11336050/Breast-cancer-breakthrough-as-Cambridge-University-finds-gene-behind-killer-disease.html )

Evidence for Screening Mammography before the age of 50

My invasive ductal carcinoma was diagnosed by routine mammography.  I know other women whose breast cancer was diagnosed after feeling a lump on self-exam.  So I did not agree with the U.S. Preventive Services Task Force (USPSTF) when it recommended the following changes in its breast cancer screening guidelines in 2009: 
 •   Routine screening of average-risk women should begin at age 50, instead of age 40. 
 •   Routine screening should end at age 74.

Moderate Alcohol Intake Does Not Increase Risk of Breast Cancer Recurrence

I enjoy the occasional cocktail or glass of wine.  So I was happy to hear about a  recent study published in the Journal of Clinical Oncology.  (http://jco.ascopubs.org/content/31/16/1939.abstract?sid=3da965f1-03df-486b-a310-19982aa74d65). This was a large population study and it showed that modest alcohol consumption (up to one drink per day in women) is not a risk factor for breast cancer recurrence.  It also showed alcohol consumption is not related to an increase in death from breast cancer and may, in fact, be associated with reduction in deaths due to cardiovascular disease as well as overall mortality.  (Unfortunately, alcohol is still thought to raise the risk of developing breast cancer in the first place.) This study is sure to stir up some controversy.  It will be interesting to hear if oncologists will be changing their recommendations to limit or discontinue alcohol consumption.
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