A CaSfA member recently gave meThe Silver
LiningCompanion Guide: A Supportive and Insightful Guide to Breast Cancer
by 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 all
). This publication reminded me of a handout I developed a few years ago:
If you are Diagnosed:
Accept feelings-anger, guilt,
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.
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.
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.
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.
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.