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Risk reduction breast cancer

Stephen J Luen, Rebecca Asher, Chee Khoon Lee, Peter Savas, Roswitha Kammler, Patrizia Dell'Orto, Olivia Maria Biasi, David Demanse, Lellean JeBailey, Sinead Dolan, Wolfgang Hackl, Beat Thuerlimann, Giuseppe Viale, Marco Colleoni, Meredith M Regan, Sherene Loi
Importance: A range of somatic driver alterations has been described in estrogen receptor-positive, HER2-negative (ER+/HER2-) early breast cancer (BC); however, the clinical relevance is unknown. Objective: To investigate associations of driver alterations with prognosis and the role of PIK3CA mutations in prediction of benefit associated with endocrine therapy in postmenopausal patients with ER+/HER2- early BC treated with tamoxifen or letrozole. Design, Setting, and Participants: The Breast International Group (BIG) 1-98 trial randomized 8010 postmenopausal patients with hormone receptor-positive, operable, invasive BC to monotherapy with letrozole, tamoxifen, or a sequential strategy for 5 years...
June 14, 2018: JAMA Oncology
K Barlow-Stewart, M Liepins, A Doble, M Otlowski
In Australia, the USA and many Asian countries the life insurance industry is self-regulated. Individuals must disclose genetic test results known to them in applications for new or updated policies including cover for critical care, income protection and death. There is limited information regarding how underwriting decisions are made for policies with such disclosures. The Australian Financial Services Council (FSC) provided de-identified data collected on applications with genetic test result disclosure from its life insurance member companies 2010-2013 to enable repetition of an independent examination undertaken of applications 1999-2003: age; gender; genetic condition; testing result; decision-maker; and insurance cover...
June 11, 2018: European Journal of Human Genetics: EJHG
Carola Modica, Klaus Hoenig
This review focuses on the question whether mindfulness in follow-up care can contribute to the prevention of breast cancer (BC) recurrence. We first introduce behavioral risk and protective factors in follow-up care by presenting current research outcomes modulating individual risk for recurrence. We argue that although increased self-awareness is undoubtedly beneficial for BC survivors, it may also trigger adverse effects in vulnerable individuals such as overarousal and impaired emotional regulation. Indeed, research shows that many BC survivors are often confronted with clinical levels of fear of recurrence and anxiety and depressive symptoms...
April 2018: Breast Care
Rafid Salim Jabir, Gwo Fuang Ho, Muhammad Azrif Bin Ahmad Annuar, Johnson Stanslas
PURPOSE: Nonhematologic adverse events (AEs) of docetaxel constitute an extra burden in the treatment of cancer patients and necessitate either a dose reduction or an outright switch of docetaxel for other regimens. These AEs are frequently associated with genetic polymorphisms of genes encoding for proteins involved docetaxel disposition. Therefore, we investigated that association in Malaysian breast cancer patients. MATERIALS AND METHODS: A total of 110 Malaysian breast cancer patients were enrolled in the present study, and their blood samples were investigated for different single nucleotide polymorphisms using polymerase chain reaction restriction fragment length polymorphism...
May 4, 2018: Clinical Breast Cancer
Marieke van de Ven, Xiaoling Liu, Eline van der Burg, Sjoerd Klarenbeek, Xanthippi Alexi, Wilbert Zwart, Fred Dijcks, Peter Bouwman, Jos Jonkers
Hereditary breast cancers in BRCA1-mutation carriers are mostly estrogen receptor alpha (ERα) and progesterone receptor (PR) negative, however, hormone depletion via bilateral oophorectomy does result in a marked reduction of breast cancer risk, suggesting that BRCA1-associated breast tumorigenesis is dependent on hormone signaling. We used genetically engineered mouse models to dissect the individual influences of ERα and PR signaling in the development of BRCA1-deficient breast cancer. In line with the human data, BRCA1-deficient mouse mammary tumors are ERα-negative and bilateral ovariectomy leads to abrogation of mammary tumor development...
June 7, 2018: Journal of Pathology
Mona Najaf Najafi, Maryam Salehi, Masumeh Ghazanfarpour, Zeinab Sadat Hoseini, Majid Khadem-Rezaiyan
This systematic review and meta-analysis aimed to critically evaluate the relation between green tea (GT) consumption and the risk of breast cancer. Popular electronic databases were systematically searched for papers in English language. All case-control and cohort studies in addition to randomized clinical trials were included if they assessed the chemopreventive effects of GT on breast cancer. The quality of included studies was assessed using the Newcastle-Ottawa and Jadad scale. This systematic review comprised 14 studies: 9 case-control studies, 4 cohort studies, and 1 clinical trial...
June 7, 2018: Phytotherapy Research: PTR
Jesse Caron, Anju Nohria
PURPOSE OF REVIEW: Breast cancer therapies, such as anthracyclines, trastuzumab, and chest irradiation, have well-established cardiotoxicities that lead to adverse outcomes. Here, we will review strategies to mitigate these cardiotoxicities. RECENT FINDINGS: Recent consensus guidelines have established criteria for the identification and surveillance of breast cancer patients at increased risk of cardiotoxicity. Dose reduction, liposomal doxorubicin, and dexrazoxane may be considered in high-risk patients receiving anthracyclines...
June 6, 2018: Current Oncology Reports
Edward Giovannucci
Higher physical activity levels have been associated with about 10% to 25% reductions in up to 13 cancers. In isolation, these results are suggestive but not compelling enough to conclude causal associations, except for colon and breast cancer. However, knowledge on the relationships between obesity and cancer, between physical activity and overall and visceral adiposity, and between physical activity and obesity-related mediators of cancer risk can inform the epidemiology of physical activity and cancer. Excluding primarily smoking-related malignancies, for which residual confounding by smoking may occur, all 13 cancers associated with lower physical activity are also obesity-related...
May 30, 2018: Journal of the National Cancer Institute
Pnina Mor, Sarah Brennenstuhl, Kelly A Metcalfe
Women with a germline pathogenic variant in the BReast CAncer susceptibility genes (BRCA1 or BRCA2) have an increased risk of early-onset breast and ovarian cancer. In addition to weighing cancer screening and risk-reduction options, healthy BRCA mutation carriers of childbearing age may choose to preclude passing the mutation to the next generation. In the current study, we report on preimplantation genetic diagnosis (PGD) practices in BRCA-positive Israeli women who were offered PGD at no cost. METHODS: we measured PGD uptake, decision satisfaction or regret, and predictors of uptake...
June 1, 2018: Journal of Genetic Counseling
Eileen M McGowan, Yiguang Lin, Diana Hatoum
" Lactation is at one point perilously near becoming a cancerous process if it is at all arrested ", Beatson , 1896. Most breast cancers arise from the milk-producing cells that are characterized by aberrant cellular, molecular, and epigenetic translation. By understanding the underlying molecular disruptions leading to the origin of cancer, we might be able to design novel strategies for more efficacious treatments or, ambitiously, divert the cancerous process. It is an established reality that full-term pregnancy in a young woman provides a lifetime reduction in breast cancer risk, whereas delay in full-term pregnancy increases short-term breast cancer risk and the probability of latent breast cancer development...
May 31, 2018: Cancers
Shanaz H Dairkee, Gloria Luciani-Torres, Dan H Moore, Ian M Jaffee, William H Goodson
As a continuous source of hormonal stimulation, environmentally ubiquitous estrogenic chemicals, i.e. xenoestrogens (XEs), are a potential risk factor for breast carcinogenesis. Given their wide distribution in the environment and the fact that bisphenol-A (BPA), methylparaben (MP), and perfluorooctanoic acid (PFOA) are uniformly detected in unselected body fluid samples, it must be assumed that humans are simultaneously exposed to these chemicals almost daily. We studied the effects of a ternary mixture of BPA, MP, and PFOA on benign breast epithelial cells at the range of concentrations observed for single chemicals in human samples...
May 28, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
Arwa A Alzaghal, Pamela J DiPiro
PURPOSE OF REVIEW: Advanced mammographic imaging modalities have been implemented in clinical practices throughout the USA. The most notable and widely used has been the three-dimensional derivative of digital mammography, known as digital breast tomosynthesis (DBT). In this article, we review the screening and diagnostic applications of DBT, along with its limitations. We also briefly address several supplemental breast imaging modalities. RECENT FINDINGS: The accumulating evidence from both small and large-scale trials has shown a significant reduction in recall rates and slight increase in cancer detection rates when using DBT...
May 29, 2018: Current Oncology Reports
Ritwika Mallik, Tahseen A Chowdhury
Metformin is a lipophilic biguanide which inhibits hepatic gluconeogenesis and improves peripheral utilization of glucose. It is the first line pharmacotherapy for glucose control in patients with Type 2 diabetes due to its safety, efficacy and tolerability. Metformin exhibits pleotropic effects, which may have beneficial effects on a variety of tissues independent of glucose control. A potential anti-tumourigenic effect of metformin may be mediated by its role in activating AMP-kinase, which in turn inhibits mammalian target of rapamycin (mTOR)...
May 26, 2018: Diabetes Research and Clinical Practice
Tialfi Bergamin de Castro, Newton Antônio Bordin-Junior, Eduardo Alves de Almeida, Debora Aparecida Pires de Campos Zuccari
PURPOSE: Changes in the circadian rhythm may contribute to the development of cancer and are correlated with the high risk of breast cancer (BC) in night workers. Melatonin is a hormone synthesized by the pineal gland at night in the absence of light. Levels of melatonin and the metabolite of oxidative metabolism AFMK (acetyl-N-formyl-5-methoxykynurenamine), are suggested as potential biomarkers of BC risk. The aims of this study were to evaluate levels of melatonin and AFMK in women recently diagnosed with BC, women under adjuvant chemotherapy, and night-shift nurses, and compare them with healthy women to evaluate the relation of these compounds with BC risk...
May 24, 2018: Endocrine
Ara A Salibian, Jordan D Frey, Mihye Choi, Nolan S Karp
Growing public awareness of hereditary breast cancers, notably BRCA1 and BRCA2, and increasing popularity of personalized medicine have led to a greater number of young adult patients presenting for risk-reduction mastectomies and breast reconstruction. Plastic surgeons must be familiar with treatment guidelines, necessary referral patterns, and particular needs of these patients to appropriately manage their care. Genetic testing for BRCA1 and BRCA2 is most often reserved for patients older than the age of consent, and can be performed in the young adult population (aged 18 to 25 years) with the appropriate preemptive genetic counseling...
June 2018: Plastic and Reconstructive Surgery
Wan-Sze Pek, Bien-Keem Tan, Yvonne Ying Ru Ng, Veronique Kiak Mien Tan, Mohamed Zulfikar Rasheed, Benita Kiat Tee Tan, Kong Wee Ong, Yee Siang Ong
BACKGROUND: Nipple-sparing mastectomies (NSMs) are increasingly performed to obtain the best aesthetic and psychological outcomes in breast cancer treatment. However, merely preserving the nipple-areolar complex (NAC) does not guarantee a good outcome. Darkly pigmented NACs and a tendency for poor scarring outcomes are particular challenges when treating Asian patients. Herein, we review the reconstructive outcomes following NSM at Singapore General Hospital. METHODS: All breasts reconstructed following NSM over an 11-year period from 2005 to 2015 were reviewed...
May 2018: Archives of Plastic Surgery
Dimitry Bazyka, Anatoly Prysyazhnyuk, Natalya Gudzenko, Iryna Dyagil, David Belyi, Vadim Chumak, Volodymyr Buzunov
This article summarizes the results of 30 y of follow-up of cancer and noncancer effects in Ukrainian cleanup workers after the Chornobyl accident. The number of power plant employees and first responders with acute radiation syndrome under follow-up by the National Research Center for Radiation Medicine decreased from 179 in 1986-1991 to 105 in 2011-2015. Cancers and leukemia (19) and cardiovascular diseases (21) were the main causes of deaths among acute radiation syndrome survivors (54) during the postaccident period...
July 2018: Health Physics
Constance A Roche, Rong Tang, Suzanne B Coopey, Kevin S Hughes
Patients with atypical hyperplasia and lobular carcinoma in situ (LCIS) (atypical breast lesions) are at high risk of developing breast cancer, and chemoprevention has been shown to confer a substantial reduction in that risk. Despite this, the overall rate of chemoprevention utilization in this group is low. This study evaluates the efficacy of a formal individualized education and counseling session on patient acceptance and adherence to chemoprevention. Patients with atypical breast lesions having an individualized education and counseling session in a single surgical oncology practice were prospectively entered into a database from 2001 to 2016, and with IRB approval, their data were analyzed...
May 21, 2018: Breast Journal
Joanne Kelly
My mother was diagnosed with triple-negative breast cancer in 1998 at age 48. Her younger sister has been diagnosed with breast cancer at age 33 but ultimately died of ovarian cancer at age 47. Her mother died of ovarian cancer at age 47. I knew my fate. Meanwhile, as the medical world around me kept turning, the medical-surgical floor on which I worked became an oncology floor. This was not part of my plan.
June 1, 2018: Clinical Journal of Oncology Nursing
Qian Zhu, Youlia M Kirova, Lu Cao, Alexandre Arsene-Henry, Jiayi Chen
Radiotherapy is an indispensable unit of multidisciplinary treatment of breast cancer. Although the application of modern techniques has led to a significantly reduction in radiation-induced heart disease, it is still recognized as the leading causes of morbidity and mortality among breast cancer survivors. With the growing number of long-term survivors, it is important to understand the cardiovascular risks associated with radiotherapy. Questions exist regarding the existence or not of a safe radiation threshold dose that the heart (or its substructures) can receive and strategies to minimize risk of radiation...
May 2, 2018: Cancer Treatment Reviews
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