Breast Cancer Archive

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Prepackaged, processed foods are typically high in fat, salt, and sugar. If that's not enough to make you put down a cookie or resist a frozen dinner, consider an observational study published online Feb. 14, 2018, by The BMJ. It analyzed dietary questionnaire answers of 105,000 middle-aged men and women in France for five years. Foods were grouped according to degree of processing — that is, the amount of change the ingredients go through as food makers improve flavor, coloring, and shelf life. For example, dehydrated soups, baked goods, sugary cereals, processed meats, biscuits, and sauces were considered ultra-processed foods. Less processed foods included canned vegetables, cheeses, and freshly made unpackaged bread. Every 10% increase in consumption of ultra-processed foods was associated with a 12% higher risk for cancer in general and an 11% increased risk for breast cancer. No significant link was found to prostate or colorectal cancer. The study doesn't prove that ultra-processed foods cause cancer, but researchers say the cumulative effects of food additives remain largely unknown.

But surveillance and other strategies — especially exercise — can limit the risk.

 Image: © Khuong Hoang/Getty Images

Better treatments for breast cancer have contributed to the growing number of breast cancer survivors, now about three million in the United States. However, these women may face a heightened risk of heart disease from the cardiotoxic effects of chemotherapy and radiation, according to a statement from the American Heart Association in the Feb. 20, 2018, issue of Circulation.

Doctors have long known that certain cancer drugs can decrease the heart's pumping ability, especially doxorubicin (Adriamycin) and trastuzumab (Herceptin), two common treatments for breast cancer. Many women receive radiation therapy as well, which can cause heart tissue to scar or stiffen, possibly leading to valve disorders, coronary artery disease, or other heart problems. But specialists who focus on keeping the heart healthy during and after cancer treatment — known as cardio-oncologists — can offer strategies to both prevent and treat heart damage from cancer therapy.

Screening for lung and breast cancer may reveal information about the health of your heart's arteries.

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Screening tests for two of the most common forms of cancer involve detailed x-ray images of the chest. Growing evidence suggests that these tests — chest computed tomography (CT) scans and mammograms — may also offer clues about a person's risk of heart disease.

"Both doctors and their patients should be aware that the low-dose CT scans used to find lung cancer can also detect plaque in the arteries of the heart," says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital. CT scans take a series of rapid-fire x-rays in seconds. Combined, the images allow doctors to "see" structures inside the body.

Several factors can make you more likely to develop a secondary cancer. Some are under your control. Others aren't. It's important for you to discuss your risks with your doctor and find out what you can do to lower your odds of developing cancer again. Equally important, discuss how often you need to get screened, so you can catch any new cancers early.

Childhood cancer. If you developed cancer before age 15, you'll need to stay on top of your health in the years to come. Some childhood tumors are caused by inherited syndromes that contribute to a lifelong increased risk for cancer. For example, Li-Fraumeni syndrome can lead to sarcoma, leukemia, and brain and breast cancers. The treatments you received to combat childhood cancer can also make you more vulnerable to future malignancies.

Research we're watching

The FDA's medical device reporting program recently announced that as of February 1, it had received 359 reports of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin's lymphoma, in women who had received breast implants. Nine women had died of the disease. The FDA uses such reports to alert clinicians about potential significant side effects from approved drugs and devices, and as it gathers more information, the data may change. Many reports contained details of the implants, including whether the outside surface was smooth or textured and whether the filling was silicone gel or saline.

ALCL is usually found within a capsule of fibrous scar tissue that forms around an implant, not in the breast tissue itself. It appears to develop more frequently in women with textured implants, regardless of filling type.

The decision depends on several factors, including your breast cancer risk, life expectancy, and personal preferences.

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As you get older, your body isn't the only thing that's changing. So are the guidelines for taking care of it. Breast cancer screening guidelines are a case in point. The current U.S. Preventive Services Task Force (USPSTF) guidelines recommend a mammogram every two years for women ages 50 to 75 with an average risk of developing breast cancer. For older women, the USPSTF said there isn't enough evidence of the potential risks and benefits of mammography on which to base a recommendation.

Although breast cancer is a leading cause of death in older women, women over 75 haven't been included in studies of mammography. However, there is evidence that most breast cancers detected in older women are relatively slow growing and easily treated. While a mammogram performed today might detect a cancer that would not spread or metastasize for several years, the percentage of women who survive to that point decreases with each passing year.

Research we're watching

For many women with breast cancer, hair loss is the most distressing side effect of chemotherapy. Although cooling the scalp with ice packs has been tested, the technique has had limited success. However, a newer approach — wearing a cap connected to a cooling system that gradually reduces scalp temperature — has been more successful, according to two reports in the Feb. 14, 2017, Journal of the American Medical Association.

In one study, 67 of 106 women with stage I or stage II breast cancer who used the FDA-approved DigniCap during their treatment with taxane (Taxol and others) lost less than half of their hair. In comparison, 16 women who underwent the same treatment but did not wear the cooling cap lost all of their hair.

Ask the doctor

Q. I have been smashed, squashed, pulled, and tugged annually for 25 years. Why isn't there a better way to take a mammogram?

A. We hear you! Compression mammography has been the "gold standard" for decades for one reason — it works. Flattening the breast makes ductal tissue easier to distinguish and reduces the amount of radiation required to do so. Studies have demonstrated that it is the most effective approach to breast cancer screening.

Research we're watching

Ductal carcinoma in situ (DCIS) differs from breast cancer because it is noninvasive, so it cannot spread to other parts of the body. However, it can progress to an invasive breast cancer, which can be life-threatening. Researchers from the Netherlands Cancer Institute wanted to determine how DCIS affected long-term survival.

The team studied almost 10,000 postmenopausal women who were diagnosed with DCIS between 1989 and 2004. They tracked the patients over an average of 10 years and compared their death rates with the expected mortality rates of the general population. They found that women who had been treated for DCIS had a 2.5% risk of dying of breast cancer over 10 years and a 4% risk at 15 years — rates that were higher than in the general population. But they also found that DCIS survivors had a 10% lower risk of dying from any cause compared with the general population. They presented their results Jan. 27, 2017, at the European Cancer Congress.

Women with early cancer in one breast may opt to remove the other, healthy breast because they overestimate their risk of a second cancer.