Breast Cancer Archive

The FDA may require mammography facilities to notify patients about this breast cancer risk factor, but women don't know what to do with this information.

Do you know how dense your breasts are? If you don't, a new proposal by the FDA may mean you will soon find out.

The agency proposed a change that, if approved, will require mammography facilities to send letters informing women about their breast density — a measure of the proportion of active tissue versus fat in their breasts (see "The FDA proposal").

The male breast is much smaller than its female counterpart, and it cannot produce milk. Because of this smaller size and simpler structure, breast disease is much less common in men than women. Still, men can develop important breast problems, both benign and malignant. Early detection is the key to a successful outcome, so every man should understand the basic elements of male breast disease.

Digital breast tomosynthesis may also reduce the number of unnecessary and nerve-racking callbacks for additional testing.

If you're in your 40s, you may want to consider switching from digital mammography to digital breast tomosynthesis (DBT) for your next breast cancer screening, say the authors of a study published online February 28 by JAMA Oncology.

A review of more than 170,000 screening mammograms using the two technologies determined that DBT — sometimes referred to as 3D mammography — did a better job at accurately detecting cancers in women of all ages. The advantages were most pronounced for women in their 40s. DBT was also better at finding cancers in women with high breast density, which can make cancers more difficult to spot on screening exams. High density indicates a larger proportion of active tissue in the breast and is a risk factor for breast cancer.

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A new study published online August 10 by the Journal of the American Medical Association shows that women with ductal carcinoma in situ (DCIS) — cancerous changes to the cells inside the milk ducts of the breast — may have better results if they have radiation in addition to a lumpectomy.

Researchers examined 15-year outcomes in 140,000 women with DCIS who underwent either lumpectomy or mastectomy alone, or both lumpectomy and radiation. Women who had radiation in addition to lumpectomy procedures were slightly less likely to die from breast cancer than women who had either a lumpectomy or mastectomy procedure alone.

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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.

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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.

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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.