Thursday, June 18, 2015

How Often Do You Really Need a Mammogram?

US News 
Nobody enjoys getting a mammogram, but it is an essential prevention measure against breast cancer deaths. Some experts, however, are questioning how often women really needmammograms to detect cancer and ultimately save lives.
Most women are used to hearing that they should get a mammogram every year starting at age 40. The U.S. Preventive Services Task Force in April issued a draft of mammography recommendations that greatly reduces that frequency, saying evidence to support annual mammograms for women in their 40s is weak. The USPSTF recommends women get mammograms every two years once they turn 50.
The USPSTF is a panel of independent experts that advises Congress, and should its guidelines be adopted, insurers would no longer be required to cover annual mammograms unless Congress mandates they do so. Since releasing the draft of recommendations, several groups have called the guidelines into question.
Traditional Wisdom
The American College of Radiology is one such group, standing firm on yearly mammographystarting at 40. "Every major group with expertise in breast cancer care and the USPSTF agree that annual mammography saves the most lives," says Dr. Debra Monticciolo, chair of the ACR's Breast Imaging Commission. "From a woman's perspective, this is the most important reason to have a mammogram -- to decrease the chance that she will die of breast cancer."
Screening mammography became widespread in the mid-1980s, Monticciolo says. According to National Cancer Institute data, the five-year survival rate of breast cancer was 78.4 percent in 1985. In 2007 it was 91 percent, an increase that is credited to annual screening mammography by experts like Monticciolo.
According to Monticciolo, the USPSTF has "no breast cancer experts on their panel -- not one. This is a major failing of the task force." She goes on to say the task force claims to be eliminating bias "but what they have eliminated is knowledge." Even though the panel consists of medical experts, breast imaging experts are the best to assess breast imaging studies, she adds.
"I wouldn't presume to review a brain study and give neurology guidance," Monticciolo says. "Without proper expertise, they have been unable to accurately and completely assess the scientific literature."
The New Analysis
To be clear, the USPSTF's new guidelines don't recommend against annual screening mammography for women in their 40s. "It's clear that the value of mammography increases with age," says Dr. Kirsten Bibbins-Domingo, vice chair of the U.S. Preventive Services Task Force. "But women between the ages of 50 and 74 are the most likely to achieve the benefits of mammography with the fewest harms," she adds, saying that screening visits every other year will still yield the same benefits.
That's for most women -- those with an average risk of developing cancer. "The decision to start screening mammography in women prior to age 50 years should be an individual one," reads the draft. The expert panel also found adequate evidence that annual mammography results "in harms for women aged 40 to 74." Those harms include stress and psychological strife from extra procedures due to false positives, such as biopsies or more imaging studies. The USPSTF says false positives are "common" in mammography.
"Our goal is to give women and their doctors advice for what frequency gives you the greatest chance of preventing death by breast cancer, while keeping negative effects and false positives minimal," Bibbins-Domingo says. Women who are at a higher risk of breast cancer, including those with a strong family history, should consult with their doctors about more frequent screening, the USPSTF advises.
You'd be forgiven for thinking that exposure to radiation is also one of the main harms, but it isn't. According to the American Association of Physicists in Medicine, dosages of radiation below 50 to 100 mSv are "too low to be detectable and may be nonexistent." An average bilateral mammogram delivers only 0.5 mSv, or 1 percent of the minimum dosage for risk.
The Fight
One of the dangers outlined in the task force's analysis is the sticky subject of overdiagnosis. "Some mammograms are going to detect a cancer that wouldn't have caused a problem for a woman in her lifetime," Bibbins-Domingo says. For example, a cancerous tissue detected by mammography that never would have spread, or at least not before something else took the patient's life first.
"If that cancer is treated, then you have all the harms that come along with overtreatment," Bibbins-Domingo says. That includes the often devastating side effects of chemotherapy, which is also expensive at an average of $80,000 to $100,000 a year.
Since it's often difficult to predict the impact of cancer down the road, the prudent thing to do istreat it, or so many believe. "When we're screening, we're looking for very early stage cancer," Monticciolo says, and the earlier cancer is detected, the better survival rates are.
Trying to estimate the percentage of cases that are overdiagnosed, or present no harm, is difficult without a crystal ball. The USPSTF calculated a rate of 19 percent -- that is 19 percent of breast cancer cases posed no threat, but it notes that some literature suggests a rate as high as 54 percent.
Monticciolo says that estimate is "markedly exaggerated, which a proper assessment of the literature will uncover." According to the International Agency for Research on Cancer, overdiagnosis is somewhere in the 1 to 10 percent range, with a summary estimate of 6.5 percent. The ACR agrees with that number based on its evaluation of the evidence, Monticciolo says.
Despite that lower estimate, the agency agreed with the USPSTF that evidence that annual mammograms reduce mortality for women in their 40s is "limited." The IARC is part of the World Health Organization, which released the same findings in 2002.
The USPSTF draft was open to public comment until May 18. After the panel carefully reviewed public comment, according to its websites, it is in the process of finalizing the recommendations. Once the final recommendations are released, many women could lose annual screening mammography coverage because the Affordable Care Act uses USPSTF guidelines to determine qualifying preventive care, according to the ACR.
There is one thing all experts agree on: Breast cancer is a highly individual disease, influenced by genes, family history and unknown factors. Talking with your doctor openly about the risks and benefits of mammography is the best guidance you can get, and annual exams are still covered as free preventive care -- for now. "Women should always be aware of their bodies, and changes in their bodies," Bibbins-Domingo says. And if something changes, make an appointment.

Thursday, June 11, 2015

Eating on Chemo: Tips to Overcome Taste and Weight Challenges

US News 
When you're being treated for cancer, food can lose all its appeal. But maintaining good nutritionis more important than ever as you move toward recovery. Dietitians -- and a patient who's been there -- share their advice for how to eat right.
The Nutrition Strategy
Linda Kao of Dallas has gone through a gamut of cancer treatment -- chemotherapy, radiation and surgery. Kao, assistant dean of global programs at Southern Methodist University's Cox School of Business, was traveling in Chile in October 2010 when she says she noticed an "odd mass" in her mouth.
On her return to Dallas, Kao found out she had tonsil cancer, and she began treatment at the Baylor Cancer Center. "From the very first meeting with my oncologist, he introduced me to the nutritionist/dietitian and told me she would be my best friend -- and one of the most important people throughout the treatment," says Kao, who answered questions via email because the cancer treatment significantly weakened her voice.
It's often difficult for patients with head and neck cancers to maintain their weight, so Kao's nutritionist recommended that she put on some pounds early on. Throughout 18 weeks of chemo, antiemetic medications and careful monitoring of her diet staved off nausea and vomiting.
While Kao says she felt "miserable" during the first week, she forced herself to eat. By week three, she felt better and ate as much as she could before facing the next round of chemo. She says she actually gained about 15 pounds. Then came radiation.
Loss of Appetite
When it comes to cancer and nutrition, "everybody wants to do their best, try their hardest to increase their chances of survivorship -- but also feel well in the moment," says Stacy Kennedy, a registered dietitian and senior nutritionist at Dana-Farber/Brigham and Women's Hospital Cancer Center in Boston.
But side effects -- including nausea and vomiting, appetite loss, constipation and diarrhea -- interfere.
Suzanne Dixon, a registered dietitian and former chair of the Academy of Nutrition and Dietetics'Oncology Nutrition Dietetic Practice Group, points out that cancer is not a single disease -- no two cases are identical. Symptoms, treatments and responses vary widely from patient to patient. So it's important to work with a registered dietitian, she says, ideally one who specializes in oncology nutrition.
To combat appetite loss, Dixon suggests doing light physical activity to stimulate appetite, keeping food handy for moments when appetite returns and eating by the clock instead of waiting for hunger cues. Eating small, frequent meals is another way to maintain nutrition as appetite shrinks, Kennedy says.
Smoothies also make great between-meal options. "You can kind of multitask in your glass," she says. "If your goal is to get fruits and vegetables, protein, hydration, fiber, electrolytes -- a smoothie can help you do all that at once."
Nausea Control
Keeping nausea at bay is a balancing act -- an empty stomach, a too-full stomach or even hunger can make it worse. Food odors can stimulate nausea, Dixon says. Eating low-odor foods, avoiding food preparation areas and using a lidded cup while drinking smoothies or nutrition supplements can minimize nauseating smells.
Acupuncture also has been shown to help prevent nausea and vomiting in people receiving chemotherapy, according to the National Cancer Institute, Dixon notes.
It's important to replenish lost nutrients, especially when patients experience vomiting, Kennedy says. "With vomiting, you have to really focus on your hydration with electrolyte-rich fluids like broth -- regular broth, not low sodium."
Dixon emphasizes that patients should not endure vomiting as an "expected" chemo side effect to be tolerated: "If you're vomiting profusely, that's a medical problem -- and you really need to talk to your physician or nurse," she says.
Temperature and Taste
Certain types of chemotherapy -- like Oxaliplatin used to treat colon cancer -- may cause sensitivity to cold, including chilly weather and cold beverages. Patients experiencing temperature side effects will be advised to avoid icy or cold drinks.
Tastes can also change during treatment, and once-favorite foods may seem "off." With bitter or metallic tastes, Dixon suggests seasoning food with fresh basil or oregano, using fruit marinades for meat and replacing metal utensils with plastic or bamboo.
Round 2: Radiation
Radiation proved tougher than chemo for Kao. "It burned up my throat -- I lost my voice completely two weeks into treatment," she recalls, adding that the treatment caused swelling inside of her mouth and throat as well as "tremendous pain." Eventually, Kao could no longer keep food down. Her dietitian recommended diet supplements and drinks to keep up with calories and protein.
"Mouth sores can be a really horrific problem with head and neck cancer patients," Dixon says, adding that.medicated mouth rinses can help relieve pain.
With mouths sores, hot foods and liquid should be avoided, and soft, bland foods are preferable to rough, dry foods such as crackers, toast or raw vegetables, Dixon says. Frozen grapes or melon balls are worth a try (if cold sensitivity isn't an issue).
Acidic items, like foods preserved in vinegar, are problematic as well. Kennedy suggests subbing cool avocado for acidic fruit such as oranges, pineapples and lemons.
Some patients who have trouble swallowing after radiation may need a small feeding tube to supplement nutrients with products like Ensure or Glucerna.
Weight Loss or Gain
Cancer and treatment can lead to unwanted weight loss. But for some patients, weight gain is the issue. That can develop from a "perfect storm" of certain treatments, types of cancer, less physical activity and craving high-carb foods, Kennedy says. Surgery can also affect weight and limit what patients eat.
Whatever the issue, Kennedy says, patients and dietitians can work together to develop an individualized plan that might change as patients go in and out of treatment.
Fighting Fatigue
Fatigue is an almost across-the-board side effect among cancer patients, Kennedy says. At home, you may be too tired to cook -- much less eat. "Going through cancer treatment itself is a full-time job," she adds.
Dana-Farber's nutrition webpage offers a free nutrition app that helps cancer patients enter food preferences, select recipes and build shopping lists to share with caregivers or others who want to lend a hand in the kitchen.
"Reach out and either ask or accept help people offer," Kennedy says. "So many people in every culture express love and care through food."
Foodie Interrupted
Kao still wasn't finished with treatment. The radiation damaged her jawbone, and she had hyperbaric oxygen therapy to repair the bone, followed by complex neck surgery to remove additional tumor found around the carotid artery. Then came the final round of chemo.
Since March 2012, Kao has been cancer-free. Over the past three years, she's learned to enjoy eating again -- but there is a difference.
"I was a foodie," Kao says. "[But] when you have a hard time swallowing from damage to the throat and saliva glands, it pretty much eliminates a whole bunch of food." The challenge, she says, is to eat what you can while taking in enough of the right foods to stay healthy. Avocado, lightly cooked eggs, smoked salmon, sashimi, medium-rare filet mignon, berries and papaya are manageable -- and tasty -- choices for Kao, along with raw fruits and veggies tossed in a blender.
During treatment, people should realize good nutrition "is one of the most important tools to help you fight cancer," Kao says. "You hate the thought of food, but you have to think positively that food is your friend."
Lisa Esposito is a Patient Advice reporter at U.S. News. You can follow her on Twitter, connect with her on LinkedIn or email her at lesposito@usnews.com.

Friday, June 5, 2015


Living With Cancer: Keep On Cooking

Turkey tail mushrooms.
SUSAN FARLEY FOR THE NEW YORK TIMES
Julia put a glass jar of turkey-tail mushrooms on the restaurant table. Drinking home-brewed tea helps her combat the side effects of treatment. The day before a blood test — which would reveal whether or not an experimental drug was working — I placed one delicate bit on the center of my palm. The ridged striations and concentric ruffles reminded me of the tiny angel-wing shells that Leslie’s partner had collected on Sanibel Island for our cancer support group. 
When I put down the mushroom to pick up a menu, nothing on it resembled the foods I had been enjoined to eat at a cancer conference I had just attended.
Next to the podium a speaker stood beside a blender in which she put almond milk, half of an avocado, a banana and flax seeds. Conference participants were told to eat fresh fruits and vegetables, to abstain from sugar and dairy and meat. We were urged to avoid white foods and instead to consume dark greens, bright oranges, vivid reds and glowing yellows. Raw and organic are the way to go, or slow roasted and locally grown. Whole grains should be a staple, but turmeric, garlic and ginger can be added abundantly, along with blueberries, walnuts, wild salmon and especially kale.
Such advice — which arrives in books and emails, on TV shows and websites — surely helps some people and might prevent disease. Decades ago, I was vigilant about carrot sticks, apples, whole wheat sandwiches and milk in my children’s lunch boxes. Yet the food gurus seem oddly irrelevant to those in treatment, at least to those of us around the table. The jar of turkey-tail mushrooms helped but did not entirely distract us from the difficulties of ordering.
Like many people with an ileostomy, I have to follow a low-fiber diet. Oddly it banishes all the foods most dieticians consider healthy: beans, cabbage, cauliflower, berries, nuts, lentils, corn and pretty much anything uncooked. I ordered a fried egg over easy and toast as the conversation turned toward appetite stimulants, medical marijuana, Nexium, the cost of Zophran and Emend, and committees deciding (“pre-certing”) which anti-nausea drugs can and which cannot be covered by insurance companies. 
Dana looked the most vulnerable because she was in radiation and had lost more than 15 pounds: “What goes in just comes out — one way or the other,” she shrugged with a crooked smile over her mashed potatoes. Leslie, after informing us that her tumor marker had risen, returned the gumbo not to her taste. Trudy, poking at her salad, laughed about a blog that recommends anorexia for people on maintenance therapy. If we starve ourselves, maybe we can help the chemo reduce the cancer. Just back from a hiking expedition to celebrate a remission, Traci sipped her wine and sampled her pate while explaining why Dexamethesone might be more effective in the bag than in pill form.
Only the next day in the hospital, while I waited for test results with an emaciated man sucking a Popsicle, did I understand what my friends were telling me. The best cancer diet consists of eating whatever we can and not eating whenever we can’t.
Maybe the turkey-tail mushrooms and angel-wing shells have brought me good luck. Or is it the gift of the company they keep? The experimental drug seems to be effective — at least for now. Silently to the man with the Popsicle, I promised to continue preparing healthy meals.
I gazed at the fragment of mushroom and the two conjoined shells tucked into a compartment of my purse. It turns out that even though turkeys migrate by walking, they can fly — one quarter of a mile, close to the ground. Let flights of turkey-tails and angel-wings take each one of us as far as we can get, I prayed.
That happened two years ago, a few months before Leslie died. Julia, Dana, Trudy and Traci still meet with me every two weeks and are thriving. We have been joined by Carrol and Ilka, both currently coping with the eating disorders that accompany another round of chemotherapy. We represent a new phenomenon of patients living longer with cancer: Two out of three people diagnosed with invasive cancer now survive for five years or more. When strong enough, we slice, simmer and serve what we can savor on the mutable menu of possibilities.
The point is to keep on cooking, if at all possible. Even on restrictive diets, there are treats to raise our spirits and those of our companions like this variation on traditional pizza. Pissaladiére, pronounced peehs/sah/lah/dyehr, needs neither tomatoes nor cheeses. For those who cannot eat raw vegetables, a bright red pepper soup is a fine alternative.
Pissaladiére
Risen pizza or focaccia dough for one pie
5 tablespoons of olive oil
4 onions sliced thin
1 teaspoon of salt
2 tablespoons or a bit more of water
3/4 cup pitted black olives sliced in half
7 anchovy fillets, rinsed, patted dry, and cut in half
2 teaspoons thyme or sprigs of fresh thyme
1. Heat 2 tablespoons of olive oil in a large skillet over high heat and then stir in the onions and salt. Stir frequently, for ten minutes. Reduce the heat to low, add water, cover, and continue until the onions become soft, sweet, and golden brown, about 20 more minutes. 
2. With well-oiled hands, punch down the dough and form it into a 13 inch by 7 inch oval on an oiled cookie sheet. Brush the edges with oil. Leaving a ½ inch border, spoon the onions evenly over the surface. Use the anchovies, olives and thyme to make a pattern. 
3. Bake in a 450-degree oven for 20-25 minutes. 
Red Pepper Soup
2 tablespoons of olive oil
2 large garlic cloves minced
1/4 cup of white wine
Pinch of red pepper
2 teaspoons of thyme
3 large red peppers cut in chunks
5 cups of stock
1. Heat the oil and sauté the onion until soft, but not brown. Raise the heat and add the garlic, wine, pepper flakes, and thyme until the liquid evaporates. Add the red peppers and stock and simmer for 1 hour. Pureé in a blender or a food processor. Add water and salt if needed.
Yield: 6 servings

Thursday, May 28, 2015

New law aims to make breast cancer testing more effective

Women with dense breast tissue — the sort that can hide potentially deadly tumors from routine mammograms — must be notified in writing and encouraged to consider additional tests under a new state law that is effective Monday.
Dr. Renee Wayne Pinsky, who specializes in breast imaging, takes a break from examining scans at the more
While mammograms remain the gold standard for detecting breast tumors, they're less reliable in almost half of women with dense breast tissue. Dense or fibrous tissue shows up as splotches of white on a mammogram — so do tumors.
That will likely surprise many of the millions of women who rely on mammography for catching the earliest signs of cancer, said Nancy Cappello. The Connecticut woman was shocked in 2004, when her gynecologist found a lump — advanced cancer that had already spread to her lymph nodes — just months after a mammogram deemed her cancer-free.
"I'm thinking, 'Why do you think I'm getting my breasts squeezed every year and getting radiation (from mammograms) every year? It's supposed to find my cancer," she said.
Cappello has been fighting for years for mandatory notification laws across the U.S. and established the www.AreYouDense.comweb site to raise awareness about the limits of mammography in dense breast tissue. Inspired by Cappello's efforts, Grand Rapids attorney Teresa Hendricks-Pitsch, pushed for the new Michigan law. She even wrote out arguments for the law in 2011 while hooked up to a chemotherapy drip to fight cancer that had spread to her lymph nodes.
“We’re not going to diagnose all cancers on mammography,” says Dr. Renee Wayne Pinsky, a radiologist who says more
Hendricks said a surgeon who excised her tumor told her it most likely had been growing for years. Hendricks-Pitsch's annual mammograms also missed the cancer.
If women know about the limitations of mammograms in dense breast tissue, they can opt for follow-up screenings — ultrasounds or an MRI, for example, the women said.
Both said their health care providers knew about the presence of dense breast tissue, but no one told them or suggested additional testing or follow-up exams.
"My radiologists knew about it. My doctor knew about it," said Cappello. "Everybody seemed to know about it but me."
In Michigan, Hendricks-Pitsch said some have suggested she file a lawsuit. A change in law makes more sense, she said: "I want other women to have the information I didn't."
A woman gets a mammogram at the U-M center on Friday.
 (Photo: Kimberly P. Mitchell/Detroit Free Press)
Exams aren't perfect
Perhaps the first step in understanding is knowing this: Finding cancer in a mammogram is a matter of interpretation — the ability to discern an abnormality from a canvass of threads and splotches and spots in black and white and shades in between.
Dr. Renee Wayne Pinsky, a radiologist at the University of Michigan Comprehensive Cancer Center, likens it to searching for a cotton ball in a snowstorm.
In a breast with fatty, less-dense tissue, the whiteness is more scattered against a gray and black landscape. An anomaly — such as a cotton ball — is easier to spot, said Pinsky.
But trying to read a scan of a dense breast tissue is more like peering through a fierce blizzard, trying to glean from a mostly white background a malignant whiteness.
"We're not going to diagnose all cancers on mammography," said Pinsky, who helped fine-tune some of the language in the law, which was introduced by Sen. Dave Hildenbrand, R-Lowell, who represents Hendricks-Pitsch's district.
Though some lawmakers and health providers raised concerns about the extra time demands on doctors, about insurance coverage and about causing unnecessary worry among patients, Michigan approved the bill in December. Gov. Rick Snyder signed it Jan. 10.
Michigan is among 22 states now with some law addressing raising awareness among women about the limits of mammograms in dense breast tissue.
The Medio-lateral Oblique scan on the left shows a fatty breast compared to the breast on the right, which more
Mammogram reports sent to doctors routinely contain information about breast density, but — without a law — its importance in screening is not always passed along to patients or discussed in a way that it's easily understood, said U-M's Pinsky.
And women with extremely dense breasts may face a twofold increased risk of breast cancer than they would if they had less-dense breasts. But Pinsky and other experts also say dense breast tissue doesn't necessarily justify more testing. On its own, dense tissue is not a cause for alarm.
"If you get the letter, the first thing I would tell you is not to worry (about dense breast tissue). It's a common factor," said Dr. Murray Rebner, chief of breast imaging at Beaumont Hospital in Royal Oak and a past president of the national Society of Breast Imaging.
Rather, it's one of many variables that are sifted into a woman's breast cancer risk calculus, he said. Others include family history, age, the age when a woman began menstruating, and the age when she first gave birth.
If a patient's level of risk warrants more testing, there are several options, including ultrasounds, that use sound waves to peer inside the breast, magnetic resonance imaging (MRI), which uses magnetic fields, or molecular breast imaging, which uses a higher dose of radiation than mammograms but has a high rate of cancer detection.
However, unlike routine mammograms, which are free under federal health reform because they're considered a preventive service, insurers differ on how they cover those tests. Blue Cross Blue Shield of Michigan and Health Alliance Plan, two of metro Detroit's largest insurers, say they cover such tests on a case-by-case basis, for example.
Cappello said the cost shouldn't discourage women from talking to their doctor. It is the doctor, she said, who can help them better understand the risk, sort through pros and cons of follow-up exams and help them work with insurers.
Contact Robin Erb : 313-222-2708, rerb@freepress.com or on Twitter @Freephealth

Wednesday, May 27, 2015

5 Cancer Research Stories Worth Following

Cancer research news in Spring 2015 included clinical trial results for immune system therapies presented at the annual meeting of the American Association for Cancer Research.What’s exciting in cancer research right now?  In this post, I’ll briefly review several notable cancer research stories that have come out this Spring.
These are a few of the recent stories that seem to have the greatest potential impact, at least from my perspective, and that I know I’ll want to follow as they develop further.
Therapies that boost the immune system’s ability to fight cancer continued to figure highly in cancer research news this Spring, including news from the annual meeting of the American Association for Cancer Research (AACR).

Immune System Therapies

One of the highlights of the AACR meeting was a report of preliminary results of a clinical trial of the drug Keytruda (generic name is pembrolizumab) for patients with advanced non-small cell lung cancer.  The study results also were published in the New England Journal of Medicine
Nearly half of the patients in the study whose tumors expressed high levels of a protein called PD-L1 had their cancers respond to the drug, and most of the patients in this group are still alive after more than a year.
Keytruda acts by “releasing the brakes” on the immune system. It has already received FDA approval for the treatment of advanced melanoma. For more about the study, see this report in MedPage Today.

Combining Therapies to Increase Effectiveness

Whether it’s immune system therapies or other molecularly targeted therapies, researchers are beginning to find that combining therapies can produce better results than individual therapies alone. Targeted therapies can also be combined with traditional chemotherapy or hormone therapies.
Typically, advanced cancers become resistant to an individual targeted therapy at some point, and it’s thought that combining therapies could help address this by blocking two different pathways that the cancer could use to progress.
Dr. Srivani Ravoori has written two interesting articles about studies on combination therapies that were presented at the AACR meeting. The first is on immunotherapy combinations for advanced melanomaand the other article is about combinations of molecularly targeted therapies for subgroups of breast and ovarian cancer.

Post-Treatment Monitoring

An experimental technique, sometimes referred to as a liquid biopsy, is beginning to show promise as a tool for detecting early signs of relapse or to determine when a treatment is no longer working, the New York Times reports. The test requires only a blood draw, and the patient’s blood is then screened for fragments of circulating tumor DNA.
study reported in The Lancet found that, for patients with a type of lymphoma, circulating tumor DNA successfully identified most patients at risk for recurrence of their disease.
Another recent study found that, for patients with early stage breast cancer, periodic testing for circulating tumor DNA may be able to detect signs of metastasis long before symptoms are evident. Prospective studies with larger  patient groups will be needed to confirm these findings.

Breast Density and Cancer Risk

Having dense breast tissue is one of the factors that has been shown to be associated with an increased risk for breast cancer. Mammograms can also be harder to read and therefore less informative for women with higher breast density. However, this condition is extremely common and there is no consensus on when and if additional imaging tests are necessary for women with dense breast tissue.
study reported in the Annals of Internal Medicine found that breast density considered along with other key risk factors including age, ethnicity, family history and history of breast biopsy provides a better indication than density alone of a woman’s risk for an invasive cancer appearing between mammograms.
Dr. Susan Love explains the study’s findings in a recent blog post, noting that not only breast density, but other factors as well, need to be taken into consideration when women and their doctors discuss additional screening.

Reducing Long Term Side Effects

The side effects of breast cancer treatment, including adverse psychological effects, can sometimes extend for years after treatment has been completed. One intervention that has been shown to be helpful is specialized training in stress management techniques. A study reported in the journal Cancer provides new evidence of the long-term benefits of this intervention.
In a randomized, controlled clinical trial, about 240 women received either a one-day psychoeducational seminar or a 10-week course in cognitive-behavioral stress management. Not surprisingly, in the short-term it was found that the training helped the women cope successfully with the stress of treatment. But interestingly, in a group of 100 women contacted for follow-up 8 to 15 years later, the women who had received the stress management training reported levels of depression and quality of life that were comparable to women who had never had breast cancer.
That’s it for this time. If there was another recent cancer research story or article that caught your attention or if you have thoughts on any of what I’ve included, I’d love to hear from you!
Photo by Lisa DeFerrari

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