GlaxoSmithKline on Tuesday announced that the European Commission has referred its breast cancer drug Tyverb, sold in the U.S. as Tykerb, to the European Union’s Committee for Medicinal Products for Human Use after new data found a risk of elevated liver enzymes in women taking the drug, Reuters Health reports. Tykerb is taken in combination with Roche’s breast cancer treatment Xeloda to treat women with HER2-positive breast cancer, an aggressive form of the disease found in about 25% of breast cancer patients that involves extra copies of the HER2 protein.
CHMP in December 2007 conditionally approved the drug but said additional data was necessary (Reuters Health, 3/18). Final CHMP approval had been expected by March 8 (Berton, Dow Jones, 3/18). A review of clinical trials and postmarketing data found that hepatotoxicity, or elevated liver enzyme, was present in four of every 1,000 women who took the drug, according to GSK. The company in a statement said the side effect was “uncommon” and that the liver enzymes “generally returned to normal” after treatment.
According to Mike Ward, an analyst at Nomura Code, the new data likely will not change the risk-benefit profile of the drug. He said that it could add a “slight delay” to the drug’s “official approval.” Ward said the risk of elevated liver enzymes will be added to the drug’s label but will not be a “major issue” (Reuters Health, 3/18).
GSK provided information about the new data to scientists overseeing clinical trials and health care providers in countries where the drug is approved. The company also sent a letter to physicians advising them to monitor the liver enzymes of patients taking the drug. A company spokesperson did not speculate on whether FDA will take any action as a result of the new data. FDA officials were unavailable for comment.
CHMP likely will discuss the drug at its next regulatory meeting, which is scheduled for April 21 to April 24, Dow Jones reports (Dow Jones, 3/18).
Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.
© 2007 The Advisory Board Company. All rights reserved.
Breast care services to remain at Llandudno and proposals to redevelop Ysbyty Glan Clwyd.
Health Minister Edwina Hart today guaranteed the continued provision of breast care services at Llandudno Hospital for the foreseeable future and announced plans to redevelop Ysbyty Glan Clwyd.
The announcement follows reviews carried out into services provided at the hospitals.
Edwina Hart said:
“Last month, I announced that following the review into services at Llandudno Hospital and the recommendations it made, I would embark on a further round of discussions with relevant groups and organisations locally.
“Today I can confirm that, following these discussions, I have accepted the recommendations into further service enhancement at the hospital and for cardiac and stroke services to be relocated, in the longer term, elsewhere in North Wales.
“I will therefore be asking Conwy Local Health Board to take these recommendations forward in partnership with the NHS Trust, Community Health Council and local clinicians. Following my discussions with local clinicians, I have agreed that they will be fully involved in this process from the start as the LHB develops its action plan.
“I received a number of important representations from women patients, emphasising the advantages of single sex wards which Llandudno provides. The current breast care service should remain at Llandudno for the foreseeable future whilst further work and advice is provided on a model of breast care services in North Wales.
“Following discussions with clinicians, and in light of my acceptance of the recommendations for the future service enhancement of Llandudno Hospital, I am persuaded that further work needs to be done to explore the possibility that Llandudno could become a centre of excellence for breast care services.
“Overall, this means that Llandudno will boast an impressive range of services including a new rheumatology service, an extended gastroenterology service, increased day case surgery capacity and enhanced neurological services.”
On the future of Ysbyty Glan Clwyd, she said:
“I am pleased to confirm that the building can continue to be used in its current form, subject to a number of caveats.
“In the short term, the Trust must address a number of issues affecting fire safety. However, longer term it is clear that the core of the existing hospital must be rebuilt. I have asked the Trust to submit proposals for redevelopment.
“In working towards this, I have made it clear that the Trust must undertake a comprehensive service modelling exercise, involving the other Trusts in North Wales and including primary and community care, and to take into account the various reviews into services in North Wales and looking at the requirement for a critical care centre.”
A further announcement on the redevelopment of Ysbyty Glan Clwyd will be made following the submission of the proposals from the Trust.
Welsh Assembly Government Press Office
http://www.wales.gov.uk
It has been said that cancer doesn’t discriminate. Sadly, that is not always the case when it comes to cancer care. In an effort to educate and inform both the public and medical community, the Northern California Cancer Center is conducting the Equality in Breast Cancer Care Study to learn more about how women from diverse cultural and ethnic backgrounds go through the experience of being diagnosed and treated for breast cancer.
“We are very excited to have the opportunity to conduct this novel inquiry into why disparities exist among certain groups of women diagnosed with breast cancer,” said Dr. Scarlett Lin Gomez of the Northern California Cancer Center. “We hope that our findings will ultimately help to improve how cancer treatment is given in various populations and to help ensure that all women, regardless of race, language, income or any other factors, have an equal opportunity for treatment.”
Dr. Gomez — the recipient of a BC06 Idea award from the Department of Defense — and her team at the Northern California Cancer Center hypothesize that racial and ethnic disparities arise from differing experiences with health care delivery systems and within women’s neighborhood environments. Based on this hypothesis, the Equality in Breast Cancer Care Study has been conceived.
The study focuses on four major racial/ethnic groups — Whites, African-Americans, Hispanics, and Asians/Pacific Islanders - and is comprised of two components: developmental and application. The developmental component uses focus groups and qualitative research, with open-ended questioning, to develop an instrument appropriate for measuring differences in cancer care among breast cancer patients. In the application component, Dr. Gomez and her team will conduct an epidemiological study to interview 1139 breast cancer patients. The data will be combined with geographic neighborhood data about residential segregation and the social and built environment. All participants will be randomly selected and recruited through the Greater Bay Area Cancer Registry. The study is funded by the U.S. Department of Defense Breast Cancer Research Program, which receives some of its proceeds from breast cancer research postage stamps.
About the Northern California Cancer Center
The Northern California Cancer Center is a nationally recognized leader in understanding the causes and prevention of cancer and in improving the quality of life for individuals living with cancer. The organization has been working with scientists, educators, patients, clinicians, and community leaders since 1974. NCCC is a 501(c)(3) nonprofit with 145 employees and a $15 million operating budget.
www.nccc.org
A LOWER total dose of radiotherapy, delivered in fewer, larger treatments has been shown to be as effective as the international standard of a higher total dose delivered over a longer time to treat women with early breast cancer - according to new research published in the Lancet and Lancet Oncology. This confirms long-held beliefs of cancer specialists in the UK who have been using shorter schedules for many years.
Nearly 4,500 women took part in the START Trials co-ordinated by the Clinical Trials and Statistics Unit at The Institute of Cancer Research and funded by Cancer Research UK, the Medical Research Council and the Department of Health. Just under half the women received the international standard radiotherapy delivering 25 treatments, treating five times per week over five weeks. The remainder received a lower total dose given in fewer, larger treatments in either three or five weeks.
Researchers then compared the rate of cancer recurrence in the treated breast along with the effects of the treatment on surrounding healthy breast tissues.
After an average follow-up of five to six years, the rate of recurrence in the breast remained very low for patients in each of the treatment groups studied. The rate of side-effects were low overall, and no higher in women receiving the revised treatment than those receiving the international standard of 25 treatments. The results suggested that a lower total dose given in fewer larger treatments is as safe and effective in treating early stage breast cancer as the longer standard schedule.
Shorter radiotherapy treatments have been used in the UK for many years with promising results but this is the first systematic and reliable evaluation to compare the longer international treatment and the shorter revised UK treatment.
The benefits of fewer sessions of radiotherapy to patients with early breast cancer mean fewer trips to the hospital for treatment, which in turn mean less upheaval in a daily routine. Reducing the number of trips to the hospital is also financially beneficial to patients. The results also offer new insights into how breast cancer cells handle radiotherapy damage to the DNA, suggesting how treatments might be improved further.
Chief Investigator, Professor John Yarnold, from The Institute of Cancer Research and the Royal Marsden Hospital, said: “These trials represent a successful 10-year collaboration between cancer specialists and several thousand women motivated to help others by volunteering for research. The results suggest that a high total dose given in 25 small treatments is no better than simpler schedules using fewer exposures to a lower total dose. Shorter therapies giving fewer, larger treatments are obviously convenient for patients. The results support the current use of shorter schedules in the UK and in other countries.”
Professor Mike Richards, National Cancer Director, said: “We welcome these findings which show that women receiving radiotherapy for breast cancer can be effectively treated with fewer hospital visits. These results are good for patients and good for the NHS.”
Sir Leszek Borysiewicz, Chief Executive of the Medical Research council said: “This research will help to refine the way we treat women who are battling this disease. The research will lead to fewer sessions of radiotherapy. This work will help patients with early breast cancer. They’ll have to go to hospital for treatment less often which means fewer trips to cancer units. But the results will also help us to understand this disease better at a genetic level so we can make treatments even better in the future.”
Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “Cancer treatment disrupts the lives of patients and their families for many weeks at a time so this is a really positive result. Fewer doses of radiotherapy that don’t increase side-effects while providing the same benefits means less time at hospital and more time at home. It is important for patients that we continue research like this to fine tune current treatment.”
Original research paper: START Trial - Standardisation of Breast RadioTherapy. Results of the START Trial B study are published in the Lancet and results of the START Trial A study are published in Lancet Oncology.
Medical Research Council
http://www.mrc.ac.uk
Coinciding with the launch of BT’s Work Fit awareness programme for employees, Claire Rayner, journalist and author, writes in the Winter edition of BTtoday, the magazine for retired BT people, about the work of the charity Cancerbackup and her own experience of the disease.
How would you cope if cancer affected your family?
We don’t like to think about it until it happens but one in three of us will develop cancer at some point in our lives, and the risk increases as we get older. It is therefore likely that all of us will face, or already have faced, the reality of cancer either a partner, a family member or close friend, or receiving the diagnosis ourselves.
This obviously can be a difficult time and it is important for everyone involved that there should be a strong team in place to help people through diagnosis and treatment. The team is likely to include consultants, nurse specialists and other health workers, but also partners, children and other close friends and family who can offer personal support and care, or just be someone to talk to.
Our children are often busy working and maybe raising their own children and so may not have a lot of time. And in the modern world with job opportunities across the country and the world, they may live many miles away. Telephone calls, email and the internet are a good way to stay in contact but it’s not the same as sitting down together and talking face-to-face.
More and more people are going online at home sending email, photos and videos of each other back and forth in seconds. As well as contacting friends and family, the internet is a huge resource of information on all kinds of subjects, including your health. Cancerbackup runs a comprehensive website with more than 6,500 pages of information on all aspects of cancer from the practical and emotional sides to living with cancer (www.cancerbackup.org.uk).
There is though, a lot of poor and inaccurate information on the internet, and you should be careful that any information you use is from a trusted source. Cancerbackup relies on evidence based information and is truly trustworthy with all the information reviewed and revised regularly. If you’re not sure where information is coming from, you can’t be sure that it is reliable. False or misleading information on cancer can be very upsetting, sometimes offering too gloomy or overly optimistic information about cancer.
Cancerbackup’s information is also available in over 70 booklets and 300 fact sheets and on audio cassette tape, all of which are provided free by the charity to patients, relatives or friends. And Cancerbackup also runs a free telephone helpline on 0808 800 1234 via which you can obtain leaflets and fact sheets, and talk to a specialist nurse who will be ready to answer any question on any cancer.
In addition to collecting the valuable information you need, It is important to attend all screening appointments, and ask to continue them if you are over the age of being invited automatically. You can ask for screening appointments to continue and I would recommend that you do. Also check yourself regularly for abnormalities of breasts, testicles, moles or any other symptoms and report anything out of the ordinary to your doctor immediately.
When I developed breast cancer in 2001 I had the good fortune to be referred to a one-stop unit where I had a mammogram, a needle biopsy (painless for me!) and an ultrasound investigation. And I was given my diagnosis just a couple of hours after arriving for my appointment.
That helped enormously. It is sitting around waiting for a diagnosis for days or even weeks which is most distressing; so do ask your GP to find out if there is such a unit in your area.
I was treated with surgery and am now completely clear of the disease. I see my consultant only once a year now (that happens after 5 years of more frequent checks). I never even think about cancer now from one year’s appointment to the next. And there are many, many patients like me.
So what ever you do, don’t panic and don’t despair; modern cancer treatments are improving all the time. And with the help of Cancerbackup to make sure you have all the info you need, you will feel much better.
Yours
Claire Rayner
http://www.cancerbackup.org.uk
Whether or not relatives talk about the family’s history of cancer significantly impacts attitudes and knowledge about genetic counseling and testing for those at moderate risk of developing breast cancer, according to a new preliminary study presented at the American Society for Preventive Oncology meeting in Bethesda, Md.
Prior research has shown that African Americans participate less often in genetic counseling and testing for the genes that put women at risk for breast cancer than Caucasians. Also, African Americans are often diagnosed with a later stage of breast cancer and thus are more likely to die from the disease.
“It’s important to understand the many reasons for these differences so we can better address them,” said Kristi D. Graves, Ph.D., a clinical psychologist in the Cancer Control program at the Lombardi Comprehensive Cancer Center, part of Georgetown University Medical Center. “In this study, we evaluated the impact of socio-cultural variables on knowledge and attitudes about BRCA 1/2 counseling and testing. We hope to use this information to better understand why there’s a difference in testing uptake among black and white women.”
Researchers conducted telephone interviews with 105 women who had a negative breast biopsy history and one or more relatives with breast and/or ovarian cancer (75 Caucasians, 30 African Americans). The researchers assessed cancer history, perceived risk, worry, medical mistrust, cancer fatalism, family/physician communication, race-based experiences, and knowledge and attitudes toward BRCA 1/2 testing.
After controlling for education, income, and socio-cultural variables like medical mistrust and cancer fatalism, Graves said, “We didn’t find a statistical difference in knowledge or attitudes between African-American and Caucasian women. We did observe a difference, however, among women who said their families discussed their cancer history versus those families who didn’t discuss cancer. We asked the women if they had talked with their relatives about the family’s history of breast cancer. The more family members the women talked with, the greater the level of knowledge about genetic counseling and testing.
“We also found that those who felt more vulnerable because they perceived a greater risk of developing breast cancer had less positive attitudes about genetic testing,” Graves said.
Next, Graves will examine if the women in this study decide to take part in genetic counseling and testing after they receive educational materials.
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Funding for this research was provided by an Institutional Research Grant from the American Cancer Society.
About Lombardi Comprehensive Cancer Center
The Lombardi Comprehensive Cancer Center, part of Georgetown University Medical Center and Georgetown University Hospital, seeks to improve the diagnosis, treatment, and prevention of cancer through innovative basic and clinical research, patient care, community education and outreach, and the training of cancer specialists of the future. Lombardi is one of only 39 comprehensive cancer centers in the nation, as designated by the National Cancer Institute, and the only one in the Washington, DC, area. For more information, go to http://lombardi.georgetown.edu/.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through our partnership with MedStar Health). Our mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis — or “care of the whole person.” The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university’s sponsored research funding.
Source: Karen Mallet
Georgetown University Medical Center
Researchers at Dana-Farber Cancer Institute report that full-body PET/CT scanning detected unsuspected, treatable tumors in 3 of 15 patients with Li-Fraumeni syndrome (LFS), a rare genetic cancer syndrome for which no screening tests have been recommended.
The results suggest that periodic scans in combination with physical exams might catch more tumors at a curable stage, the investigators report in the March 19 issue of the Journal of the American Medical Association. But they caution that further, larger studies are needed to determine whether PET/CT screening is beneficial in LFS patients, who are highly susceptible to a variety of cancers from an early age because of an inborn gene mutation.
“We need to be cautious, and we shouldn’t say that every patient with the syndrome should have a PET/CT examination,” said Annick Van Den Abbeele, MD, clinical director of radiology and director of nuclear medicine/positron emission tomography (PET) at Dana-Farber. “But the study showed some interesting findings that justify a larger, international study in these patients.”
PET detects cancers by tracking their abnormal appetite for sugar (glucose) compared to normal tissues, while CT (computed tomography) uses X-rays to show anatomical and structural details. Combining the two modalities in a single machine allows a patient to undergo both exams in one session; the resulting images are superimposed to reveal the precise location of suspected tumors.
LFS is a rare hereditary cancer syndrome named for the researchers who first described it, Frederick Li, MD, of Dana-Farber and Joseph Fraumeni Jr., MD, of the National Cancer Institute. In most cases, the cause is a mutation in the TP53 tumor suppressor gene that can be inherited and creates a high risk of a variety of malignancies, including sarcomas, breast cancer, leukemia, brain tumors, and many more common cancers at unusually early ages, including childhood. Among individuals with LFS, the chance of developing any cancer has been estimated at 50 percent by age 30, and 90 percent by age 60. A survivor of one cancer has a high risk of developing a new malignancy over time.
The syndrome is usually diagnosed after several members of a family develop early-onset tumors, prompting a test for the mutated gene. At present, there is no specific screening test to detect cancers before they become symptomatic in people carrying the Li-Fraumeni mutation because they are prone to such a wide variety of cancer types.
“We decided to study this in the adult LFS population because PET/CT scanning is used in the care of many of the type cancers that occur in LFS. Both LFS families and physicians have been frustrated by the lack of information for families with a rare and burdensome condition,” said Judy Garber, MD, MPH, senior author of the paper and director of Dana-Farber’s Cancer Risk and Prevention Clinic.
The pilot study recruited 15 healthy members of Li-Fraumeni families carrying the TP53 mutation and who had not been diagnosed with cancer in the past five years. Many of the volunteers were members of Li-Fraumeni families who had participated in research through Dana-Farber and the NCI for many years.
The combined PET/CT images revealed thyroid cancer in a 31-year-old breast cancer survivor and in a 48-year-old survivor of breast cancer and a childhood sarcoma. In addition, a 36-year-old man with no cancer history was found to have a tumor at the junction of his esophagus and stomach. All were given potentially curative treatments, the researchers said. Subjects are currently being followed one year later.
Whether earlier detection of tumors in LFS patients will translate into increased survival remains to be shown in longer-term studies, the scientists said. Another uncertainty is whether the potential benefit from periodic screening would outweigh the risks that the radiation exposure might trigger cancers in the cancer-prone LFS patients. Each PET/CT scan exposes the individual to an amount of radiation that is half of the allowable annual limit for a worker in the radiation industry, according to the paper. Still more questions exist about when to begin screening with imaging or colonoscopy in childhood, adolescence or adulthood.
“We will need to be cautious about the radiation issue, and to determine what is best for the patients in terms of a screening schedule,” said Serena Masciari, MD, lead author. “We also need to know if there is a high rate of false-positive findings from screening that would have to be followed up,” she added.
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In addition to Li and Fraumeni, other authors include Lisa R. Diller, MD, Iryna Rastarheyva, MD, Jeffrey Yap, PhD, Katherine Schneider, MPH, and Lisa DiGianni, PhD, all of Dana-Farber, and Sapna Syngal, MD, of Dana-Farber and Brigham and Women’s Hospital.
The research was supported by the Perini Family Survivor Center at Dana-Farber, the Swim Across America Foundation, and the Starr Foundation.
Dana-Farber Cancer Institute (http://www.dana-farber.org/) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.
Source: Bill Schaller
Dana-Farber Cancer Institute
Cancer imaging technology company Michelson Diagnostics Ltd (MDL) has announced that it hascommenced the engineering phase of its development of probes for in-vivo imaging with opticalcoherence tomography (OCT).
According to MDL Applications Director Dr Gordon McKenzie, more than one type of probe will startclinical testing during 2008. The probes will be suitable for a variety of applications, including researchinto diagnosis, treatment and monitoring of cancer of the oral cavity, oesophagus, skin, cervix, colorectaltract and lung. “All of the probes will use MDL’s breakthrough multi-beam OCT technology”, he said,”which will provide at least double the resolution of competing equipment, for much crisper, clearerimage of clinical features.”
Dr McKenzie confirmed that users of the existing EX1301 OCT Microscope will easily be able to upgradeto the in-vivo technology as soon as it is released. He also said that MDL is interested in finding clinicalteams that are interested in conducting clinical trials with the in-vivo probes.
For further details, please contact Dr Gordon McKenzie, Applications Director, on 44 (0)7973 343414,Email: Gordon.McKenzie@md-ltd.co.uk
Higher resolution versions of the pictures are available on request from the contact above.Michelson Diagnostics Ltd is the UK’s leading independent manufacturer and developer of OpticalCoherence Tomography medical imaging equipment. Founded in 2007, it is based in SE London, UK.The company’s highly innovative optical probe technology offers the best available sub-surface OCTimages for research applications in cancer surgery guidance, surveillance and diagnosis.
http://www.michelsondiagnostics.co.uk
A chemical reaction in genes that control breast cancer provides a molecular clock that could one day help researchers more accurately determine a woman’s risk for developing breast cancer and provide a new approach for treatment, UT Southwestern Medical Center researchers have found.
In a study published in today’s issue of Cancer Epidemiology Biomarkers & Prevention, scientists from UT Southwestern show that the chemical process, called methylation, is strongly correlated with breast-cancer risk and with precancerous changes in the breast cells.
The researchers determined that methylation acts as a type of biological clock, indicating how many times a cell has divided. This information could aid researchers in determining an individual’s cancer risk.
“The more a cell has divided, the greater the risk for cancer,” said Dr. David Euhus, professor of surgical oncology. “Monitoring methylation levels could give researchers a way of seeing how often cells have divided and where a woman stands on that clock. Once the clock reaches a certain hour, breast cancer is more likely to ensue.”
During methylation, small molecules called methyl groups attach themselves to a gene and turn off, or “silence,” the gene.
Previous studies by Dr. Euhus have shown that apparently normal breast cells from women with breast cancer had increased methylation of a tumor-suppressor gene called RASSF1A.
In the current study, Dr. Euhus wanted to see if methylation of RASSF1A and other genes increased over time during the years when the ovaries are actively secreting estrogen and progesterone each month.
Dr. Euhus and his team sampled cells from 164 women women with breast cancer, women at high risk of developing breast cancer, and women with a low risk for the disease. The researchers examined methylation levels of five tumor-suppressor genes whose job is to stop tumors from developing in the breast.
A computer program developed by Dr. Euhus was used to determine the breast-cancer risk for patients in the study. Dr. Euhus has written several interactive software tools for risk measurement, which are used by major cancer centers worldwide.
His findings indicate that methylation of RASSF1A and other genes increases steadily during the years of ovarian cycling up to about age 55 suggesting that methylation is, indeed, a molecular clock recording the history of cell divisions.
“Interestingly, having children, which is known to reduce breast-cancer risk if it occurs early in life, was associated with a reduction in methylation for some genes,” Dr. Euhus said.
Dr. Euhus says the clock is not always marching forward, and there are ways to turn it back.
“Methylation can be stopped or slowed down,” said Dr. Euhus, who also directs the Mary L. Brown Breast Cancer Genetics and Risk Assessment Program at the Harold C. Simmons Comprehensive Cancer Center. “We found that having a baby set the clock backward and so did getting close to menopause. Things that are known to reduce breast-cancer risk may also turn the clock backward.”
A test for methylation of tumor-suppressor genes is not commercially available and Dr. Euhus says additional research is necessary to fully understand the mechanism. For example, it is not clear whether tumor-suppressor gene methylation is simply a marker of prior cell divisions, or whether it can cause increased cell division, hastening the development of breast cancer.
Dr. Euhus said medications that interfere with methylation might provide a new approach for reducing breast-cancer risk.
“Even if there’s a lot of methylation, I can’t tell for sure if a woman is going to develop breast cancer,” Dr. Euhus said. “However, if I took two women from our study and one had more methylation than the other, the one with more methylation was more likely to have already had breast biopsies for benign disease, or had already been diagnosed with breast cancer.”
Measuring tumor-suppressor gene methylation might not work well to predict breast-cancer risk in all women. For women with a strong family history of breast cancer, the concept won’t work because those breast cancers are associated with DNA repair issues and not methylation, Dr. Euhus said.
Dr. Euhus is currently conducting a federally funded study to determine which of the approximately 20,000 to 25,000 genes in the human genome are most strongly associated with breast-cancer risk when methylated. Women interested in participating in this project can contact Florence Kampmeier at 214-648-7039.
Other UT Southwestern authors on the journal paper are Dr. Dawei Bu, a research instructor of surgery; Dr. Sara Milchgrub, clinical professor of pathology; Dr. Xian-Jin Xie, assistant professor of clinical sciences; Aihua Bian, a biostatistical consultant in clinical sciences; Dr. Marilyn Leitch, professor of surgical oncology; and Dr. Cheryl Lewis, a research instructor of surgery.
The research was supported by the American Cancer Society.
Visit http://www.utsouthwestern.org/cancercenter to learn more about UT Southwestern’s clinical services in cancer.
UT Southwestern Medical Center
5323 Harry Hines Blvd.
Dallas, TX 75390-9060
United States
http://www.utsouthwestern.edu
Among women at high risk of developing breast cancer, breast ultrasound combined with mammography may detect more cancers than mammography alone, according to results of a multicenter trial that included UT Southwestern Medical Center researchers.
Overall, 40 participants were diagnosed with breast cancer. Of those cases, a dozen lesions were suspicious only on ultrasound and eight were suspicious on both ultrasound and mammography.
The most recent findings, presented in the current issue of The Journal of the American Medical Association, are from the first round of screening in the American College of Radiology Imaging Network’s ACRIN-6666 trial. More than 2,800 women at high risk of developing breast cancer participated. The median age of the participants was 55 years and more than half had a personal history of breast cancer.
Breast ultrasound is a noninvasive procedure that uses sound waves to make a picture of the tissues inside the breast. It has traditionally been used after mammography to evaluate possible abnormalities found at screening or on physical examination. Because of recently reported studies, breast cancer screening using ultrasound for high-risk women is beginning to gain traction.
Dr. W. Phil Evans, a study author and professor of radiology at the UT Southwestern Center for Breast Care, said ultrasound is attractive for supplemental screening because it is widely available, is well-tolerated by patients and involves no radiation. It’s also less costly than magnetic resonance imaging.
“However, adding a single ultrasound to mammography does increase the number of false positives,” said Dr. Evans. “Whether or not the risk of false positives will diminish with subsequent rounds of the screening trial remains to be seen, but it’s something we’re tracking.”
The trial compared the effectiveness of using ultrasound screening and mammography with mammography alone in detecting breast cancer. Potential candidates were excluded if they had signs or symptoms of breast cancer; had recent surgical or image-guided breast procedures; or if they had undergone MRI or tomosynthesis within 12 months, or mammography or whole breast ultrasound within 11 months. Women with breast implants and those who were pregnant, lactating or planning to become pregnant within two years of study entry were also excluded.
The results come on the heels of a recommendation by the American Cancer Society that annual breast MRI be used in addition to mammography for screening women at very high risk of breast cancer. The society’s guidelines don’t apply to the large number of women who are considered to be at intermediate or high risk for developing breast cancer but are not eligible for MRI.
The work was supported by the Avon Foundation and the National Cancer Institute.
Dr. Evans is on the scientific advisory board of Hologic, a diagnostic and medical imaging systems maker that’s considered a leader in breast cancer diagnostics.
Visit http://www.utsouthwestern.org/cancercenter to learn more about UT Southwestern’s clinical services in cancer.
Dr. Phil Evans — http://www.utsouthwestern.edu/findfac/professional/0,2356,12114,00.html
UT Southwestern Medical Center
5323 Harry Hines Blvd.
Dallas, TX 75390-9060
United States
http://www.utsouthwestern.edu