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Lifestyle affects risk of second breast cancer

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Lifestyle affects risk of second breast cancer

Surviving breast cancer is no guarantee that a new cancer won’t appear in the other breast. However, research now suggests that women can build their own personal armor to at least partially protect themselves from this occurring.

All it takes, says Dr. Christopher I. Li, is to “stay at a normal weight, don’t smoke, and drink in moderation.”

The research, headed up by Li at the Fred Hutchinson Cancer Center in Seattle, Washington, suggests that obesity, smoking and drinking too much are all risk factors for breast cancer in the opposite breast — also called the “contralateral” breast — of women who’ve had an “estrogen receptor-positive invasive breast cancer.”

That’s because estrogen can fuel these tumors’ growth, and both fat tissue and excessive alcohol use directly increase estrogen levels in the body, Li and his team propose. They believe that smoking contributes to the risk because of all the cancer-causing substances one inhales when smoking.

Until now, there haven’t been many studies regarding ways that women could protect themselves from second breast cancers, according to the report in the September 8th online issue of the Journal of Clinical Oncology.

The new study included 365 women with a first estrogen receptor-positive breast cancer and a second contralateral cancer and 726 control subjects. By reviewing medical charts and interviewing the women directly, the researchers determined body mass index (BMI) and alcohol and tobacco use. BMI is an estimate of a person’s relative body fat calculated from her height and weight.

Compared with normal weight women, those who were obese were almost half again – by 40% — as likely to develop a contralateral breast cancer. Consumption of 7 or more alcoholic drinks per week nearly doubled the risk compared with no alcohol use. Findings were similar for current smoking.

Women who both smoke and drink following diagnosis of the first cancer had an even greater risk of a second cancer. The study showed that consuming 7 or more alcoholic drinks per week coupled with current smoking increased the odds of contralateral breast cancer more than 7-fold.

In a related editorial, Dr. Jennifer A. Ligibel, from the Dana-Farber Cancer Institute in Boston, points out that the study by Li and his team took place before use of hormonal therapy for estrogen receptor-positive breast cancer became routine. Therefore, a more modern study examining the effect of modifiable lifestyle factors should involve patients treated according to current guidelines.

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Diabetes drug kept breast tumors away in mice

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Diabetes drug kept breast tumors away in mice

Adding the common diabetes drug metformin to chemotherapy helped shrink breast cancer tumors faster in mice and keep them away longer than chemotherapy alone, raising hope for a more effective way to treat cancer, U.S. researchers said on Monday.

They said metformin appeared to target breast cancer stem cells — a kind of master cancer cell that resists conventional treatment and may be the source of many tumors that grow back.

“What’s exciting here is we now have something that is mechanistically a different kind of killer of cancer that can synergize with chemotherapy,” Kevin Struhl of Harvard Medical School, whose study appears in the journal Cancer Research, said in a telephone briefing.

Many teams have been looking for ways to destroy the master cancer cells in the hope of making cancer easier to cure.

Last month, a team at the Broad Institute of Harvard and the Massachusetts Institute of Technology reported that a chemical called salinomycin could kill breast cancer stem cells.

What is different with his study, Struhl said, is that metformin is a widely used drug with a long safety track record. “There are tens of millions of people who take this drug,” he said.

“Although our studies are limited to mice and cells, metformin has a history of anti-cancer effects,” he said.

Metformin has already been shown to reduce the risk of some cancers, including pancreatic and breast cancer, in large studies of people with diabetes.

Struhl said metformin’s affect on cancer stem cells appeared to be separate from its ability to help the body use insulin and lower blood sugar — which also can improve breast cancer survival.

His team studied metformin and the cancer drug doxorubicin in lab dishes and found they killed both human cancer stem cells and non-stem cancer cells.

Mice that had tumors and got metformin and chemotherapy were less likely to have tumors grow back two months after treatment compared with mice that got chemotherapy alone.

“When we had both drugs together, we lost the tumors faster, but more importantly, there was no relapse,” Struhl said.

He said with metformin, it may be possible to reduce the chemotherapy dose and still get the same benefit.

That will need to be studied in people and a study is getting under way. Dr. Jennifer Ligibel, at Dana-Farber Cancer Institute and Harvard, is organizing a large trial with colleagues in Canada to study metformin in women with early stage breast cancer.

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Healthy habits prevent breast cancer: study

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Healthy habits prevent breast cancer: study

Breast cancer is a cancer that starts in the breast, usually in the inner lining of the milk ducts or lobules. There are different types of breast cancer, with different stages (spread), aggressiveness, and genetic makeup. With best treatment, 10-year disease-free survival varies from 98% to 10%. Treatment includes surgery, drugs (hormone therapy and chemotherapy), and radiation.

Nearly 40 percent of all breast cancer cases in the United States could be prevented if women kept a healthy weight, drank less alcohol, exercised more and breastfed their babies, according to a report published on Tuesday.

The report, which reviewed 81 new studies on the links between lifestyle and cancer, showed that 70,000 breast cancer cases could be prevented in the United States alone every year.

“We are now more certain than ever that by maintaining a healthy weight, being physically active and limiting the amount of alcohol they drink, women can dramatically reduce their risk,” Dr. Martin Wiseman of the American Institute for Cancer Research/World Cancer Research Fund, who led the study, said in a statement.

“We estimate that almost 40 per cent of breast cancer cases in the United States, or about 70,000 cases every year, could be prevented by making these straightforward everyday changes,” added the AICR’s Susan Higginbotham.

Breast cancer kills 400,000 women and a few men globally every year, and 40,000 in the United States alone.

Many studies have shown a low-fat diet, regular exercise, keeping a lean weight and breastfeeding babies can prevent breast cancer. However, a significant percentage of cases are caused by faulty genes and not linked to lifestyle.

Signs and symptoms

The first symptom, or subjective sign, of breast cancer is typically a lump that feels different from the surrounding breast tissue. According to the The Merck Manual, more than 80% of breast cancer cases are discovered when the woman feels a lump. According to the American Cancer Society, the first medical sign, or objective indication of breast cancer as detected by a physician, is discovered by mammogram. Lumps found in lymph nodes located in the armpits can also indicate breast cancer.

Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain (“mastodynia”) is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.

When breast cancer cells invade the dermal lymphatics—small lymph vessels in the skin of the breast—its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange-peel texture to the skin referred to as peau d’orange.

Another reported symptom complex of breast cancer is Paget’s disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget’s advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharg

Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain.Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are “non-specific”, meaning they can also be manifestations of many other illnesses.

Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.

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