Mammograms are key, but new tools for detection are promising, reports MARCIA FRELLICK
TODAY the chance of a woman being diagnosed with invasive breast cancer is one in eight. The chance of it killing her is one in 35. And it remains the second leading cause of cancer death for American women behind lung cancer.
But missing in those statistics from the American Cancer Society is a message of progress and hope for October, which is National Breast Cancer Awareness Month. Millions of lives have been saved through advances in early detection, surgical procedures and research into prevention and new ways to attack the cells.
Successes with drugs such as Tamoxifen and Herceptin have led to discoveries of an overwhelming selection of targeted therapies, which interfere with the pathways that help cancer cells divide and spread.
Now researchers are racing to compute mountains of information to find the best approach for treating specific patients.
A leading breast cancer scientist, V. Craig Jordan, who has been called the “father of Tamoxifen,” is finding new promise in the natural hormone estrogen. His research has uncovered its use as a killer of cancer cells rather than an agent that fans their flames.
“I’m excited beyond belief,” said Jordan, scientific director and vice chairman of the department of oncology at the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center in Washington DC.
“After having contributed all of my career to helping women treat or prevent their cancers, I have new insight into being able to kill breast cancer cells with a natural hormone – estrogen.”
The challenge now, he said, is how to go from three in 10 responses to low-dose estrogen to 100% responses.
An indication of how far researchers have to go is how long it has taken to get to this point. Mortality rates started to head down only 20 years ago after consistently climbing. Developing a map for understanding humans’ genetic makeup, the Human Genome Project, took until 2003 to complete.
But science has come far enough that finding a lump no longer has to shorten a life or even doom its quality.
“Eighty percent or more [of those diagnosed with breast cancer] are going to survive long term and will end up dying of something else,” said Dr Debasish Tripathy, co-leader of the Women’s Cancer Program at the Norris Comprehensive Cancer Center, University of Southern California.
“They’re essentially cured of breast cancer even though there’s a chance the cancer might come back. The biggest part of that has been earlier detection.” While recognising the part that mammography has played in early detection, Tripathy is hopeful that new methods, such as MRI (magnetic resonance imaging), will have even more reliable results and reduce false positives that lead to unnecessary biopsies. Because of the expense, he said, MRI is now used mostly for high-risk patients. “Mammography leaves a lot to be desired,” Tripathy said. “We are desperately looking for better tools.” As to hopes for a cure, both experts say progress will come in small steps. “Cancer is too complicated for us to find one drug or one treatment that’s going to cure it,” Tripathy said. “I don’t see a cure in our lifetime for those in which the cancer has spread. What we will see in our lifetime more likely will be more diagnostic tests, more therapies that can extend life or – if [the cancer is] caught early – prevent recurrence to a greater degree.Advances will come one step at a time.” – www.chicagotribune.com
Factors that can contribute to cancer risk
Factors that the National Cancer Institute and the American Cancer Society list as carrying an increased risk for breast cancer:
Factors governed by lifestyle
* Not having children or having them later in life: Women who have not had children, or who had their first child after age 30, have a slightly higher risk. Being pregnant more than once and at an early age reduces breast cancer risk.
* Alcohol use: Those who have two to five drinks daily have about 1 1/2 times the risk of women who drink no alcohol. The ACS suggests stopping at one drink a day.
* Recent use of birth control pills.
* Postmenopausal hormone therapy (PHT).
* Not breast-feeding.
* Being overweight or obese.
* Lack of exercise.
Factors you can’t change
* Age: The chance of getting breast cancer goes up as a woman gets older. About two out of three women with invasive breast cancer are 55 years or older when the cancer is found, ACS says.
* Genetic risk factors: About 5% to 10% of breast cancers are thought to be linked to inherited gene mutations. The most common are the BRCA1 and BRCA2 (breast cancer 1 and 2) genes. Women with these gene changes have up to an 80% chance of getting breast cancer.
* Family history: Breast cancer risk is higher among women whose close blood relatives have this disease.
* Personal history of breast cancer: A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast.
* Race: White women are slightly more likely to get breast cancer than are African-American, Hispanic or Asian women.
* Dense breast tissue.
* Menstrual periods before 12 or menopause after 55.
* Breast radiation before age 30.
* Treatment with DES (diethylstilbestrol).