One in three breast cancer patients under age 45 removed the healthy breast along with the breast affected by cancer in 2012, a sharp increase from the one in 10 younger women with breast cancer who had double mastectomies eight years earlier, says new study published in JAMA Network, as reported in the New York Times.

Women often remove the healthy breast so they don’t have to worry about developing another cancer, even though there is no evidence that removing the healthy breast extends lives.

Both the American Board of Internal Medicine and the American Society of Breast Surgeons recommend against the practice, labeled prophylactic mastectomy, unless a woman is at unusually high risk for a new cancer because of a condition like increased genetic risk, such as a mutation in the BRCA1 or BRCA2 genes.

“This study again underscores the fact that women are making this decision out of anxiety rather than medical necessity,” said Dr. E. Shelley Hwang, the chief of breast surgery at Duke Cancer Institute, who was not involved in the study but has studied patients’ quality of life after double mastectomies.

To learn more read the study at JAMA Network, or the report in the New York Times.

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Watch as Dr. Jay Harness explains why a patient may ask to refuse anti-hormone, anti-estrogen treatment for breast cancer, and why in the face of such a challenging question he recommends that a refusal is typically not a good idea:

“Among my jobs, my responsibility to the individual who comes to me for care is to ensure they are fully informed of the benefits and the risks of any therapies recommended to them, so they may make the right decisions for themselves.”

Dr. Harness also describes how he assists patients as a friendly voice and their advocate, as their project manager, as their surgeon when the need arises, and as the patient’s long-term follow-up caregiver.

The video is also available at this link.

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    Watch as Dr. Jay Harness explains why estrogen receptor status is important in determining treatment for the newly diagnosed breast cancer patient:

    “After testing, if a patient is found estrogen receptor positive [ER+], invasive breast cancers can be treated with anti-estrogen medication, including tamoxifen in pre-menopausal women, and aromatase inhibitors in post-menopausal women. Use of tamoxifen blocks the uptake of estrogen onto cancer cells remaining within the breast, while aromatase inhibitors blocks the body’s production of estrogen.

    With some 80% of breast cancers hormone-dependent [that is, breast cancer cells stimulated by the body's production of estrogen], by blocking hormone production with anti-hormone medication, cancer cells may be successfully treated to place cancerous cells in “suspension,” prolonging survival as a result.”

    As Dr. Harness shares, knowing your estrogen-receptor status in very important in determining breast cancer treatment options.

    The video is also available at this link.

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The majority of breast cancers are estrogen-receptor positive, often treated with anti-estrogen drugs such as tamoxifen. However, resistance to hormone therapy eventually develops in a large percentage of patients, leaving them with few options. Now, new research reveals a molecular explanation for this type of drug resistance and could lead to new therapies and better treatment decisions for estrogen-driven breast tumors, as discussed in this media report.

Some 80 percent of breast cancers are estrogen-receptor positive (ER+) – that is, tumor growth is driven by the hormone estrogen.

Researchers have worked to understand the underlying mechanisms of resistance to hormone therapy in breast cancer.

The new study concerns two cytokines – small signaling proteins – called interleukin 1 beta (IL1β) and tumor necrosis factor alpha (TNFα).

These pro-inflammatory immune system molecules are thought to be involved in the spread of drug-resistant tumors, but the underlying mechanisms have been somewhat of a mystery.

The team found that IL1β and TNFα switch on pathways that change the structure of the estrogen receptor on the breast cancer cells.

This change seems the reason the tumor develops resistance to the anti-estrogen drug tamoxifen, as Kendall Nettles, one of the study leaders and associate professor at TSRI, explains:

“Cytokines change the shape of the estrogen receptor, and that change overrides the inhibitory effects of tamoxifen and leads to drug resistance.”

Learn more in the study appearing in the journal Molecular Cell, and in this media report.

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A new study finds the Mediterranean diet reduced the risk of developing one of the deadliest forms of breast cancer, in this report from Huffington Post.

The study, published by the International Journal of Cancer found that the Mediterranean diet reduced the risk of developing estrogen-receptive negative breast cancer by 40 percent.

“The Mediterranean diet in the study was rich in legumes, seafood and olive oil.

Estrogen-receptive negative breast cancer is not linked to estrogen, and is considered the most dangerous form of the disease.

The study found a strong link between the Mediterranean diet and reduced rates of ER-negative breast cancer among post-menopausal women even in a non-Mediterranean population.”

Read more about the study at this link, or the full report at Huffington Post.

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Women with breast cancer receive confusing messages about soy-based foods, including soy milk, edamame and tofu.

Some studies have suggested the estrogen-like compounds in soy — called isoflavones — may inhibit the development or recurrence of breast cancer.

In contrast, there’s been concern that consuming soy-based foods may interfere with the effectiveness of breast cancer drugs such as tamoxifen.

A new study published in the journal of the American Cancer Society, Cancer, helps to resolve this question, in this report from NPR.

“Our finding would suggest that soy food consumption does not have a harmful effect,” says Fang Fang Zhang, a cancer epidemiologist at Tufts University.

In an editorial accompanying study results, Omer Kucuk, an oncologist who has studied nutrition and cancer prevention at the Winship Cancer Institute of Emory University, argues that the new data helps answer the question of whether soy is safe for women.

“We now have evidence that soy foods not only prevent breast cancer but also benefit women who have breast cancer,” Kucuk concludes.

Learn more about the study at this link, and in this media report from NPR, presented via audio above.

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New research reveals exercise helps those battling the fatigue caused by cancer and by its treatment — and usually does it better than drugs do, in this report from NBC News.

Karen Mustian of the University of Rochester Medical Center and colleagues looked through all the studies they could find on the various ways to help cancer patients get their energy back. Exercise was the clear winner, they reported in the Journal of the American Medical Association’s JAMA Oncology.

“If a cancer patient is having trouble with fatigue, rather than looking for extra cups of coffee, a nap, or a pharmaceutical solution, consider a 15-minute walk,” Mustian said.

Cancer-related fatigue is different from any other type of exhaustion. Sleep doesn’t help and patients often feel that even raising a hand to sip some tea or coffee is almost more than they can manage. Conversation, even watching television, can be just too much to manage.

“Exercise and psychological interventions are effective for reducing cancer related fatigue during and after cancer treatment, and they are significantly better than the available pharmaceutical options,” Mustian’s team wrote.

Learn more in the video above and this NBC News report, which includes the story of breast cancer patient Amy Schnitzler of Rochester, New York. For the study, please see the Journal of the American Medical Association’s JAMA Oncology.

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For decades women were told to regularly examine their breasts — with an actual feel-yourself kind of exam. The thinking was that this would help women spot breast cancers forming early on and, therefore, save lives. But that idea has fallen out of favor with pretty much every major cancer organization, and experts are now reversing that once-common guideline, in this report from the digital media site for women, Refinery29.com.

“Most groups have moved away from a specific recommendation for breast self-exam and instead use the idea of ‘breast awareness’ as the concept that we want to communicate,” says Therese Bevers, MD, medical director of the Cancer Prevention Center at MD Anderson.

Rather than giving directions for a specific type of exam and telling you to do it every month, for instance, breast awareness simply means knowing how your breasts normally look and feel. And, if there’s any sort of change, it means getting that checked out by a professional.

So why such a major adjustment? Dr. Bevers says much of the shift comes from the results of a large trial performed in China.

Not only does there seem to be no real upside to doing the exams, and evidence of one major downside: women who were told to practice self-exams were twice as likely to undergo biopsies than the control group.

To learn more click on the links within this column, or read the full report in Refinery29.

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