Best of Breast: news for week ending 13 December 2013

A weekly round-up of Google Alerts on the latest medical developments in Breast Cancer.  I was puzzled as to why there was such a surge this week, and realised that it was due to studies being released at the San Antonio Breast Cancer symposium 2013 (http://www.sabcs.org/PressReleases/Documents/2013/b3c6acef3fe26baa.pdf)

There’s fantastic news that the aromatase inhibitor, anastrazole (aka Arimidex), can cut the risk of breast cancer in women by 50% and with fewer side-effects than drugs like tamoxifen.  But please note (and this is not being made clear in newspaper headlines), anastrozole is usually only used in post-menopausal women (because the ovaries in premenopausal women produce too much aromatase for the inhibitors to block effectively).  There’s also little discussion on the side-effects which may make it difficult for women to comply with taking the medication.

The FDA has issued a warning about nipple aspirate tests being used as a substitute for mammograms.  The message is:  they’re not reliable, and don’t.  They sound awfully like thermograms to me – I had a thermogram done about 3 days’ after my initial diagnosis, and the practitioner who conducted the test told me that without the mammogram, he wouldn’t have diagnosed breast cancer from my thermogram. (part of the issue is that the thermogram machines in the UK are not sophisticated enough to give the detailed results required for such diagnosis).

smart-bra

404 error … Windows cannot recognise the software … one or both servers is not working … please reinstall drivers … image credit: nytimes.com

1A.  Microsoft working on a smart bra that detects breast cancer and measures moods

I was waiting for this – trust Microsoft to muscle in on breast cancer. I just hope that the smart bra proves more reliable than their operating systems.  I’d hate for my smart bra to give an error code just when I need it.  And why bras?  Microsoft said that women tend to have a more emotional relationship (i.e. moods) with eating.

http://nypost.com/2013/12/04/microsoft-developing-smart-bra/

Microsoft’s research developers are designing a smart bra that helps detect bio-signatures like stress, body rhythms and can even help locate early signs of breast cancer.

Last year the US firm applied for a patent to analyse breast heat in order to detect breast cancer as well.

Prototype bras use sensors embedded in the material to detect changes to the body’s stress levels, and alert the wearer.

High stress can trigger emotional overeating in both women and men, although a Microsoft executive told Discovery News that it was mainly women who succumbed.”

In a paper outlining the results of a pilot projectinvolving four women who wore the prototype garments, researchers said information on stress levels delivered in a timely fashion “served as a health intervention to encourage the person to be more active or consume less food”.

“The bra form-factor was ideal because it allowed us to collect EKG (electrocardiagram) near the heart,” the researchers stated. However the prototype was limited because its batteries only lasted for four hours at a time, they said.

Streaming information to a smartphone from the bra emits potentially harmful electromagnetic radiation. This new “smart bra” may be a very dumb idea.  Read what cardiologist Stephen Sinatra says about using smartphones to monitor the heart.

For more information:  http://www.cs.rochester.edu/hci/pubs/pdfs/FoodMood.pdf

Now read:

1B.  Cardiologist Warns About Using the New Heart Tracking Application

http://mieuxprevenir.blogspot.ch/2013/04/cardiologist-warns-about-using-new.html

A doctor using this technology ( a smartphone application which can track and store data about the heart), in his or her office is exposing his patients and him or herself to WiFi on an all-day, every-day basis—which is an even larger dose of WiFi than pilots and flight crew are getting on airplanes equipped with WiFi.

The truth is that Wi-Fi is a big human experiment, and we still lack research about the effects that wireless frequencies may have on our electrical bodies.

2.  Drug cuts breast cancer cases by more than 50 percent in high risk POST-MENOPAUSAL women

Taking the breast cancer drug anastrozole for five years reduced the chances of post-menopausal women at high risk of breast cancer developing the disease by 53% compared with women who took a placebo, according to a study published in the Lancet today.

This class of drugs is more effective than previous drugs such as tamoxifen and crucially, it has fewer side effects.

The findings led to urgent calls for the drug, which costs just £1.95 per month, to be made available on the NHS.

For more information:

Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial

3.  FDA Warns: Nipple Aspirate Test for Cancer Screening Is Not An Alternative To Mammography

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm378489.htm

BACKGROUND: A nipple aspirate device is a type of pump used to collect fluid from a woman’s breast. A nipple aspirate test can determine whether the fluid collected from the breast contains any abnormal cells.

Certain manufactures are promoting the use of nipple aspirate tests as a stand-alone evaluation tool for screening and diagnosing breast cancer, claiming they are an alternative to biopsy or mammography.

They also claim that a nipple aspirate test can detect pre-cancerous abnormalities and diagnose breast cancer before mammography with just a sample of a few cells.

The FDA is concerned that women will believe these misleading claims about a nipple aspirate test and not get mammograms and/or other needed breast imaging tests or biopsies. This may lead to serious adverse health consequences.

RECOMMENDATION: Do not use a nipple aspirate test as a substitute for mammography or by itself for breast cancer screening or diagnosis.

4.  Reducing G-CSF to Cut Costs Boosts Neutropenia

http://www.medscape.com/viewarticle/817391

The cost of the G-CSF treatment, coupled with its increasing use with anthracycline and taxane therapy, is driving a discussion of the economics of its use.

When the use of prophylactic granulocyte-colony stimulating factor (G-CSF) to reduce febrile neutropenia (FN) was decreased in patients receiving chemotherapy for breast cancer, it led to a more than 5-fold increase in FN episodes and an early end to the clinical trial.

“This study demonstrated that primary pegfilgrastim prophylaxis cannot be limited to the first 2 chemotherapy cycles because of an unacceptable high FN rate,” Dr. Aarts and colleagues write. “In fact, this rate is as high as that reported in previous studies of TAC [docetaxel, doxorubicin, and cyclophosphamide] chemotherapy without primary G-CSF prophylaxis.”

“On the basis of our results, we can only recommend continued use. Whether administration should continue past the third cycle was not tested, and hence, our recommendation cannot speculate on that. Therefore, we recommend primary G-CSF prophylaxis throughout all chemotherapy cycles in patients at risk for FN,” they conclude.

The study involving 167 patients was published in the December 1 issue of the Journal of Clinical Oncology.

5.  Nanoparticles can overcome drug resistance in breast cancer cells

http://yottafire.com/2013/12/nanoparticles-can-overcome-drug-resistance-breast-cancer-cells/

Nanoparticles filled with chemotherapeutic drugs can kill drug-resistant breast cancer cells, according to a study published in the scientific journal Biomaterials.

Nanoparticles are just as small, or even smaller, than many blood proteins. They can therefore pass through the walls of healthy and sick cells, which make them interesting carriers of drugs against cancer and other diseases.

In the present study, researchers from Karolinska Institutet have shown that nanoparticles made from biodegradable plastics can overcome drug resistance in breast cancer cells. Such resistance is especially common in relapsing cancer patients and depresses, even neutralises the effect of the therapy against the tumour in many instances.

For more information:  http://ki.se/ki/jsp/polopoly.jsp?l=en&d=130&a=170478&newsdep=130

6.  Biomarker linked to aggressive breast cancers, poor outcomes in African-Americans

http://medicalxpress.com/news/2013-12-biomarker-linked-aggressive-breast-cancers.html

Among African-American women with breast cancer, increased levels of the protein HSET were associated with worse breast cancer outcomes, according to results presented here at the Sixth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held Dec. 6-9.

“We were surprised to find that HSET levels appeared to be a better predictor of cancer outcome than other routinely used breast cancer predictors, such as assigning triple negative status,” said Aneja. “We are working around the clock to define ways in which this new biomarker can be used most effectively and as soon as possible in the clinical setting.”

More information: Abstract Number: PR12

Presenter: Ritu Aneja, Ph.D.

Title: Nuclear HSET, a predictor for metastasis, disease relapse and poor survival, is a racial disparity biomarker in triple negative breast cancer patients

7.  Scientists Discover Better way to Predict Breast Cancer Risk in Women

http://www.ibtimes.co.uk/articles/528634/20131209/breast-cancer-risk-treatment-prediction-disgnosis-method.htm

Scientists at Washington University School of Medicine in St Louis have designed a method in what has been described as a better way to predict risk of breast cancer in women.

The new model, called Rosner-Colditz, can not only help quantify a woman’s risk of developing breast cancer but also identify women who are at greater risk.

According to the study, the model considers factors such as a woman’s age at menopause and whether she had natural or surgical menopause to determine cancer risk, besides considering the known predicting factors such as body mass index, alcohol consumption and age at first menstrual period.

The model can accurately predict the likelihood of women aged 47 to 69 who would develop breast cancer in the next five years.

For more information:

Validation of Rosner–Colditz breast cancer incidence model using an independent data set, the California Teachers Study

Breast Cancer Research and Treatment
© The Author(s) 201310.1007/s10549-013-2719-3

8.  New solution to detect lymphoedema

http://www.oncologynurseadvisor.com/new-solution-to-detect-lymphedema-from-breast-cancer/article/324843/

Lymphedema is viewed as one of the most feared outcomes of breast cancer treatments. It is a condition that affects the lymphatic system and causes psychosocial distress and physical challenges for patients. Doctors struggle to detect and diagnose it.

Lymphedema can be accurately assessed through the use of Bioelectrical Impedance Analysis (BIA) ratios, according to a new study. Since the low-frequency electric current cannot travel through cell membranes, BIA provides a direct measure of lymph fluid outside the cells. This allows for a more accurate assessment of lymphedema using an index called the L-Dex ratio.

For more information:

The diagnosis and treatment of peripheral lymphedema: 2013 Consensus Document of the International Society of Lymphology.

9.  Patients with metastatic breast cancer may not benefit from surgery and radiation after chemotherapy

http://medicalxpress.com/news/2013-12-patients-metastatic-breast-cancer-benefit.html

After a response to initial chemotherapy, treatment with radiotherapy and surgical removal of the breast tumor and nearby lymph nodes do not provide any additional benefit to patients with metastatic breast cancer, according to results of a clinical trial presented here at the 2013 San Antonio Breast Cancer Symposium, held Dec. 10-14.

10.  Avastin Misses Mark Again in Breast Cancer

http://www.medpagetoday.com/MeetingCoverage/SABCS/43378

  • The addition of bevacizumab (Avastin) to standard adjuvant therapy for HER2-positive breast cancer failed to improve invasive disease-free survival (iDFS) in a randomized clinical trial.
  • The study suggests that given the negative outcomes in several other studies, the results could spell the end of clinical investigation of anti-angiogenesis inhibitors in breast cancer.

11. High levels of immune cells in tumors may identify breast cancers most likely to benefit from trastuzumab

http://www.sciencecodex.com/high_levels_of_immune_cells_in_tumors_may_id_breast_cancer_pts_most_likely_benefit_from_trastuzumab-124524

Women with HER2-positive breast cancer who had the highest levels of immune cells in their tumors gained the most benefit from presurgery treatment with chemotherapy and trastuzumab, according to results presented here at the 2013 San Antonio Breast Cancer Symposium, held Dec. 10-14.

Levels of tumor-infiltrating lymphocytes may be a good biomarker of response to trastuzumab in primary breast cancer.

In a mouse model of HER2-positive breast cancer, tests showed that combining trastuzumab with either an agent that blocks PD-1 or an agent that blocks a protein to which PD-1 binds, PD-L1, resulted in greater tumor regression compared with trastuzumab alone.

For more information:  http://www.sabcs.org/PressReleases/Documents/2013/b3c6acef3fe26baa.pdf

12.  Herceptin plus taxol highly effective in lower-risk breast cancer patients

http://medicalxpress.com/news/2013-12-herceptin-taxol-highly-effective-lower-risk.html

A remarkable 98.7 percent of certain lower-risk breast cancer patients were cancer free for at least three years after taking a combination of the drugs Herceptin and Taxol, a study has found.

Results were presented during the 2013 San Antonio Breast Cancer Symposium.

13.  Multi-gene test could help triple-negative breast cancer patients

http://medicalxpress.com/news/2013-12-multi-gene-breast-cancer-patients.html

A new test has the potential to help physicians identify patients with the most lethal forms of triple-negative breast cancer, a disease which requires aggressive and innovative treatment.

Patients diagnosed with triple-negative breast cancer face a difficult battle. These tend to be aggressive cancers with a poor prognosis. They lack three primary components—the estrogen receptor, the progesterone receptor and a protein called HER2—that are the targets of effective therapies with few side effects.

Triple-negative cancers represent 14 to 20 percent of all breast cancers. They often recur after treatment, spread to the brain and lung, and develop resistance to standard chemotherapies. They occur more often in younger women, African-American women, Hispanic/Latina women and women who have BRCA1 mutations.

The researchers studied genetic pathways around a gene known as RKIP (Raf Kinase Inhibitory Protein) to generate prognostic gene signatures. This RKIP-based pathway suppresses metastasis, the spread of cancer to distant sites, leading them to the BPMS (BACH1 Pathway Metastasis Signature).

The test, described in the Dec. 11 issue of PLOS ONE, was able to distinguish between  with a good or poor prognosis, even within groups of patients already stratified by existing tests such as MammaPrint and Oncotype DX, as well as to extend its predictions to patients with more advanced or difficult-to-treat cancers.

The genetic “signature” associated with poor prognosis, which incorporates information from about 30 genes, also reveals potential targets for the development of new drugs and therapies.

14.  Avoiding radiotherapy is an option for some older patients with breast cancer

http://medicalxpress.com/news/2013-12-radiotherapy-option-older-patients-breast.html

Omission of radiotherapy is a reasonable option for women age 65 or older who receive hormone therapy after breast-conserving surgery for hormone receptor-positive, axillary node-negative breast cancer, according to results of the PRIME 2 trial presented here at the 2013 San Antonio Breast Cancer Symposium, held Dec. 10-14.

“Radiotherapy has been known to reduce the risk of breast cancer  three- to fourfold. However, what our trial has shown is that although this is still the case, the proportion of women who will actually have a recurrence without  is very small (less than 5 percent), five years after treatment,” said Ian Kunkler, F.R.C.R., professor of clinical oncology at the Edinburgh Cancer Research Center in the University of Edinburgh.

15.  Agent used in lymphoma shows promise in treating inflammatory breast cancer

http://medicalxpress.com/news/2013-12-agent-unique-clinical-inflammatory-breast.html

A drug now used to treat a type of lymphoma has shown surprising benefit in preclinical studies of inflammatory breast cancer, according to a researcher at Thomas Jefferson University’s Kimmel Cancer Center.

 The finding, published online this month in the Journal of Experimental Therapeutics and Oncology, has led to development of a phase 1/2 clinical trial at Kimmel Cancer Center to test the agent, Romidepsin (Istodax), in combination with nab-paclitaxel (Abraxane) chemotherapy for advanced  (IBC).
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