May 6, 2007, 5:30 PM CT

Cryoablation is safe for breast cancer patients

Ultrasound-guided cryoablation of small breast cancer may be a safe procedure linked to minimal morbidity and high patient satisfaction, as per a recent case report by radiologists at the University of Wisconsin Hospital & Clinics in Madison, WI.

The report presents a case of an 85-year-old woman with two small ( < 1 cm ) biopsy proven invasive ductal carcinomas that were treated with ultrasound-guided cryoablation alone (tissue destruction by controlled freezing and thawing). "The patient refused surgery, radiation treatment, chemotherapy or chemoprevention treatment," says Gale A. Sisney, MD, lead author of the report. In all but one published case, cryoablation in breast cancer has been followed by surgery to remove the tumor. The patient had "an excellent cosmetic result, with no scar or volume reduction in her breast," said Dr. Sisney. She is also without known progressive disease at one year mammographic and ultrasound follow-up, Dr. Sisney added.

The patient had absolutely no pain during the procedure and was fully alert and talking. At one year follow up we can not see the incision sites," said Dr. Sisney.

"Over the first year of follow up, the tumors slowly are melting away on imaging as the body presumably reabsorbed the tissue. It is exciting that others have suggested that an immune response may be occurring that may give additional protection," she said. "A number of questions remain unanswered regarding the use of cryoablation. Clinical trials will be needed to further understand the feasibility of cryoablation in minimal breast cancer therapy. While cryoablation of breast cancer is currently an investigational technique, cryoablation of non-malignant fibroadenomas in the breast has recently become available as a FDA approved clinical procedure. This case supports the findings already in the literature regarding the safety and efficacy of cryoablation in small breast tumors," Dr. Sisney said......... Posted by: Betsy      Read more         Source

April 25, 2007, 9:41 PM CT

New hereditary breast cancer gene discovered

A new hereditary breast cancer gene has been discovered by scientists at the Lundberg Laboratory for Cancer Research and the Plastic Surgery Clinic at the Sahlgrenska Academy in Sweden. The researchers found that women with a certain hereditary deformity syndrome run a nearly twenty times higher risk of contracting breast cancer than expected.

Several research teams around the world have long been searching for new hereditary breast cancer genes, but thus far few have been found.

"Our findings are extremely important, providing new knowledge of hereditary cancer genes and how they can cause breast cancer. The discovery also makes it possible to uncover breast cancer in women who have a predisposition for Saethre-Chotzen malformation syndrome," says Gran Stenman.

By detailed mapping of families with Saethre-Chotzen syndrome, the Gteborg scientists have now found that women with this syndrome have an elevated risk of contracting breast cancer. Saethre-Chotzen is a syndrome that primarily involves malformations of the skull, face, hands, and feet. The syndrome is caused by mutations in a gene called TWIST1.

"Our findings show that women with this syndrome run a nearly twenty times greater risk of contracting breast cancer than expected. Moreover, many of the women were young when they were affected by breast cancer," says Gran Stenman......... Posted by: Betsy      Read more         Source

April 15, 2007, 9:09 PM CT

Breast Cancer: Race, Smoking And Birth Size

Women can encounter environmental factors that increase their risk of breast cancer at various periods of their physical development, beginning before birth and extending until menopause. These non-inherited, or epigenetic, changes in DNA can correlate with risk factors for breast cancer, as per research being presented at the 2007 Annual Meeting of the American Association for Cancer Research.

To study the effects of epigenetic changes in DNA, a team of scientists from Columbia University School of Public Health, led by Mary Beth B. Terry, Ph.D., collected information from former participants of the National Collaborative Perinatal Project born between 1959 and 1966.

"Weve been following a birth cohort of women who were all born at Columbia in the late 50s and early 60s," said Terry. "Were interested to find if early life factors are linked to breast cancer susceptibility." .

The scientists gathered data on childhood and adult exposures, along with blood samples and mammograms, from 263 women. Terry and her colleagues looked at an epigenetic effect called DNA methylation, whereby DNA is tagged by a molecular "methyl" fragment, which alters activation of the genes. In this instance, the scientists looked at global hypomethylation aberrant methylation throughout the entirety of a persons DNA......... Posted by: Betsy      Read more         Source

April 11, 2007, 11:05 PM CT

A genetic 'gang of 4' drives spread of breast cancer

Studies of human tumor cells implanted in mice have shown that the abnormal activation of four genes drives the spread of breast cancer to the lungs. The new studies by Howard Hughes Medical Institute researchers reveal that the aberrant genes work together to promote the growth of primary breast tumors. Cooperation among the four genes also enables cancerous cells to escape into the bloodstream and penetrate through blood vessels into lung tissues.

Although shutting off these genes individually can slow cancer growth and metastasis, the researchers found that turning off all four together had a far more dramatic effect on halting cancer growth and metastasis. Metastasis occurs when cells from a primary tumor break off and invade another organ. It is the deadliest transformation that a cancer can undergo, and therefore researchers have been looking for specific genes that propel metastasis.

In the newly published experiments, the researchers also found that they could reduce the growth and spread of human breast tumors in mice by simultaneously targeting two of the proteins produced by these genes, using drugs already on the market. The researchers are exploring clinical testing of combination therapy with the drugscetuximab (trade name Erbitux) and celecoxib (Celebrex)to treat breast cancer metastasis......... Posted by: Betsy      Read more         Source

March 28, 2007, 10:14 PM CT

MRI improves breast cancer diagnosis

Women who have been diagnosed with breast cancer in one breast have a higher risk of contracting the disease in their opposite breast as well. A thorough examination of the opposite breast using mammography and ultrasound is therefore common practice. However, a number of tumours still remain undetected when using mammography. Magnetic resonance imaging (MRI) promises better results, as is shown in an inter-national study involving the University of Bonn. In almost 1,000 women with a recent diagnosis of breast cancer in one breast, MRI helped identify 30 cancers in the seemingly normal opposite breast. In women with a normal (negative) MRI of the opposite breast, there was a 99.6% confidence that in fact no breast cancer was present -- which means that if the MRI study is normal, preventive mastectomy of the opposite breast, which some women want, is definitely unnecessary. These findings have now been reported in the prestigious journal "New England Journal (NEJM)".

About two dozen sites in North America took part in the study, as well as one sole site outside the USA, the University of Bonn. Bonn was selected as a team member due to its internationally leading position in breast cancer diagnostics. A total of 968 patients were examined, almost 200 of them at the University of Bonn alone. "Therefore, proportionally, most patients came from our Department, which means that the data from Bonn had a substantial impact on the results of the entire study," explains Professor Christiane Kuhl from the Department of Radiology of the University of Bonn. All the women had previously been diagnosed with tumours in one breast. A mammography as well as a clinical examination of the opposite breast had remained normal and without evidence of breast cancer. The patients then underwent breast MRI.Using MRI, the doctors found tumours in the other breast in as a number of as 30 women, yielding a contralateral cancer yield of over 3% - which is a high rate given the fact that regular breast cancer screening yields a detection rate of around 1 per million. "It is already well established that an MRI is essential before breast cancer surgery in order to delineate the extent of the disease and provide a road map for the surgeon. Now we know that it is also important for discovering further tumours in the opposite breast which was presumed to be healthy," Professor Kuhl says......... Posted by: Betsy      Read more         Source

March 20, 2007, 9:18 PM CT

Saliva Test for Breast Cancer

Breast cancer is the second leading cause of death among women in the United States. In 2006, the American Cancer Society estimated that there would be 212,920 new cases of invasive breast cancer, and in that year, 40,970 women would die from it. A number of women's lives could be saved if this cancer was diagnosed earlier, and early diagnosis could be achieved if there were more and easier opportunities to do so.

Sebastian Z. Paige and Charles F. Streckfus, DDS, MA, the authors of the study, "Salivary analysis in the diagnosis and therapy of breast cancer," reported in the March/April 2007 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-evaluated journal, researched a new method of diagnosis.

They observed that the protein levels in saliva have great potential to assist in the diagnosis, therapy, and follow-up care of breast cancer. And general dentists are perfect candidates to assist with this diagnosis samples because they can easily remove saliva samples from a patient's mouth during routine visits. As the AGD's Vice-President Paula Jones, DDS, FAGD says, "Since a patient visits the dentist more frequently than their physician, it makes sense that this diagnostic tool could be very effective in the hands of the general dentist." ......... Posted by: Betsy      Read more         Source

March 13, 2007, 9:53 PM CT

Tykerb wins FDA approval

GlaxoSmithKline plc announced recently that the United States Food and Drug Administration (FDA) approved TYKERB (lapatinib), in combination with Xeloda (capecitabine), for the therapy of patients with advanced or metastatic breast cancer whose tumors overexpress HER2 and who have received previous treatment including an anthracycline, a taxane, and trastuzumab. It is the first targeted, once-daily oral therapy option for this patient population. TYKERB was granted Priority Review by the FDA in November 2006.

"Tykerb is a significant breakthrough for women with advanced HER2 (ErbB2) positive breast cancer. The data clearly show that this small molecule, oral, targeted agent, in combination with capecitabine, is effective for women whose disease has progressed on prior therapies, including anthracyclines, taxanes and trastuzumab," said Paolo Paoletti, MD, Senior Vice President of the Oncology Medicine Development Center at GSK. "The approval of TYKERB demonstrates our R&D organization's strong commitment to the discovery and development of novel cancer therapys. We are dedicated to the further study and development of Tykerb in a variety of settings including adjuvant breast cancer as well as in other solid tumor types."

This approval reflects more than 16 years of research, including more than 60 clinical trials and investigator-initiated collaborative research studies. TYKERB inhibits two validated targets in oncology, the kinase components of the EGFR (ErbB1) and HER2 (ErbB2) receptors, usually linked to cancer cell proliferation and tumor growth. As a targeted treatment, TYKERB is designed to interfere with discrete cellular processes or disease mechanisms prevalent in cancer. TYKERB will be available in the United States within two weeks and, as an oral treatment, offers added convenience for patients......... Posted by: Betsy      Read more         Source

March 12, 2007, 9:58 PM CT

Which Breast Cancer Patients Need Chemotherapy?

Most postmenopausal women with small breast tumors don't need chemotherapy to reduce their recurrence risk after lumpectomy.

To try to determine who does, a test that measures a tumor's aggressiveness based on its DNA will be tested nationally in more than 10,000 of these women.

"The dilemma physicians have with these patients is, because they have such small tumors, it's hard to tell who needs chemotherapy," said Dr. Thomas A. Samuel, Medical College of Georgia hematologist/oncologist specializing in breast cancer and a study principal investigator.

If you take 100 postmenopausal women with a small tumor that has estrogen receptors - most do - and no sign the disease has spread to the lymph nodes, probably 12 to 15 of the women need chemotherapy to reduce recurrence, Dr. Samuel says.

To save those patients' lives, all 100 have to be treated with chemotherapy, because no definitive test indicates who really needs it, says Dr. Samuel. Yet the vast majority will do well with lumpectomy, radiation and hormone treatment that keeps cells from being refueled by estrogen.

Eventhough chemotherapy is a powerful tool, he's seen a number of patients struggle with notorious side effects such as hair loss, nausea, vomiting and increased risk for leukemia and heart problems. Some patients even opt to stop therapy. "I know that many these patients probably don't need it but there is no way for me to know who they are ahead of time. I think this trial will help us find who should get it and who should not"......... Posted by: Betsy      Read more         Source

February 20, 2007, 9:14 PM CT

Gene profiling and resistance to Herceptin

Using gene chips to profile tumors before treatment, researchers at Harvard and Yale Universities found markers that identified breast cancer subtypes resistant to Herceptin, the primary treatment for HER2-positive breast cancer. They say this advance could help further refine therapy for the 25 to 30 percent of breast cancer patients with this class of tumor.

In the February 15 issue of Clinical Cancer Research, the researchers found that HER2-positive tumors that did not respond to Herceptin expressed certain basal markers, growth factors and growth factor receptors. One of these, insulin-growth factor receptor 1(IGF-1R), was associated with a Herceptin response rate that was half that of tumors that did not express IGF-1R.

They also discovered that resistant tumors continue to over-express the HER2 growth factor protein -- an important finding given that many scientists had thought that loss of HER2 was likely responsible for Herceptin resistance.

"Herceptin has revolutionized the care of HER2-positive breast cancer for many patients, but unfortunately, not for some. This work demonstrates that digging deeper into the molecular subtypes of these tumors helps us understand why some tumors are resistant and may point to ways to remedy that," said the studys lead author, Lyndsay Harris, M.D., associate professor and Director of the Breast Cancer Disease Unit at Yale University Medical Center......... Posted by: Betsy      Read more         Source

February 15, 2007, 4:56 AM CT

ER and HER-2 status of breast tumors

Two critical characteristics of breast cancer that are important to therapy can be identified by measuring gene expression in the tumor, a research team led by researchers at The University of Texas M. D. Anderson Cancer Center reports in Lancet Oncology online.

Scientists developed and validated a new genomic microarray test that identifies whether a tumor's growth is fueled by the female hormone estrogen and the role of a growth factor receptor known as HER-2 that makes a tumor vulnerable to a specific drug. The status of these factors is now determined by pathology tests.

"This is one important step towards personalized diagnosis and therapy planning based on an integrated genomic test of an individual tumor," said senior author W. Fraser Symmans, M.D., associate professor in the M. D. Anderson Department of Pathology. The Lancet Oncology paper results are the latest in an effort by the research team to develop a single test to quickly and efficiently determine the characteristics and vulnerabilities of a patient's breast cancer and ultimately to guide therapy.

About 70 percent of breast cancers are estrogen-receptor positive and another 15 to 25 percent are human epidermal growth factor receptor-2 (HER-2) positive. Each receptor status requires different types of therapy......... Posted by: Betsy      Read more         Source