Breast Cancer

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Breast Cancer

NIH - Medical Encyclopedia Breast cancer

"There are several different types of breast cancer. Ductal carcinoma begins in the cells lining the ducts that bring milk to the nipple and accounts for more than 75% of breast cancers. Lobular carcinoma begins in the milk-secreting glands of the breast but is otherwise fairly similar in its behavior to ductal carcinoma. Other varieties of breast cancer can arise from the skin, fat, connective tissues, and other cells present in the breast. … Some women have what is known as HER2-positive breast cancer. HER2, short for human epidermal growth factor receptor-2, is a gene that helps control cell growth, division, and repair. When cells have too many copies of this gene, cell growth speeds up. It’s believed that HER2 plays a key role in turning healthy cells into cancerous ones. Some women with breast cancer have too much HER2, and are therefore considered HER2-positive. … Some families appear to have a genetic tendency for breast cancer. Two variant genes have been found that appear to account for this: BRCA1 and BRCA2. … The body's reduced ability to get rid of abnormal cells leads to damage that gradually accumulates. Women carrying mutated BRCA1 and/or BRCA2 genes start with pre-existing dysfunction of this system and have a "head start" in this damaging process. Hormones are important because they encourage cell growth. High levels of hormones during a woman's reproductive years, especially when they are not interrupted by the hormonal changes of pregnancy, appear to increase the chances that genetically damaged cells will grow and cause cancer."

Types of breast cancer

Breast lumps: Types of lumps and what they mean

Highlighted Articles

Mammographic Breast Density as a General Marker of Breast Cancer Risk (Cancer Epidemiology Biomarkers & Prevention 2007)

"Overall mammographic density seems to represent a general marker of breast cancer risk that is not specific to breast side or location of the eventual cancer."

Lifetime physical activity and the risk of breast cancer: A case-control study. (Cancer Detect Prev. 2007)

"Conclusions: These data are in concordance with the hypothesis that lifetime total physical activity is associated with decreased breast cancer risk. They also suggest that recreational physical activity at ages 14-20 years is the most beneficial. In addition, these findings confirm the majority of previous reports which implicated physical inactivity as important risk factor for breast cancer."

Highlighted Internet Site

NCI - Breast Cancer (PDQ®): Prevention

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Breast Cancer

Diagnosis, Imaging, and Screening

NEWS:

60% 'unaware of cancer age link': Most British women are unaware that breast cancer risk increases with age, a poll suggests.

Benefits of Mammograms For Women in 40s Challenged "The nation's largest medical specialty group is challenging the widely accepted recommendation that women routinely undergo mammograms in their 40s, saying the risks of the breast exams may outweigh the benefits for many women. Reopening a long-running debate, the American College of Physicians, which represents 120,000 internists, issued new guidelines today that instead urge women in their 40s to consult with their doctors about whether to have the breast X-rays. The group based its recommendations on a comprehensive review of mammography research that concluded that the benefits are less clear for women in their 40s than for those 50 and older, and that screening carries significant risks, including exposure to radiation and unnecessary biopsies, surgery and chemotherapy."

Call to Increase M.R.I. Use for Breast Exam "Two reports being published today call for greatly expanded use of M.R.I. scans in women who have breast cancer or are at high risk for it."

Computer-Aided Detection Reduces the Accuracy of Mammograms

Counseling Women About Mammography: Benefits vs. Harms

Debate Heats Up Over Breast MRI vs Mammogram "New American Cancer Society screening guidelines recommend MRI for women at the highest risk for breast cancer. And data published in a recent New England Journal of Medicine paper seemed to stack up in favor of MRI, suggesting that screening at the time of diagnosis of 1 breast cancer can lead to finding a second breast cancer (Lehman CD et al. New Engl J Med 2007;356:1295-1303.) But not everyone has been as enthusiastic about breast MRI. The latest National Comprehensive Cancer Network (NCCN) guidelines caution against relying too heavily on MRI and using laboratory testing as the sole determinant for therapy. "

Experts Offer Better Means of Gauging Breast Cancer Risk

False-positive mammograms have negative effects "Women who are told their mammogram shows a possible cancer that turns out to be a false alarm are likely to suffer anxiety for a long time, according to a new study."

Health Tip: Breast Self-Exams

In Breast Cancer, Removing Three Sentinel Lymph Nodes Isn't Enough "Despite recent suggestions that removing three sentinel lymph nodes from women with breast cancer is enough for a biopsy, all sentinel lymph nodes (SLNs) should be removed to reduce the risk of false-negative results, according to a report in the May Archives of Surgery."

Low Number of Uninvolved Lymph Nodes Predicts Breast Cancer Recurrence "A variety of factors, including the number of involved and uninvolved lymph nodes, may be predictive of risk of locoregional failure following mastectomy for breast cancer, and such patients might benefit from radiotherapy (RT), according to researchers. "Postmastectomy RT is generally recommended in most guidelines if 4 or more nodes are involved," lead investigator Dr. Per Karlsson told Reuters Health. "RT in the 1-to-3 positive-node group is controversial." "

Mammograms lower rates of advanced breast cancer "Mammography screening has significantly reduced the number of breast cancers cases involving large tumors or disease that has spread to the lymph nodes, according to a Swedish study."

[Mammography screening.] (Radiologe. 2007) "Exclusive biannual mammography screening for women ages 50-69 years reduces the mortality from breast cancer among participants by 35%. Compared with 50% of clinically detected cancers, only 20% of carcinomas detected in screening have nodal metastases, and up to 55% of screening carcinomas are in the T1 stage of "minimal cancer.""

Mammographic Screening Reduces Breast Cancer Mortality "The results of a study published in the March issue of the International Journal of Cancer suggest that screening mammography reduces subsequent mortality rates from breast cancer for women older than 40 years of age."

MRI best at spotting ductal carcinoma in situ "Magnetic resonance imaging (MRI) seems to be much more sensitive than mammography in diagnosing ductal carcinoma in situ (DCIS) in general, and aggressive, high-grade DCIS in particular, according to the results of a large study presented at the annual meeting of the American Society of Clinical Oncology. DCIS is a noninvasive, precancerous condition that can progress to invasive cancer if untreated. DCIS can be any one of a wide variety of pathological tissues that are classified into subtypes based largely on their appearance. Some subtypes appear to be "high-grade," or more aggressive, and have a greater chance of being invasive. Compared with mammography, MRI doubled the overall sensitivity of detecting DCIS and doubled the sensitivity of diagnosing high-grade DCIS as well "

MRI Detects Cancers in the Opposite Breast of Women Newly Diagnosed with Breast Cancer

Screening Mammography in Women 40 to 49 Years of Age: A Systematic Review for the American College of Physicians (Annals 2007) "Conclusions: Although few women 50 years of age or older have risks from mammography that outweigh the benefits, the evidence suggests that more women 40 to 49 years of age have such risks."

Ultrasound plus mammography finds more cancers, but increases false positives

ARTICLES:

ASCO/CAP Guidelines HER2 Testing Breast Cancer

Breast Cancer: Understanding Your Mammogram Results "Potential abnormalities are found in 6% to 8% percent of women who have screening mammograms. This small group of women needs further evaluation that may include diagnostic mammography, breast ultrasound, or needle biopsy."

Breast MRI: Imaging test to detect breast cancer

Breast self-exams: One way to detect breast cancer

Mammograms Beginning at Age 40? Mortality Reduced, but Not Conclusively

JOURNAL ARTICLES:

A standardized sentinel lymph node enhanced pathology protocol (SEPP) in patients with breast cancer. (J Surg Oncol. 2007)

Accuracy of CT perfusion in assessing metastatic involvement of enlarged axillary lymph nodes in patients with breast cancer. (Breast Cancer Res. 2007)

American cancer society guidelines for breast screening with MRI as an adjunct to mammography. (CA Cancer J Clin. 2007)

Bilateral Breast Cancer: Differential Diagnosis Using Histological and Biological Parameters. (Jpn J Clin Oncol. 2007)

Breast imaging and needle biopsy in women with clinically evident breast cancer: Does combined imaging change overall diagnostic sensitivity? (Breast. 2007)

Breast MRI and 18F FDG PET/CT in the management of breast cancer. (Ann Nucl Med. 2007) "CONCLUSIONS: As expected, BMRI is more sensitive than PET/CT in the detection of breast lesions. However, PET/CT as a whole-body examination changed the management of disease by detection of distant lesions in 6 of the 21 patients. Our study suggests that 18F FDG PET/CT and BMRI should be considered as complimentary imaging tools in the pre- and postoperative work-up of patients diagnosed with breast cancer."

Clinical, pathological and molecular characteristics of newly diagnosed breast cancers. (Neoplasma. 2007) "Selection of breast carcinoma therapy is based on standard prognostic markers, such as tumor size, infiltration of regional lymph nodes, tumor grade, and expression of hormonal receptors. Insufficient treatment results stimulate a search for new markers which may lead to a more precise characterization of these tumors and to a more effective treatment. In our study we determined essential clinical and histopathological characteristics of non-metastasizing breast cancer - primary tumor size, involvement of the regional lymph nodes, expression of hormonal receptors and a status of ERBB-2 protein (HER-2), DNA ploidy, and their possible inter-correlation."

Combination blue dye sentinel lymph node biopsy and axillary node sampling: The Edinburgh experience. (Eur J Surg Oncol. 2007) "CONCLUSION: Axillary node sampling adds to the accuracy of the sentinel node biopsy using blue dye. Pathological features suggest that the principal cause of false negative sentinel node biopsy is due to blocking of the lymphatic channels by the cancer."

Comparison of breast cancer detection by diffusion-weighted magnetic resonance imaging and mammography. (Radiat Med. 2007) "CONCLUSION: DW-MRI may be useful for detecting breast cancer in a wide age group of women, including young women with dense mammary glands."

Follow-up in breast cancer: does routine clinical examination improve outcome? A systematic review of the literature. (Br J Cancer. 2007)

How should we screen for breast cancer? Mammography, ultrasonography, MRI. (Cleve Clin J Med. 2007)

Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings. (Breast Cancer Res Treat. 2007) "CONCLUSION: MRI was the most accurate imaging technique in detecting a primary BPL in IBC patients. Sonography can be useful in diagnosing regional nodal disease. PET/CT provides additional information on distant metastasis, and it should be considered in the initial staging of IBC."

[Interests and perspectives of PET-CT for breast cancer: review of the literature] (Bull Cancer. 2007)

Mammography Surveillance and Mortality in Older Breast Cancer Survivors (Journal of Clinical Oncology 2007)

MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. (N Engl J Med. 2007) "CONCLUSIONS: MRI can detect cancer in the contralateral breast that is missed by mammography and clinical examination at the time of the initial breast-cancer diagnosis."

MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study (The Lancet 2007) "MRI could help improve the ability to diagnose DCIS, especially DCIS with high nuclear grade."

Nonsteroidal anti-inflammatory drugs (NSAIDs) and mammographic density. (Breast Cancer Res Treat. 2007)

Palpable masses in breast during lactation. (Clin Imaging. 2007) " CONCLUSIONS: The density of the lactating breast compromises breast cancer diagnosis. Ultrasound should be the method of choice. If possible mammography and MR mammography should be done after lactating period."

Positive and negative aspects of sentinel lymph node biopsy in breast cancer. (Future Oncol. 2007)

Recurrence after sentinel lymph node biopsy with or without axillary lymph node dissection in patients with breast cancer. (Breast Cancer. 2007) " Conclusions: The axillary recurrence rate was low in patients treated with SLNB alone. Omitting ALND is concluded to be safe after adequate SLNB. Risk factors for regional nodal failure after SLNB alone are negative hormone receptor status and high NG."

Role of axillary ultrasound examination in the selection of breast cancer patients for sentinel node biopsy. (Am J Surg. 2007) "CONCLUSIONS: The US of axillary nodes, possibly associated with core biopsy, improved the preoperative evaluation of breast cancer patients scheduled for SNB."

Screening for Breast Cancer: Current Recommendations and Future Directions (Am Fam Physician 2007) "Breast cancer is one of the most significant health concerns in the United States. Recent reviews have questioned the value of traditional breast cancer screening methods. Breast self-examination has been shown not to improve cancer-specific or all-cause mortality in large studies, but it is commonly advocated as a noninvasive screen. Patients who choose to perform self-examination should be trained in appropriate technique and follow-up. The contribution of the clinical breast examination to early detection is difficult to determine, but studies show that sensitivity is highly dependent on time taken to do the examination. Up to 10 percent of cancers are mammographically silent but evident on clinical breast examination."

Screening for hereditary breast cancer. (Semin Oncol. 2007)

Sentinel Lymph Node Biopsy in Staging Small (up to 15 mm) Breast Carcinomas. Results from a European Multi-institutional Study. (Pathol Oncol Res. 2007)

Sentinel node biopsy for breast cancer: technical aspects and controversies. (Breast Cancer. 2007)

Sentinel node biopsy in patients with multiple breast cancer. (Breast Cancer Res Treat. 2007)

Stage of breast cancers found during the surveillance of women with a familial or hereditary risk. (Eur J Surg Oncol. 2007) " CONCLUSION: Breast cancers detected in a MG alone surveillance program for women at increased risk fulfill most goals set for population screening except for the BRCA2 carriers. Breast self-examination appears to be a valuable additional detection method especially for BRCA1 carriers, who are at risk of developing a highly proliferating breast cancer."

Testing for HER2-positive breast cancer: a systematic review and cost-effectiveness analysis (CMAJ 2007)

The effectiveness of training for breast cancer and breast self-examination in women aged 40 and over. (J Cancer Educ. 2007)

The Reliability of Nipple Aspirate and Ductal Lavage in Women at Increased Risk for Breast Cancer--a Potential Tool for Breast Cancer Risk Assessment and Biomarker Evaluation. (Cancer Epidemiol Biomarkers Prev. 2007)

Tumor Size and Lymph Node Status in Multifocal Breast Cancer (The Breast Journal 2007) "Our results indicate that in multifocal breast cancer, only the diameter of the largest tumor breast cancer has relationship with lymph node metastasis."

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