Breast Cancer

Cancer and Family History

cancer_family_treeResearchers in Milan, Italy have recently published their research in the Annals of Oncology. The study followed  some 12,000 patients with cancer at different sites in the body including bowel, pancreatic, liver, breast, ovarian, cervical and prostate cancer.

The patients were compared with approximately 11,000 people without the disease.

Researchers collected specific information on the family history of cancer, particularly in a first-degree relative -those who share about 50% of their genes (ie. a parent, sibling or child).

Among their findings were that men had a 3.4-fold increased risk of prostate cancer if a first-degree relative had bladder cancer and that woman had an increased risk of breast cancer if they also have a family history of bowel cancer.  They also confirmed the long-suspected associated risk of having the same type of disease as a near relative.

In some cases, the links may be due to shared environmental factors, such as family smoking and drinking habits, she said. But there was also evidence of genetic factors affecting multiple sites in the body.

Some easy take away’s from the study are that you can lower your risk, genetics notwithstanding by being a non-smoker, reducing alcohol consumption, remaining physically by being active and eating a more balanced diet.

This study was based on a network of Italian and Swiss case–control studies conducted between 1991 and 2009, and including more than 12 000 cases and 11 000 controls. They collected information on history of any cancer in first degree relatives, and age at diagnosis. Odds ratios (ORs) for Family History (FH) were calculated by multiple logistic regression models, adjusted for major confounding factors.  All sites showed an excess risk in relation to FH of cancer at the same site.

The Lewis Law Firm has a history of representing patients who are diagnosed with cancer.  If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with cancer contact the Lewis Law firm today for a FREE consultation.

Breast Cancer Surgery New Technology

Source: UC Irvine Health News, Making Breast Cancer Surgery More Precise;

breast-cancer-surgeryOne of the many problems facing breast cancer patients is weather their surgeon cut out all of the cancer in her breast during surgery. The goal in a lumpectomy is to completely remove the cancer while preserving as much normal breast tissue as possible. If a pathologist finds cancer cells on the edges of the tissue taken out, surgeons must assume the lumpectomy didn’t get the entire tumor. According to some statistics 30-60% of the time cancerous cells are found on the margins of the original cutting area, which require another surgery for the patient.

Using a sterile handheld probe and a portable console, surgeons at UC Irvine Medical Center are the first in the country to find a better way to get a definitive answer, the first time. When the probe tip touches an excised lumpectomy specimen, radio-frequency signals are transmitted into the tissue and reflected back to the console (think sonar), where they are analyzed using a specialized algorithm to determine tissue status. The MarginProbe System lets the surgeon immediately assess whether cancer cells remain on the margins of excised tissue. Currently, patients have to wait days for a pathologist to make the determination, assuming the pathologist gets it right.

“All of my patients know someone who has had to go back into surgery because their doctor didn’t get the entire tumor out,” said UC Irvine Health surgical oncologist Dr. Alice Police. “The ability to check tissue in the operating room is a game changer in surgery for early-stage breast cancer.” The US Food & Drug Administration (FDA) approved MarginProbe in December 2012, and UC Irvine Medical Center is the first hospital in the U.S. to employ the system, according to manufacturer Dune Medical Devices. Dr. Police, assistant professor of surgery at UC Irvine and medical director of Pacific Breast Care in Costa Mesa, and Dr. Karen Lane, associate professor of surgery and clinical director of the UC Irvine Health Breast Health Center in Orange, began operating with MarginProbe in early March.

They had participated in an FDA trial that included more than 660 women across the U.S. In the prospective, multicenter, randomized, double-arm study, surgeons applied the device to breast tissue removed during in-progress initial lumpectomies and, if indicated, shaved additional tissue on the spot. This was found to reduce by 56 percent the need for repeat surgeries.  “It will save you a lot of anxiety,” said Jane Madigan, a Costa Mesa resident who underwent the procedure with Police as part of the MarginProbe trial. “You will come out of that surgery knowing you are cancer-free.”

The Lewis Law Firm has a history of representing women who are diagnosed with breast cancer.  If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.

Breast Cancer Dense Breast Spread Risk

Sources: Nature Cell Biology, May 2013; Washington University School of Medicine, St. Louis

Promote Breast Cancer AwarenessBreast Cancer Spread (metastasis) risk is higher in women with dense breast tissue.  Researchers at Washington University School of Medicine in St. Louis have discovered why breast cancer patients with dense breasts are more likely than others to develop aggressive tumors that spread. This greater density is caused by an excess of a structural protein called collagen.

“We have shown how increased collagen in the breasts could increase the chances of breast tumors spreading and becoming more invasive,” says Gregory D. Longmore, MD, professor of medicine. “It doesn’t explain why women with dense breasts get cancer in the first place. But once they do, the pathway that we describe is relevant in causing their cancers to be more aggressive and more likely to spread.”

Working in mouse models of breast cancer and breast tumor samples from patients, Longmore and his colleagues showed that a protein that sits on the surface of tumor cells, called DDR2, binds to collagen and activates a multistep pathway that encourages tumor cells to spread. “We had no idea DDR2 would do this,” says Longmore. “The functions of DDR2 are not well understood, and it has not been implicated in cancer — and certainly not in breast cancer — until now.”

At the opposite end of the chain of events initiated by DDR2 is a protein with the unfortunate acronym of  “SNAIL1,” which has long been associated with breast cancer metastasis. Longmore and his colleagues found that DDR2 is one factor helping to maintain high levels of SNAIL1 inside a tumor cell’s nucleus, a necessary state for a tumor cell to spread. Though they found it is not the only protein keeping SNAIL1 levels high, Longmore says DDR2 is perhaps the one with the most potential to be inhibited with drugs. “It’s expressed only at the edge of the tumor,” says Longmore. “And it’s on the surface of the cells, which makes it very nice for developing drugs because it’s so much easier to target the outside of cells.”

The researchers emphasize that DDR2 does not initiate the high levels of SNAIL1. However, it is required to keep the level elevated. This mechanism that keeps tumor cells in a state that encourages metastasis requires constant signaling — meaning constant binding of DDR2 to collagen. If that signal is blocked, the cell remains cancerous, but it is no longer invasive. So a drug that blocks DDR2 from binding with collagen won’t destroy the tumor, but it could inhibit the invasion of these tumors into surrounding tissue and reduce metastasis. “This whole notion of fiber alignment and the tumor interface is a hot topic right now,” Longmore says. “Our co-authors at the University of Wisconsin have developed a scoring method for collagen alignment that correlates with prognosis. And the bad prognosis disappears when you take away DDR2.”

70% of invasive ductal breast cancers show DDR2. But in 95% of these tumors the genes in this pathway — from DDR2 to SNAIL1 — are entirely normal, without mutations. “Currently there are no DDR2 specific inhibitors,” Longmore says. “But there is great interest and work being done here and elsewhere to develop them.”

The Lewis Law Firm has a history of representing women who are diagnosed with breast cancer.  If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.

Breast Cancer Research

Source:  Molecular Cell, May 2013; Western Schulich School of Medicine & Denistry (Ontario, Canada)

Support Breast Cancer ResearchBreast Cancer isn’t all the same. There is a type of breast cancer called “triple negative” which has limited treatment options and the worst chance of survival. Triple negative breast cancer is generally diagnosed based upon the presence, or lack of, three “receptors” known to fuel most breast cancers: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2).

The most successful treatments for breast cancer target these receptors.  Unfortunately, none of these receptors are found in women with triple negative breast cancer. In other words, a triple negative breast cancer diagnosis means that the offending tumor is estrogen receptor-negative, progesterone receptor-negative and HER2-negative, thus giving rise to the name “triple negative breast cancer.” While triple negative breast cancer is typically responsive to chemotherapy, triple negative tumors generally do not respond to receptor targeted treatments. Depending on the stage of its diagnosis, triple negative breast cancer can be particularly aggressive, and more likely to recur than other subtypes of breast cancer.

New research explains why some cancer cells don’t respond to chemotherapy, and identifies a mechanism to rectify that. The team at Western’s Schulich School of Medicine & Dentistry, led by Shawn Li, PhD, identified that a protein called “Numb” functions to promote the death of cancer cells by binding to and stabilizing a tumor suppressor protein called p53 -a master regulator of cell death. The scientists found when Numb is reduced or methylated by an enzyme called Set8, it will no longer protect p53. The research is published in the May 23rd issue of Molecular Cell. A related research paper on the role of chemotherapeutic agents on regulating protein methylation, also from the Li lab, will be published in the June 7th issue of Molecular Cell.

“If you don’t have Numb in a cell, then the p53 can be degraded very quickly, and these cells become resistant to chemotherapy,” explains Li, a professor of Biochemistry and Canada Research Chair in Cellular Proteomics and Functional Genomics. “So if we can prevent Numb from being methylated in cancer cells, then we will have the means to sensitize the cell to chemotherapy.”

Now that they’ve identified the Set8-Numb-p53 pathway, Li and his team are investigating various drugs to find a Set8 inhibitor which could be used as a novel breast cancer therapy alone, or in combination with other chemotherapy regiments.

For more information on Triple Negative Breast Cancer Click here for the TNBC Foundation®  

The TNBC Foundation® is devoted to finding targeted treatment for triple negative breast cancer. With your help, we will find a cure.

The Lewis Law Firm has a history of representing women who are diagnosed with breast cancer.  If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.

Breast Cancer -Early Detection Key

Sources: American Cancer Society; and 30+ years of medical malpractice experience

Prevent-Breast-CancerEARLY detection of breast cancer, before it causes symptoms, is the key to cure and long-term survival of this disease.  The goal of screening exams for early breast cancer detection is to find cancers before they start to cause symptoms.  Breast cancers that are found because they are causing symptoms tend to be larger and are more likely to have already spread (metastasized) beyond the breast.

Although not all will admit this when they are Defendants in a medical malpractice case, most doctors believe that early detection tests for breast cancer save thousands of lives each year and that the size of a breast cancer when it is found and how far it has spread, and genetics, are the most important factors in predicting the prognosis (outlook) of a woman with this disease.

What are the risk factors for breast cancer? Many women with breast cancer have no apparent risk factors.  There are breast cancer risk factors you cannot change.  Among these are: Gender, men can develop breast cancer, but this disease is about 100x more common in women; Aging, your risk of developing breast cancer increases as you get older; Genetics,  5% to 10% of breast cancer cases are caused directly from genes BRCA1 and BRCA2; Family history of breast cancer, having a first-degree relative (mother, sister, or daughter) with breast cancer almost doubles a woman’s risk. 85% women who get breast cancer do not have a family history for it; Personal history of breast cancer, a woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast (contralateral) or in another part of the same breast; Race and Ethnicity, white women are slightly more likely to develop breast cancer than are African-American women, but African-American women are more likely to die of this cancer; Dense breast tissue, women with dense breasts have a higher risk of breast cancer; Menstrual periods, women who started menstruating early (before age 12) and/or went through menopause later (after age 55) have a slightly higher risk of breast cancer; Previous chest radiation, treatment for hodgkin’s disease or lymphoma increases the risk of breast cancer as does chemotherapy.

What are the Signs and symptoms of breast cancer? The most common symptom of breast cancer is a new lump (mass).  A mass that is painless, hard, and has irregular edges is more likely to be cancerous, but breast cancerscan be tender, soft, or rounded. They can even be painful. For this reason, it is important to have any new mass, lump, or breast change checked by your doctor and possibly by a breast surgeon.  Other signs are: Swelling of the breast; Skin irritation or dimpling of the breast; Nipple pain or retraction (turning inward); Redness or scaliness of the breast; and, discharge. The American Cancer Society recommends that women age 40 and older should have a mammogram every year.

The Lewis Law Firm has a history of representing women who are diagnosed late with breast cancer.  If you are in Philadelphia or New Jersey and you or a loved one have been diagnosed with breast cancer contact the Lewis Law firm today for a FREE consultation.

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