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The Pink Page Two new studies offer options to women looking to stop breast cancer before it starts. More Than a Mammogram 
Yearly breast exams are on every woman's to do list, but for women with a high risk for breast cancer, mammograms aren't the only option. According to a study conducted at the University of Texas M.D. Anderson Cancer Center, magnetic resonance imaging (MRI) alternated with mammograms can detect breast cancers not identified by mammography alone. "In the high-risk population, the recent standard of practice is to perform mammography and MRI every year," said Huong Le-Petross, M.D., assistant professor of diagnostic radiology at M.D. Anderson and the study's first author. "What we started to do at M.D. Anderson was to see if we could do mammography and then six months later do a breast MRI exam, followed six months later with a mammogram exam, and then six months after that with a breast MRI. That way the women would receive an imaging modality screening every six months." While mammography only has a 16-40 perfect accuracy rate for detecting breast cancers, MRI has a 71-100 percent accuracy rate. In the study, the alternating screening program detected nine cancers among the 86 high-risk women who underwent the alternating approach. Of those nine, MRI alone detected five cancers, while both MRI and mammography detected three. The final cancer was a tumor one millimeter in size and was overlooked by both screening techniques. With the five cancers detected by MRI, the mammogram from six months earlier was either normal or suggested benign findings. "We found that MRI picked up the majority of cancers, while mammography picked up only three of the nine," Le-Petross says. "The global picture is that MRI can pick up cancers that mammography cannot. This would suggest that in this population it is more beneficial for the patient to have screening MRI so that we can pick up small lesions before a mammogram can detect them." The study, which was conducted between Jan. 1997 and Dec. 2007, included 334 female participants who underwent between one and four high-risk screening techniques. The women were considered high risk if they had hereditary breast and ovarian cancer, a personal history of breast cancer, a biopsy indicating atypia or lobular carcinoma in situ,or a 20 percent or higher lifetime risk of developing breast cancer. Fruits, Veggies and Fiber Cut Recurrence Rates 
Doctors have always recommended a healthy diet of fruits and vegetables to patients. But for a sub-group of early-stage breast cancer survivors, following that advice may be life changing. A recent clinical trial has shown that a diet loaded with fruits, vegetables and fiber - and is somewhat lower in fat compared to standard federal dietary recommendations - can cut the risk of second breast cancers in survivors, specifically those who didn't have hot flashes, by approximately 31 percent. "Women with early stage breast cancer who have hot flashes have better survival and lower recurrence rates than women who don't have hot flashes," says Ellen B. Gold, PhD., professor and chair of the University of California, Davis, Department of Public Health Sciences and first author of the study. "Our results suggest that a major change in diet may help overcome the difference in prognosis between women with and without hot flashes." Typically, hot flashes are associated with lower circulating estrogen levels, while the absence of hot flashes is associated with higher estrogen levels. Reducing the effect of estrogen is a major treatment strategy in the fight against breast cancer. The study, led by researchers at the Moores Cancer Center at the University of California, San Diego, along with six other sites, divided its 3,088 participants, all breast cancer survivors, into two dietary groups. One half of the 447 participants who reported having no hot flashes were randomly assigned to the high-vegetable fruit diet. The trial found that those on the special diet had a rate of 16.1 percent of a second breast cancer event, while participants on the federally recommended diet had a 23.6 percent rate of recurrence. The dietary effect was particularly larger for women who had been through menopause, with a 47 percent lower risk rate. These findings come on the heels of a report last year from the original study, the Women's Healthy Eating and Living Trial (WHEL), which found no overall difference in recurrence among the two diet groups. According to the WHEL study principal investigator, John P. Pierce, PhD., this specific dietary pattern is only significant for women with higher levels of estrogen. "It appears that a dietary pattern high in fruits, vegetables and fiber, which has been shown to reduce circulating estrogen levels, may only be important among women with circulating estrogen levels above a certain threshold," Pierce says. |
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