Breast cancer in the news

Once again we report some of the more interesting tidbits found in the news in the last 2 weeks.

Here is a rather alarming and well done study. Researchers at Univ of Southern California found that eating 1/4 of a grapefruit or more per day was associated with a 30 percent increase in breast cancer risk in certain postmenopausal women. The increased risk from eating 1/4 or more of a grapefruit per day was seen in women who never took hormone therapy to treat menopausal symptoms as well as in women who were taking estrogen alone or combined estrogen and progesterone. Breast cancer risk was also higher in the thin women who ate grapefruit than it was in the overweight women who did. The probable mechanism is that grapefruit increases estrogen levels - increased estrogen is a known risk factor for breast cancer.

Even Dr. Susan Love says the study is well done. She does not recommend abandoning grapefruit but cautions it may be wise to cut down intake. This is a rather strong recommendation from a very well respected authority. Most readers know I'm generally wary of the multitude of reports of this type. There are just so many. But the grapefruit report has gotten my attention. Be careful of the well known grapefruit diet!


US scientists have now said that women should think twice before taking the herbal therapy black cohosh. The report indicates the herb can increase the chance of breast cancer cells migrating from the breast to the lung.


In a report on their findings, published in the journal Cancer Research, they said: "These results suggest caution for black cohosh use in women with and without breast cancer."
Black cohash has been popular as a natural treatment of menopausal symptoms. I think the popularity is about to go down!

And now for some good news!

As reported in the journal Breast Cancer Research.

Researchers followed 32,269 post-menopausal women for eleven years and found that vigorous exercise was protective against breast cancer - independent of body weight.

Vigorous activity was defined as anything from strenuous sports such as running, biking up hills, and aerobics to taxing housework such as scrubbing floors, chopping wood or heavy yard work.
Fascinatingly, non-vigorous activity was not protective (non-vigorous activity included walking, light housework, leisure biking).

One of the takeaways of this article is woman may want to think about increasing the intensity level of their exercise. But I make this comment with hesitation. The increase in injuries, accidents, heart attacks etc may negate the positive effects for some woman. That said, if a woman is in good general health and has a doctors OK then the increased intensity should be good for women on many levels. Just do it!

That's it for this week in the news. I find the above particularly interesting because all three of the above are popular foods or activities. But more importantly they are things women can do right now - today - to lower the risk of breast cancer.

Mammosite and you

So many things we have to decide when it comes to treating breast cancer with radiation therapy. It used to be so simple. After lumpectomy a woman underwent 6 weeks of daily radiation and that was that.

Oh, things have changed. And mostly for the better. But like everything else there is always more to the story. So, here is the story on partial breast radiation and mammosite.

Firstly, it is in widespread use and remains controversial. For select women it is an excellent option - but only if the patient understands the controversy, risks, and benefits and then decides it is for her.

What is the controversy? Read the New York Times recent article which does a great job of explaining. Read it here.

Basically, the track record is not long. It is based on data from few women compared to the standard treatment. And the device was "fast tracked" by the FDA which means it was not determined if it is actually effective at treating breast cancer. The fast track approval means the Mammosite was actually approved because it performed as advertised - it delivered radiation to the resection cavity. It was not approved because it was proven to be better or equal to the standard 6 week course of radiation.

Secondly, it is not for everyone. It should be offered to the selection of women who meet the strict criteria. This prevents placing women at increased risk of local failure, skin damage, lung/rib damage when a safer alternative is available.

Partial breast techniques include mammosite, other implant techniques/devices, external beam with 3D or IMRT and all should only be delivered in an institution with expertise and perhaps in a study setting. The informed consent should make sure the patient clearly understands the procedure is controversial, not tested in the long term, and the side effects may be differnet than the standard 6 week course of radiation.

On the other hand, for the women who are good candidates for mammosite it can be a great idea. I've used the mammosite personally with many women and generally it is well tolerated and side effects minimal.

The leaders in partial breast techniques in the country are doing a great service to women who may need or want this approach. But like anything else in this world - there is more to the story than meets the eye. Please read the NY Times article for more info - here.