Hormone-Negative Women Under 50 Benefit Most From Double Mastectomy

Women under 50 with stage 1 to 3 hormone-receptor-negative breast cancer benefit the most from having a double mastectomy, according to a study published online today in the Journal of the National Cancer Insitute. The benefit, the researchers say, is “small”—a 4.8 percent reduced relative risk. And, they note, this is an observational study, using data from the Surveillance Epidemiology and End Results (SEER) program through the National Cancer Institute.

NOTE: This is a reduced relative risk, which means it is 4.8 percent benefit beyond whatever your original risk was, based on your tumor’s characteristics. So, if your doctor says you have a ten percent risk of recurrence, you will reduce that risk by 4.8 percent, which means a total reduced risk of less than a half percent. But, if your risk is 50 percent, you also cut that by 4.8 percent, but that give s bigger benefit—2.4 percent reduced risk. So the worse your original odds, the more you benefit.

Also, this is an observational study, using existing data on 107,106 women who had a mastectomy to treat stage 1 to stage 3 breast cancer. Among that group, 8,902 women also had their healthy breast removed. Here’s what researchers say about the data they used:

As an observational study, the results are subject to a variety of confounding factors, such as selection bias. The data used in the study were limited in terms of patient and tumor factors, such as BRCA mutation status, family history, and chemotherapy, which might affect the results.

Shorter May Be Better for Radiation

From the National Cancer Institute:

Giving radiation therapy in fewer but larger doses may be an alternative to standard radiation therapy for some women with early-stage breast cancer. A trial testing this approach, called hypofractionated radiation therapy, has found that the regimen tested did not increase long-term toxicities and resulted in rates of survival and local recurrence similar to those seen with standard radiation therapy. The study, published in the February 11 New England Journal of Medicine, had the longest follow-up results of any study to date of hypofractionated radiation therapy for breast cancer.

Breast-conserving surgery (BCS) plus adjuvant radiation therapy has been firmly established as a safe alternative to full mastectomy for most women with early-stage breast cancer. The radiation therapy part of that regimen is vital, as long-term data have shown that it greatly reduces the risk of tumor recurrence.

However, almost a third of women in North America do not get radiation therapy after BCS. “Although the use of breast-conserving surgery is increasing, the number of women who receive appropriate radiation therapy after breast-conserving surgery is actually decreasing,” said Dr. Timothy Whelan, professor of oncology at McMaster University in Ontario, Canada. MORE.

Aspirin May Reduce Recurrence and Death of Triple Negative

Breast cancer patients who took a low-dose aspirin two to five days a week—regardless of hormone receptor status—were 60 percent less likely to have a recurrence and 71 percent less likely to die from breast cancer.

The research:

Researchers at Brigham and Women's Hospital in Boston studied data from 4,164 female nurses in the Nurses' Health Study who were diagnosed with breast cancer between 1976 and 2002. By 2006, there had been 400 recurrences and 341 deaths among the nurses. They studied the women's aspirin use beginning 12 months after diagnosis, when the treatment was usually finished.

The findings:

• the majority of women took 81 mg a day, usually for their heart

• taking aspirin once a week produced no benefit.

• Tylenol or acetaminophen provided not benefit.

• Both hormone-negative and hormone-positive women benefitted.

• Results were essentially the same, regardless of stage, menopausal status, or body mass index.

The interpretation:

Doctors believe aspirin’s benefit may come from its anti-inflammatory properties.

The warning:

•The data so far show an association, not a cause, and other factors could be at work, such as the fact that the women who took the aspirin might be more health conscious than those who did not take aspirin.

• If you have a health problem that can be exacerbated by aspirin, such as ulcers, visit your doctor before considering this approach.

• Aspirin can interfere with the chemotherapy or produce side effects, so check with your doctor if you are undergoing treatment.

The research was published in the Journal of Clinical Oncology, published online February 16, 2010.

Beware of Whole Grain Impostors

Whole grain foods have a solid place in the healthy diet, providing B vitamins, Vitamin E, magnesium, iron and fiber, as well as other valuable antioxidants not found in some fruits and vegetables. Most of these goodies are in the germ and the bran of the grain. That’s why you need whole grains, because they include the germ and bran. Refined, or processed, grains have been milled, stripping these benefits away.

Whole grains fill you up quicker and make you feel full longer, so they’re excellent for diets.

Refined grains, by contrast, are simple carbs that are related to increased hormone-negative breast cancer risk.

BUT, we can easily get tricked into thinking our food is made with healthy whole grains when, in fact, they are made of their less-healthy, refined cousins.

Here’s a quick guide to make sure you’re getting the right stuff.

• Look for the word “whole” on the label, ideally as the first ingredient.

• Look for items with at least three grams of fiber per serving.

And watch out for trick words that make processed grains look like they are whole grains:

Multi-grain

Honey grain

All wheat

These are usually NOT whole grains. White flour is all wheat, and it is a processed carb that can put you at risk of hormone negative breast cancer. And honey grain and multi-grain are usually just fancy versions of simple carbs.

Breast Cancer is Seasonal

Breast cancer is most often diagnosed in spring and fall, especially in areas the farthest from the equator, according to a study of 2,921,714 breast cancer cases across 64 global regions and published in the journal Breast Cancer Research and Treatment (February, 2010).

Researchers write:

These data make it clear that human breast cancer discovery occurs non-randomly throughout each year with peaks near both equinoxes and valleys near both solstices. This stable global breast cancer seasonality has implications for better prevention, more accurate screening, earlier diagnosis, and more effective treatment. This complex latitude-dependent breast cancer seasonality is clearly related to predictable local day/night length changes which occur seasonally. Its mechanism may depend upon seasonal sunlight mediation of vitamin D and seasonal mediation of nocturnal melatonin peak level and duration.

TNBC on the Today Show

Jennifer Griffin, a mother of 3 and the National Security Correspondent for Fox News will tell her TNBC story on NBC's Today Show this Thursday, February 11 between 8 am and 9 am Eastern. Jennifer was diagnosed with Stage 3 triple negative breast cancer on September 28. So far she has undergone 13 rounds of chemo will have a double mastectomy in the spring. The Today Show followed her for two days and interviewed her doctor, Claudine Isaacs, M.D., of Georgetown University and Dr. Susan Love about triple negative. Check out Jennifer's blog.

Add Radishes to Your Anti-Cancer Diet

My husband brought home a big batch of fresh radishes the other day, preparing to make a special recipe. He now can’t find the recipe and has no idea what it was or what to do with the radishes. So, first, welcome to my life. And second, let’s talk radishes.

Turns out this shy little vegetable is actually quite healthy:

• Radishes are part of the family of cruciferous vegetables, known cancer-fighters.

• Radishes are a good source of Riboflavin, Vitamin B6, Calcium, Magnesium, Copper, Manganese, fiber, Vitamin C, Folate and Potassium.

 Calcium, fiber and folate are especially important in fighting breast cancer, especially triple negative.

So, we’ve been munching them as quick little snacks and accompaniments to salads.

Some things to watch out for: Radishes are high in sugar, so don’t go overboard. And the idea of radishes in Iowa in the middle of winter is simply unnatural, so I am leery of what additives might have kept them fresh on their trip from Florida, Mexico, or parts even farther south. And, if they came from outside of the U.S., the level of pesticides and herbicides could be high. Still, they are not on the Environmental Working Group’s Dirty Dozen, a list of high-contaminant vegetables. And they are being tested for use on the International Space Station, which I suspect means absolutely nothing to me.

Still, I wash them thoroughly for safety. And I am keeping me eyes out for the recipe that brought them here in the first place. I hope it was not this one.

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Curcumin May Be Non-Toxic TNBC Fighter

Curcumin, an ingredient in the Indian spice turmeric, can slow the growth of triple-negative breast cancer cells, according to a study on cell cultures published in the journal Breast Cancer: Basic and Clinical Research (September, 2009). In lab research, curcumin killed TNBC cancer cells within 72 hours, without interfering with healthy cells and reduced the ability of TNBC cells to migrate to other parts of the body.

Curcumin was effective against hormone-positive cancer as well, but not to the level of its strength against TNBC.

Clinical trials will be necessary to determine the effect of curmumin on the body.

The researchers write:

These results are novel, having never been previously reported, and suggest that curcumin could provide a novel, non-toxic therapy, which could lead to improved survival for patients with triple negative breast cancer. Curcumin should be studied further in this subset of breast cancer patients, for whom treatment options are severely limited.

Surgery Does Not Benefit Women With Advanced Stage TNBC

Women with stage IV triple-negative breast cancer tumors are much less likely to benefit from surgery than those with hormone-positive or Her2-positive disease. Researchers at Memorial Sloan-Kettering Cancer Center in New York evaluated 186 patients with stage IV tumors, 68 of whom had surgery. Those with ER+, PR+, or Her2+ saw improved survival rates with surgery. Those with triple negative, however, had no survival benefit. The study was published in the journal Cancer (January 2010.)