In 2008, it’s estimated that more than 184,000 American women and almost 2,000 American men will be diagnosed with breast cancer, according to the American Cancer Society. Behind the scenes, researchers are steadily working toward conquering this potential killer. Here, we report on advances in screening, treatment and prevention.The screening arena
Doctors are constantly refining methods for identifying those at risk for the disease and for detecting breast cancer in its earliest stages. Here, some findings from the past decade:
- mathematical equation derived from the ongoing National Surgical Adjuvant Breast and Bowel Project can help calculate a woman’s lifetime risk for an invasive form of breast cancer. The formula estimates risk based on factors such as age at first menstruation, childbirth history and family history of the disease. This method can be useful for women considering preventive therapies, offer peace of mind to those who overestimate their risk and help women and their doctors develop an effective screening schedule.
- Scientists have found that mutations in the BRCA1 and BRCA2 genes—which can be detected through a blood test—increase a woman’s risk for breast cancers. Less than 10 percent of the new cases diagnosed each year can be attributed to heredity.
- Magnetic resonance imaging (MRI) and technetium tetrofosmin scintimammography (Tc-99 tetrofosmin) are being used in addition to standard mammography to enhance diagnosis. MRI has proven useful in detecting and staging invasive lobular breast cancer, a form that is difficult to diagnose with mammography. It is used to supplement mammography in screening women at very high risk for breast cancer, such as those with the BRCA1 and BRCA2 genes. MRI is also used to find tumors in the opposite (contralateral) breast of women newly diagnosed with the disease. For its part, the Tc-99 tetrofosmin scan uses a radioactive isotope to detect malignancies in dense tissue.
- Sentinel node biopsy can give women important information about the extent of their cancer while sparing them from major surgery. Traditionally, all the lymph nodes near the affected breast are removed to test for the spread of cancer cells. This can lead to complications. But in sentinel node biopsy, only the nodes that would be first affected are removed for analysis.
Certain chemotherapy drugs appear to launch a more effective attack against cancer cells than traditional chemotherapy. Some work on the body’s immune system, while others interfere with the functioning of the cancer cells.Preventive measures
In 1998, the FDA approved tamoxifen, a drug long used to treat breast cancer, for use in preventing the disease in women at high risk. The drug works by disrupting estrogen’s effect on breast tissue. The nationwide Study of Tamoxifen and Raloxifene (STAR) compared raloxifene’s breast cancer-fighting abilities to those of tamoxifen and showed they were equally effective. Raloxifene has recently been approved by the FDA for breast cancer prevention in certain groups of women.
- Seven hours of moderate exercise per week reduced breast-cancer risk by nearly 20 percent in women ages 30 to 55, according to the Nurses’ Health Study.
- Mayo Clinic researchers warn that women who consistently eat very-well-done red meat may raise their risk of breast cancer. They speculate that cooking protein at high temperatures creates a chemical that can directly mutate DNA.
- Women who have more than one alcoholic drink a day may increase their breast cancer risk by as much as 25 percent.
The screening arena