Breast cancer research and treatment
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Breast Cancer Res. Treat. · Jul 2011
Age of diagnosis, tumor size, and survival after breast cancer: implications for mammographic screening.
If mammographic screening is to be recommended to women aged <50, it is necessary that mammographic screening leads to the detection of small cancers and that the survival rate of young women with small cancers is superior to that of women with larger cancers. We reviewed the survival experience of 2,173 patients with invasive breast cancer. There were 392 cancer-specific deaths in the cohort after a mean of 8.9 years of follow-up. ⋯ The 10-year survival rate for young women with small mammogram-detected breast cancers (<1 cm) was 94%, compared to 86% for women with palpable cancers in the same size group (P < 0.01). Women with a small non-palpable breast cancer that is diagnosed through a mammogram experience very good survival, compared to women with a palpable breast cancer of similar size. Our findings suggest that mammography preferentially detects cancers with good prognosis and calls into question the assumption that detecting breast cancers when they are small by mammography will impact upon mortality from breast cancer.
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Breast Cancer Res. Treat. · Jul 2011
The impact of contralateral mastectomy on mortality in BRCA1 and BRCA2 mutation carriers with breast cancer.
Among women with breast cancer and a BRCA1 or BRCA2 mutation, the lifetime risk of breast cancer may be as high as 40%. Many physicians recommend prophylactic contralateral mastectomy, which is an effective measure of minimising the risk of contralateral cancer. ⋯ Under the simple model presented here, among women who retain the contralateral breast, 0.4% of women are expected to die of contralateral breast cancer within 5 years, but 6.8% are expected to die at 20 years from diagnosis. These unnecessary deaths can be prevented by bilateral mastectomy.
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Breast Cancer Res. Treat. · Jun 2011
Randomized Controlled TrialWomen's interest in taking tamoxifen and raloxifene for breast cancer prevention: response to a tailored decision aid.
Although tamoxifen can prevent primary breast cancer, few women use it as a preventive measure. A second option, raloxifene, has recently been approved. The objective of the study was to determine women's interest in tamoxifen and raloxifene after reading a decision aid (DA) describing the risks and benefits of each medication. ⋯ Participants were not particularly worried about taking tamoxifen or raloxifene and did not perceive significant benefits from taking these drugs. Over 50% did not perceive a change in their risk of getting breast cancer if they took tamoxifen or raloxifene. After reading a DA about tamoxifen and raloxifene, few women were interested in taking either breast cancer prevention drug.
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BRCA2 and PALB2 function together in the Fanconi anemia (FA)-Breast Cancer (BRCA) pathway. Mono-allelic and bi-allelic BRCA2 and PALB2 mutation carriers share many clinical characteristics. Mono-allelic germline mutations of BRCA2 and PALB2 are risk alleles of female breast cancer and have also been reported in familial pancreatic cancer, and bi-allelic mutations cause a severe form of Fanconi anemia. ⋯ One truncating PALB2 mutation, c.509_510delGA, resulting in p. Arg170X, was found in a male breast cancer patient. We conclude that germline mutations of PALB2 do not significantly contribute to cancer risk in non-BRCA1/2 cancer families with at least one patient with ovarian cancer, male breast cancer, and/or pancreatic cancer.
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Breast Cancer Res. Treat. · Jun 2011
The role of polymorphisms in circadian pathway genes in breast tumorigenesis.
Disruption of the circadian rhythm or biological clock, which is regulated by a number of clock genes, including circadian locomotor output cycles kaput (CLOCK), period genes (PERs), and cryptochrome genes (CRYs), is a risk factor for breast cancer. We hypothesized that genetic variation in these clock genes may influence breast cancer risk. To test this hypothesis, we designed a hospital-based study that included 1,538 breast cancer patients and 1,605 healthy controls. ⋯ When stratified by the CLOCK genotype, patients with the CLOCK CT/ CRY2 CC genotypes had significantly lower cancer risk than those with the GG genotype (aOR = 0.36, 95% CI = 0.14-0.95). Individuals carrying both the CLOCK CC and PER2 AA genotypes had an increased cancer risk (aOR = 2.28, 95% CI = 1.22-4.26). Our study suggests that genetic variants of the circadian rhythm regulatory pathway genes contribute to the differential risk of developing breast cancer in Chinese populations.