The American Cancer Society recently made changes to its mammogram and breast exam recommendations.

In 2015, there will be 231,840 new cases of invasive breast cancer and 40,290 deaths in the United States.

The American Cancer Society has revised its guidelines, recommending that women have fewer mammograms beginning at a later age. The group originally urged women to get a mammogram and a clinical breast exam every year after they turn 40.

The society now suggests a breast cancer screening every year from age 45 to 54. The women should then get cancer screenings every other year until it is no longer likely that they will live another 10 years.

Reasons For The Shift

Breast cancer is uncommon in women under the age of 45 and the risks decrease after menopause, which creates a target age group for testing.
Image: Safe Bee

The new guidelines were published in the Journal of the American Medical Association, along with an editorial and an article on the benefits and risks of screening. Another article and editorial were also published in JAMA Oncology.

Women who don’t have a personal, family or genetic history are considered to have an average risk of developing breast cancer. The guidelines only apply to these women.

A clinical breast exam involves a lump inspection for women of all ages, regardless of if they have experienced symptoms or breast abnormalities. Many of these women do not need additional exams.

The American Cancer Society carefully reviews research data to update its screening guidelines, said Dr. Richard C. Wender, the chief cancer control officer. The last review was in 2003, while the current research began in 2013.

Regular mammography can reduce the risk of dying from breast cancer by about 20 percent, but breast cancer is less common in younger women. New evidence illustrates the flaws of mammography, such as false-positive results, overdiagnosis and unnecessary biopsies.

The new guidelines were based on a 2001 study that found 61 percent of women who had yearly mammograms starting at age 40 had at least one false-positive by the time they were 50. The JAMA Oncology article showed that this was cut to 42 percent when women were tested less frequently.

The recommendation attempts to weigh the risks for each age group. Because breast cancer is uncommon in women under 45, the recommended testing begins at that age and continues once a year as women get older.

The risk of developing breast cancer during the next five years is 0.6 percent in women ages 40 to 44, 0.9 percent from ages 45 to 49 and 1.1 percent from ages 50 to 54. But at age 55, the majority of women are finished with menopause and the risk stops increasing. In addition, tumors are not as aggressive and mammograms are easier to read.

The American Cancer Society made sure to not be too strict, staying open to each women’s preferences. Women from age 40 to 44 may still “have the opportunity” to receive tests if they desire. Mammograms should still be available for women age 55 and older.

A Continued Debate

Some argue that early and yearly mammograms were meant to counteract the fear of missing the presence of breast cancer.
Image: Market America

Many health professionals continue to encourage women to seek out breast exams as early and as frequently as possible. However, some groups suggest fewer check-ups. Doctors and patients are equally confused about how to interpret the information.

Dr. Nancy L. Keating, a professor of health care policy and medicine at Harvard and a co-author of the JAMA editorial, said the guidelines were headed in the right direction. While some doctors hope the new guidelines will help to end the confusion, others worry that they are no better than the last.

“I think it has the potential to create a lot of confusion amongst women and primary care providers,” said Dr. Therese B. Bevers, the medical director of the Cancer Prevention Center at the University of Texas M.D. Anderson Cancer Center in Houston.

The National Comprehensive Cancer Network suggests patients receive mammograms every year starting at age 40. The American College of Obstetricians and Gynecologists recommends tests every year or two from ages 40 to 49, and every year after that. It also recommends yearly clinical breast exams starting at age 19.

The American College of Obstetricians and Gynecologists  will be holding a conference in January to collaborate with the American Cancer Society and other groups to agree on the guidelines.

“This area is rapidly changing. In five to seven years, we’ll have more knowledge in this area that will let us be more personalized in our approach,” Dr. Kevin C. Oeffinger, the chairman of the cancer society subgroup that developed the guidelines.

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Researchers have created a test that can detect breast cancer recurrence earlier than traditional scans by finding residual cancer DNA in the blood.

An experimental breakthrough in blood testing could be able to predict a breast cancer relapse earlier than ever before.

The study is focused on gathering data about technology that locates cancer DNA in the blood before tumors would be visible on traditional detection scans.

The first study of its kind, the technology takes on an important challenge in modern medicine by addressing how to uncover returning cancer cells.

The Study

Breast cancer can return to the original site (known as local recurrence) or return and spread to other parts of the body (known as metastasis or distant recurrence).
Via: Daily Mail

The detection technology is described in a study outlined in the journal Science Translational Medicine. It uses mutation tracking to find circulating tumor DNA in the blood.

The study focused on finding traces of disease by locating cancer cells that were left behind. By looking for stragglers, health professionals can find residual cancer cells that would develop into new tumors even after treatment.

The researchers took tumor and blood samples from 55 patients with early stages of breast cancer who had previously received chemotherapy or other surgical cancer treatments. The samples were tested immediately after a treatment session and then again every six months to follow-up and track the disease.

The test discovered a cancer relapse in 12 out of the 15 women whose cancer returned. It found the recurrence of cancer about eight months before tumors would be detectable on standard PET and CT scans.

The medical breakthrough is clear: this is the first blood test that could be used to predict a cancer relapse.

“We have shown how a simple blood test has the potential to accurately predict which patients will relapse from breast cancer, much earlier than we can currently,” said study author Nicholas Turner, team leader in molecular oncology at The Institute of Cancer Research, London.

The Future Of Cancer Detection

According to the American Cancer Society, 39,620 American women were expected to die from breast cancer in 2013. The ability to catch a breast cancer relapse would help to save thousands of lives.
Via: Branches Physio

The researchers faced some technical challenges when implementing the technology, but ultimately believe that it is a fairy cost-effective test. It is important to remember that although price comes into play, it isn’t as important when life-saving technology is put on the table.

Although the detection technology will not be available for many years, the goal is to continue to personalize cancer treatments down the road. The ultimate hope is to find a cure, with many believing the medical breakthrough is another step in the right direction.

“Such unprecedented early prediction could allow for intervention before the reappearance of cancer in high-risk patients. In addition, the authors were able to shed light on the genetic events driving such metastases, by massively parallel sequencing of the ctDNA, which could inform new drug-based therapies on the basis of the patients’ individual mutations,” according to the study.

Researchers will be conducting more clinical trials in the coming years.

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Many of us have not experienced the formidable overgrowth of abnormal cells, while others have been spared from witnessing the life-threatening struggle of a family member or friend. For unaffected observers, the ribbon is merely a symbol that signifies collective moral support. But for the people who have lived with this disease, it means much more.

According to a new study published in the Dec. 1 issue of Clinical Cancer Research, a vaccine to disarm the debilitating disease has shown great promise in experimental trials. Although nothing has been confirmed, the vaccine seems to be safe and effective in slowing down the progression of the disease.

The study conducted by the Washington University School of Medicine in St. Louis included fourteen women who were diagnosed with an “advanced” stage of breast cancer, which means that the illness was severe enough to require chemotherapy. Because chemotherapy is known to weaken the immune system, the patients had not received treatments for a month prior to the start of the study.

To understand the vaccination, one must understand the disease. Breast cancer is caused by the overproduction of abnormal cells that begin to invade breast tissue, form a malignant tumor and spread throughout the body. These cancerous cells are incorrect copies of replicated DNA, which have fought against the body’s natural suicide mechanism and have also escaped undetected by the immune system.

The vaccine works by instructing a certain white blood cell to attack and destroy an excess protein found in breast tumors called mammaglobin-A. This protein is a marker for the disease because it is present in 80 percent of breast cancer patients, according to the researchers. It is anticipated that the vaccine will simultaneously boost the immune system while slowing the progression and spread of the disease.

One year after the vaccine was administered, scientists concluded that the disease did not progress in about 50 percent of the patients in the trial. The side effects were reported to be minimal, including rashes, tenderness and mild flu-like symptoms. In comparison, within a similar group of 12 patients, only 20 percent showed no signs of progression after one year, according to the study.

Dr. William Gillanders, co-author of the study and vice chairman for research in the department of surgery at the Washington University School of Medicine in St. Louis, claimed that although the clinical trial was small, the researchers could confidently say that the vaccine is safe.

“We can also say with confidence that we were able to generate an immune response in almost all the patients who were vaccinated,” he said. “And there is preliminary evidence that the vaccine may have an impact on breast cancer progression. But that needs to be studied further to be confirmed.”

Researchers admittedly require a longer study with a larger sample size, but believe that the vaccine would be even more effective in newly diagnosed women who have yet to undergo chemotherapy.

Dr. Courtney Vito, a breast surgeon and assistant clinical professor of surgical oncology with the City of Hope Comprehensive Cancer Center in Duarte, Calif., said that the vaccine “makes a lot of sense and is very promising.”

“Ramping up the immune system specifically against breast cancer cells is really just augmenting nature’s own lines of defense, possibly without the side effects of drugs like chemotherapy, which is what this trial showed,” Vito said.

Because breast cancer is a disease that does not discriminate based on age, class, race, ethnicity, and in some cases, even gender, it comes without warning and without mercy. The findings from the study are both promising and exciting, especially for those who have yet to see improvement in their condition. Although the vaccine is still in the early stages of development, its existence represents the powerful changes created by the collective hope that is symbolized by the petite pink ribbon.

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