Postpartum gestational breast cancer
Women diagnosed with breast cancer within 12 months of giving birth are more likely to die than other young women with breast cancer, a study in Australia has shown. The research involved 2,752 women. Of these, 182 were diagnosed with gestational breast cancer (55 when pregnant, 127 postpartum). Postpartum gestational breast cancer was associated with a 48 per cent increased risk of death compared to non-gestational breast cancer; gestational breast cancer diagnosed during pregnancy had only a 3 per cent increased risk of death.
Another study in Sweden, involving 17,035 women followed for a mean 10.2 years, investigated breastfeeding and breast cancer. It found that women who breastfed for six months or longer had a statistically significant risk of developing more aggressive breast tumours.
Ives A, Saunders C, Bulsara M et al. Eur J Cancer Suppl 2010; 8(3): 206 (abstr 502).
Butt S, Borgquist S, Anagnostaki L et al. Eur J Cancer Suppl 2010; 8(3): 206 (abstr 503)
Requests for prophylactic mastectomy
Women requesting prophylactic mastectomy need a 'cooling off' period, say UK researchers. Their study of 27 patients diagnosed with breast cancer examined why these women, who were undergoing surgery for unilateral breast cancer, had requested bilateral mastectomy. A 12-month cooling off period was offered after counselling. All of the women had overestimated their risk of contralateral breast cancer by a factor of five to 10. Twelve months later, all of the patients were less anxious about their risk - four still requested prophylactic surgery, but the other 23 were pleased they had been given the opportunity to rethink.
Chaudhry A, Sahu A. Eur J Cancer Suppl 2010; 8(3): 126 (abstr 233)
Protective effect of pregnancy
Pregnancy appears to confer a protective effect on breast cancer survivors, the results of a study carried out in Europe suggest. The meta-analysis involved 14 trials that had investigated a total of 1,417 pregnant women who had a history of breast cancer and 18,059 women with a history of breast cancer who were not pregnant. Women who became pregnant following a diagnosis of breast cancer had a 42 per cent lower risk of death compared to breast cancer survivors who did not become pregnant. The researchers suggest that several immune and endocrine factors could be involved, including estrogen, prolactin and fetal antigens.
Azim HA, Santoro L, Pavlidis N et al. Eur J Cancer Suppl 2010; 8(3): 207 (abstr 504)
Prognostic factors in breast cancer
Locoregional recurrence of breast cancer remains the strongest independent prognostic factor for subsequent metastasis and death, researchers in the Netherlands have found. They pooled data from 7,749 early-stage breast cancer patients involved in four trials, in which the average follow-up period was 10.9 years. In two multivariate analyses, involving all patients in the study and then those who were disease-free after at least five years, locoregional recurrence was identified as the strongest prognostic factor for overall and metastasis-free survival. A third analysis looking at patients who were disease-free after at least 10 years found locoregional recurrence was the only independent prognostic factor.
Van der Hage JA, Mieog JS, van de Vijver M et al. Eur J Cancer Suppl 2010; 8(3): 89 (abstr 106)
Chemotherapy during pregnancy
Pregnant women who have breast cancer can be treated with chemotherapy without endangering the health of the fetus, according to the results of a study carried out in Germany. Data on 151 patients were included. Of these, 91 patients received chemotherapy during pregnancy (median two cycles). Median gestational time of delivery was 36 weeks (range 28-42). Infants exposed to chemotherapy in utero weighed slightly less than those who were not (mean 2,636mg versus 2,791mg). However, the researchers concluded that most of the problems they saw in those babies who were exposed to chemotherapy were not related to the treatment. Furthermore, outcomes did not differ significantly from those seen in babies who had not been exposed to chemotherapy.
Loibl S, Bontenbal M, Ring A et al. Eur J Cancer Suppl 2010; 8(3): 205 (abstr 499)
Beta-blockers in breast cancer therapy
Treatment with beta-blockers could reduce metastasis and mortality in breast cancer patients. A collaborative study carried out by researchers in the UK and Germany investigated 466 patients with primary operable breast cancer. Ninety-two had received antihypertensive treatment and 43 of these were taking beta-blockers at the time of their breast cancer diagnosis. In the beta-blocker group, there were significant reductions in distant metastasis and local recurrence and a 71 per cent reduced risk of death from breast cancer compared with other patients in the study.
Powe DG, Voss MJ, Habashy HO et al. Eur J Cancer Suppl 2010; 8(3): 188 (abstr 445)
Radiotherapy in early breast cancer
Internal mammary and medial supraclavicular lymph node radiotherapy appears to be well tolerated in women with early breast cancer, initial results from a phase III trial suggest. The 4,004-patient multicentre study carried out by the EORTC radiotherapy and breast cancer groups found limited toxicity and no impairment on performance score at three years. Analysis of the primary endpoint, overall survival at 10 years, will be carried out in 2012.
Poortmans P, Fourquet A, Collette L et al. Eur J Cancer Suppl 2010; 8(3): 54 (abstr 6N)
Coffee does not increase colon cancer risk
Drinking large quantities of coffee or sugary carbonated drinks does not appear to increase the risk of colon cancer. Researchers analysed data from 13 studies involving 731,441 participants, 5,604 of whom developed colon cancer. The risk for those drinking >1,400g (six cups) of coffee a day did not differ from that of people who drank less. Similarly, those who drank >550g of sugar-sweetened, carbonated drinks a day (2 per cent of participants) did not have a higher risk of colon cancer. There was a modest association between drinking large quantities of tea (more than four cups a day) and colon cancer risk, but numbers were small and the researchers say this could be down to chance.
Zhang X, Albanes D, Beeson WL et al. J Natl Cancer Inst 2010; doi:10.1093/jnci/djq107