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Fat rats show why breast cancer may be more aggressive with obesity

Fat rats show why breast cancer may be more aggressive in patients with obesity

Published
Adapted Media Release

Women with obesity are more likely to get breast cancer, and a number of studies have provided a reasonable explanation why: after menopause, fat tissue manufactures estrogen, and the estrogen then promotes tumor growth. But why, then, do women with obesity continue to have more aggressive tumors even after anti-estrogen treatment? Once the tumor’s source of estrogen is removed, obesity should have no effect on prognosis, but it does.

A University of Colorado Cancer Center study published in the journal Hormones & Cancer offers a possible explanation: In an animal model of obesity and breast cancer (affectionately referred to as the “fat rat”), tumor cells in obese animals, but not lean animals, had especially sensitive androgen receptors, allowing these cells to magnify growth signals from the hormone testosterone. Similar to the way in which many breast cancers drive their growth with estrogen receptors, these tumors in obese rats drove their growth with androgen receptors.

“Our original goal was to make a model of obesity and breast cancer that would reflect the condition in women. At first, we were disappointed to discover that rats don’t make much estrogen in fat tissue like humans do. But we then realized that this aspect of the model gave us an excellent opportunity to study cancer progression after anti-estrogen treatment. Because fat cells in these rats don’t make estrogen, they are like human breast cancer patients treated to remove estrogen. This allowed us to ask what is responsible for obesity-associated tumor progression in conditions of low estrogen availability,” says Elizabeth Wellberg, PhD, the paper’s first author, who works with Steven Anderson, PhD and Paul MacLean, PhD. Dr. Anderson is the vice chair for research at CU Cancer Center and James C. Todd Professor of Experimental Pathology in the CU School of Medicine. Dr. MacLean is a professor in the Division of Endocrinology, Metabolism, & Diabetes, also in the CU SOM. Together, these investigators and their team have identified an important role for obesity in changing how breast tumors respond to hormones.

About 40 percent of American women have obesity; about 75 percent of breast cancers are estrogen-receptor positive, most of which will go on to be treated with anti-estrogen therapies. This combination means that thousands of women every year could benefit from treatments aimed at the aspects of obesity that promote breast cancer in low- or non-estrogen environments.

Androgen receptors and their hormone partner, testosterone, have long been known as drivers of prostate cancer and work at CU Cancer Center and elsewhere is implicating androgen as a driver in many breast cancers. When Wellberg and colleagues treated their obese rats with the anti-androgen drug enzalutamide, existing tumors shrank and new tumors failed to form. But this brought up another question: If overactive androgen receptors create poor prognosis in obese breast cancer patients, what is creating these overactive androgen receptors? It wasn’t that they were simply responding to more testosterone – it was that these receptors had been somehow tuned to be more sensitive to existing levels of testosterone.

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2016 National Cancer Survivors Day

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Today is National Cancer Survivors Day. A day of celebration for cancer survivors and demonstrates that we CAN beat Breast Cancer! This day falls on the first Sunday of June every year and serves as an inspiration for those recently diagnosed, support for women and families struggling, and a way for the community to come together and give back.

Celebrate this special day by honoring a cancer survivor or a loved one by helping women who are still struggling with cancer. Your purchase today of The Breast Chek Kit makes a difference. Please join us in the fight against Breast Cancer!  “Everyday I wake up is another day I have survived Breast Cancer.”

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Happy Mother’s Day

Happy Mother's Day!

Happy Mother’s Day!

BORNandMADE & I AM THAT GIRL CAMPAIGN

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Joining any kind of social media campaign is a big decision and one I don’t take lightly. I’m very excited about Carol’s Daughter ‪#‎BornandMade‬ and ‪#‎IamthatGirl‬ campaign because it’s about Empowering girls to love themselves, removing the negativity, judgments, self-doubt that as a girl we’ve all dealt with at some point in our lives.

For me, it means Empowering girls to Take Charge of Their Health which is at the core of our mission and what The Breast Chek Kit [a tool that teaches girls how to do a breast self-exam & learn about their breast] was created to do. As Girls we are bombarded with mixed messages about looks and image-consciousness to epidemic proportions to the point for some of being ashamed or feeling guilty as their body and breast begin to change…regardless of age. Breast Cancer for women creates such stigma for many, even today. By joining in this campaign I am taking another step to Empower girls and women to say “You are Beautiful, You are Enough, Just as you are.”

If I could tell every girl or woman in the World 1 thing… it would be to “Believe in your own self-worth… you are worthy to be loved, dream big, learn to be happy with yourself, You are Enough” I AM LINDA, I AM GERALDINE’S DAUGHTER and #IAMTHATGIRL…#BORNandMADE

Lesser-known signs of breast cancer women should watch out for

Lesser-known signs of breast cancer women should watch out for

While feeling a lump or mass on the breast is a sure sign you should go see a doctor, it is not the only way breast cancer can present itself.

Breast cancer remains the most common cancer — aside from some skin cancers — in women in the United States, with over 230,000 new cases expected in 2015, according to the American Cancer Society.

Experts say that while a lump is the classic warning sign, women should be aware of other, lesser-known symptoms of breast cancer, including swelling of all or part of a breast, skin irritation or dimpling, nipple inversion, nipple discharge other than breast milk, and a redness, scaling, or thickening of the nipple or surrounding skin.

“A lot of people think that you feel a lump and that triggers getting tested,” Dr. Naoto Ueno, chief of Translational Breast Cancer Research at the University of Texas MD Anderson Cancer Center in Houston, told CBS News. “That’s true, but there are breast cancers that present as half a lump or there may be no lump at all actually. It could just be a strange-looking skin appearance or skin being red or dimples.”

Dr. Clifford Hudis, chief of Breast Medicine Service at Memorial Sloan Kettering Cancer Center in New York City, said that although we live in an era where the majority of women are screened for cancer regularly — the American Cancer Society recommends annual mammograms for women 40 and older, while guidelines from the U.S. Preventive Services Task Force suggest mammography every other year starting at age 50 — even routine screening has limits and people still need to be aware of warning signs.

“In between screening tests, patients still have to be alert to changes that might indicate cancer,” he told CBS News. “It’s a common misconception, but screening tests can’t be expected to find every single cancer. They don’t, and there’s always the possibility of something happening between screens.”

Women with a family history of breast cancer or others at higher risk may need more frequent screening starting at a younger age, and should be vigilant about checking any physical changes.

Lisa Royle of Manchester, England, recently brought the topic into the spotlight when she posted a selfie on Facebook that went viral showing the subtle warning signs of the breast cancer she had been diagnosed with.

“This is all that I found,” she wrote before she underwent a mastectomy. “Very subtle dimples underneath that could easily be missed.”A survey of women in the UK shows that fewer than half of women over 70 could name a single symptom of breast cancer other than a lump, highlighting the lack of knowledge that exists in this area.

Doctors say it’s important for women to be familiar with what’s normal for their own bodies and pay attention to any changes that occur.

“What we’re talking about here is a change in appearance,” Hudis said. “Some people live their whole lives with their nipples inverted, for example. It’s a change that we care about, not so much that it’s always been that way.”

And Hudis emphasized that while recognizing the different potential signs of breast cancer is important, having one or more of these symptoms does not automatically mean you have cancer. But a doctor visit to determine the cause is still necessary.

“If it’s physically uncomfortable, you don’t want to suffer with this longer than you need to,” he said. “If it’s an infection you need antibiotics. If it’s cancer you need diagnosis and treatment. If it’s some other illness then you need treatment, but you can’t feel better until it’s diagnosed.”

Why Black Women Should Still Get a Mammogram Starting at age 40 Not 50

Why Black Women Should Still Get a Mammogram Starting at Age 40, Not 50

New federal guidelines recommending mammograms at age 50 have alarmed breast-cancer activists, who say African-American women are at higher risk at a younger age and for more-aggressive forms of cancer.

Posted: June 5 2015 3:00 AM

mammogram

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In April, the United States Preventive Services Task Force proposed new breast-cancer screening guidelines that advise women to get their first mammogram, the test that screens for breast cancer, at age 50 and then once every two years thereafter.

These recommendations are at odds with long-standing advice from organizations like the American Cancer Society, the American College of Obstetricians and Gynecologists, the Black Women’s Health Imperative and the Susan G. Komen organization—all of which recommend that women at average risk obtain their first mammogram at 40, followed by one mammogram each year afterward.

The task force recommends that 40-something women discuss their need for mammograms with their doctor. But many experts believe that waiting until 50 for a mammogram is dangerous.

“The recommendations may cause women under 50 to delay paying attention to their breast health and breast-cancer risk,” said Komen President and CEO Dr. Judith A. Salerno in a press release.

“Anytime scientists can’t or don’t agree, it gives some men and women an excuse not to do something that could very well save their lives,” says Linda Goler Blount, president and CEO of the Black Women’s Health Imperative, a Washington, D.C.-based health-advocacy organization. “As a very good friend said, ‘If the scientists can’t agree on when I should have a mammogram, then why should I have a mammogram?’”

Troublesome Advice for Younger Black Women

Early detection of breast cancer saves lives among all women, but particularly black women, who are 10 percent less likely to develop breast cancer than white women but 40 percent more likely to die of it, in part because black women are 45 percent less likely to have health insurance, plus are less likely to be diagnosed early, when more treatment choices exist and they are more effective.

Black women are also more likely to develop a very aggressive strain, triple-negative breast cancer, at a young age. “Younger black women get breast cancer at higher rates and five to seven years younger than white women,” says Blount. For example, it’s not uncommon for black women to develop breast cancer in their 30s.

Half of black women (pdf) are diagnosed before age 57 and half after, compared with age 62 for white women.

Because the task force advises the government, many health advocates—including breast-cancer survivor Rep. Debbie Wasserman Schultz of Florida, who found a lump in her breast at age 41—fear that if its guidelines take hold, health insurers may not cover the full cost of mammograms for women under 50.

Stressed vs. Dead

Experts try to balance the benefits of tests with the harm the tests may cause. For example, mammograms that yield a false-positive result can stress women out and lead to breast biopsies and other unnecessary tests that can be painful and even jeopardize their lives.

Roughly half of women will receive a false-positive result after 10 annual mammograms; fewer than 1 in 10 women who are called back will have breast cancer. Task force Vice Chair Dr. Kristen Bibbins-Domingo wrote in the Washington Post that the task force found that the best balance between benefit and harm existed beginning at age 50.

But let’s be serious: Most women would rather be stressed out for a few weeks than dead.

Blount questions whether the research the task force evaluated is even relevant to black women, noting that the evaluated studies were performed primarily in Sweden and Canada, which do not have large populations of black women.

“Even assuming that the studies were all very well designed and executed, there are no black women in those studies,” says Blount. “So we can’t say [that the task force analysis] applies to women who have a very different lived experience than Swedish and Canadian women. We don’t have any random control trials of mammography on black women. There are [a] few black women in the U.S. studies, but not many.”

The “lived experience” of African-American women includes experience of both racism and sexism and, often, poverty, toxic levels of stress, neighborhoods with high rates of environmental toxins and so on. “If you look at those factors alone, then take studies that were done 30 to 40 years ago in Sweden and Canada and apply it to black women today—it doesn’t make sense,” says Blount.

How to Protect Your Breasts From Breast Cancer

In addition to a no-cost, annual well-woman preventive-care exam, where your health care provider will give you a clinical breast exam beginning at age 20, the Affordable Care Act covers the entire cost of a mammogram, including any deductible and copay. Discuss your risk of breast cancer with your health care provider and follow the advice you are given. If you have a family history of breast cancer or are otherwise at high risk, you may want to consider getting your first mammogram prior to age 40. And particularly if your breast tissue is dense, as is many black women’s, ask your health care provider whether 3-D mammography could be right for you.

If your risk of breast cancer is average, stick to the advice offered by the American Cancer Society, the American College of Obstetricians and Gynecologists, the Black Women’s Health Imperative and the Komen organization: Get your first mammogram by age 40, followed by one per year thereafter.

Obtain your mammogram at a high-volume mammography center, where the doctors who read mammograms have a lot of experience—typically a large hospital—or at a Food and Drug Administration-certified mammography center. Go here to find an FDA-certified mammography site near you.

Conduct a breast self-examination at the same time each month. They do not help women detect cancer early or survive longer if it exists, but they do help women become familiar with the feel of their breasts, so they can notify their doctor immediately if any changes occur.

Philadelphia-based writer Hilary Beard is co-author of Promises Kept: Raising Black Boys to Succeed in School and in Life and Health First! The Black Woman’s Wellness Guide, both of which have won an NAACP Image Award. Follow her on Twitter and Facebook.

Be aware of these lesser known signs of breast cancer

Lesser-known signs of breast cancer women should watch out for

While feeling a lump or mass on the breast is a sure sign you should go see a doctor, it is not the only way breast cancer can present itself.

Breast cancer remains the most common cancer — aside from some skin cancers — in women in the United States, with over 230,000 new cases expected in 2015, according to the American Cancer Society.

Experts say that while a lump is the classic warning sign, women should be aware of other, lesser-known symptoms of breast cancer, including swelling of all or part of a breast, skin irritation or dimpling, nipple inversion, nipple discharge other than breast milk, and a redness, scaling, or thickening of the nipple or surrounding skin.

“A lot of people think that you feel a lump and that triggers getting tested,” Dr. Naoto Ueno, chief of Translational Breast Cancer Research at the University of Texas MD Anderson Cancer Center in Houston, told CBS News. “That’s true, but there are breast cancers that present as half a lump or there may be no lump at all actually. It could just be a strange-looking skin appearance or skin being red or dimples.”

Dr. Clifford Hudis, chief of Breast Medicine Service at Memorial Sloan Kettering Cancer Center in New York City, said that although we live in an era where the majority of women are screened for cancer regularly — the American Cancer Society recommends annual mammograms for women 40 and older, while guidelines from the U.S. Preventive Services Task Force suggest mammography every other year starting at age 50 — even routine screening has limits and people still need to be aware of warning signs.

“In between screening tests, patients still have to be alert to changes that might indicate cancer,” he told CBS News. “It’s a common misconception, but screening tests can’t be expected to find every single cancer. They don’t, and there’s always the possibility of something happening between screens.”

Women with a family history of breast cancer or others at higher risk may need more frequent screening starting at a younger age, and should be vigilant about checking any physical changes.

Lisa Royle of Manchester, England, recently brought the topic into the spotlight when she posted a selfie on Facebook that went viral showing the subtle warning signs of the breast cancer she had been diagnosed with.

“This is all that I found,” she wrote before she underwent a mastectomy. “Very subtle dimples underneath that could easily be missed.”A survey of women in the UK shows that fewer than half of women over 70 could name a single symptom of breast cancer other than a lump, highlighting the lack of knowledge that exists in this area.

Doctors say it’s important for women to be familiar with what’s normal for their own bodies and pay attention to any changes that occur.

“What we’re talking about here is a change in appearance,” Hudis said. “Some people live their whole lives with their nipples inverted, for example. It’s a change that we care about, not so much that it’s always been that way.”

And Hudis emphasized that while recognizing the different potential signs of breast cancer is important, having one or more of these symptoms does not automatically mean you have cancer. But a doctor visit to determine the cause is still necessary.

“If it’s physically uncomfortable, you don’t want to suffer with this longer than you need to,” he said. “If it’s an infection you need antibiotics. If it’s cancer you need diagnosis and treatment. If it’s some other illness then you need treatment, but you can’t feel better until it’s diagnosed.”

Why are breast cancer survivors prone to weight gain?

Women who survive breast cancer are more likely to gain weight over the following years than women who have not had cancer – especially if they have a family history of the disease – according to a new study. Women treated with chemotherapy are at particular risk for weight gain, claim researchers from Johns Hopkins Kimmel Cancer Center in Baltimore, MD.
normal and overweight women
Among both the breast cancer survivors (46.9%) and cancer-free women who had a family history of breast cancer (55.1%), the study found a high prevalence of overweight participants.

Previously, studies have found that women who have survived breast cancer and go on to gain weight are at increased risk of having their cancer return. In addition, weight gains of 11 lb or more have been linked with an increased risk of cardiovascular disease.

In the new study, published in the journal Cancer Epidemiology, Biomarkers & Prevention, the Johns Hopkins team recruited 303 breast cancer survivors and 307 cancer-free women between 2005 and 2013. All women completed a questionnaire at the start of the study, and they were followed-up 4 years later. About a quarter of the women in the study were premenopausal and the majority of the participants were white.

The researchers found that breast cancer survivors gained significantly more weight during the 4-year follow-up period than women who had not had cancer. Breast cancer survivors gained an average of 3.6 lb more in weight.

Among women in the study who had been diagnosed with cancer during the last 5 years of the study period, 21% put on at least 11 lb over 4 years, while only 11% of the cancer-free women put on this much weight over 4 years.

Does chemotherapy contribute to weight-gain association?

Women who had completed chemotherapy within 5 years of the study were found to be 2.1 times as likely as women who had not had cancer to gain at least 11 lb during the study.

After taking into account other factors that may have influenced weight, such as age, menopausal status and level of physical activity, the association between cancer history and weight gain remained strong.

“Above and beyond age and menopausal status, there seems to be a weight gain associated with treatment of cancer, particularly in women having chemotherapy and those diagnosed with estrogen receptor-negative, invasive cancers,” says Amy Gross, a doctoral candidate in epidemiology at the Bloomberg School of Public Health.

Cholesterol-blocking drugs also seemed to affect weight gain among breast cancer survivors. Women who had been treated with chemotherapy and who now used statins gained an average of 10 lb more than cancer-free women using statins and women from both groups who did not use statins.

Among both the breast cancer survivors and cancer-free women who had a family history of breast cancer, the study found a high prevalence of overweight participants – 46.9% of breast cancer survivors and 55.1% of cancer-free women with a family history of breast cancer were overweight or obese. This group included women with an inherited predisposition for breast cancer, such as carrying the BRCA1 or BRCA2 gene mutations.

Kala Visvanathan, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health and director of the Clinical Cancer Genetics and Prevention Service at the Kimmel Cancer Center, says:

“There is limited data on weight change in breast cancer survivors, including those at higher risk for the disease compared to the general population. A lot of studies have focused on breast cancer survivors alone, so we don’t get a sense of whether women without cancer gain more or less weight, or whether the gain is due to the cancer or the treatment.”

The team will continue to follow-up with the group every 3-4 years to investigate the long-term weight changes of the women.

Visvanathan says that the authors are not suggesting any weight gain intervention at the time of chemotherapy. “But we are suggesting that oncologists, internists or anyone treating breast cancer survivors, including those with a family history of the disease, could help them monitor their weight over the long term,” she explains.

Written by David McNamee/Medical News Today

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