Leading Breast Cancer Organization Comments on Long Term Mammography for Breast Cancer Survivors
BREASTCANCER.ORG SAYS:
Women who’ve been diagnosed with breast cancer are at risk for the cancer coming back (recurrence) and also have a higher-than-average risk of being diagnosed with a new, second breast cancer. So regular breast cancer screening is very important for survivors.
To find out if doctors were recommending breast cancer screening to survivors, researchers surveyed British physicians who care for women diagnosed with breast cancer. The researchers also reviewed the results of eight studies on the benefits of ongoing breast cancer screening for survivors.
The results:
- Doctors didn’t consistently recommend ongoing, long-term breast cancer screening for survivors.
- Ongoing, long-term screening for survivors is lifesaving: women who were screened consistently for 10 years or more were 72% less likely to die from recurrent or new breast cancer compared to women who didn’t get consistent, long-term screening.
- The risk of a recurrence or a new, second breast cancer was about the same during each of the 10 years after diagnosis. Most people think that if breast cancer is going to come back or a new cancer to develop, it will be in the first 2 or 3 years after diagnosis — this study found that isn’t the case.
The results were published in the September 2011 issue of Health Technology Assessment.
These results underscore the importance of long-term, regular screening mammograms for survivors. Still, other research has shown that mammograms alone can be less effective at detecting breast cancer in women with a personal history of breast cancer. Survivors may benefit from other screening tests — such as breast MRI or breast ultrasound — in addition to screening mammograms. Some experts think that screening with 3-D mammograms also may be especially useful for survivors. The FDA has approved a 3-D mammogram system, but the technology may not be widely available.
If you’ve been diagnosed with breast cancer, you and your doctor should develop a screening plan tailored to your unique situation. If the plan includes only regular mammograms, you may want to ask your doctor if breast MRI or ultrasound along with mammograms might make sense for you. No matter what your screening plan includes, be sure to stick with it over the long term, not just in the first few years after you’ve finished treatment.
Long Term Mammography Needed for Breast Cancer Survivors
(MedPage Today) –Regular surveillance mammography after breast cancer boosts survival and should be continued for at least a decade, a systematic review suggested.
Second cancers in the same or opposite breast occurred at a fairly constant rate over the first 10 years instead of being largely in the first two or three years as often thought, Clare Robertson, MSc, of the University of Aberdeen, Scotland, and colleagues found.
Mammographic follow-up to detect these tumors was associated with reduced all-cause mortality and breast cancer-specific mortality in the studies reviewed.
Because the analysis also presented favorable data regarding cost-effectiveness, the group argued online in Health Technology Assessment for routine surveillance mammography out to at least 10 years.
- Yearly surveillance mammography after breast cancer boosts survival and should be continued for at least a decade.
- Note that surveillance mammography for breast cancer survivors appeared to be cost-effective.
Annual surveillance after breast cancer surgery is recommended in guidelines from the American Society of Clinical Oncology, and is common practice in both Britain and the United States.
The researchers surveyed 183 surgeons and radiologists at 105 British centers and found that most stopped following women with surveillance mammography (74%). Slightly over half said they stop at 10 years, though discontinuation at five years was also common at 35%.
Though surveillance schedules varied widely, follow-up mammography usually started at 12 months (87%), repeated annually (72%), and was coordinated using a symptomatic breast service (96%).
Most clinicians surveyed also reported discharging women from clinical follow-up (82%), typically at five years after breast cancer surgery (65%).
The researchers cautioned that their response rate was low (17% of 1,048 surveys sent out) but noted that the responses correlated fairly well with prior surveys on the topic and were likely representative.
The review also looked at the eight cohort studies that have reported on the mortality impact of surveillance mammography among breast cancer survivors.
All suggested a benefit of routine follow-up, though methods differed sufficiently to preclude pooled analysis.
All-cause mortality was 34% lower with yearly surveillance mammography than without it (age-adjusted odds ratio 0.66, 95% confidence interval 0.51 to 0.86) in one study.
Breast cancer-specific mortality was 72% lower with surveillance mammography (multivariate adjusted hazard ratio 0.28, 95% CI 0.22 to 0.37) in another study.
The smaller tumors that could only be found with imaging were associated with better survival odds than larger tumors among these women as well, the group reported.
Tumors larger than 20 mm in diameter — which represent about 80% of those detected with mammography done every three years — independently raised the relative risk of death 2.26-fold compared to those under 10 mm in diameter (95% CI 1.58 to 3.24).
Tumors with missing size data, which likely were those of women who did not have surgery, were associated with 3.19-fold higher risk of death (95% CI 2.24 to 4.53).
“While we have no information as to how these events were detected in clinical practice, the implication is that surveillance mammography may be of value,” Robertson’s group wrote, since it suggests, “that surveillance mammography could be used to reduce the size at which ipsilateral breast tumor recurrence or [second contralateral] cancers are detected.”
Yearly mammography alone, without additional clinical examination, appeared to be the regimen with the biggest net benefit and most likely to be considered cost-effective in the group’s economic analysis.
The incremental cost of yearly surveillance mammography was $7,364 (£4,727) per quality-adjusted life-year compared with no surveillance, falling well below the traditional British regulatory threshold of £30,000 for cost-effectiveness.
But for lower risk women, such as the 70-year-old in the scenario modelled, “it may be more cost-effective for surveillance to be performed less often (every two or three years) with mammography alone or another similarly less intensive and less costly test or combination of tests,” the group wrote.
They acknowledged the paucity of data available to go into the economic models, making it an exploratory analysis that should be interpreted cautiously.
By Crystal Phend, Senior Staff Writer, MedPage Today
Published: October 02, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
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National Women’s Health Week May 8-14, 2011
The 9th annual National Women’s Checkup Day will be held on Monday, May 9, 2011, during National Women’s Health Week. The day is dedicated to encouraging women to visit health care professionals to receive or schedule a checkup and promoting regular checkups as vital to the early detection of breast cancer, heart disease, diabetes, other types of cancer, and many other conditions.
National Women’s Checkup Day is a nation wide effort coordinated by the Department of Health and Human Services Office on Women’s Health to:
- Encourage women to visit their health care providers to receive or schedule a checkup.
- Promotion of regular checkups as vital to the early detection of illnesses and other conditions.
It is important for women to get regular checkups because:
- Screenings tests such as mammograms can find and detect breast cancer early, when it is easier to treat. Some women may need certain tests earlier or more often than others.
- Screenings and routine care can help women lower their risks of many health conditions early including breast cancer and heart disease.
How can you participate in this important event?
- Contact your physician or local health clinic to schedule screenings or checkups on Nationl WOmen’s Checkup Day.
- During your checkup discuss what screenings and tests are right for you, when you should have them and how often.
- Take the CheckUp Day Pledge and Pledge to schedule at least one preventive health screenings during the month of May.
- Click here for the Interactive Screening Chart and Immunization Tool to determine what screenings and immunizations you need and at what age.
- Take the Pledge:
As a participant in National Women’s Checkup Day, I will:
- Contact my current doctor or nurse to schedule checkups and screening services;
- Use the interactive screening chart and immunization tool to learn what screenings and immunizations I need and at what age;
- Discuss with my health care professional during my checkup which of the tests are right for me, when I should have them, and how often;
- Schedule an appointment for at least one of the preventive health screenings during May 2011
Click here I’m ready to take the pledge! to select your state and then click Submit My Pledge to commit to a Healthier You! Print out your Certificate like the one below!
Obesity Boosts Risk for Aggressive Breast Cancer
March 1, 2011 — Obesity and a sedentary lifestyle appear to increase the risk for an uncommon but aggressive breast cancer that is not fueled by the hormone estrogen, a surprising new study shows.
The analysis of data from a health study involving postmenopausal women revealed that the heaviest women were 35% more likely to develop so-called triple-negative breast cancers than the thinnest women.
Triple-negative breast cancers make up 10% to 20% of all cancers of the breast. They have a poorer prognosis than other tumors, in part because there are no targeted hormonal therapies to treat them.
They are referred to as triple-negative tumors because they do not express the hormones estrogen and progesterone or HER2 protein.
Fat tissue is a significant source of estrogen production in women and obesity is a known risk factor for estrogen-sensitive tumors.
The finding that obesity also appears to raise the risk for triple-negative tumors, which are not fueled by estrogen, was unexpected, study researcher Amanda I. Phipps, PhD, tells WebMD.
Phipps is a postdoctoral fellow at Seattle’s Fred Hutchinson Cancer Research Center.
“Hormones are one pathway by which obesity can impact cancer growth, but there are others,” Phipps says. “The fact that we see this association with triple-negative tumors suggests that these other pathways are important.”
Exercise, Body Mass Index, and Cancer Risk
The analysis included 155,723 participants enrolled in the Women’s Health Initiative (WHI), which followed postmenopausal women for 15 years starting in the early 1990s to assess their risk for cancer, heart disease, and osteoporosis.
During about eight years of follow-up, 307 of the study participants were diagnosed with triple-negative breast cancers and 2,610 were found to have estrogen-sensitive breast cancers.
The women in the study were divided into four groups according to body mass index (BMI).
Compared to women with the lowest BMIs, those with the highest were 39% more likely to be diagnosed with estrogen-sensitive tumors and 35% more likely to have triple-negative tumors.
Compared to women who exercised the least, those who exercised the most were 15% less likely to develop estrogen-sensitive tumors.
The study appears in the March 1 issue of Cancer Epidemiology, Biomarkers & Prevention.
African-Americans, Younger Women Have Higher Risk
Triple-negative breast cancers are common among women who have a genetic predisposition known as BRCA1, and they also occur more often in African-American women and tend to occur in younger women.
While none of these risk factors is modifiable, Phipps says the new study suggests two potential interventions that may lower a woman’s risk for developing the disease.
“There are already hundreds of reasons for women to maintain a healthy weight and remain physically active,” she says. “This may be one more.”
University of Wisconsin associate professor Amy Trentham-Dietz, PhD, agrees.
“These findings suggest that avoiding obesity and staying active could lower a woman’s risk for all types of breast cancer, not just those that are estrogen-receptor positive,” she tells WebMD. “That is a very positive message.”
Number of Childbirths and Cancer Risk
Triple-negative breast cancers were first identified less than a decade ago, and Phipps says they are still something of a mystery to researchers and doctors.
Findings from a separate analysis of the WHI data, reported last week by Phipps and colleagues, also surprised the researchers. That study was published Feb. 24 online in the Journal of the National Cancer Institute.
The analysis suggested that the more children a woman has delivered, the higher her risk for the cancer. Women in the study who had never given birth had a 40% lower risk for triple-negative cancers than women who had.
Childbirth is known to be protective against estrogen-receptor positive breast cancers.
Womentorz The Real Women Inventors of America
Womentorz The Real Women Inventors of America
Melinda Knight has a passion for Women Inventors, she’s an Inventor, Wife and Mother herself! But, when she created Womentorz a group comprised of Women Inventors who are not just Inventors; they are Entrepreneurs, some are Wives, Moms, juggling husbands, children and family, but all are busy women running day to day businesses. Melinda envisioned a one stop shop for Women Inventors, a place where they could find inspiration, advice from each other and more. Melinda is always thinking of the next thing that could help the women that join Womentorz.
Melinda’s recent endeavor may just be one of her best ideas yet! Womentorz presents The Real Women Inventors of America are women she will feature each week who aren’t waiting for financial backing or coveted license deals. They’re taking matters into their own hands; accepting the risk for the chance of reward. These are the REAL women inventors of America who will be documenting what it takes to not only be an inventor, but a successful entrepreneur. Each inventor will have a chance to meet with three professionals from the industry who bring unique perspectives and knowledge to help the inventors take their businesses to the next level.
The Breast Chek Kit was invented by a women and is a proud member of Womentorz! Show your support for Womentorz-The Real Women Inventors of America by following us on Facebook, Twitter, You Tube and be sure to share with all of your friends!
Protecting and Strengthening Women’s Health
Most people don’t know that the Affordable Care Act is the strongest women’s health law since Medicare. If you look around the country you can see millions of American women getting more freedom in their health care choices.
It’s about time.
Despite all the progress women have made in the workplace, when President Obama took office less than half of us had the option of getting health insurance through our employer. That meant that many of us had to look for coverage in the individual market where the insurance companies had most of the power. If you had a breast cancer diagnosis, they could deny your application. Sometimes, they could even deny you coverage if you had been a victim of domestic violence. If your child had diabetes, they could deny him or her coverage, too.
Thanks to the Affordable Care Act, that’s changing. As of last fall, insurers can no longer deny coverage to children because of their pre-existing health conditions. And in 2014, this protection will extend to all Americans.
That’s not just important for women who are currently locked out of the health insurance market. It also makes an enormous difference for women with insurance who will have the freedom to make important choices, like changing jobs, without worrying about health coverage.
The law is also bringing greater fairness to women and families. Before the law was enacted, a 22-year-old woman could pay 150 percent more than a 22-year-old man for the exact same health insurance. Yet her coverage often failed to meet her needs. Thanks to the law, in 2014 it will be illegal to charge women extra for health insurance.
And starting in 2014, new, competitive health insurance marketplaces will be established where plans will be required to cover newborn and maternity care.
The health law is also protecting women from many of the worst abuses of the insurance industry. The Patient’s Bill of Rights has banned harmful policies like lifetime dollar limits, which often meant your benefits disappeared when you needed them most.
And we’ve removed the obstacles between families and their doctors, so you won’t have to ask permission from your insurance company to see a pediatrician or OB-GYN in your network.
The law also ensures that women have access to the care they need to lead healthy lives. In the past too many women went without care or screenings due to expensive co-pays. But under the law, every American who buys a new plan can access free preventive care like Pap smears and mammograms. That means women are no longer going to have to put off breast cancer screenings, taking the risk that their cancer could be caught late – when chances of survival can be as low as 23 percent – instead of early – when the survival rate is 98 percent.
These new rights and benefits are just the beginning. In the coming months and years the Affordable Care Act will continue to improve women’s health.
To learn more about how the law is helping women and families, check out this new web resource dedicated to the new rights and benefits available to women.
Mammograms Not as Accurate in Women Who Have Not Had Breast Cancer
By Catherine Donaldson-Evans Feb 23rd 2011
Categories: News
Mammograms are helpful at finding breast cancer in women who have already had the disease, but aren’t as accurate as in those who have no history of it, according to new research.
Scientists from Seattle found that there were more second cases of breast cancer detected in between mammograms, as well as more false positive test results, in women with a history of the disease compared with those who had never gotten a malignant breast tumor in the past.
“Screening mammography does work well in women with a history of breast cancer, so they should continue to get their annual screening mammogram,” study co-author Diana Miglioretti, a senior investigator at Group Health Research Institute in Seattle, told HealthDay News. “But they also need to remain vigilant because they are at increased risk of cancers not detected on mammography that show up between mammograms.”
The researchers analyzed results of almost 60,000 mammograms for nearly 20,000 women with early-stage breast cancer over a 12-year period, according to HealthDay. They compared it with the same number of mammograms for more than 55,000 women with no history of the disease.
Risk factors like age and breast density were taken into account, said the authors of study, published Wednesday in the Journal of the American Medical Association.
In the year after their screening, 655 incidences of cancer showed up in women who’d had the disease before, while 342 cancers were discovered in those who hadn’t, the researchers said.
More specifically, the mammograms found about 77 percent of the breast cancers in patients who’d never had it versus 65 percent of the tumors in those who had. Only 1 percent of women without a history of breast cancer had a false positive test, while nearly 2 percent of those with a history had a false positive screening, the study showed.
As for the likelihood of “interval cancer” — tumors that crop up between mammogram screenings — the rate was 3.6 per 1,000 for those who’d previously had breast cancer compared with 1.4 per 1,000 in those who’d never had the illness.
“I think it’s mostly positive news,” Miglioretti told HealthDay. “Of the ones that are missed, most of them are early stage.”
She said the findings emphasize the importance of getting regular screenings after breast cancer is treated and going to the doctor right away if anything seems amiss.
Dr. William Audeh, a breast cancer risk specialist at Cedars-Sinai Medical Center in Los Angeles who wasn’t involved in the study, said cancer radiation and surgery can cause a woman’s breasts to change.
“That helps explain the false positives,” he told HealthDay.
Robert Smith, director of cancer screening for the American Cancer Society, said that though mammograms aren’t infallible, they are still very good at finding breast tumors.
“Despite poorer performance compared with women without a prior history of breast cancer, overall screening mammography was effective at detecting the majority of breast cancer in women with a [history] at an early favorable stage,” he told HealthDay.
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