<![CDATA[Breast Cancer - Health.com]]>

<![CDATA[Breast Cancer - Health.com]]> en daily 1 Subscribe with My Yahoo!Subscribe with NewsGatorSubscribe with My AOLSubscribe with BloglinesSubscribe with NetvibesSubscribe with GoogleSubscribe with PageflakesSubscribe with PlusmoSubscribe with The Free DictionarySubscribe with Bitty BrowserSubscribe with Live.comSubscribe with Excite MIXSubscribe with WebwagSubscribe with Podcast ReadySubscribe with WikioSubscribe with Daily Rotation <![CDATA[Study: Moderate Drinking Ups Risk of Breast Cancer Return]]>

THURSDAY, Dec. 10, 2009 (Health.com) — Breast cancer survivors who have just a few alcoholic drinks per week are more likely than women who drink little or no alcohol to see their breast cancer return, according to research presented today at an annual meeting of breast cancer specialists.

The study, which followed about 1,900 early-stage breast cancer survivors for eight years, found that women who consumed an average of at least three to four alcoholic drinks in a week had a 34% higher risk of breast cancer recurrence. (One drink equals a 5-ounce glass of wine, a 12-ounce beer, or a 1.5-ounce shot of liquor.)

The increased risk was more pronounced among breast cancer survivors who had gone through menopause and those who were overweight or obese, the study found.

Wine was by far the most common drink among women in the study, followed by liquor and beer, but no one type of alcohol was found to be significantly more or less associated with the risk of recurrence.

In all, there were 349 breast cancer recurrences and 332 deaths during the follow-up period. Alcohol use was not linked to the risk of death from breast cancer, however.

“More research should be done, but there is a growing body of evidence which suggests that women previously diagnosed with breast cancer should speak with their doctor about possibly limiting their consumption of alcohol,” says the lead researcher on the study, Marilyn L. Kwan, PhD, a staff scientist at Kaiser Permanente in Oakland.

Previous research has suggested that alcohol consumption may increase the risk of developing breast cancer in the first place. Kwan's research extends these findings to include the risk of recurrence among women who have already been diagnosed and treated for breast cancer, a population that numbers about 2.5 million in the United States, according to the American Cancer Society.

“Cutting back on alcohol represents a real step that a breast cancer survivor can take to reduce her risk of recurrence,” says Marisa Weiss, MD, the president and founder of the advocacy group Breastcancer.org. “You don’t have to give up alcohol, but use it more carefully and in moderation,” she says.

Limiting alcohol intake can improve the overall health of breast cancer survivors, according to Dr. Weiss, the author of the forthcoming book Living Beyond Breast Cancer. “Alcohol is liquid calories, and being overweight is a risk factor for breast cancer,” she says. “If you consume a lot of alcohol, you tend to be less physically active and/or smoke. So, for a number of reasons, that one step of cutting back on alcohol does have a number of health benefits."

Exactly how alcohol consumption affects breast cancer risk is not fully understood, says Kwan, although estrogen, which fuels the growth of most types of breast cancer, is likely involved.

“It has been suggested that alcohol could increase the risk of breast cancer by increasing estrogen metabolism and circulating levels of estrogen, thus promoting growth of the tumor,” she says. “A similar mechanism might be responsible for increasing the risk of breast cancer recurrence.”

Drinking-related weight gain could also play a role, Kwan adds. “Obesity may…promote estrogen production and breast cell proliferation, in addition to the direct effect alcohol can have on estrogen metabolism and levels in the body,” she explains.

The study, which was funded by the National Cancer Institute, was presented at the San Antonio Breast Cancer Symposium, an annual meeting for oncologists, surgeons, and other breast cancer specialists. The symposium is co-hosted by the American Association for Cancer Research and the Cancer Therapy & Research Center at the University of Texas Health Science Center at San Antonio.

]]> Istockphoto <![CDATA[Study: Soy May Benefit Breast Cancer Survivors]]>

breast cancer who eat more soy are less likely to die or have a recurrence of cancer than women who eat few or no soy products, according to a new study.

In the past, physicians have often warned breast cancer patients not to eat soy. The new research represents "a complete turnaround" from the previous understanding about the link between soy consumption and breast cancer, says Sally Scroggs, a registered dietician and senior health education specialist at M.D. Anderson's Cancer Prevention Center in Houston.

"We have gone from saying, 'No soy for breast cancer survivors' to, 'It's not going to hurt,'" Scroggs says. "Now it looks like we can say, 'It may help.'"

The study followed more than 5,000 women in China who had undergone a mastectomy for about four years. The women who consumed the most soy protein (about 15 grams or more a day) had a 29% lower risk of dying and a 32% decreased risk of breast cancer recurrence compared to the women who consumed less than about 5 grams of soy protein a day, according to the study, which appears in the December 9 issue of the Journal of the American Medical Association. The National Cancer Institute and the U.S. Department of Defense's Breast Cancer Research Program funded the study.

Women who ate between 9.5 and 15 grams of soy protein saw nearly the same decrease in risk as the women who ate more than 15 grams. In fact, the researchers found no additional benefits to eating more than 11 grams of soy protein a day. (An 8-ounce glass of soy milk and a cup of shelled edamame contain about 7 and 14 grams of soy protein, respectively.)

In all, 534 women had a breast cancer recurrence or died from breast cancer during the study period.

Soy foods—such as milk, tofu, and edamame—are rich in naturally occurring estrogens (especially isoflavones) that can mimic the effects of estrogen in the female body. Because the most common types of breast cancer depend on estrogen to grow, experts once feared that soy isoflavones could stimulate the estrogen receptors in breast-cancer cells, even though the estrogens in soy are much weaker than those produced by the body.

The current study suggests the exact opposite: Soy may actually reduce the amount of estrogen that's available to the body.

"Soy isoflavones may compete with estrogens produced by the body. Soy isoflavones may also reduce the body's production of estrogen, and increase clearance of these hormones from the circulation—all of which together reduce the overall amount of estrogen in the body," says the lead author of the study, Xiao Ou Shu, MD, PhD, a cancer epidemiologist at the Vanderbilt-Ingram Cancer Center of Vanderbilt University Medical Center in Nashville, Tenn.

Dr. Shu says, however, that factors beyond estrogen may be at work. Other components of soy foods, such as folate, protein, calcium, or fiber (or some combination thereof) may also be responsible for the health benefits reported in the study, she says.

Next Page: Findings could confuse women

The new findings, which seem to contradict what many women have heard from their doctors over the years, could prove perplexing for women such as Andrea Mulrain, 44, a former music executive who was first diagnosed with breast cancer 10 years ago.

After her diagnosis, Mulrain's doctors told her to steer clear of all soy foods because these foods could encourage the growth of cancer cells. Mulrain had estrogen-sensitive breast cancer, which means that estrogen helps the cancer grow.

Her doctors eventually softened their stance a bit, and said she could consume soy in moderation. "I pretty much avoided soy for 10 years after diagnosis but recently was told it was OK to have soy in moderation as long as I read the labels and make sure it's not the main ingredient in any food," says Mulrain, who is currently being treated for a recurrence.

In the study, the association between soy consumption and lower risk of death and cancer recurrence was seen in women like Mulrain with estrogen-sensitive breast cancers, and in women taking tamoxifen, a drug designed to prevent cancer recurrence by blocking the effects of estrogen in the breast tissue.

Despite the study's findings, the final verdict on soy and breast-cancer recurrence is not yet in, according to an accompanying editorial written by Rachel Ballard-Barbash, MD, of the National Cancer Institute in Bethesda, Md., and Marian L. Neuhouser, PhD, of the Fred Hutchinson Cancer Research Center in Seattle.

The follow-up period in the new study was relatively short, they say, and breast-cancer diagnosis and treatment may be different in China compared to the United States. Similarly, there may be differences in the types of soy foods that Chinese and American women eat. (In general, Chinese women consume significantly more soy than American women.)

More studies are needed to confirm these findings, especially as they apply to women with estrogen-sensitive breast cancer or those who take drugs such as tamoxifen to keep breast cancer at bay, say Ballard-Barbash and Neuhouser. Still, they say, "Patients with breast cancer can be assured that enjoying a soy latte or indulging in pad thai with tofu causes no harm, and when consumed in plentiful amounts may reduce risk of disease recurrence."

The study should be reassuring to women who have been trained to steer clear of soy, says Scroggs. "Don't freak out if there is some tofu mixed in with your vegetables at an Asian restaurant," she says.

Her soy prescription for breast-cancer survivors? "Eat soy in moderation, and your soy proteins should come from foods, not concentrated supplements," she says. "Soy is a complete protein so it is high in fiber and has a place in a healthy, balanced diet."

Eating more soy is beneficial because it tends to replace less healthy foods in people's diets, Scroggs says. "When people are eating soy protein, they are likely eating less of something else, such as red meat," she says.

]]> Istockphoto <![CDATA[Panel Says Women Should Start Mammograms at 50, Not 40]]>

However, a number of prominent groups say they strongly disagree with the new advice, which was issued by the U.S. Preventive Services Task Force (USPSTF) on Monday.

The USPSTF panel has backed off a 2002 statement advising women to have a routine mammogram every year or two beginning at age 40. The panel now recommends that women undergo mammography screening every two years starting at age 50 and continue being screened through age 74.

The USPSTF concluded that the benefit gained by starting screening at 40 versus 50 is “small” and that the decision to start screening before 50 should be an individual one.

The new guidelines would seem to reopen a debate that raged in the 1990s, but seemed to have been settled years ago. The American Cancer Society (ACS) now recommends that women get an annual mammogram and have a clinical breast examination beginning at age 40.

Otis W. Brawley, MD, the chief medical officer of the ACS, said in a statement that the ACS would stick to its current guidelines.

Mammograms are the “one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member,” Dr. Brawley said. The USPSTF is an independent panel, sponsored by the federal Agency for Healthcare Research and Quality, whose members make recommendations about preventive-care services and published the new recommendations in the Annals of Internal Medicine.

The panel’s recommendations are based, in part, on a review of the latest scientific evidence on the benefits and harms of breast cancer screening. The pooled data show that mammography screening does reduce breast cancer death—by 15% for women ages 39 to 49. To prevent one cancer death in this group, 1,904 women would have to be screened. Among women 50 to 59, one death is avoided per 1,339 screenings.

Because breast cancer risk increases with age, younger women are at a somewhat lower risk of developing the disease, explains George W. Sledge Jr., MD, a professor of oncology at Indiana University’s Melvin and Bren Simon Cancer Center, in Indianapolis, and president-elect of the American Society of Clinical Oncology.

They’re also somewhat more likely to have a false-positive mammogram—a test result that triggers a biopsy or other tests, but turns out not to be cancer—because they tend to have denser breasts, he says.

“No one is saying, or no one should say, that screening mammography has no value for younger women,” he says.

What the task force is saying is that the absolute reduction in breast cancer deaths is much greater in an older population.

But the American Cancer Society’s Dr. Brawley reasoned that “the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”

Next Page: Guidelines don't assess individual risk

The panel also considered data from a study using computer simulation models to compare expected outcomes of starting and stopping screening at different ages and screening at different intervals. The models suggest that screening average-risk women ages 50 to 74 every two years achieves most of the benefit of annual screening, but with less harm due to factors such as false-positive results, unnecessary biopsies, and “overdiagnosis” of cancers that wouldn’t have progressed or would have not led to the person’s death.

“[The models] only tell us what happens on average in the population. They do not tell us what will happen for an individual woman,” says Jeanne S. Mandelblatt, MD, the lead author of one of the studies commissioned by the USPSTF and a professor of oncology and medicine at Georgetown University’s Lombardi Comprehensive Cancer Center.

For an individual woman, the decision to have a mammogram “is one that she needs to consider with her providers based on her risks and her values for the balance of harms and benefits,” she adds.

But W. Phil Evans, MD, the president of the Society of Breast Imaging, questions the wisdom of biennial screening. “It doesn’t make any sense when you know more cancers can be found in the 50-year-old age group to lengthen the screening time, because the idea is to find the cancer early and to treat it while it’s small, because treatment can be less when the cancer is detected early,” says Dr. Evans, a professor of radiology and the associate vice president for clinical imaging services at the University of Texas Southwestern Medical Center, in Dallas.

“The Society of Breast Imaging and the American College of Radiology are not going to change their guidelines because of this,” he says. “We think it’s very important to begin screening at age 40 and screen yearly thereafter.”

The USPSTF panel did not make recommendations on screening women 75 and older because the current evidence is insufficient to weigh the additional benefits and harms. For the same reason, it did not weigh in on the value of clinical breast examinations, beyond mammography, in women 40 and older or on the value of other imaging techniques, such as digital mammography or magnetic resonance imaging.

However, it did recommend against teaching women how to perform breast self-examination, saying there’s no evidence that it reduces breast cancer deaths.

The critical thing is not to ignore this lifesaving procedure, says Dr. Sledge, who urges all women to discuss mammography with their doctor, beginning at age 40.

“What’s not mentioned in these discussions, but what’s incredibly important, is that in the United States, perhaps as many as even a third of all women just simply don’t follow even the most conservative of screening mammogram recommendations, just as a significant portion of the population doesn’t get screening for colorectal cancer or screening for cervical cancer,” Dr. Sledge notes.

“We could significantly reduce the number of cancer deaths if we applied even the most conservative of screening guidelines,” he says.

Breast cancer is the second-leading cause of cancer death in women, after lung cancer. In 2009, an estimated 254,650 breast cancer cases will be diagnosed, and 40,170 women will die from the disease.

]]> Getty Images <![CDATA[Nearly Half of Breast Cancer Survivors Have Lingering Pain]]>

breast cancer surgery still have pain or numbness two to three years later, according to a new study. Women younger than 40 who receive lumpectomies are at the greatest risk.

In general, women are most likely to have pain or a loss of sensation in the breast region, followed by the armpit, the arm, and their sides. However, 40% of women with lingering symptoms have pain in parts of the body not affected by treatment, according to a report in the Journal of the American Medical Association.

“This is a very well-done study by very well-respected surgeons in Denmark,” says Allen Burton, MD, a professor and the chair of the department of pain medicine in the division of anesthesiology and critical care at M.D. Anderson Cancer Center, in Houston.

“This is a known phenomenon,” says Dr. Burton, who wasn’t involved in the study. “These women have pain and huge numb patches in their chest, underarm, down their arm, and in their back that never feels normal again.”

None of the women in the study had reconstructive breast surgery, which is commonplace in the United States. “It would be interesting to see if that changes the outcome,” Dr. Burton says. “Would they have more pain? Less pain? Different kinds of pain?”

In the study of 3,754 breast cancer survivors ages 18 to 70, 47% had pain in one or more area, and 58% reported problems in the treated breast, including burning and a loss of sensation for one to three years after their surgery. Overall, 13% of women with lingering problems said their pain was severe, 39% said it was moderate, and 48% reported light pain. And 76% of patients with severe pain said they ached every day.

Women at the greatest risk for chronic pain were ages 18 to 39 and had undergone breast-conserving surgery, or lumpectomy, in which doctors remove only the tumor and some surrounding tissue. Other risk factors for persistent pain included radiation therapy, which is directed at the breast area to destroy any remaining cancer cells after surgery.

Next Page: Why some women have lasting pain

There are several reasons that breast cancer survivors experience pain such as nerve damage or injury from the surgery or radiation, but in the future, nerve-sparing surgery may help take the sting out of this persistent pain, according to study authors led by Rune Gärtner, MD, of the University of Copenhagen.

The first priority is to always treat the breast cancer as effectively and aggressively as possible, Dr. Burton says. That said, a paravertebral block, which is an injection of local anesthetic into nerves of the spine to block the pain, may also help cut the risk of postsurgical breast cancer pain.

“We are studying it and trying to determine whether or not it impacts the prevalence of long-term chronic pain after breast cancer surgery,” he says. “We think it does because it makes sense that the better you control acute pain around the surgery, the less likely you are to get chronic pain syndrome later.”

For women who already have chronic pain from breast cancer surgery, help is available now, says Judy C. Kneece, RN, an oncology-certified nurse and the president of EduCare, a breast health education company in Columbia, S.C.

“Pain decreases quality of life and should be a cause to reach back out to the surgeon or radiologist and ask for a referral to a physical therapist for intervention,” says Kneece, who is also the author of Your Breast Cancer Treatment Handbook. “Most pain can be addressed and reduced or eliminated.”

Physical therapists can help women develop a plan to reduce or eliminate pain. In general, range-of-motion exercises after surgery can help reduce the risk of pain, according to Kneece. “If not performed, there will be a fibrous tissue which forms in the area restricting motion and causing pain when the arm is stretched,” she says.

One potential cause of pain is lymphedema, a swelling of the arm and hands. Lymphedema can occur after breast surgeons remove lymph nodes from a woman’s underarm region to test them for cancer.

Some women are candidates for sentinel node mapping, a technique that reduces the risk of lymphedema; dye is injected to see which lymph node is closest to the breast tissue (and therefore most likely to contain cancer cells.) If this node is cancer free, doctors don’t have to remove multiple lymph nodes, which reduces the risk of pain and swelling.

“If one notices increasing swelling accumulating in the affected limbs or trunk, it is likely an early warning sign of lymphedema and she should be evaluated by a fully certified lymphatic drainage therapist,” says occupational therapist Cathy Kleinman-Barnett, a lymphedema specialist at Northwest Medical Center, in Margate, Fla.

“The additional fluid buildup can cause abnormal sensations such as tingling, aching, [and] heaviness, and should diminish or stop with range-of-motion exercises, stretching, and massage to stimulate lymphatic flow,” she says. “There is help available, and women should not have to live in pain.”

]]> Getty Images <![CDATA[Drugs Help Prevent Breast Cancer but Pose Risks Too]]>

Now, a new analysis suggests that women and their doctors need to weigh the dangers of the drugs’ side effects—which can include blood clots, cataracts, and cancer of the uterine lining—against the benefits of breast cancer prevention.

The analysis, funded by the U.S. Department of Health and Human Service’s Agency for Healthcare Research and Quality, was published in the September 15 issue of Annals of Internal Medicine.

However, the bigger problem may be that not enough women who are candidates for the drugs are actually taking them. About 2% of U.S. women are at high risk for breast cancer, but many don’t take tamoxifen or raloxifene, according to Christy Russell, MD, an American Cancer Society spokesperson who chairs the organization’s breast cancer advisory committee.

“That’s extremely unfortunate, because we have 200,000 new cases of invasive breast cancer every year and we could potentially reduce that number by half using drugs that are already approved by the [Food and Drug Administration] for this specific purpose,” she says. Dr. Russell says the drugs are underused due to a lack of education among both patients and physicians as to their safety and effectiveness.

“As a culture, it’s a very hard sell to convince us to take drugs for a disease we don’t already have,” she adds.

In the new review, Heidi Nelson, MD, of the Oregon Health & Science University, and her colleagues looked at eight clinical trials of three drugs—tamoxifen, raloxifene, and tibolone. The trials were all conducted in women at high risk of breast cancer who had not been diagnosed with the disease.

Tamoxifen and raloxifene are both selective estrogen-receptor modulators (SERMs), a class of drug that cuts the risk of invasive breast cancer in at-risk women. Both drugs are FDA-approved for that purpose. Tibolone works in a different way and is not approved for use in the United States. (It is approved for menopausal symptoms in 90 countries, and for osteoporosis in 45 countries.)

The researchers found that the three medications reduce invasive breast cancer by 30% to 68%, depending on the drug. Tamoxifen and raloxifene were about the same in terms of reducing the risk of estrogen-receptor-positive breast cancer, which makes up about 60% of breast cancers.

However, the two drugs also increase the risk of blood clots, one of the most serious complications. (Clots can cause heart attacks and strokes).

Patients who took tamoxifen had a higher risk of cataracts and a greater chance of blood clots compared to those who took raloxifene. Women who took tamoxifen also had twice the risk of cancer of the endometrium, or uterine lining, as women who didn’t take the drugs. Although doctors can monitor a woman for the early signs of endometrial cancer, she may need a hysterectomy to treat it.

Both tamoxifen and raloxifene cause hot flashes and other menopausal symptoms, according to the review. Tibolone was associated with a greater risk of stroke than other drugs, but the study authors say they need more data to truly determine its safety and effectiveness.

Dr. Russell recommends that women who are at high risk for breast cancer speak with their doctors and weigh the risks and benefits of drug therapy. High-risk women who have not yet entered menopause should consider tamoxifen; postmenopausal women should choose raloxifene due to its lower risk of certain side effects, she says.

The good news is that taking a SERM for about five years lowers a woman’s risk even after she stops taking it. (Still, it doesn’t guarantee that she won’t get breast cancer.) The drugs prevent 7 to 10 cases of invasive breast cancer per 1,000 women per year of the drug’s use.

So why aren’t more women taking them? Dr. Russell says that explaining the risks and benefits of the drugs—and managing and monitoring possible side effects—can take time, a rare commodity for most doctors.

What’s more, prevention of most conditions, whether breast cancer, diabetes, or heart disease, often takes a backseat to testing and treatment. “Physicians just are not rewarded for these types of preventive approaches,” Dr. Russell says.

Women are considered to be at high risk for breast cancer based on several factors, including having close relatives with breast cancer (a mother, daughter, or sister) and being diagnosed with a precancerous breast condition.

In general, women can lower their risk of breast cancer by maintaining a healthy body weight, exercising regularly, and limiting alcohol consumption, according to the American Cancer Society. Although regular mammograms don’t prevent breast cancer, they can lead to earlier detection and more successful treatment.

]]> (ISTOCKPHOTO) <![CDATA[Can Twitter and Facebook Help Fight Breast Cancer?]]>

I had granola for breakfast! I’m stuck in traffic!

But Laurie Brosius, 31, isn’t buying it. Brosius, a business analyst in Dallas, used Twitter to raise $6,000 for a walk for breast cancer research in 2008. “Fifty percent of that came from online strangers,” she says. She was able to reach those people in part because her Twitter followers re-tweeted her messages.

In 2004, Brosius started blogging about her upcoming wedding. But after she married, she felt a key person was missing from the happy picture—her husband’s mother, who had died of breast cancer at age 48 when her husband was 20 years old. “I felt like I missed out on having her in my life,” says Brosius. “I felt cheated.”

She wanted to raise money for breast cancer research, so she participated in a three-day walk and fund-raiser, but felt she could do more. She had used Twitter to raise a small sum for that first walk, but for the second walk she relied mainly on tweets to direct people to the donation website.

(Anyone can see breast cancer–related tweets by typing #breastcancer into Twitter’s search field.)

Brosius still blogs and says that breast cancer organizations’ websites are great places to donate. However, Brosius says, they only reach a specific crowd—those already interested in the topic.

“[Social media sites] are reaching people who might not be specifically looking for that kind of information,” she explains. “They’re reaching everyone.”

Next Page: Is brevity the key to charity?

Is brevity the key to charity?
In a busy world, Twitter posts are succinct and to the point, and that’s one of the main reasons they’re so successful in charity promotion, says Adam Hirsch, the chief operations officer of Mashable.com, a social media blog. Navigating websites can be time-consuming, notes Hirsch. Twitter, however, states a user’s case in no more than 140 characters. “It’s a message you know people will read because, face it, it’s only 140 characters,” he says.

With Twitter, users can interact one-on-one, but they can also broadcast a message to many followers. Even if an individual doesn’t have a lot of followers (say, just family and friends), those people can re-tweet that message in outgoing concentric circles of social contacts—potentially reaching thousands.

“With social media, you have the ability to spread a message with like-minded individuals pretty rapidly and virally to a targeted audience that is receptive to this message,” Hirsch explains.

Mashable.com is leveraging its social media savvy through its Summer of Social Good, which is an online charitable campaign. The site is raising money for four big charities: the Humane Society (you can search for @HumaneSociety on Twitter): LiveStrong, the Lance Armstrong Foundation (@LiveSTRONG); OxfamAmerica, which seeks to end poverty (@OxfamAmerica); and the World Wildlife Fund (@WWF_Climate).

The idea got started last year when Mashable founder Pete Cashmore tweeted on his birthday, asking followers to donate to Charity: Water in lieu of birthday gifts. He raised $10,000 in a little over a day.

“I thought, ‘This is definitely an interesting way to use social media,’” says Hirsch. “It’s time to give back and to really try to make a big difference.” Mashable’s Social Media for Social Good campaign ends on August 28.

Peg Mulligan, 40, is a content developer in Beverly, Mass., who raises awareness of breast cancer via Twitter, by tweeting (or re-tweeting) fundraising initiatives, blog posts, and other relevant links. Although she has breast cancer in her family and cares about the topic, she says she doesn’t necessarily want to think about it all the time. That’s one reason people may not seek out traditional breast cancer donation channels, she says.

Unlike such message boards and topic-specific websites, Mulligan says, Twitter is a “gentler way of reaching people” because it indirectly grabs users’ attention in a stream of other topics.

Next Page: Facebook vs. Twitter

Facebook vs. Twitter
Mashable’s Hirsch prefers Twitter to Facebook for social causes because anyone can choose to follow someone on Twitter, which leads to broader, looser networks of people. “Facebook is inherently different because it’s more built around friends,” he says.

However, some people are using Facebook to communicate their personal messages to their immediate social circle—though it’s not always smooth sailing.

Earlier this year, a breast cancer survivor named Sharon Adams posted pictures of her ropy red mastectomy scars on Facebook. She hoped to shock friends in her suburban England network into checking their own breasts for cancer. “I wanted to take something positive out of a bad situation,” says the 45-year-old, who posed for the shots just six days after having surgery.

Instead, Facebook management took down the photos in a routine purge of “sexual” images. The result? An avalanche of media attention and a 900-member protest that quickly grew to 3,000, even as the company rapidly apologized and backpedaled. Facebook said they had “made a mistake” and Adams put the images back up.

Adams says that despite the setback, she realized her goal—extra online chitchat about the issue and maybe more checked breasts. In her own circle alone, several friends and a niece made the extra effort. “It turned out to be a good thing in a way,” she says. “This amount of publicity would never have arisen if they had not [removed the photographs].”

The largest breast cancer–related group on Facebook is LookPink, a search engine that aims to provide free mammograms for women. It has 850,000 members and acts as a fund-raising and awareness hub with round-the-clock discussion—especially during October, breast cancer awareness month. It’s one of several Facebook gateways to the corresponding LookPink website.

But there are hundreds of breast cancer groups on Facebook, many no bigger than the page of eight women from the Persian Gulf city of Doha, Qatar.

The Facebook page that hosts Sharon Adams’s protest group has a link to her own efforts to raise cash for breast cancer research in the U.K., for instance, and a petition to the U.S. Department of Health & Human Services to get gene tests covered by insurance.

“There is a huge presence of women who have battled or are battling breast cancer who are connecting online,” says Alison Gordon, the vice president of strategy, marketing, and communications for Rethink Breast Cancer, a Canadian nonprofit that encourages breast self-exams.

“Social media offers an incredible forum for women to expand their online communities from around the world and share their stories,” she says.

Part of Brosius’s story—and another reason she started using Twitter to raise funds—is her concern for her husband’s sister and her sister-in-law’s three daughters. “I wanted to do all I could to find a cure before they grow up,” she says.

]]> <![CDATA[Breast Cancer Risk and Estrogen Alternatives]]>

hormone therapy (HT), which may increase your risk of breast cancer. If you can, consider nondrug remedies first, says JoAnn Manson, MD, a professor of medicine at Harvard Medical School and the author of Hot Flashes, Hormones & Your Health.

Dr. Manson has several suggestions for managing hot flashes and night sweats:

 

Wear layered clothing.
Lower the thermostat.
Use portable fans.
Avoid dietary triggers such as caffeine, spicy foods, and alcohol.
Avoid tobacco.
Increase your intake of soy-based foods.
Consider trying the herb black cohosh.

A low dose of a selective serotonin-reuptake inhibitor (SSRI) or the antiseizure medication gabapentin may also be useful, according to Kala Visvanathan, MBBS, assistant professor of epidemiology and oncology at Johns Hopkins Bloomberg School of Public Health, in Baltimore.

"If a woman has only vaginal dryness and discomfort with intercourse and no other symptoms, she can use a topical estrogen or a vaginal estrogen ring, which have a much lower absorption of estrogen," adds Dr. Manson, who notes that relaxation and breathing techniques have worked for some women as well. "I would encourage women to try lifestyle modifications before going with estrogen, especially if they have mild symptoms," she says.

Dr. Visvanathan agrees: "You definitely want to try simple things first, then go to [HT] if you need to. It used to be that hormones were the first thing you tried, but the paradigm is changing because we’ve determined the long-term breast cancer and cardiovascular risk associated with HT, and because the benefits of HT have been shown to be less effective than previously thought. Women with modest menopausal symptoms can often treat their symptoms effectively with nonmedical therapies."

Share Your Thoughts

Have you tried estrogen alternatives for hot flashes?

Post a Comment

Read Comments

If you end up needing estrogen or combination HT, though, and you want to keep your breast cancer risk low while still keeping menopause symptoms in check, ask your doctor about transdermal patches, gels, and sprays, which deliver low doses of estrogen through the skin and may have fewer risks than pills. "Transdermal estrogen may be less likely to cause blood clots and gallbladder disease," Dr. Manson explains. "And lower doses may be less likely to increase the risk of breast cancer or other cancers."

The bottom line: Consider alternative approaches to see if one or several together can control your menopause symptoms before turning to oral estrogen or combination HT.

]]> Taking estrogen may increase a woman's risk of getting breast cancer. (ISTOCKPHOTO/HEALTH) <![CDATA[Estrogen and Your Breast Cancer Risk]]>

• Combination hormone therapy (HT): If you’re considering taking estrogen and progestin (a synthetic form of the hormone progesterone) to give you relief from annoying menopause symptoms like hot flashes and night sweats, be sure to limit the time you’re on the drugs. That’s because over time your breast cancer risk climbs, says JoAnn Manson, MD, professor of medicine at Harvard Medical School and author of Hot Flashes, Hormones & Your Health.

"In the Women’s Health Initiative (WHI) trial, when women got seven years of estrogen alone, there was no increased risk of breast cancer, but after four to five years on combined hormone therapy, the risk emerges," she says. In fact, over time, estrogen plus progestin can raise a woman’s risk for breast cancer by 24%; even if you take estrogen on its own for more than 10 to 15 years, your risk may still go up.

Dr. Manson was a coauthor on a March 2008 study in the Journal of the American Medical Association that followed up on the WHI trial. It showed that even after the women stopped taking combination HT, their breast cancer risk remained elevated. "The risk of breast cancer does decline after stopping hormone therapy," she stresses, "but if a tumor has formed while a woman is on hormones it’s very likely to come to light even after she stops hormones, so there is some residual risk. Stopping drug therapy doesn’t mean a tumor evaporates, but the risk gradually declines."

• HT and early diagnosis of breast cancer: If you have no family history of the disease, you’ve probably been encouraged to get your first mammogram by age 40 and every one to two years after that to help ensure that any tumor is caught early, when it’s most treatable. That’s good advice, but taking HT may complicate things. "Estrogen-and-progestin HT can lead to increased mammographic density"—denser breast tissue—"that can obscure breast tumors and delay diagnosis," says Dr. Manson. Denser breasts are believed to be an independent risk factor for breast cancer, but they also make it harder to accurately read a mammogram and that "can lead to abnormal mammograms that may require extensive follow-up and anxiety about repeat testing and even unnecessary biopsies," Dr. Manson adds.

• HT and risk for benign breast disease: In April 2008, the Journal of the National Cancer Institute found that postmenopausal women who’d taken estrogen on its own doubled their risk of a noncancerous type of breast disease, but one that’s associated with a higher risk of breast cancer. A September 2008 study led by the same author, Thomas E. Rohan, MD, PhD, an epidemiologist at the Albert Einstein College of Medicine, in New York City, found similarly disturbing evidence in a study of women taking estrogen and progestin: Combined HT raised a woman’s risk of benign breast disease by 74%.

Next Page: Estrogen, testosterone, and breast cancer risk

• Estrogen, testosterone, and breast cancer risk: Low sexual desire and vaginal dryness are two common—not to mention very unpleasant—hallmarks of menopause for many women. Estrogen can help ease the latter and researchers have looked at whether adding testosterone—another hormone that’s crucial to libido, even in women—into the mix might help. The extent to which testosterone will perk up your love life is uncertain, but combining estrogen and testosterone may increase your breast cancer risk. A 2006 study collected data from more than 121,000 women who were part of the Nurses' Health Study and found that for the women who'd taken estrogen and testosterone, the risk of developing breast cancer went up 17% for every year they took the combo, compared to those who’d never taken hormones for menopause symptoms.

The bottom line: "The recommendation for hormone therapy is for the lowest effective dose for the shortest duration, to minimize the risk of breast cancer and to minimize risk overall," sums up Dr. Manson.

Talk to your doctor about whether HT is right for you in the first place and, if it is, annually revisit the decision to stay on hormones. "If they develop hot flashes or irregular periods, women don’t automatically go on hormones for their lifetimes anymore; they go on them if they have symptoms that are severe and aren’t controlled by other approaches," explains Kala Visvanathan, MBBS, assistant professor of epidemiology and oncology at Johns Hopkins Bloomberg School of Public Health, in Baltimore. "After a period of time you can reduce the dose and see if you’re still getting symptoms. Rethink it on a yearly basis, asking your doctor, 'Should I continue on it, do I need it?'"

Dr. Manson suggests trying to limit combination HT to two to three years, and to no more than five years, if possible. If you have dense breasts (your doctor can tell whether you do), ask about ways to lower your cancer risk and make sure your annual mammogram and clinical breast exams are thorough and regular. You may also want to consider alternatives to HT and/or switch to a lower dose. Skip the supplemental testosterone too.

If you’re in treatment for breast cancer
To keep breast cancer from coming back, your oncologist will want to keep the level of natural estrogen in your body at an all-time low; it’s unlikely he’ll OK either estrogen or combination HT while you’re still in treatment. "It’s very controversial and I would try to avoid it," Dr. Manson says. Instead, you’re more likely to be put on medications that do just the opposite—deplete the estrogen you do have in order to prevent a recurrence. If you’re prescribed raloxifene (Evista) or tamoxifen, these not only block estrogen receptors to stop a tumor from growing, but they can also do a lot to stave off another cancer. Aromatase inhibitors such as Arimidex and Femara—mainly used by postmenopausal women—keep your body from making the hormone in the first place, significantly lowering the chances that breast cancer will return.

The bottom line: If at all possible, pass up HT while you’re still in treatment. If your symptoms are still poor after treatment, reevaluate the decision with your doctor.

If you’re at increased risk of breast cancer
If your odds of getting breast cancer are higher than average—because you have a family history or because you carry a mutation of the BRCA-1 or BRCA-2 genes (which puts you at a much higher risk)—you’re bound to wonder whether taking hormones to relieve menopause symptoms is worth it.

"If a woman is at very high risk for breast cancer, I’ll try to avoid using HT," says Dr. Manson. "But if she doesn’t respond to other treatments and she’s highly symptomatic—disrupted sleep, severe hot flashes, vaginal dryness—and she’s not getting adequate relief, a short course of hormones for two to three years should not really increase her risk." Talk to your doctor about what’s right for you; you may be able to find nonhormonal relief before turning to drugs. Dr. Visvanathan notes that if you’ve had your uterus removed, your physician may suggest estrogen alone, which is associated with lower odds for breast cancer as are other alternatives to HT.

Keep in mind too that when it comes to breast cancer risk and hormones, researchers definitely don’t have all the answers. An October 2008 Journal of the National Cancer Institute study of postmenopausal women who’d taken hormones actually offered reassuring news, at least for BRCA-1 carriers: The researchers found that the BRCA-1 women who’d taken estrogen alone or combined estrogen and progesterone actually had a decreased risk of breast cancer compared with those who hadn’t had HT. Why? That’s not clear, says Steven Narod, MD, one of the study’s authors and director of the familial breast cancer research unit at the Women’s College Research Institute in Toronto.

The bottom line: Skip or postpone HT, if possible, or talk to your doctor about a short course of hormones while menopause symptoms are at their worst.

]]> Taking estrogen may increase a woman's risk of getting breast cancer. (GETTY IMAGES/HEALTH) <![CDATA[Products That May Reduce Your Risk of Breast Cancer]]>

breast cancer and household products, whether they be soap or water bottles. But many consumers, activists, and experts are concerned that a variety of goods contain hormone disruptors, chemicals that when absorbed into the body can mimic or interfere with hormones such as estrogen. Some researchers believe that chemicals with estrogenic characteristics can cause normal breast cells to divide.

"Each time they divide, they have the risk of copying DNA incorrectly and creating mutations in key genes, which may lead to increased breast cancer risk," says Suzanne Snedeker, PhD, the associate director for translational research for the Program on Breast Cancer and Environmental Risk Factors at Cornell University. Chemicals that mimic estrogen might also enable an existing breast tumor to keep growing, because most tumors depend on estrogen to grow.

Individual products contain only small amounts of these questionable chemicals, if they do at all. But there is growing concern that the ubiquity of such agents in cosmetics, household products, and certain plastics, may have a cumulative estrogenic effect. "We are not saying if you use a certain product with estrogenic ingredients it will cause breast cancer," Snedeker says. "But the science suggests your risk may be reduced if you avoid these ingredients." Here are a few ways to play it safe.

View the slideshow

]]> (GETTY IMAGES) <![CDATA[Breast Cancer During Pregnancy: What You Need to Know]]>

Australian runner, age 41, who died Monday from breast cancer that spread to her liver and brain. Sadly, about 1.3 million women will be diagnosed with breast cancer worldwide this year, and 465,000 women will die from it—McCann is just one of many. The twist on the story is that she discovered her breast lump while pregnant, and initially she thought it was nothing.

Breasts can do all sorts of strange things during pregnancy: They blow up, they get tender and lumpy, they squirt mysterious substances. For many women, pregnancy boobs are a downright strange experience. When I was pregnant, it was the first time I had a generous bosom, and I poked my boobs every now and then to see if they were real. What I didn't do was check them to make sure they were healthy.

Like McCann, I figured breast changes during pregnancy were normal. And they usually are. Breast cancer during pregnancy is quite rare. In the United States, just 1 in 3,000 pregnant women is diagnosed with breast cancer.

But you still need to be vigilant. That means doing routine breast self-exams and reporting anything suspicious to your doctor immediately. Breast tenderness is normal during pregnancy, but hard lumps are not. It's really important to take action quickly: The average reported delay in reporting a lump or other symptom detected during pregnancy is 5 to 15 months, a factor that may contribute to less promising outcomes.

Share Your Thoughts

Have you checked your breasts during pregnancy?