Research Roundup: Progress Towards a Breast Cancer Cure
This month’s top news stories from the world of breast cancer research – and their potential impact on you.
Does taking birth control pills increase breast cancer risk?
A new study says yes. But hold on; the news isn’t as distressing as it might seem.
An article printed early this month in the online journal Cancer Research details a 19-year study of women aged 20-49 years old – the prime demographic for birth control. Results of the study indicate that women taking certain types of high-estrogen pills may triple their risk of breast cancer during their child-bearing years; and women taking a moderate-estrogen pill potentially double their risk.
So, why is this news less frightening than it seems?
First, only about ½ of 1% of women take a high-estrogen pill; it’s prescribed typically in cases where other underlying conditions require higher doses of estrogen. Examples of this type of pill include Continuin, Femulen, and Ortho 75.
Second, the study showed that the increased risk disappeared within a year of stopping the pill. So if you’re an older woman, there’s no need to go back and check what type of birth control pills you used years ago.
And finally, breast cancer risk for women in the 20-49-year-old age group is already minimal – about 1.5% at age 20, and 2.38% at age 50. (Khazan, 2014) Even if that risk is doubled or tripled, it’s still very low.
Bottom line: If you take birth control pills, ask your doctor if they’re considered high-estrogen; and if they are, ask whether a lower-estrogen pill would be suitable for you.
And if you’re having to make a decision between responsible pregnancy prevention, and breast cancer risk – understand that your risk of an unwanted pregnancy is probably much greater than your cancer risk.
New drug for HER2 survivors
A new drug, neratinib, has shown promise in women with stage II-stage IIIc, node-positive, HER2+ breast cancer.
Women with HER2+ breast cancer typically receive the drug Herceptin, a targeted therapy that destroys cancerous cells, while leaving healthy cells alone. A study released in early August shows that pairing Herceptin with a newer drug, neratinib, improved disease-free survival (no recurrence) by 33%, compared to being treated with Herceptin alone.
Bottom line: Neratinib isn’t available yet; but its manufacturer, Puma Biotechnology, expects to submit a new drug application to the FDA in 2015 – first step in the approval process.
BRCA1, BRCA2… and PALB2
Genetic mutations can increase a woman’s risk of breast cancer by up to 70%. The most familiar of these mutations involve the BRCA1 and BRCA2 genes; and women at risk often undergo genetic testing, to identify whether these specific genes are damaged, and thus dangerous.
Now, an additional gene – PALB2 – has been added to the mix. And it appears to raise a woman’s lifetime risk (to age 70) of breast cancer to 35% (compared to just 12% in the general population). In addition, for women with the PALB2 mutation and two or more family members diagnosed with breast cancer, the risk rises to 58%.
The study, published early this month in the New England Journal of Medicine, also revealed that women with this newly identified mutation are slightly more likely to be diagnosed with triple negative breast cancer, an aggressive and harder to treat form of the disease.
Bottom line: If you have a family history of breast cancer that warrants genetic testing, ask to be tested for PALB2, as well as for the BRCA genes. And if you’ve already tested negative for BRCA1 and BRCA2, you might want to consider the PALB2 test – to further define your risk.
Aspirin lowers breast cancer risk for heavier women
A study published Aug. 15 in the online journal Cancer Research indicates that regular use of aspirin lowers breast cancer risk by about 50% in women who are classified as overweight or obese (i.e., whose BMI – body mass index – is over 30).
It’s believed this positive effect is the result of aspirin’s ability to disrupt a metabolic process that manufactures estrogen. Estrogen production is directly related to fat tissue – the heavier you are, the more circulating estrogen your body contains. And estrogen is critical for the growth of hormone-positive breast cancer – the type most survivors have.
Overweight women are more likely to be diagnosed with breast cancer, and more likely for it to recur, due to their higher levels of circulating estrogen. Thus, aspirin’s ability to lower circulating estrogen has a greater effect on overweight women than on those of normal weight.
Bottom line: If your BMI is over 30, talk to your doctor about taking low-dose aspirin to help prevent breast cancer. In the end, aspirin’s risk may outweigh its benefits if you have other specific health issues; but it’s worth a chat.
Antoniou, A. (2014, August 7). Breast-Cancer Risk in Families with Mutations in PALB2. New England Journal of Medicine. Retrieved August 7, 2014.
Elizabeth, B. (2014, May 24). Recent Oral Contraceptive Use by Formulation and Breast Cancer Risk among Women 20 to 49 Years of Age. Retrieved August 2, 2014, from http://cancerres.aacrjournals.org/content/74/15/4078.short?rss=1
Inman, S. (2014, July 23). Extended Adjuvant Neratinib Improves DFS in Phase III Breast Cancer Study. Retrieved August 3, 2014, from http://www.onclive.com/web-exclusives/Extended-Adjuvant-Neratinib-Improves-DFS-in-Phase-III-Breast-Cancer-Study
Khazan, O. (2014, August 1). The Link Between Birth Control Pills and Breast Cancer. The Atlantic. Retrieved August 2, 2014, from http://www.theatlantic.com/health/archive/2014/08/the-link-between-birth-control-pills-and-breast-cancer/375448/
Park, A. (2014, August 14). How Aspirin Can Prevent Breast Cancer. Time Magazine. Retrieved August 15, 2014.