Computer-Aided Detection on Performance of Screening Mammography

Kevin Knopf, MD Health Guide
  • I’m going through old papers on my desk, packing up my office for my move to SF. It’s a bittersweet thing to move from Annapolis to SF, and I’m sad to say goodbye to my patients.

    Two articles I thought I should write about – the first, about Exercise Reducing the Chance of Breast Cancer Recurrence, appeared in the Journal of the American Medical Association on May 25, 2005. This was a well done survey of breast cancer survivors enrolled in the Nurses’ Health Study who were asked about how much exercise they did on a weekly basis and this was correlated with whether they had a recurrence or not.
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    It turned out that physical activity reduced the risk of death from breast cancer. Not a lot was needed – walking 3 to 5 hours a week at an average pace reduced the risk of recurrence by almost 50 percent in this study. So finally we have something proactive that can be done to decrease the chance of recurrence (in addition to adjuvant therapy). It didn’t seem that super-exercisers garnered any additional benefits so there is no need to become a triathalete (unless you want to of course!).

    Incorporating exercise in your life is not too hard. Every little bit adds up – even taking the stairs at work every day adds up when you do it twice a day, five days a week. Particularly if your office is on the 10th floor.

    The second thing that caught my eye is more recent – presentations at the American Association for Cancer Research meeting this spring. Kaempferol (hard to pronounce) was found to decrease the risk of ovarian cancer again in a survey from the Nurses Health Study. Kaempferol is found in broccoli, kale, and green and black tea.

    Dr. Fink from UNC/Chapel Hill studied women in Long Island, NY and found that women who consumed the most flavonoids were 46 percent less likely to develop breast cancer. Flavonoids are found in green and black tea, green salad, tomatoes, and apples. There are flavonoid supplements available but my bias has been to get these products from their natural source.

    I have started to drink green tea more often (the data on prostate cancer prevention also looks promising). It is a calm and peaceful experience, enjoyable at the end of the day to unwind. An ancient practice with many facets and features, and at times a meditative experience. Try it, you might like it.

    The idea of skipping the foods that have flavonoids and jumping to dietary supplements begs the question about dietary environment and cancer. It’s not just what we eat (or supplement) but what we DON’T eat that determines the risk of developing diseases like cancer and heart disease. Two societies that have very low incidence of both are the Japanese and the people living in the Southern Mediterranean. In Japan, the risk of breast cancer (and colon cancer and prostate cancer) is among the lowest in the world. However, when Japanese people move to America and eat the typical American diet, their risk goes up to ours within one or two generations, arguing against a strong genetic component.

  • What is the Japanese diet? My wife lived in Kyoto for two years as an English teacher after graduating college. She has said that red meat is eaten very rarely there; and obviously fresh seafood (sushi) is a staple of the diet. Portions are smaller in Japan, as well. And apparently Japanese incorporate exercise into their daily routine – remember the TV shots of office workers starting the day with calisthenics?
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    The Southern Mediterannean diet (detailed on many Web sites and in many fine cookbooks) also has sparse amounts of red meats, ample servings of fresh fruits and vegetables, seafood, grains and legumes, and very low amounts of saturated fats. Olive oil is used when a fat is needed, and butter is not. And meals are a very social occasion, eaten slowly over time, in reasonably sized portions.

    Should one exercise and change diet after a diagnosis of breast cancer? People find dietary changes to be more difficult, particularly after a lifetime of eating a certain way. Most anyone can enjoy exercise of 3 to 5 hours walking a week without too much trouble.

    These changes are not a guarantee of cure but it certainly can’t hurt and very likely will help your overall health. It is something that you can do proactively. It makes you feel good anyway – exercise has been shown to improve sleep, reduce depression, and increase ones state of well being. Also when we consider that most patients with early stage breast cancer are cured after adjuvant therapy then it’s time to step back and make sure our general health is good. Heart disease is still the #1 cause of mortality in women in America, and diet and exercise definitely reduce the chance of that happening. So I think watching what we eat and exercise make perfect sense.
Published On: September 05, 2006