The latest studies around breast cancer: lowering risk, increasing survival.
BRCA carriers: double mastectomy increases survival chances No woman wants to undergo a double (contralateral) mastectomy (removal of both breasts) - particularly when one of them is apparently healthy.
But for women carrying dangerously mutated BRCA1 or BRCA2 genes, having a double mastectomy, rather than simply removing the breast with cancer, can cut the risk of dying from breast cancer by 48 percent, a recent long-term study shows. The Canadian Breast Cancer Foundation-funded study followed 390 women, all of whom were identified as defective BRCA1/BRCA2 carriers, for 20 years. Some chose to have a single mastectomy; some had an immediate double mastectomy, and some delayed removing the remaining breast for two to three years.
By the end of the study, the women who’d had both breasts removed (whether immediately, or several years later) experienced a 48 percent decrease in mortality compared to those who’d had a single mastectomy.
Researchers, translating those figures to a future model, wrote, "We predict that of 100 women treated with contralateral mastectomy, 87 will be alive at 20 years compared with 66 of 100 women treated with unilateral mastectomy."
If you’ve been identified as being at high risk for breast cancer due to BRCA gene mutations, this information is well worth keeping in mind.
Smoking identified as breast cancer risk predictor
Younger women who smoke are more likely than their non-smoking peers to be diagnosed with breast cancer, a study conducted by researchers at Seattle’s Fred Hutchinson Cancer Research Center reveals.
The study, released Feb. 13, indicates that smoking as little as 10 packs a year - either currently, or for 15 years sometime in the past - increases a woman’s breast cancer risk by 50 percent, compared to women who have never smoked, or who smoked for fewer than 15 years.
In addition, younger women who are currently smoking or who’ve smoked in the past, even if fewer than 15 years, showed an increased risk of 30 percent.
This risk increase was linked only to ER-positive breast cancers; smoking didn’t show any apparent association with triple-negative breast cancer. The study covered women ages 20-44, and supported results of previous studies showing a correlation between pre-menopausal smoking and breast cancer.
Folic acid: good for baby, not for Mom?
Folate, a B vitamin, is found in leafy green vegetables, egg yolks, lentils, and oranges. Folate is the natural form of folic acid, which is added as a government-mandated fortification to such foods as flour, pasta, and cornmeal products. About 30% to 40% of North Americans take folic acid supplements, usually as part of their daily multivitamin.
Folic acid and folate have been shown to cut the risk of babies being born with spina bifida, and thus moms-to-be are urged to consume more than the normal 400mcg RDA of folate - some consuming up to 4,000mcg daily, often on the advice of their obstetricians.
Now, researchers doing tests involving the mammary glands of lab rats reveal that high doses (as little as 1,000mcg-2,000mcg) of folic acid or folate may increase the growth of existing breast cancer cells - while at the same time possibly preventing development of cancer in healthy tissues.
What does this mean for you, a woman who’s pregnant - or considering pregnancy?
The benefit of folic acid to your baby probably still outweighs the possible risk that it may encourage any existing cancer cells in your breast to grow. But if you’re a mom-to-be who’s been diagnosed with breast cancer, you may want to speak to your doctor about these new findings.
Don’t wait too long to start chemotherapy
For breast cancer survivors being treated with surgery followed by chemotherapy, the time lapse between the two can be hugely variable. Perhaps it’s summertime, and half the hospital staff is on vacation. Maybe your surgery was tougher than normal, and your oncologist wants to give you a chance to fully recover before starting the next round of treatments.
Now, a study printed Jan. 27 in the online Journal of Clinical Oncology shows a link between the length of time a patient waits before stating chemo, and the patient’s risk of dying from breast cancer.
Women who started chemo more than 60 days after their surgery were 19% more likely, overall, to die of their cancer than women who started it within 30 days. The negative effect of waiting to start chemo increased for women with a higher stage or more aggressive type of cancer.
Your takeaway? Waiting longer than 30 days post-surgery to start chemo may lessen your chances of breast cancer survival - especially if your cancer has been identified as stage III; triple negative, or HER2+.
Azvolinsky, A. (2014, February 13). Smoking increases risk of ER-positive breast cancer._ Retrieved from https://www.cancernetwork.com/breast-cancer/smoking-increases-risk-er-positive-breast-cancer
Ellis, M. (2014, January 23). Folic acid linked to breast cancer growth in animal study. Retrieved from https://www.medicalnewstoday.com/articles/271601.php
Gagliato, D. (2014, January 27). Clinical impact of delaying initiation of adjuvant chemotherapy in patients with breast cancer. Retrieved from https://jco.ascopubs.org/content/early/2014/01/21/JCO.2013.49.7693.abstract?sid=9f587d4e-a7b8-4674-8d7b-4e630661fdc3
Kaplan, K. (2014, February 12). Breast cancer and BRCA mutations: Removing healthy breast saves lives. Retrieved from https://www.latimes.com/science/sciencenow/la-sci-sn-breast-cancer-brca-contralateral-mastectomy-20140211,0,7706141.story
Metcalfe, K. (2014, February 11). Contralateral mastectomy and survival after breast cancer in carriers of BRCA1 and BRCA2 mutations: retrospective analysis. Retrieved from https://www.bmj.com/content/348/bmj.g226
Searing, L. (2014, February 03). Delaying chemotherapy after breast cancer surgery increases mortality risk, study says. Retrieved from https://www.washingtonpost.com/national/health-science/delaying-chemotherapy-after-breast-cancer-surgery-increases-mortality-risk-study-says/2014/02/03/2face7b0-89bd-11e3-a5bd-844629433ba3_story.html
PJ Hamel is senior digital content editor and food writer at King Arthur Flour, and a James Beard award-winning author. A 16-year breast cancer survivor, her passion is helping women through this devastating disease. She manages a large and active online survivor support network based at her local hospital and shares her wisdom and experience with the greater community via HealthCentral.com.