Breast exam guidelines now call for less testing “Several patient advocacy groups and many breast cancer experts welcomed the new guidelines, saying they represent a growing recognition that more testing, exams and treatment are not always beneficial and, in fact, can harm patients. Mammograms produce false-positive results in about 10 percent of cases, causing anxiety and often prompting women to undergo unnecessary follow-up tests, sometimes-disfiguring biopsies and unneeded treatment, including surgery, radiation and chemotherapy.”

New advice: Wait until 50 for mammograms “Most women should wait until age 50 to get mammograms and then have one every two years, a government task force said Monday in a major reversal that conflicts with the American Cancer Society's long-standing recommendation of annual screening starting at 40. Also, the task force said breast self-exams do no good and women shouldn't be taught to do them.”

Task Force Doctor Stands by Mammogram Advice

The role of MRI in breast cancer screening. (J Natl Compr Canc Netw. 2009) “The NCCN now recommends considering breast MRI as an adjunct to annual mammography and clinical breast examination for women who have a BRCA1 or -2 mutation or who have a first-degree relative who has a BRCA1 or -2 mutation but who have not undergone genetic testing themselves; those who are determined to have a lifetime risk greater than 20% based on models that are highly dependent on family history; and those with a history of lobular carcinoma in situ. MRI is also recommended for patients who underwent radiation treatment to the chest between 10 and 30 years of age, and in those who carry or have a first-degree relative who carries a genetic mutation in the TP53 or PTEN genes (Li-Fraumeni, Cowden, and Bannahyan-Riley-Ruvalcaba syndromes). MRI is specifically not recommended for screening women at average risk for breast cancer.”

1 in 4 breast cancers 'not threatening' “They concluded that screening was picking up many slow-growing cancers that would otherwise not have been detected. While this can be seen as a helpful "early diagnosis", it also falls into the category of "over-diagnosis", says Morrell. "Some of those early-diagnosed cases would not manifest clinically during that woman's lifetime," he says. Morrell says 23% to 29% of all invasive breast cancers detected in NSW are "over-diagnosed". … Roder agrees: "We need to identify a group of tumours that we dare to leave and not treat," he says. In the meantime, he says doctors may be increasingly likely to remove abnormal cells for fear of being sued. Roder says there should be more research on how best to communicate to women the uncertainties involved with screening mammography to ensure they are properly informed. "We don't want [women] to forgo the breast cancer mortality reduction by scaring them," he says. "But we don't want them to go into screening not aware of potential negatives."”

Chronic Pain May Persist for Years After Breast Cancer Surgery

Even With Very Small Breast Tumors, Studies Find HER2 Status Matters “Two retrospective studies have found that women with HER2-positive breast tumors (that is, tumors that produce too much of the HER2 protein) that are 1 centimeter or smaller had a higher risk of their disease returning within 5 years than women with similarly small HER2-negative tumors. The findings, published online November 2 in the Journal of Clinical Oncology, may shed some light on an area of clinical uncertainty: Whether women with small, HER2-positive tumors should receive post-surgical, or adjuvant, treatment with the targeted agent trastuzumab (Herceptin).”

Circulating Carotenoids, Mammographic Density, and Subsequent Risk of Breast Cancer. (Cancer Res. 2009) “Overall, circulating total carotenoids were inversely associated with breast cancer risk (P trend = 0.01). Among women in the highest tertile of mammographic density, total carotenoids were associated with a 50% reduction in breast cancer risk (odds ratio, 0.5; 95% confidence interval, 0.3-0.8). In contrast, there was no inverse association between carotenoids and breast cancer risk among women with low mammographic density. Similarly, among women in the highest tertile of mammographic density, high levels of circulating alpha-carotene, beta-cryptoxanthin, lycopene, and lutein/zeaxanthin were associated with a significant 40% to 50% reduction in breast cancer risk (P trend < 0.05). Our results suggest that plasma levels of carotenoids may play a role in reducing breast cancer risk, particularly among women with high mammographic density.”