Thursday, March 14, 2013

ALL MONEY RAISED AT OUR GALA GOES TO THE BEFORE FORTY INITIATIVE: Here's Why

BEFORE FORTY: NOW MORE THAN EVER.

Young women are presenting with breast cancer that has already advanced. Would that be happening if they were screened younger and able to treat their cancers earlier? At The No Surrender Breast Cancer Foundation, we believe that young women need to be screened before the age of forty utilizing all techniques, including ultrasound and breast MRI. Tumors must be found small, before they have spread. While there are no guarantees that finding a tumor early will prevent it from spreading, the greatest chance a woman has to fight it from spreading is treating it while it is still localized.

Our Before Forty Initiative is educating young women to become aware of their risks and to be armed with the knowledge they need to demand early screening. We will continue to fight until the "Guidelines" that prevent young women from obtaining life saving screening are changed.


Metastatic Breast Cancer Incidence is Rising 

Among Young Women

IMNG Medical Media, 2013 Feb 26, MA Moon

The incidence of breast cancer presenting with distant involvement has risen significantly over the past 30 years among young women, and this trend shows no signs of abating, according to a report in the Feb. 27 issue of JAMA.

In contrast, the rate of locoregional breast cancer has not increased in this age group, and the incidence of all stages of the disease have not shown any increasing trends among older women, said Dr. Rebecca H. Johnson of Seattle Children’s Hospital and the University of Washington, Seattle, and her associates.

This trajectory “predicts that an increasing number of young women in the United States will present with metastatic breast cancer in an age group that already has the worst prognosis, no recommended routine screening practice, the least health insurance, and the most potential years of life” lost, the investigators noted.

They used data from three of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registries to examine time trends in breast cancer between 1976 and 2009. They found a steady, and possibly accelerating, rise in the rate of women aged 25-39 years presenting with metastatic breast cancer, from 1.53/100,000 in 1976 to 2.90/100,000 in 2009.

“No other age group had statistically significant increases, either for distant, regional, or localized disease at diagnosis,” Dr. Johnson and her colleagues said (JAMA 2013;309:800-5).
In a different analysis of the data, the category of metastatic breast cancer as a proportion of all invasive breast cancer in this age group rose from 4.4% in the 1970s to 4.8% in the 1980s, 5.5% in the 1990s, and 7.2% in the early 2000s.

This trend was evident in women of all races/ethnicities, in women residing in both urban and nonurban regions, and in women with estrogen receptor–positive and estrogen receptor–negative tumors. “Non-Hispanic white and African-American individuals appear to have been more affected by the increase, as have women with the ER-positive subtype of the disease,” they said.
“The absolute increase of 1.37/100,000 over 34 years is relatively small, but the trend shows no evidence of abatement and may indicate increasing epidemiologic and clinical significance,” the researchers said.

These findings must be corroborated in other studies. If they are confirmed, they will be particularly concerning “because young age itself is an independent adverse prognostic factor for breast cancer.
“The most recent national 5-year survival data for distant disease for 25- to 39-year-old women is only 31% ... compared with a 5-year survival of 87% for women with locoregional breast cancer,” they added.
Dr. Johnson reported having served on a board for Critical Mass Young Adult Cancer Alliance and having served as a speaker at the Leukemia and Lymphoma Society AYA Survivorship Conference. One of her colleagues reported being a consultant and speaker for Sigma-Tau Pharmaceuticals; another researcher’s salary was funded by the Seattle Children’s Guild Association Teen Cancer Grant. No other disclosures were reported.

Your Heart: After Cancer

Important information about chest radiation and heart disease.

We have warned about this in the past, but a new study confirms earlier ones.

Bottom line: Keep an eye on your cholesterol, it elevates after chemotherapy; exercise at least 5 times a week; keep your weight down. Make sure you have your cholesterol checked when you go to your oncologist (since you probably see that doc more than any other one)


Background

Radiotherapy for breast cancer often involves some incidental exposure of the heart to ionizing radiation. The effect of this exposure on the subsequent risk of ischemic heart disease is uncertain.

 

Methods

We conducted a population-based case–control study of major coronary events (i.e., myocardial infarction, coronary revascularization, or death from ischemic heart disease) in 2168 women who underwent radiotherapy for breast cancer between 1958 and 2001 in Sweden and Denmark; the study included 963 women with major coronary events and 1205 controls. Individual patient information was obtained from hospital records. For each woman, the mean radiation doses to the whole heart and to the left anterior descending coronary artery were estimated from her radiotherapy chart.


Results: 

The overall average of the mean doses to the whole heart was 4.9 Gy (range, 0.03 to 27.72) Rates of major coronary events increased linearly with the mean dose to the heart by 7.4% per gray (95% confidence interval, 2.9 tp 14.5 with no apparent threshold.


The increase started withing the first 5 years after radiotherapy and continued into the third decade after radiotherapy. The proportional increase in the rate of major coronary events per gray was similar in women with and women without cardiac risk factors at the time of radiotherapy.

Conclusions

Exposure of the heart to ionizing radiation during radiotherapy for breast cancer increases the subsequent rate of ischemic heart disease. The increase is proportional to the mean dose to the heart, begins within a few years after exposure, and continues for at least 20 years. Women with preexisting cardiac risk factors have greater absolute increases in risk from radiotherapy than other women. (Funded by Cancer Research UK and others.)

Supported by funding to the Oxford University Clinical Trial Service Unit from Cancer Research UK, the British Heart Foundation, and the U.K. Medical Research Council and by grants from the European Commission (FI6R-012796), the U.K. Department of Health (RRX 108), the British Heart Foundation Centre for Research Excellence (CRE RE/08/004, to Dr. Cutter), and the Oxford National Institute for Health Research Biomedical Research Centre (to Dr. Rahimi).

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
No potential conflict of interest relevant to this article was reported.
We thank research nurses Ann-Sofie Andersson and Milka Krestelica in Sweden and Liselotte Jeppesen in Denmark for data abstraction; and Ulrich H. Koehler in Denmark for data management.

Source Information

From the Clinical Trial Service Unit (S.C.D., P.M., D.C., R.P., C.T.) and the George Centre for Healthcare Innovation (K.R.), University of Oxford, Oxford, and the Department of Medical Physics, Royal Surrey County Hospital and Surrey University, Guildford (A.N.) — both in the United Kingdom; the Department of Oncology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense (M.E.), the Oncology Department, Aalborg Hospital, Aalborg (D.B.), and the Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen (M.-B.J.) — all in Denmark; the Department of Medical Epidemiology and Biostatistics (A.M.B., P.H.) and the Division of Cardiovascular Epidemiology, Institute of Environmental Medicine and Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital (B.G.), Karolinska Institutet, and the Departments of Oncology (U.B.-G.) and Medical Physics (G.G.), Karolinska University Hospital — all in Stockholm; and the H. Lee Moffitt Cancer Center and Research Institute, University of Southern Florida, Tampa (C.C.).
Address reprint requests to Dr. Darby at the Clinical Trial Service Unit, Richard Doll Bldg., Old Road Campus, Oxford OX3 7LF, United Kingdom, or at .

Friday, March 8, 2013

March 8th, International Women's Day



The No Surrender Breast Cancer Foundation is proud to be a member of International Women's Day, as we salute survivors across the world with our
There & Back: A Celebration of Survival Gala.
Photo's to come.
We Salute YOU!