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Mom With Breast Cancer Has Healthy Baby After Chemo

Nov. 4, 2019 — Jade Devis was just a few months pregnant when she learned she had a fast-growing type of breast cancer. Her OB-GYN™s outlook was grim, she says: œMy baby was too young to save, and it was life-and-death for me.”

œWithin an hour of leaving the office and her telling me that, I was crying in the car, parked somewhere,” Devis says.

But today, after getting a lumpectomy and months of chemotherapy during her pregnancy, this 36-year-old bookkeeper in California is a happy first-time mom to Bradley, a 3-month-old boy. œWe™re doing really good right now,” she says.

photo of mom and newborn

She™s still getting chemo, with her final infusion scheduled for the end of November. Then she™ll get radiation therapy for a month. These treatments, along with surgery, are the main therapies for triple-negative breast cancer (TNBC), the disease Devis is battling.

œHoping for the best “ [a] cure!!” says her oncologist, Gayathri Nagaraj, MD, of Loma Linda University Cancer Center in California.

TNBC is an aggressive type of breast cancer that™s more common among women under 40, like Devis. It™s called triple negative because it isn™t fueled by the hormones estrogen or progesterone, or by a protein called HER2. That means hormone therapy and HER2-targeted drugs that treat other types of breast cancer don™t work for TNBC, which leaves those who have it with fewer treatment options.

Devis says she suspected something was wrong before her doctor diagnosed her with cancer. In January, just weeks into her pregnancy, she noticed a hard, painful lump above her left breast. The area felt like it was burning. She says her doctor at the time told her it was probably a clogged milk duct. But Devis was skeptical, and she kept voicing her concerns until she got a biopsy. It showed that she had cancer.

œI don™t think anybody understood my symptoms,” she says.

Triple-negative breast cancer can have the same signs as other types of breast cancer, and a new lump or mass is the most common red flag. Other symptoms of breast cancer are breast swelling, dimpling, or a nipple turning inward. Since there are a lot of warning signs, it™s important to have your doctor check any changes you notice.

After Devis got surgery to remove her cancerous lump and 10 nearby lymph nodes — operations that are generally safe for pregnant women — she went to the Loma Linda University Cancer Center in May to get the first of several rounds of chemotherapy.

œI was very upset because I thought I™d gone through so much already with the surgery, and my body was already bruised and injured and tired, and I was 6 months pregnant,” she says.

While chemotherapy isn™t safe for an unborn baby during the first 3 months of pregnancy, certain chemo drugs seem safe during months 4 through 9, the American Cancer Society says. Research shows that they don™t raise the chances of birth defects, stillbirths, or health problems soon after birth, though they could make an early delivery more likely. Also, researchers aren™t sure if chemo drugs could affect a baby™s health later in life.

In Devis™s case, her oncologist, Nagaraj, took safety measures to protect her and her baby. Nagaraj and her team made sure all the medications they gave Devis — including the chemo and meds to treat its side effects — were safe for her. They also carefully planned when they™d start and stop her chemo so they could pause it a safe number of weeks before Devis was scheduled to be induced. In general, the American Cancer Society says that getting chemo after 35 weeks of pregnancy or within 3 weeks of delivery is risky because it can lead to complications like bleeding or an infection during childbirth.

Devis also had a whole team caring for her. Nagaraj says maternal-fetal medicine specialists kept close tabs on the baby™s health. Pharmacists double-checked the safety of all her medicines. A dietitian gave her nutrition advice. Social workers provided psychological support through counseling. Nurses helped coordinate her care.

photo of woman receiving chemo

Even though the baby™s father wasn™t there for Devis, she got support from her mother and sisters, who did things like cook meals and go to the market for her. That was important to Devis, œbecause at the time I was hiding,” she says. She™d lost her hair during chemo and œdidn™t want to walk around, go out pregnant and bald — a lot of insecurities there.”

Uncertainty plagued her during treatment. Would the baby be OK? Would the chemo harm him? œI didn™t have a nursery yet set up because I wasn™t sure what the outcome was going to be,” she says. œAnd I was refusing baby gifts from everybody because I didn™t want to come home and have to return all these baby gifts in the worst-case scenario.”

œThe whole time I felt like I was being punished. I would sit in my room like I was in a jail cell, just waiting for the verdict,” she says.

Her worst fears didn™t come true. In late July, she gave birth to a healthy son. œWhen the baby was born, and I heard crying, and the NICU cleared him, it was like the verdict was in,” she says. œIt™s like that ˜we made it™ feeling, you know? ˜We™re here, we did it.™”

photo of baby birth announcement

Sources

SOURCES:

Jade Devis, Rancho Cucamonga, CA.

Gayathri Nagaraj, MD, oncologist, Loma Linda University Cancer Center, Loma Linda, CA.

CDC: œTriple-Negative Breast Cancer.”

American Cancer Society: œTreating Breast Cancer During Pregnancy,” œTreatment of Triple-negative Breast Cancer,” œTriple-negative Breast Cancer.”

Breastcancer.org: œTriple-Negative Breast Cancer.”

Up to Date: œER/PR negative, HER2-negative (triple-negative) breast cancer.”

National Breast Cancer Foundation: œTriple Negative Breast Cancer.”

Johns Hopkins Medicine: œTriple Negative Breast Cancer.”

National Cancer Institute: œNCI Dictionary of Cancer Terms.”

© 2019 WebMD, LLC. All rights reserved.

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Don’t Delay Very Early-Stage Breast Cancer Surgery

By Robert Preidt
HealthDay Reporter

THURSDAY, Oct. 24, 2019 (HealthDay News) — Delaying surgery for a noninvasive breast cancer can have dire consequences, a new study shows.

Longer delays in surgery for ductal carcinoma in situ (DCIS) breast cancer lead to a higher risk of invasive ductal carcinoma and a slightly lower survival rate, researchers found.

“For each month of delay, there was well under a 1% difference in survival. But for each month of delay, there was an approximate 1% increase in the finding of invasive cancer,” said study author Dr. Richard Bleicher, a professor of surgical oncology at Fox Chase Cancer Center, in Philadelphia.

“The survival difference with a delay is small,” Bleicher noted in a center news release. “While it’s not an emergency to get treated immediately, delays do have an effect and long delays should be avoided.”

DCIS occurs when abnormal cells form in the milk duct of the breast and is the earliest stage of breast cancer. When cancerous cells spread beyond the milk duct, it becomes invasive ductal carcinoma.

Standard treatment for DCIS is surgery and radiotherapy, along with endocrine therapy. But research suggests that some DCIS may never progress to invasive disease, and clinical trials are being conducted to determine whether DCIS can be observed, rather than surgically removed.

This study “suggests that delays in operative management of DCIS are associated with invasion and slightly worse short-term outcomes,” Bleicher said. “Since observation represents infinite delay, it suggests that observation should not yet be pursued outside of a clinical trial in patients who will tolerate excision.”

The study included more than 140,600 U.S. women (123,947 with DCIS, 16,668 with invasive ductal carcinoma). They were diagnosed between 2004 and 2014.

Survival was compared with five time intervals in delays to have surgery: less than 30 days, 31-60 days, 61-90 days, 91-120 days, or 121-365 days.

Overall survival was 95.8%, with a median time from diagnosis to surgery of 38 days. However, each increase in diagnosis-to-surgery interval was associated with a 7.4% increase in the risk of death.

The study was published Oct. 21 in the Annals of Surgical Oncology.

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Sources

SOURCE: Fox Chase Cancer Center, news release, Oct. 21, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Many Women Are Sharing Breast Milk, and That Has Health Experts Worried

FRIDAY, Oct. 25, 2019 — “Informal” sharing of breast milk may be more common than thought, with too many parents mistakenly thinking it’s risk-free, new research suggests.

In a pair of studies, researchers delved into the issue of donor breast milk, and how parents are choosing to get it. In one, a survey of 655 parents who used donor milk found that only about 36% got it from official “milk banks” that screen and pasteurize donations.

Most said they’d turned to “informal” sharing, where parents get breast milk either from a nursing mom they know or via the internet. It’s a practice discouraged by the American Academy of Pediatrics (AAP) and U.S. Food and Drug Administration due to safety concerns.

There is a risk of dilution, or contamination with viruses or bacteria, particularly with donor milk obtained online, explained Dr. Lori Feldman-Winter, who chairs the AAP’s Section on Breastfeeding.

Certain viruses, such as HIV, can also be transmitted through breast milk.

“If you get breast milk from someone you know, it’s probably a low-risk situation,” said Feldman-Winter.

However, she added, that doesn’t mean there’s no risk.

Study author Dr. Ruth Milanaik, of Cohen Children’s Medical Center/Northwell Health in New York, made the same point. Even when breast milk is given for free, with the best of intentions, she said there could be accidental contamination or temperature instability that causes the milk to spoil.

“The only recommended option for obtaining donor breast milk is through a milk bank,” said Milanaik.

That is easier said than done, however.

Right now, there are 28 nonprofit milk banks across the United States that are part of the Human Milk Banking Association of North America. And most of that milk, Feldman-Winter explained, goes to hospitals for preemies whose mothers cannot yet express their own breast milk.

That means little left over for moms of full-term infants who cannot breastfeed, or for adoptive or male gay parents. And even when it is available, there is a steep cost — around $ 4 an ounce, Milanaik said.

With informal sharing, parents may get breast milk for free — either from a friend or by finding a local donor with the help of social networking. There are also websites that allow women to sell their breast milk — it’s not a cheap option, but the prices are typically lower than those of a milk bank, Milanaik noted.

Breast milk is considered the best nutrition for infants. However, it’s not clear whether, for most babies, donor breast milk is a healthier choice than formula.

There’s proof of the benefits to preemies in the hospital, Feldman-Winter said. But when it comes to healthy, full-term infants, “the science just isn’t there yet,” she said.

So if breastfeeding or banked milk are not options, the AAP recommends formula-feeding.

The new findings will be presented by Milanaik and co-author and Cohen researcher Nikita Sood on Saturday at the AAP’s annual meeting in New Orleans, and are based on two related studies. Such research is considered preliminary until published in a peer-reviewed journal.

In the first study, a survey found that of those who chose informal sharing, 56% said they had no safety concerns, and 78% did not ask for medical information from donors because they “trusted them.” More than half said they opted for informal sharing over milk banks due to costs.

In the other study, the researchers looked at 122 parenting-blog posts on donor breast milk. Most, they found, focused on informal sharing rather than milk banks, and most “lacked important discussion of safety concerns.”

It’s not clear how many parents are choosing informal milk sharing. But the new findings suggest it may be more common than pediatricians realize, Feldman-Winter said.

“Certainly one of the take-home messages here is that doctors should talk about this,” she said. “We’re missing an opportunity, as pediatricians, to open up a dialogue and help clarify misperceptions.”

As for nursing moms who have extra milk they want to donate, Milanaik urged them to give to a milk bank.

More information

The Human Milk Banking Association of North America has more on breast milk donation.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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Don’t Delay Surgery for Very Early-Stage Breast Cancer, Study Suggests

THURSDAY, Oct. 24, 2019 — Delaying surgery for a noninvasive breast cancer can have dire consequences, a new study shows.

Longer delays in surgery for ductal carcinoma in situ (DCIS) breast cancer lead to a higher risk of invasive ductal carcinoma and a slightly lower survival rate, researchers found.

“For each month of delay, there was well under a 1% difference in survival. But for each month of delay, there was an approximate 1% increase in the finding of invasive cancer,” said study author Dr. Richard Bleicher, a professor of surgical oncology at Fox Chase Cancer Center, in Philadelphia.

“The survival difference with a delay is small,” Bleicher noted in a center news release. “While it’s not an emergency to get treated immediately, delays do have an effect and long delays should be avoided.”

DCIS occurs when abnormal cells form in the milk duct of the breast and is the earliest stage of breast cancer. When cancerous cells spread beyond the milk duct, it becomes invasive ductal carcinoma.

Standard treatment for DCIS is surgery and radiotherapy, along with endocrine therapy. But research suggests that some DCIS may never progress to invasive disease, and clinical trials are being conducted to determine whether DCIS can be observed, rather than surgically removed.

This study “suggests that delays in operative management of DCIS are associated with invasion and slightly worse short-term outcomes,” Bleicher said. “Since observation represents infinite delay, it suggests that observation should not yet be pursued outside of a clinical trial in patients who will tolerate excision.”

The study included more than 140,600 U.S. women (123,947 with DCIS, 16,668 with invasive ductal carcinoma). They were diagnosed between 2004 and 2014.

Survival was compared with five time intervals in delays to have surgery: less than 30 days, 31-60 days, 61-90 days, 91-120 days, or 121-365 days.

Overall survival was 95.8%, with a median time from diagnosis to surgery of 38 days. However, each increase in diagnosis-to-surgery interval was associated with a 7.4% increase in the risk of death.

The study was published Oct. 21 in the Annals of Surgical Oncology.

More information

The American Cancer Society has more on treatment of DCIS.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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Beyonce’s Dad Puts Spotlight on Male Breast Cancer

TUESDAY, Oct. 15, 2019 — Beyonce Knowles’ father first suspected something was wrong when he noticed a dot of blood that kept appearing on his shirts and bedsheets.

“Imagine a piece of white paper and you took a red pen and just put a dot,” Mathew Knowles told the New York Times. “That’s what it looked like in my T-shirt.”

Knowles scheduled a mammogram in July after he squeezed a nipple and a bit of bloody discharge came out. The diagnosis: stage 1A breast cancer.

Knowles is one of about 2,670 cases of breast cancer that will occur among men in 2019, according to the American Cancer Society. About 500 men die from breast cancer every year.

“Most men who get breast cancer usually present with a mass behind the nipple,” said Dr. Hank Schmidt, an associate professor of surgery with the Icahn School of Medicine at Mount Sinai.

It’s an extremely rare form of cancer in men, and male breast cancer accounts for just 1% of all breast cancer cases, said Dr. Siddhartha Yadav, a hematology-oncology fellow with the Mayo Clinic in Rochester, Minn.

Men just don’t have as much breast tissue in which a tumor could grow, Yadav said. They also don’t have high levels of the female hormone estrogen, which can fuel breast cancer.

“Men just don’t have that kind of exposure,” Yadav said.

About 9 out of 10 male patients with breast cancer have estrogen receptor-positive tumors, making their cancers more sensitive to the smaller levels of estrogen typically found in men, according to a new review Yadav and colleagues conducted of nearly 11,000 men with breast cancer.

Because of this, treatment options for men are largely constrained to those developed for women, Yadav and Schmidt said. Not enough male patients are available to conduct solid clinical trials.

Men with breast cancer typically undergo either a lumpectomy combined with radiation treatment or a full mastectomy, the experts said.

Knowles chose a mastectomy, which he underwent the same month as his diagnosis. Lymph nodes removed at the same time showed that the cancer hadn’t spread elsewhere in his body. He plans to undergo a second mastectomy early next year to reduce his future risk.

That is one major difference between male and female treatment for breast cancer, according to the review by Yadav and colleagues published Oct. 7 in the journal Cancer.

More than 7 out of 10 men choose to undergo a full mastectomy for their breast cancer, while in women about two-thirds will choose a breast-sparing lumpectomy, Yadav said.

Even though male breast cancer is rare, most of these cancers appear to be caught at an early stage, Yadav’s review concluded.

About 38% of men are diagnosed at stage 1, while about 43% are diagnosed at stage 2, the researchers found.

This might be related to the fact that men just don’t have a lot of breast tissue, said Schmidt, who wasn’t involved with the review.

“If there is a tumor, people may be more likely to notice it,” Schmidt explained.

About 44% of male breast cancer patients receive chemotherapy, and 62% with estrogen receptor-positive tumors get anti-estrogen therapy, according to the study authors.

“Roughly one-third of men with ER-positive tumors aren’t getting anti-estrogen therapy,” Yadav said. “That is an area for improvement.”

Screening all men for breast cancer simply wouldn’t be effective, given the disease’s rarity, Yadav said.

But since genetics appear to play a large role in male breast cancer, it might make sense to screen men who carry BRCA1 or BRCA2 mutations or have a family history of breast cancer, Yadav said.

“We could potentially screen that population,” Yadav said. “That would be a very limited number of people.”

Knowles learned that he has a BRCA2 mutation, which is more common among male breast cancer patients. He has urged his daughters to undergo genetic testing as well.

Although it’s pretty well-known that men can develop breast cancer, there’s a stigma that remains, Yadav said.

Yadav related the story of a recent male patient who went in for a mammogram and became embarrassed that he was surrounded by women there for the same screening.

“He felt so uncomfortable that he asked the people at the mammogram place if he could come in after the office closed,” Yadav said.

Removing this stigma could go a long way toward men getting the treatment they need, Yadav said.

More information

The American Cancer Society has more about breast cancer in men.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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AHA News: Scientists Find Biological Link Between High Blood Pressure and Breast Cancer

FRIDAY, Sept. 6, 2019 (American Heart Association News) — Researchers have identified a protein that may be a risk factor for both high blood pressure and breast cancer.

Previous studies have found women with high blood pressure have about a 15% increased risk of developing breast cancer compared to women with normal blood pressure. High levels of the protein GRK4 (G-protein coupled receptor kinase 4) have been shown to cause high blood pressure, also called hypertension. The new study, presented Friday at the American Heart Association’s Hypertension Scientific Sessions in New Orleans, showed the GRK4 protein was present in breast cancer cells but not in normal breast cells.

“Cancer and hypertension share common risk factors,” said Dr. Wei Yue, the study’s lead investigator and a research scientist at the University of Virginia School of Medicine in Charlottesville. “Our laboratory’s previous research on GRK4 found that it is regulated by an oncogene called c-Myc, which plays a role in many cancers, including breast cancer. This led us to hypothesize that GRK4 could be a link.”

Nearly half of all adults with high blood pressure are women. After age 65, women are more likely than men to have high blood pressure. Pregnancy, birth control medications and menopause can all increase the risk of developing high blood pressure. If left untreated, it can cause health problems such as heart disease, stroke and vision loss.

In women, breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death.

“While previous studies have shown that breast cancer risk is increased in hypertensive women, this study adds to the current knowledge by providing the molecular mechanisms that underlie this association,” said Dr. Vesna D. Garovic, chair of the division of Nephrology and Hypertension Research at the Mayo Clinic in Rochester, Minnesota.

Garovic, who was not involved in the new research, said studies like this one that identify the molecular mechanisms and signaling pathways that cause a disease to develop can provide new insights into treatment options.

Not all breast tumors are the same. The study looked for GRK4 in two specific types of breast cancer, known as hormone-sensitive and triple-negative.

“Our conclusion may not be applicable to other types of breast cancer,” said Yue.

Garovic noted GRK4 genetic variations may not be the same in all racial groups. Studies that look for GRK4 in women with breast cancer across racial and ethnic groups, she said, may provide insights into previously reported race-based differences in tumor type, treatment response and outcomes.

GRK4 is one of seven GRK proteins. Other studies have looked for GRK2 and GRK5 in different types of cancers, but Yue said their group is the first to look for a link between GRK4, high blood pressure and breast cancer. “No one else is working on this,” she said.

Yue said this molecule is unique because it’s not normally expressed – meaning made into a protein by a gene – in breast tissues, making it a potential target for drug development.

“A drug that targeted GRK4 could potentially be used to treat the patients with hypertension and breast cancer.”

© 2019 HealthDay. All rights reserved.

Posted: September 2019

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Finances Affect Women’s Choice of Breast Cancer Treatment: Study

FRIDAY, Aug. 2, 2019 — Cost often influences breast cancer patients’ decisions about surgery, even if they have good incomes and insurance, a new study finds.

“Eligible women with early-stage breast cancer often have choices for surgical treatments that are equally effective and result in excellent cancer outcomes,” said lead study author Dr. Rachel Greenup. She is a surgeon at Duke Cancer Institute in Durham, N.C.

“Surgeons often discuss the emotional and physical side effects of treatment, yet we rarely discuss the costs,” Greenup noted in an institute news release.

For the study, the researchers surveyed more than 600 women with stage 0 to stage 3 breast cancer. Of those, 90% were white; 70% had private health insurance; 25% had Medicare; 78% were college educated; and 56% had household incomes above $ 74,000 a year.

Even though the women were more affluent than the U.S. average, 43% said cost was a consideration when deciding on treatment, and nearly one-third said it played into the type of surgery they chose.

Among women with annual household incomes below $ 45,000, treatment cost was more important than keeping their breast or its appearance, the study findings showed.

Also, 35% said their treatment caused a financial burden, and 78% never discussed costs with their cancer care team. Even among top earners, 65% said they were financially unprepared for the cost of their cancer treatment.

Of the types of breast cancer surgeries — lumpectomy with radiation; mastectomy; and double mastectomy with or without breast reconstruction — double mastectomy was associated with higher patient debt and financial hardship.

The findings were published online July 29 in the Journal of Oncology Practice.

“Women are weighing many factors when deciding what type of surgery is best for them, including their personal desire for breast preservation, options for reconstruction, recovery time, sexuality, appearance, demands for future surveillance, and their own peace of mind,” Greenup said.

“While other side effects of surgical choice are routinely discussed with their physicians, the potential for financial harm is not explicitly addressed, including both the out-of-pocket payments and lost productivity for patients and their families,” she added. “Our study suggests this should change.”

More information

The American Cancer Society has more on breast cancer surgery.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

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Textured Breast Implants Recalled for Cancer Risk

July 24, 2019 — Pharmaceutical giant Allergan has ordered the recall of all of its BIOCELL textured breast implants after the FDA flagged a series of reports that the implants were causing cancer in hundreds of patients worldwide.

The FDA says the textured surface, unique to Allergan’s implants, are tied to 481 cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a type of non-Hodgkin’s lymphoma. There have been 573 cases of BIA-ALCL worldwide, including 33 deaths. In 13 cases where a patient died and the manufacturer of the breast implant was known, 12 of them involved an Allergan breast implant.

Most cases of this particular cancer, which attacks the immune system, are not diagnosed for years after the original implantation.

Daniel Maman, MD, a board-certified plastic surgeon with 740 Park Plastic Surgery in New York City, says it remains unclear why these types of implants could cause cancer.

“But these rare cases are showing that the texture of the shell surrounding the implant can cause this lymphoma response in capsule tissue that surrounds the breast implant,” he says.

The FDA says anyone with an Allergan BIOCELL implant should not have it removed, unless symptoms are present. Those symptoms include persistent swelling or pain near the implant. Patients found to have BIA-ALCL would have the implants removed, along with surrounding scar tissue.

The FDA says in most cases, the cancer is limited to the scar tissue and fluid near the implant, but it can spread through the body. While the diagnosis is serious and can lead to death, the risk is considered to be low, the agency says. Some patients may need chemotherapy and/or radiation therapy.

The FDA says the risk of getting BIA-ALCL from an Allergan textured implant is roughly 6 times the risk compared to similar products from other manufacturers. Textured implants represent 10% of all breast implants sold in the United States.

“The popularity of the different types of implants is heavily dependent on the surgeon and what they prefer using, but there are pros and cons of each type of implant,” Maman says. “I personally have not put in a textured implant in over 5 years.”

The recalled products are:

Allergan Natrelle Saline-Filled Breast Implants (formerly McGhan RTV Saline-Filled Mammary Implant) approved under P990074. The following are the textured styles:

  • Style 163: BIOCELL Textured Shaped Full Height, Full Projection Saline Breast Implants
  • Style 168: BIOCELL Textured Round Moderate Profile Saline Breast Implants, also referred to as 168MP (168 Moderate Profile)
  • Style 363: BIOCELL Textured Shaped Moderate Height, Full Projection Saline Breast Implants, Allergan catalog includes 363LF, or 363 Low Height Full Projection
  • Style 468: BIOCELL Textured Shaped Full Height Moderate Projection Saline Breast Implants

Allergan Natrelle Silicone-Filled Textured Breast Implants (formerly Inamed Silicone-Filled Breast Implants) approved under P020056. The following are the textured styles:

  • Style 110: BIOCELL Textured Round Moderate Projection Gel Filled Breast Implants
  • Style 115: BIOCELL Textured Round Midrange Projection Gel Filled Breast Implants
  • Style 120: BIOCELL Textured Round High Projection Gel Filled Breast Implants
  • Style TRL: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRLP: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRM: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRF: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TRX: Natrelle Inspira BIOCELL Textured Responsive Silicone-Filled Breast Implants
  • Style TCL: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCLP: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCM: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCF: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TCX: Natrelle Inspira BIOCELL Textured Cohesive Silicone-Filled Breast Implants
  • Style TSL: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSLP: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSM: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSF: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants
  • Style TSX: Natrelle BIOCELL Textured Soft Touch Silicone-Filled Breast Implants

Natrelle 410 Highly Cohesive Anatomically Shaped Silicone Filled Breast Implants approved under P040046. The following are the textured styles:

  • Style 410FM
  • Style 410FF
  • Style 410MM
  • Style 410 MF
  • Style 410 FL
  • Style 410 ML
  • Style 410 LL
  • Style 410 LM
  • Style 410 LF
  • Style 410 FX
  • Style 410 MX
  • Style 410 LX

Allergan tissue expanders for the breast that have BIOCELL texturing originally cleared as:

  • Natrelle 133 Plus Tissue Expander (K143354)
  • Natrelle 133 Tissue Expander with Suture Tabs (K102806)

Sources

FDA.gov: “The FDA Takes Action to Protect Patients from Risk of Certain Textured Breast Implants; Requests Allergan Voluntarily Recall Certain Breast Implants and Tissue Expanders from the Market: FDA Safety Communication.”

Daniel Maman, MD, board-certified plastic surgeon, 740 Park Plastic Surgery, New York City.

© 2019 WebMD, LLC. All rights reserved.

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Breast Implants Tied to Rare Cancer Risk Recalled

WEDNESDAY, July 24, 2019 — Allergan’s textured breast implants will be recalled due to their link to a rare cancer, the U.S. Food and Drug Administration announced Wednesday.

Following a request from the FDA, the company will proceed with a worldwide recall of its Biocell textured breast implant products, the agency said.

The recall stems from concerns about a tumor known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

“The recall of these textured implants is a big deal in protecting women from the potential risks of developing, and dying from, this rare type of aggressive lymphoma,” explained one expert, Dr. Joshua Brody.

He directs the Lymphoma Immunotherapy Program at The Tisch Cancer Institute at Mount Sinai, in New York City.

“By preventing further use of these implants, the FDA is helping women to protect themselves from the medically serious and emotionally exhausting effects of these risks,” Brody said.

Though very rare, cases of BIA-ALCL appear to be on the rise. The FDA noted that 573 cases of BIA-ALCL, including 33 related deaths, have been reported worldwide — that’s up from the 116 cases and 24 deaths reported earlier this year.

Of the 573 cases, 481 are attributed to Allergan textured implants, the agency said. Of the 33 deaths, 12 of the 13 patients for which the maker of the implant is known had an Allergan textured breast implant at the time of their cancer diagnosis.

“Based on the currently available information, including the newly submitted data, our analysis demonstrates that the risk of BIA-ALCL with Allergan Biocell textured implants is approximately six times the risk of BIA-ALCL with textured implants from other manufacturers marketing in the U.S.,” the agency said in a news release.

“Although the overall incidence of BIA-ALCL appears to be relatively low, once the evidence indicated that a specific manufacturer’s product appeared to be directly linked to significant patient harm, including death, the FDA took action to alert the firm to new evidence indicating a recall is warranted to protect women’s health,” FDA Principal Deputy Commissioner Dr. Amy Abernethy said in the news release.

The textured implants being recalled include: Natrelle Saline-filled breast implants, Natrelle Silicone-filled breast implants, Natrelle Inspira Silicone-filled breast implants, and Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-filled breast implants.

According to Brody, “some types of implants induce inflammation, which can both increase the chance of developing cancer, and also help to ‘hide’ developing cancers from the immune system.”

He also explained that the inflammation triggered by textured implants may help foster “[gene] mutations and the expression of immune-suppressive proteins, which prevent anti-tumor immune cells from clearing the cancer.”

Also included in the new recall are so-called “tissue expanders,” used by patients before breast augmentation or reconstruction. Those products include the Natrelle 133 Plus Tissue Expander and the Natrelle 133 Tissue Expander with Suture Tabs, the FDA said.

In addition, the FDA issued a safety communication Wednesday for patients with breast implants, patients considering breast implants and their health care providers. The communication outlines the known risks and what steps patients should consider when watching for the cancer, including swelling and pain in their breasts.

“The FDA has been diligently monitoring this issue since we first identified the possible association between breast implants and ALCL in 2011 and, at that time, communicated to patients and providers that there is a risk for women with breast implants, more frequently occurring in women with textured implants, for developing this disease,” Abernethy said.

“Based on new data, our team concluded that action is necessary at this time to protect the public health,” Abernethy added.

“We will continue to monitor the incidence of BIA-ALCL across other textured and smooth breast implants and tissue expanders, as well as other devices intended for use in the breast,” Abernethy added. “If action is needed in the future, we will not hesitate to do what is necessary to protect patients.”

More information

The U.S. Food and Drug Administration has more on breast implants.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

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Early Risers May Be a Little Less Likely to Get Breast Cancer

THURSDAY, June 27, 2019 — If you’re a woman who greets the early morning with a smile, new research delivers good news — you have a slightly reduced risk of developing breast cancer.

For night owls and people who tend to sleep more than the usual seven to eight hours nightly, the analysis suggested a slightly increased risk of breast cancer.

“Sleep does impact health,” said study co-author Caroline Relton, a professor at the University of Bristol in the United Kingdom.

“The study found evidence for a protective effect of morning preference on breast cancer risk,” she said.

What the study team couldn’t tease out from the data was exactly why your sleep type — early bird or night owl — could affect your risk of breast cancer.

Eva Schernhammer, author of an editorial accompanying the study, said “one possible mechanism could relate to the misalignment between internal and external clocks.” She is chair of epidemiology at the Medical University of Vienna in Austria.

The disruption of a normal circadian rhythm can impact how the body functions. An example is the normal variation of melatonin levels, Schernhammer said in her editorial. Melatonin is a naturally occurring hormone.

Dr. Daniel Barone, a sleep specialist at NewYork-Presbyterian and Weill Cornell Medicine in New York City, said that melatonin is a powerful antioxidant.

“If you’re reducing melatonin, that could potentially lead to an inflammatory response in the body,” he said. (Inflammation has been linked to cancer and other health conditions.)

Both Barone and Schernhammer pointed out that night-shift work has been linked to an increased risk of heart disease. Diet may be one reason why. He said it’s harder to find nutritious food options at night, and night-shift workers may get food from places like vending machines. Diet can impact heart disease and breast cancer risk.

The new analysis looked at two large groups of data, which included about 400,000 women altogether.

Previous studies had asked women about their sleep type — whether they preferred morning or evening, how long they slept, and whether or not they had insomnia.

But these researchers controlled the data to account for other factors that can affect breast cancer risk, including obesity, family history of breast cancer, alcohol use and smoking.

Women who said they were “morning people” were slightly less likely to develop breast cancer. The researchers said that early birds had about one less case of breast cancer per 100 women than did night owls.

So, should night owls be worried?

Maybe not just yet, said breast cancer surgeon Dr. Alice Police.

“This study suggests that there may be a lower incidence of breast cancer in ‘morning people,'” she said, but noted that the data in the study is “vague.”

“Until we understand other correlations, such as obesity rates and exercise rates in morning people versus night owls, I do not think definitive conclusions can be drawn,” Police added. She’s the Westchester regional director of breast surgery at Northwell Health Cancer Institute in Sleepy Hollow, N.Y.

Relton agreed that more research is needed, particularly to figure out the underlying reason why morning people seem to have a reduced risk of breast cancer.

In the meantime, she said it’s possible that changing your sleep times to become more of a morning person might change your risk, though more research is necessary before doctors could make a specific recommendation.

If you’d like to try to get some shuteye earlier in the night, sleep expert Barone said the best change you could make is to limit “blue light” at night.

“Any screen you can look at without an additional light on is blue light, and blue light tells our brains that the sun is out and we should shut off melatonin production. Shut off blue light a good hour or so before bed to help keep the body more in tune with what it’s designed to do,” he said.

If you have trouble sleeping, taking a melatonin supplement a half-hour or so before bed can help, Barone noted.

If you’re wondering what else you might do to reduce the risk of breast cancer, editorial author Schernhammer said, “A woman should be more concerned about other, more established, breast cancer risk factors.”

Relton agreed, explaining that risk factors such as alcohol intake and obesity increase the risk of breast cancer much more than your sleeping pattern might.

More information

Learn about preventing breast cancer from the American Cancer Society.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

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Heart Disease Is Lasting Threat to Breast Cancer Survivors

FRIDAY, June 21, 2019 — Postmenopausal women who survive breast cancer may have a higher risk for developing heart disease, a new study says.

Heart problems can appear more than five years after radiation treatment for breast cancer, and the added risk persists for as much as 30 years, according to Brazilian researchers.

Heart disease is the leading cause of death in older women.

“Heart disease appears more commonly in women treated for breast cancer because of the toxicities of chemotherapy, radiation therapy, and use of aromatase inhibitors, which lower estrogen. Heart-healthy lifestyle modifications will decrease both the risk of recurrent breast cancer and the risk of developing heart disease,” said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society (NAMS).

In this study, researchers led by Dr. Daniel de Araujo Brito Buttros, from Botucatu Medical School at Sao Paulo State University, compared and evaluated heart disease risk factors in 96 postmenopausal breast cancer survivors and 192 women without breast cancer.

The investigators found that cancer survivors were much more likely to have metabolic syndrome, diabetes, atherosclerosis, abdominal obesity and high triglyceride levels in their blood. All are major risk factors for heart disease.

The risk of heart-related death among breast cancer survivors was similar to the risk of death from breast cancer itself.

The study was recently published online in Menopause, the journal of NAMS. The findings suggest that women consider including a cardiologist in their cancer treatment decisions.

“Women should schedule a cardiology consultation when breast cancer is diagnosed and continue with ongoing follow-up after cancer treatments are completed,” Pinkerton advised in a journal news release.

More information

The nonprofit organization Susan G. Komen has more on later effects of breast cancer treatment.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

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Newer Drug Extends Lives of Young Breast Cancer Patients

SATURDAY, June 1, 2019 — Adding a newer drug to standard hormone therapy lengthens the lives of younger women with advanced breast cancer, a new trial has found.

The drug, called Kisqali (ribociclib), is already approved for treating such patients — based on earlier results showing it can delay the progression of their cancer.

This is the first evidence it can also extend their lives, said senior researcher Dr. Debu Tripathy, chair of the breast medical oncology department at M.D. Anderson Cancer Center in Houston.

After 3.5 years, 70% of patients given hormone therapy plus Kisqali were still alive. That compared with 46% of those given hormone therapy alone.

That proof of a survival advantage hits “a pretty big milestone,” Tripathy said.

And, he added, it argues for giving the drug as a “first-line or second-line” treatment to these patients.

The findings were to be presented Tuesday at the American Society of Clinical Oncology annual meeting, in Chicago, and they will also be published in the New England Journal of Medicine.

Kisqali is one of three newer drugs on the market called CDK4/6 inhibitors; the others are Verzenio (abemaciclib) and Ibrance (palbociclib). They work by blocking two proteins that help cancer cells grow and divide.

Kisqali, taken as a tablet, was originally approved as a first-line treatment for postmenopausal women with advanced breast cancer that is hormone receptor-positive — which means estrogen fuels the cancer’s growth. Most breast cancers fall into that category.

Last year, the U.S. Food and Drug Administration extended that approval to include younger, premenopausal women. That was based on earlier findings from the current trial, which showed Kisqali typically doubled the time that patients remained progression-free — from one year to two.

The new evidence of longer survival is exciting, said Dr. Larry Norton, medical director of the Lauder Breast Center at Memorial Sloan Kettering Cancer Center, in New York City.

“My expectation is that, when faced with these data, it’ll be hard for doctors not to include this in the standard of care,” said Norton, who was not involved in the trial.

But, he added, the findings also raise “a lot of interesting questions.”

One is whether the other two CDK4/6 inhibitors could have the same benefits. “Is this an effect of the drug, or a drug-class effect?” Norton said.

According to Tripathy, “We don’t know the answer to that yet.” Tripathy has served as a consultant to Kisqali maker Novartis — which funded the trial.

“There are some biochemical differences between the drugs,” he noted. On the other hand, all three have been shown to roughly double the time patients remain progression-free, Tripathy said.

Norton pointed to another, related question: Once a woman on Kisqali sees her cancer progress, can she benefit from another CDK4/6 drug?

Again, the answer is unknown, Tripathy said. But in the “real world,” some doctors will likely try that strategy, he noted.

The latest findings are based on 672 women with advanced breast cancer, aged 25 to 58, who were premenopausal or going through menopause. All had cancer that was hormone receptor-positive, but negative for a protein called HER2 — a common scenario in breast cancer.

All of the women were given standard hormonal therapy — an aromatase inhibitor or tamoxifen — plus a medication that shuts down the ovaries’ production of estrogen. Half were randomly assigned to also take Kisqali. The other half took inactive placebo tablets.

Kisqali is taken in cycles of three weeks on the drug and one week off.

Norton said it’s “relatively non-toxic,” versus chemo.

The possible side effects include fatigue, nausea, diarrhea and constipation, and a drop in certain white blood cells that help fight infections.

A small number of women develop what’s called a QT prolongation — a change in the heart’s electrical activity that can trigger an abnormal heart rhythm. Novartis says that as a precaution, Kisqali patients should have their heart activity checked before and during treatment.

There’s also a steep cost. CDK4/6 inhibitors run several thousand dollars per treatment cycle. Insurance usually covers treatment, Tripathy said, but some women may have trouble affording the co-payments. The drug companies do have financial assistance programs, he noted.

While the drugs are an advance, there’s more work to do, Tripathy said.

“Eventually, these patients progress,” he said. “We still need to keep developing new therapies.”

More information

For more on treating metastatic breast cancer, visit the American Cancer Society.

© 2019 HealthDay. All rights reserved.

Posted: June 2019

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Is AI a New Weapon in Breast Cancer Detection?

By Amy Norton

HealthDay Reporter

TUESDAY, May 7, 2019 (HealthDay News) — Artificial intelligence is the hot new trend in medicine, and now new research suggests it could help doctors better predict a woman’s breast cancer risk.

The study is the latest to explore the potential role of artificial intelligence (AI) in medicine.

Typically, it works like this: Researchers develop an algorithm using “deep learning” — where the computer system mimics the brain’s neural networks. It’s exposed to a large number of images — tumor samples, for example — and it teaches itself to recognize key features.

Studies so far have suggested that computers can outperform humans when it comes to diagnosing certain tumors. One found that an algorithm was better able to distinguish harmless moles from melanoma skin cancer, when stacked up against a group of dermatologists.

In the new study, researchers applied a variation of the same principle to breast cancer.

The ultimate hope is to be able to tailor breast cancer screening to individual women, said lead researcher Adam Yala, a Ph.D. candidate at the Massachusetts Institute of Technology.

“If you know a woman is at high risk, maybe she can be screened more frequently, or be screened using MRI,” Yala explained.

As it stands, doctors already consider certain factors to get a sense of a woman’s breast cancer risk. Family history matters, for example. Women with a mother or sister diagnosed with the disease, especially at a younger age, have a higher-than-average risk.

But the current risk-prediction “models” only go so far, Yala said.

To try to build a better model, his team exposed a deep-learning system to more than 70,000 digital mammography images from women who’d undergone screening at one medical center.

From there, the researchers developed two deep-learning models: One that used the mammography information alone, and a “hybrid” model that also included traditional factors, like age and family history, and a woman’s breast density. (Women with dense breasts typically have a higher cancer risk than those whose breasts have more fat tissue.)

Yala’s team tested the two models’ accuracy against a standard tool that doctors use, called the Tyrer-Cuzick model. It estimates a woman’s risk of developing breast cancer based on traditional risk factors and breast density.

Continued

For that test phase, the researchers used another 8,700-plus mammogram images. Just over 3% of those images had been followed by a breast cancer diagnosis within the next five years.

Overall, the study found, both deep-learning models were better than the standard approach in spotting women at high risk of developing breast cancer. But the hybrid version was most accurate.

It placed almost one-third of women who developed breast cancer into the top 10% risk category. In contrast, the standard model put 18% of those women into the top-10%.

The findings were published May 7 in the journal Radiology.

The study authors noted that the computer model worked just as well among black women as it did in white women, which is not the case with traditional models.

“That suggests we can move toward not only more accurate prediction, but more equitable prediction,” Yala said.

But a researcher not involved in the study said the potential role of AI is far from clear at this point.

One issue is, no one knows what the computer is “seeing” in the mammogram that signals a higher risk, said Arkadiusz Sitek, who wrote an editorial published with the study.

“Imagine a physician who says to a patient, ‘You’re at very high risk for breast cancer. I don’t know why, but the computer says so,'” said Sitek, a senior scientist at IBM Watson Health, in Cambridge, Mass. “That’s a scenario that neither physician nor patient wants to be in.”

Sitek said researchers need a clearer understanding of what’s going on.

Beyond that, he said, further studies need to verify the computer model’s accuracy — using mammograms from women at additional medical centers.

And no, computers will not replace doctors any time soon.

In the foreseeable future, Sitek said, AI will serve as “a radiologist’s assistant” — helping to improve efficiency and watch out for “errors and inconsistencies.”

WebMD News from HealthDay

Sources

SOURCES: Adam Yala, Ph.D. candidate, Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA; Arkadiusz Sitek, Ph.D., senior scientist, IBM Watson Health, Cambridge, MA; May 7, 2019,Radiology, online

Copyright © 2013-2018 HealthDay. All rights reserved.

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Breast Surgeons Issue New Mammogram Guidelines

By Robert Preidt

HealthDay Reporter

FRIDAY, May 3, 2019 (HealthDay News) — The largest organization representing U.S. breast surgeons is issuing new screening guidelines, advising women at average risk to begin annual mammograms at age 40.

Those guidelines differ from advisories from the influential U.S. Preventive Services Task Force (USPSTF), which moved first mammogram screening from 40 to 50 years of age, as well as that of the American Cancer Society, which puts the starting age at 45.

The American Society of Breast Surgeons (ASBrS) says it based the new guidelines on a different model than that used by the USPSTF.

The new guidelines recommend that all women undergo formal risk assessment by age 25. Screening based on specific risk factors is recommended for women with an increased risk of breast cancer.

Women with average risk should begin annual screening at age 40, however.

“Routine screening for women age 40 to 49 has been unequivocally demonstrated to reduce mortality by 15%,” ASBrS president Dr. Walton Taylor said in a society news release.

“However, today’s USPSTF guidelines delay annual screening until age 50 because they are based on an ‘efficiency’ statistical model that also considers the impact of potential screening risks,” he said.

Risks or adverse effects in the USPSTF’s calculations include the cost of screening, as well as the probability “of false-negative and -positive results,” Taylor explained. Mistaken findings can mean unnecessary anxiety and unnecesssary medical procedures, he said.

In contrast, the new ASBrS guidelines “are based on a ‘life-years gained’ model,” Dr. Julie Margenthaler said in the news release.

“They are based solely on the demonstrated breast cancer survival benefits. The ASBrS prioritizes life,” said Margenthaler. She directs breast surgical services at the Siteman Cancer Center and is also professor of surgery at Washington University School of Medicine, both in St. Louis.

Individual risk assessment is a key part of the new guidelines, the ASBrS said.

For example, women with a predicted lifetime breast cancer risk of 20% or more should begin mammography screening, with access to supplemental MRI imaging, starting at age 35.

Continued

Similar imaging should start at age 25 for women with breast cancer-related genetic abnormalities, the group advised.

“While mammographic screening is not as easy or accurate in younger women, when we find and treat cancer, the benefits in years of life saved are highly significant. Many current guidelines will leave a subset of these women to die,” Margenthaler explained.

Dr. Dana Smetherman is chair of the American College of Radiology (ACR) Commission on Breast Imaging. “Catching more cancers early by starting yearly screening at age 40 — rather than less frequent or later screening — increases the odds of successful treatment and can preserve quality of life for women,” she said in the news release.

“We are pleased that ASBrS has reaffirmed their support for this most sensible approach,” said Smetherman. The new ASBrS guidelines are in keeping with ACR recommendations.

Two more experts in breast cancer care supported the new guidelines.

“As breast surgeons we have long realized that one-size-fits-all screening is a problem,” said Dr. Alice Police, regional director of breast surgery for Northwell Health Breast Care Centers of Westchester County in Sleepy Hollow, N.Y.

She believes that guidelines that don’t account for individual risk profiles “sacrifice many ‘life years’ for some women for a greater good that claims to be more cost-effective and to create less anxiety.”

Breast surgeons “think the life years are more important,” Police said.

Dr. Kristin Byrne is chief of radiology at Lenox Hill Hospital in New York City. She believes the new guidelines are “individualized, in order to balance the benefits and harms of screening in each category without risking the patient’s lives.

“For example, mammography should not be used on a patient under the age of 30 [under the ASBrS guideline],” Byrne noted. Instead, young, at-risk patients “with genetic mutations or prior chest wall radiation should have annual screening MRI until they feel it is safe for mammography screening,” she said.

And at the other end of the life span, the new guidelines recommend stopping screening mammography when life expectancy is less than 10 years. This is “medically reasonable,” Byrne said.

Continued

“Many guidelines have arbitrarily chosen the age of 74 to stop screening mammography, but this does not reflect the life expectancy of many individuals, and the risk of breast cancer increases with age,” she said.

Finally, “screening every year for women of average risk over the age of 40 is essential to early diagnosis,” Byrne believes.

WebMD News from HealthDay

Sources

SOURCES: Alice Police, M.D., regional director, breast surgery, Northwell Health Breast Care Centers in Westchester, Sleepy Hollow, N.Y.; Kristin Byrne, M.D., chief, radiology, Lenox Hill Hospital, New York City; American Society of Breast Surgeons, news release, May 3, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Device Spots Lymphedema Early in Breast Cancer Patients, to Help Stop It

THURSDAY, May 2, 2019 — An easy-to-use, noninvasive device can detect early signs of the cancer complication known as lymphedema, a new study reports.

Lymphedema is the buildup of fluid in the body’s tissues when a part of the lymph system is damaged, as can happen in cancer care, according to the U.S. National Cancer Institute (NCI).

The fluid causes swelling, usually in the arms or legs, and can be severe enough to limit range of motion in an affected limb.

Detecting lymphedema sooner can give doctors a chance to intervene when it’s possible to stop development of this chronic, painful and potentially debilitating condition.

Researchers found that when they used a bioimpedance spectroscopy device after breast cancer surgery, the risk of lymphedema dropped by nearly 70%. The device uses slight electrical currents to measure fluid volume in body tissue.

“Bioimpedance spectroscopy takes about a minute to do, and the device takes up the space of a scale. If you used this every time you saw a breast cancer patient for an appointment, you would know if they’re starting to get into trouble,” said study lead author Sheila Ridner. She directs the Ph.D. in Nursing Science Program at the Vanderbilt School of Nursing in Nashville, Tenn.

Ridner said there are several causes of lymphedema, including surgery, trauma, radiation, obesity, genetics and some types of chemotherapy.

“It’s hard to predict with 100% accuracy who will get lymphedema,” she said.

The condition often occurs in women who have had lymph nodes removed from the underarm area along with breast cancer surgery, according to the NCI.

Treatment includes wearing compression garments or bandages to prevent fluid buildup, weight loss, a special type of massage and some light exercises.

The study included just over 500 patients who completed at least a year of follow-up. All had had breast cancer surgery — either with or without lymph node involvement. The average age was 59 and 77% of the women were white. Almost 57% had stage 1 cancer; 39% had stage 2 or 3 breast cancer.

The women were randomly assigned to testing with either a tape measure (to detect swelling through increased size) or with bioimpedance spectroscopy. Ridner said the device is painless and can also detect body fat and bone mass.

Just 5% of women who had bioimpedance spectroscopy eventually needed complex interventions for swelling, compared to nearly 15% of women who had tape-measure surveillance.

Dr. Lauren Cassell, chief of breast surgery at Lenox Hill Hospital in New York City, said despite surgical advances, lymphedema is still a big concern. She wasn’t involved in the current research.

“Breast cancer-related lymphedema remains one of the most challenging problems we face in patients undergoing treatment for breast cancer,” Cassell explained. “Once a patient develops swelling of the arm, it becomes almost impossible to eliminate it. We can only hope to keep it under control.”

Cassell said identifying early swelling looks promising for preventing long-lasting lymphedema.

“Using a tape measure is just not as sensitive as the use of bioimpedance spectroscopy,” she said. “This study suggests that following these patients closely in the immediate postoperative period with bioimpedance spectroscopy may help us avoid significant lymphedema and its subsequent complications.”

The study is scheduled to be presented Thursday at the American Society of Breast Surgeons’ meeting, in Dallas.

Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

More information

The U.S. National Cancer Institute has more about lymphedema .

© 2019 HealthDay. All rights reserved.

Posted: May 2019

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