Study Explores Non-Drug Treatments for Menopausal Symptoms

Exercise and cognitive behavioral therapy may reduce menopausal symptoms among young women who have been treated for breast cancer. These results were presented at the eighth European Breast Cancer Conference (EBCC-8).????

For women with breast cancer, treatments such as chemotherapy and hormonal therapy can be life-saving. Side effects, however, may include the sudden and early onset of menopausal symptoms. When severe, symptoms such as hot flashes, night sweats, and vaginal dryness can have a profound effect on quality of life.????

To explore non-drug approaches to managing menopausal symptoms in young women with breast cancer, researchers in the Netherlands conducted a study among 422 women with an average age of 48. The researchers assigned women to one of four groups:????

Cognitive behavioral therapy?Physical exercise?Cognitive behavioral therapy AND physical exercise?None of the above (this was the control group)?

Cognitive behavioral therapy consisted of six weekly group sessions. The sessions included relaxation exercises, and focused primarily on hot flashes and night sweats. ?

The exercise program was a 12-week, home-based program. Women were asked to exercise for 2 ? to 3 hours per week at a level that allowed them to reach a target heart rate.?

Women who received one of the interventions (exercise or cognitive behavioral therapy or both) experienced an overall decrease in menopausal symptoms, along with improvements in sexual and physical functioning. These benefits were still apparent six months later.????

For women who are not able to take estrogen to manage menopausal symptoms, or who choose not to take estrogen, finding effective, non-hormonal approaches to managing menopausal symptoms is important. The current study reports on two promising approaches: regular physical activity and structured cognitive behavioral therapy.????

Reference: Oldenburg HSA, Duijts SFA, van Beurden MM et al. Efficacy of cognitive behavioral therapy and physical exercise in alleviating treatment-induced menopausal symptoms in patients with breast cancer- results of a randomized controlled multicenter trial. Paper presented at: eighth European Breast Cancer Conference (EBCC8); March 21-24, 2012; ?Vienna, Austria. Abstract 199.?

Posted March 29, 2012

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Study Explores Breast Cancer Prognosis By Race

Breast cancer prognosis may be worse among black women than among white women regardless of the subtype of breast cancer. These results were presented at the 2013 annual meeting of the American Association for Cancer Research (AACR).?

It’s long been known that breast cancer prognosis varies by race among women in the United States, with black women tending to have worse outcomes than white women. Some of this variability has been attributed to the fact that black women have higher rates of triple-negative breast cancer than women of other races. How race affects prognosis among women with certain subtypes of breast cancer, however, has been uncertain.?

To explore the relationship between race and prognosis by subtype of breast cancer, researchers evaluated 1,688 breast cancer survivors who participated in the Life After Cancer Epidemiology and Pathways studies. Women have been followed for more than six years.??

Consisted with previous studies, black women had higher rates of breast cancer mortality overall, and were also more likely to be diagnosed with triple-negative breast cancer. ?Differences in survival between black and white women were seen in all subtypes of breast cancer. Among women with triple-negative breast cancer, mortality rates were 30% higher in black women than in white women. Among women with other types of breast cancer, mortality rates were more than twice as high among black women.?

These results suggest that variability in breast cancer prognosis by race is not due entirely to the more frequent diagnosis of triple-negative breast cancer in black women. A better understanding of the reasons for the variability may suggest ways to improve treatment.?

Reference: Kroenke C, Kwan M, Bernard P et al. Race and breast cancer prognosis by PAM50 subtype in the LACE and Pathways Studies. Presented at the 2013 annual meeting of the American Association for Cancer Research. Washington, DC, April 6-10, 2013. Abstract 131.?

Posted April 11, 2013???

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Study Explores Risk of Invasive Breast Cancer in Women with DCIS

Among women with breast ductal carcinoma in situ (DCIS), evaluation of three molecular markers in a sample of DCIS tissue may provide information about the subsequent risk of invasive breast cancer. These results were published in the Journal of the National Cancer Institute.

DCIS refers to a condition in which abnormal cells are found within a breast duct, but have not spread outside of the duct to other tissues in the breast. It is most commonly detected by screening mammography. If not treated, some cases of DCIS may progress to invasive breast cancer.

The probability that DCIS will progress to invasive cancer is thought to vary widely among women, but thus far it hasn’t been possible to accurately predict risk. As a result, some DCIS patients are probably overtreated and some may be undertreated. Treatment for DCIS often involves lumpectomy plus radiation therapy or mastectomy. Women may also receive hormonal therapy.

An important goal of DCIS research has been to develop a better understanding of DCIS behavior and more individualized approaches to treatment. In the current study, researchers evaluated information from 1162 women diagnosed with DCIS between 1983 and 1994 and treated with lumpectomy alone.

Women with DCIS that was positive for three molecular markers—p16, COX-2, and Ki67—had a higher risk of subsequent invasive breast cancer. Risk was also higher when the DCIS had been detected by palpation of the breast (rather than by screening mammography). Among women with DCIS that was positive for all three markers or had been detected by palpation, the eight-year risk of invasive breast cancer was 20%. Approximately 28% of women fell into this high-risk group. In contrast, among women with DCIS that had been detected by screening mammography and was negative for all three markers, the eight-year risk of invasive breast cancer was 4%. Seventeen percent of women fell into this lowest-risk group.

Research in this area is still at an early stage, and the results of this study are not expected to change patient care in the near future. Nevertheless, this type of research offers hope for improved understanding of DCIS and more individualized DCIS treatment.

Reference: Kerlikowske K, Molinaro AM, Gauthier ML et al. Biomarker Expression and risk of subsequent tumors after initial ductal carcinoma in situ diagnosis. Journal of the National Cancer Institute. 2010;102:627-637.

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