Amy and Phil Mickelson gave us the Masters' moment to remember yesterday when they embraced just off the 18th hole after Phil won his third green jacket. This moment had all of the makings for a Hollywood ending: a professional athlete at the top of his game, three darling children and a beautiful wife who had come back from a year of battling breast cancer to be by her husband's side.
At 37, Amy Mickelson is young to develop this disease. Only 7 percent of all breast cancer cases occur in women younger than 40 years old. However, breast cancer can occur at any age, so all women should be aware of their personal risk factors.
In my last entry, I blogged about the breast cancer questionnaire that I use to help assess breast cancer awareness with my patients. I encourage you to take the survey to learn more about risk factors and to determine your breast health IQ.
A new study is providing insight into how estrogen fuels many breast cancers, and researchers say the findings could lead to new cancer-fighting drugs. The study found that estrogen inhibits a protein that causes normal cell death. Blocking this protein leads to uncontrolled growth of cancer cells and resistance to chemotherapy. Targeting this regulating protein could give us a new angle to treating breast cancer.
About 60 percent of all breast cancers are estrogen-positive or progesterone-positive. This means the cancer cells have receptors for the female hormones estrogen and progesterone. Consequently, the hormones fuel the tumor's growth.
In laboratory experiments, researchers found that in estrogen-positive and progesterone-positive cancer cells, there is a reduction in the activity of the protein which causes cell death. This lack of normal cell death allows the cancerous cells to continue growing, changing and developing resistance to chemotherapy.
The next step will be to look for a drug that will overcome the inhibitory effect of estrogen on this protein. This drug would be taken in combination with chemotherapy drugs.
In other research, a gene test that predicts whether early stage breast cancer patients will benefit from chemotherapy is having a big impact on treatment decisions by patients and doctors alike. Doctors said the test increased their confidence in their treatment recommendations in 76 percent of cases. And in 97 percent of cases, doctors said they would order the test again. After receiving test results, patients reported they were significantly less conflicted about their treatment decision and felt significantly less anxiety about their situation.
The test examines 21 genes from a tumor sample to determine how active they are. A test score between 0 and 100 predicts how likely the cancer is to recur. For women with low scores, chemotherapy is not recommended.
More than 120,000 breast cancer patients have undergone the test since it became commercially available in 2004. The test is intended for patients who have a type of breast cancer, called estrogen-receptor-positive, which has not spread to the lymph nodes. About 100,000 such cases are diagnosed each year.
This test of patients' own breast cancer provides us with greater certainty of who derives benefit from chemotherapy and who can safely avoid it. Given that the trend in cancer treatment is toward personalized medicine, we likely will see more tests similar to this one in the future.
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