Sunday October 21, 2018

All Breast Lumps are Not Cancerous, Says Radiologist Expert

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breast lump simulation
breast lump simulation. Wikimedia
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New Delhi, Oct 7, 2017: Breast Cancer is one of the supreme causes of female deaths, however, it’s awareness is low in India. A leading Radiologist, Dr. Jyoti Arora, Associate Director, Medanta – the Medicity states that 8 out of 10 cases of breast lumps are not cancerous and undergoing biopsy is the only way to rule out breast cancer.

In India, two responses with respect to breast lumps are generally normal. Either the feeling of a lump formation in the breast is disregarded or the patient gets hysterical. The two responses are extreme and caused by the absence of proper awareness but in altogether different ways.

A recent study summarized that its predominance is as high as 25.8 per 1,00,000 women and its death rate are 12.7 per 1,00,000 women, mentioned ANI.

Dr. Arora has disclosed that because of the absence of awareness, a huge number of Indian women do not choose  appropriate tests and treatment.

Arora said, “One of the first symptoms of breast cancer is the formation of lumps in the breast. While many women from not so educated and aware sections of society do not identify lump in the breast as a reason enough to see the doctor, those who are aware of the connection between breast lumps and cancer does not realize that in 8 out of 10 cases, lumps in breasts are non-cancerous. For them, a breast lump is the synonym of breast cancer and they feel it’s the end of their life so do not get it evaluated.”

As the lumps are associated with pain, some females do not seek medical advice. The non-cancerous lumps are cyst formation, fibro-adenoma which is an abnormal non-cancerous growth, or maybe a temporary sign due to woman’s menstrual cycle.

Cancerous lumps are usually hard to feel and not associated with pain.

So if a female feels a lump, she should visit a breast specialist who will get a mammography and ultrasound done. If a solid lump is confirmed on imaging then in most of the cases biopsy would be needed to confirm whether the lump is cancerous or not.

To check cancerous cells, a radiologist removes tissue while conducting a breast biopsy from the suspected area for lab testing.

Also Read: Esteé Lauder’s Breast Cancer Awareness ‘Pink Ribbon Campaign’ Marks 25 Year Milestone 

“There are various types of biopsies that a patient is offered. Tru cut needle biopsy is performed in majority of the cases, however when the abnormality is very small, subtle or when seen only on the mammograms in the form of calcifications or only on the breast MRI, vacuum-assisted breast biopsies (VABB) are preferred as they increase the accuracy and sensitivity of getting a representative sample from the abnormal area. Through VABB, more tissue can be removed than by the true cut needle biopsy and hence a more accurate report can be generated by the pathologist,” added Arora.

One should look for changes in the breast in terms of size and shape. Other than formation of lump, observe whether there are skin changes such as swelling and redness, in drawing of the nipples or if there is pain, irritation, change of color, or peeling and flaking of nipple skin.

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Immunotherapy Drugs Show Significant Improvement Against Breast Cancer: Study

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts.

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Breast Cancer
This undated fluorescence-colored microscope image made available by the National Institutes of Health in September 2016 shows a culture of human breast cancer cells. For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. VOA

For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. But the benefit for most women was small, raising questions about whether the treatment is worth its high cost and side effects.

Results were discussed Saturday at a cancer conference in Munich and published by the New England Journal of Medicine.

Drugs called checkpoint inhibitors have transformed treatment of many types of cancer by removing a chemical brake that keeps the immune system from killing tumor cells. Their discovery recently earned scientists a Nobel Prize. Until now, though, they haven’t proved valuable against breast cancer.

Breast Cancer
Weight loss may lower breast cancer risk for post-menopausal women. Pixabay

In the study

The new study tested one from Roche called Tecentriq plus chemo versus chemo alone in 902 women with advanced triple-negative breast cancer. About 15 percent of cases are this type, their growth is not fueled by the hormones estrogen or progesterone, or the gene that Herceptin targets, making them hard to treat.

Women in the study who received Tecentriq plus chemo went two months longer on average without their cancer worsening compared with those on chemo alone, a modest benefit. The combo did not significantly improve survival in an early look before long-term follow-up is complete.

Failed protein test

Previous studies found that immunotherapies work best in patients with high levels of a protein that the drugs target, and the plan for the breast cancer study called for analyzing how women fared according to that factor if Tecentriq improved survival overall.

breast cancer
FILE – A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice, July 26, 2012. VOA

The drug failed that test, but researchers still looked at protein-level results and saw encouraging signs. Women with high levels who received the combo treatment lived roughly 25 months on average versus about 15 months for women given chemo alone.

That’s a big difference, but it will take more time to see if there’s a reliable way to predict benefit, said Dr. Jennifer Litton of the MD Anderson Cancer Center in Houston. She had no role in running the study but enrolled some patients in it and oversees 14 others testing immunotherapies.

“We’re really hopeful that we can identify a group of women who can get a much bigger and longer response,” she said.

Another breast cancer specialist with no role in the study, Dr. Michael Hassett at Dana-Farber Cancer Institute in Boston, said he felt “cautious excitement” that immunotherapy may prove helpful for certain breast cancer patients.

Breast Cancer
Breast cancer cell, Wikimedia Commons

Side effects and cost

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts, but serious ones were more common with the combo treatment and twice as many women on it stopped treatment for that reason.

Three of the six deaths from side effects in the combo group were blamed on the treatment itself; only one of three such deaths in the chemo group was.

Also Read: New DNA Tool To Predict People’s Height And Risk For Cancer

Cost is another concern. Tecentriq is $12,500 a month. The chemo in this study was Celgene’s Abraxane, which costs about $3,000 per dose plus doctor fees for the IV treatments. Older chemo drugs cost less but require patients to use a steroid to prevent allergic reactions that might interfere with the immunotherapy. Abraxane was chosen because it avoids the need for a steroid, said one study leader, Dr. Sylvia Adams of NYU Langone Health.

The study was sponsored by Roche and many study leaders consult or work for the company or own stock in it. (VOA)