Cancer Breakthroughs: New research in breast cancer

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by KING 5 News

KING5.com

Posted on October 20, 2009 at 12:09 PM

Updated Friday, Jan 4 at 10:45 AM

They may look so small and fragile, but babies can be big helpers in the fight against breast cancer, especially hungry babies.

New research confirms breast feeding can significantly lower a mother's risk of the disease.

"And what we found is overall this is true and it's associated with about 20 percent lower risk of the most common breast cancer and least aggressive form of breast cancer and about a 50 percent lower risk of one of the more aggressive forms of breast cancer," said Amanda Phipps of Fred Hutchinson Cancer Research Ctr.

The benefit comes when women breast feed for six months or more in their lifetime.

"So at least six months we see a lowering of breast cancer risk, the hope is even great if women breast feed for even longer," said Phipps.

Even if you are breasting feeding or have breast fed your babies, doctors say that doesn't mean you get to skip your yearly mammograms.

For women over 40 mammograms remain the gold standard for detecting breast cancer early.

But after you get one, don't be alarmed if you're asked back to the doctor's office.

Around Christmas-time last year, Ally Svenson received a disturbing phone call concerning her mammogram.

"You know, there was nothing warm and fuzzy about it, you know there is a focal density on your left breast, the radiologist urgently needs to see our films," she said. "I thought that was a really bad sign."

Ally was told the abnormality on her mammogram needed further examination. While she waited, all sorts of frightening scenarios invaded her thoughts.

"You carry around for a week and a half the very distinct possibility that this next year is going to be, you know, full of a battle I didn't want to fight ... you can't help but go there," she said.

To Ally's relief, she was cancer-free. Her experience is not uncommon.

Research from Dr. Joanne Elmore confirms this unnerving fact about false positive mammograms.

"The first time a woman goes for a mammogram, she has about a 10 percent chance of a false positive mammogram," she said. "Now, what this means is you send 100 women to get a screening mammogram and 10 of them will get a letter that says you need to have more testing," said Dr. Elmore.

The more yearly mammograms a woman has, the more that number goes up.

"After 10 years, on her 10th exam she has about a 50 percent chance of having at least one false positive mammogram," said Dr. Elmore.

Since it's hard to identify a single reason for false positives, Dr. Elmore says her research helps calm women like Ally, who get that alarming letter or phone call.

"Somehow we need to do a better job of telling our friends and family, don't worry, that's part of the process and that's a normal part of the process," she said.

The other side to this story - the false negative

For some women, mammograms don't detect all breast cancer tumors.

Nancy Arnson never thought she'd be modeling in the Macy's breast cancer fashion show, but then she never thought she'd get breast cancer either.

"It was quite a surprise," she said. "I woke up one morning and I discovered this lump under my left arm and I knew if was something I better have checked immediately."

So she did, but as Dr. Steven Scallon explains, the tumor didn't even show up on the mammogram.

"It should be right here in this area here but as you can see her breast tissue is quite white and it's obscuring where the tumors are," he said. "Cancers are also white on mammography so that's why dense tissue can obscure the underlying tumor in the breast."

So more tests were ordered, including a breast MRI. This time the diagnosis was obvious: fourth-stage metastatic breast cancer.

Without the breast MRI, there was only one surgical option: a mastectomy.

"She would have had to have a mastectomy to ensure that the tumor in her breast was removed, but now we're able to identify where the primary tumor was in her breast so she could have a smaller area of her breast surgically removed," said Dr. Scallon.

Ironically, Nancy's tumor might have been picked up six months earlier when she went in for her annual mammogram. But back then she didn't get a breast MRI.

"Now would I have it? Yes. Do I tell my children and my grandchildren and everyone out there? I would recommend asking if it's a possibility and right there and definitely now I would have asked," she said.

When is MRI necessary?

When should an MRI be requested and does every woman need one? To answer these questions we turn to Dr. Connie Lehman, Director of Radiology at Seattle Cancer Care Alliance.

"MRI is not for everyone, so we are going target women who are very high risk for getting cancer in their breast," she said.

"There are two patient groups we target, the first of our high risk patients are based on their family history, women who have a 20 percent greater lifetime risk that might be, for example, if they had two first degree relatives with breast cancer, particularly if they were premenopausal when they were diagnosed with breast cancer."

Jean Enersen: Actually looking at the genetic relation for a woman, say myself, I would look at the women in my family, but I also look at the men in my family and the women they are related to make the whole accurate tree, correct.

Dr. Lehman: Exactly, we use to not pay as much attention to a woman's father and all of his relatives and it's very important that we look at both sides.

Jean: What about a woman with dense breasts, I mean. Does that make her more of a candidate for different kinds of detection"

Dr. Lehman: At this time we still don't recommend MRI for women if their only risk factor is dense breast tissue, but we do think they should be very careful for getting a digital mammogram, getting a good clinical breast exam every year and if they find something in their breast they are concerned about or worried about, talk to their doctor.

Jean: So dense breast and cancer in the family might make them a candidate for MRI.

Dr. Lehman: Absolutely.

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