Hot topics for Breast Cancer Awareness Month

-added 09/27/2011

This article is part of the Cancer Center's News Archive, and is listed here for historical purposes. The information and links may no longer be up-to-date.

Ann Arbor - This year, an estimated 209,060 Americans will hear their doctor say, "You have breast cancer." More than 40,000 will die from the disease.

As October marks Breast Cancer Awareness Month, here are some of the hot topics in breast cancer from the University of Michigan Comprehensive Cancer Center:

New trends in breast reconstruction

Women making a decision about breast cancer surgery should include a plastic surgeon in that discussion. Several options for breast reconstruction give women choices, with each choice carrying its own risks and benefits.

"The decision tree is complicated. A plastic surgeon ultimately has to walk through the choices with patients and help them consider which option is best for their individual situation and preferences," says Adeyiza Momoh, M.D.going to a new website, assistant professor of plastic surgery at the U-M Medical Schoolgoing to a new website.

As more younger women at high risk of breast cancer choose to have their breasts removed before cancer develops, a procedure called a DIEP (Deep Inferior Epigastric Perforator) flap has become increasingly popular. The technique involves transplanting tissue from the woman's abdomen into her chest. But unlike traditional tissue reconstruction, called a pedicled TRAM flap, where the entire rectus muscle was included with the flap, a DIEP flap involves a complex approach to dissecting out the small blood vessels and leaving the muscle behind. The blood vessels are then reconnected to blood vessels in the chest.

The technique preserves the abdominal muscle function and typically has fewer abdominal complications.

U-M is one of only a handful of hospitals in the country with surgeons trained to perform DIEP flaps. The procedure requires highly specialized training in microvascular surgery, which is what allows the surgeon to reattach the fine blood vessels.

"Breast reconstruction with abdominal tissue can be a very good option for patients who have already had radiation therapy. The DIEP flap may decrease detrimental effects to the abdomen and speed up recovery," says Jeffrey Kozlow, M.D.going to a new website, assistant professor of plastic surgery at the U-M Medical School. However, Kozlow advises that every patient is unique and not all are candidates for this type of reconstruction.

To learn more about breast reconstruction, call the U-M Cancer AnswerLine at 800-865-1125.

What you need to know about mammograms

The bottom line: Mammography saves lives. Various organizations may not agree perfectly on screening recommendations, but don't use that as an excuse to throw up your hands and do nothing.

"Mammography is one of the few screening tools that has been proven to save lives. Every woman over 40 should at least begin a discussion about screening with her doctor," says Mark Helvie, M.D.going to a new website, director of breast imaging at the U-M Comprehensive Cancer Center.

Here's what everyone does agree on:

  • All women 50-74 should receive regular mammograms.
  • Mammography may be the right choice for women in their 40s. While many groups, such as the American Cancer Societygoing to a new website and the National Comprehensive Cancer Networkgoing to a new website, continue to recommend routine screening, others advocate a discussion between women and their health care providers.
  • Yearly or every other year? Many groups continue to recommend annual exams. The difference of opinion comes down to a balance between benefit and harm. Annual screening saves more lives but at a cost of more harms. Talk to your doctor about your options.
  • Women at very high risk for breast cancer may benefit from additional screening with MRI.

Early screening may be particularly important for African-American women, a study from U-M researcher Lisa A. Newman, M.D., M.P.H.going to a new website, found. Black women were on average seven years younger than white women when diagnosed with breast cancer, and among women younger than 44, breast cancer occurred more often in black women than white women, the researchers reported. Furthermore, among women ages 40-49, African Americans were diagnosed with biologically more aggressive patterns of breast cancer compared to white Americans.

"Early detection of breast cancer is the most powerful determinant of outcome, and is especially important for women facing an increased risk of developing biologically aggressive disease. Our study emphasizes the need to continue intensive breast cancer surveillance among African-American women ages 40-49," says Newman, director of the Breast Care Center at the U-M Comprehensive Cancer Center.

To schedule a mammogram, call the U-M Cancer AnswerLine at 800-865-1125.

U-M researchers test new treatments targeting breast cancer stem cells

Why does breast cancer often come back or spread to other parts of the body? Researchers at the U-M Comprehensive Cancer Center believe it's because current chemotherapy and radiation treatments don't kill the key driver of cancer - a small number of cells within a tumor called cancer stem cells. These are the only cells capable of regenerating new cancer cells.

In 2003, U-M researchers were first to identify breast cancer stem cells. Now, the research has advanced to clinical trials, where patients are being treated with a drug that specifically targets these cells.

Initial results show the drug is well-tolerated. Biopsies given before and after treatment with the drug show the number of stem cells in the tissue decreased after treatment - an encouraging sign that the drug is killing the stem cells.

Several clinical trials are testing different potential ways to use drugs that fight cancer stem cell in combination with traditional treatments that will wipe out the rest of the tumor cells.

To learn more about clinical trials at the U-M Comprehensive Cancer Center, visit www.UMClinicalStudies.org/cancergoing to a new website or call the U-M Cancer AnswerLine at 800-865-1125.

 

Written by: Shantell Kirkendoll, contact: telephone 734-764-2220; email: smkirk@umich.edu.

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