plus 4, We need a new women's health movement - Los Angeles Times

We need a new women's health movement - Los Angeles Times
Annual Screening With Breast Ultrasound Or MRI Could Benefit Some ... - Redorbit.com
Study: Mammograms May Raise Breast Cancer Risk - WebMD
Women researchers less likely to receive major career funding grants - Science Centric
Radiation Exposure From Annual Mammography Increases Breast Cancer ... - Medscape News

We need a new women's health movement - Los Angeles Times

Posted: 02 Dec 2009 09:22 AM PST

Annual Screening With Breast Ultrasound Or MRI Could Benefit Some ... - Redorbit.com

Posted: 02 Dec 2009 09:36 AM PST

Posted on: Wednesday, 2 December 2009, 11:37 CST

Results of a large-scale clinical trial presented today at the annual meeting of the Radiological Society of North America (RSNA) provide the first strong evidence of the benefit of annual screening ultrasound for women with dense breasts who are at elevated risk for breast cancer. In addition, the study confirmed that MRI is highly sensitive in depicting early breast cancer.

"We found that annual screening with ultrasound in addition to mammography significantly improves the detection of early breast cancer," said lead researcher Wendie A. Berg, M.D., Ph.D., breast imaging specialist at American Radiology Services, Johns Hopkins – Green Spring Station in Lutherville, Md., "and that significantly more early breast cancer can be found when MRI is performed, even after combined screening with both ultrasound and mammography. However, both ultrasound and MRI increase the risk of false-positive findings."

Women who are at high risk for breast cancer need to begin screening at a younger age, because they often develop cancer earlier than women at average risk. However, women below age 50 are more likely to have dense breast tissue, which can limit the effectiveness of mammography as a screening tool.

Multicenter trials have shown that MRI enables radiologists to accurately identify tumors missed by mammography and ultrasound. The American Cancer Society recommends that some groups of women with a high risk of developing breast cancer should be screened with MRI in addition to their yearly mammogram beginning at age 30. However, MRI is not for everyone.

"Because MRI is a very expensive test and requires intravenous contrast, it is something we only recommend for screening the approximately 2 percent of women who are known or likely carriers of BRCA1 or BRCA2 gene mutations or have other unusual circumstances that put them at very high risk for breast cancer," Dr. Berg said.

"There are another 10 to 15 percent of women who are at some increased risk because of personal history of breast cancer, family history of breast cancer and/or dense breast tissue," she added. "For many of these women, MRI is not currently justified, but annual ultrasound would be appropriate in addition to mammography."

The researchers studied 612 women, mean age 55 years, at elevated risk of breast cancer enrolled at 14 sites in the American College of Radiology Imaging Network (ACRIN) 6666 trial funded by the Avon Foundation and the National Cancer Institute. Women underwent baseline screening mammography and ultrasound with follow-up exams at 12 and 24 months and then a single, contrast-enhanced MRI at 24 months.

Sixteen women were diagnosed with breast cancer. Twelve of the cancers were invasive, and four were ductal carcinoma in situ (DCIS). Over the course of the study, 50 to 56 percent of cancers were shown on mammography. Adding ultrasound allowed detection of 70 to 94 percent of cancers. Adding MRI allowed for detection of additional cancers at their earliest stage.

The study also found that supplemental screening with ultrasound or MRI significantly increased the risk of false-positive findings, leading to unnecessary biopsies in some women.

"It is important that women are advised of the increased potential of undergoing an unnecessary biopsy as a result of screening with ultrasound or MRI," Dr. Berg said, "but we hope this study motivates women and their doctors to learn more about their risk factors and to consider supplemental screening in addition to mammography where indicated."

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Study: Mammograms May Raise Breast Cancer Risk - WebMD

Posted: 02 Dec 2009 09:43 AM PST

Study: Mammograms May Raise Breast Cancer Risk

Dec. 2, 2009 (Chicago) -- Low-dose radiation from mammograms or chest X-rays may place some young high-risk women at increased risk of developing breast cancer, a new study suggests.

Women, especially those under 30, who are already at high risk of breast cancer because they carry a breast cancer gene or have a family history of breast cancer may want to consider other screening methods, such as magnetic resonance imaging (MRI), that do not involve exposure to radiation, the researchers say.

The researchers pooled results from six studies that looked at the effect of exposure to low-dose radiation on women at high risk of breast cancer.

A total of 9,420 women at high risk of breast cancer were included in the studies.

Among the findings:

High-risk women were two-and-one-half times more likely to develop breast cancer than women in the general population.
High-risk women who had mammograms or chest X-rays before age 20 were two-and-one-half times more likely to develop breast cancer than high-risk women who were not exposed to low-dose radiation.
High-risk women who had mammograms or X-rays after age 20 were one-and-one-half times more likely to develop breast cancer than high-risk women who were not exposed to low-dose radiation, but that finding could have been due to chance.

"For young, high-risk women, it is important to screen for breast cancer," says Marijke C. Jansen-van der Weide, PhD, of the University Medical Center Groningen in the Netherlands.

"But they should weigh the risks and benefits with their doctors to come up with a screening strategy," she tells WebMD.

If alternative screening methods are not available, Jansen-van der Weide recommends having mammograms every other year, starting at age 30.

The results were reported at the annual meeting of the Radiological Society of North America.

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Results Apply to Few Women

Mary C. Mahoney, MD, of the University of Cincinnati Medical Center and vice president of public information for the RSNA, stresses that that the findings do not apply to the general population.

Also, the results apply to a very small number of breast cancer patients - "only 5% of all breast cancers," Mahoney says.

High-risk women have a mutation in a damage-repair gene, which makes them more susceptible to the effects of DNA-damaging ionizing radiation.

"These tumors are biologically different, much more susceptible to radiation," Mahoney says.

Jansen-van der Weide says further studies in which women are followed over time are needed to more accurately estimate cancer risks from radiation exposure.

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Women researchers less likely to receive major career funding grants - Science Centric

Posted: 02 Dec 2009 08:53 AM PST

Women were less likely than men to receive major funding for scientific research, according to a study from the University of Michigan Health System. The study also found that only a quarter of all researchers, both men and women, who received a major early career award went on to get further federal funding within five years.

The study looked at 2,783 researchers who received the highly competitive early career awards called K08 or K23. These awards provide funding that protects a researcher's time and include a mentoring component to help nurture a young clinician-scientist's career. The funding is typically for three to five years.

The researchers then matched the K award recipients to those who were awarded an R01, a prestigious federal grant that is a milestone in a researcher's career.

They found that within five years of a K08 or K23 award, only 23 percent of all researchers had attained an R01. But while 25 percent of men had been awarded an R01, only 19 percent of women had. After 10 years, fewer than half of all K awardees had an R01: 36 percent of women and 46 percent of men.

Results appear in the Dec. 1 issue of Annals of Internal Medicine.

'It's concerning that the whole group is not succeeding at a higher rate, and it is especially concerning that the women are doing even worse than the men,' says lead study author Reshma Jagsi, M.D., D.Phil., assistant professor of radiation oncology at the U-M Medical School.

'The K08 and K23 grants are highly competitive, prestigious awards that are supposed to help young scientists become independent investigators. People who get these awards are expected to be the best and the brightest, and they are expected to succeed. They not only have the aptitude for and commitment to research, but the grant is supposed to give them the resources they need - protected time and mentorship,' Jagsi adds.

The authors suggest that family demands, including childbirth, could pull some women scientists from their careers. Women may also be more likely to feel pressures to contribute to the clinical workload and be less successful at negotiating with their department chairs for adequate time to devote to research.

The authors also say some of the fall-off between a K award and an R01 may occur as researchers choose other career paths, such as leadership or administrative roles. They believe further research is necessary to understand how to retain promising young physicians in research careers.

'We in academic medicine need to work harder to help promising young researchers succeed,' says senior study author Peter Ubel, M.D., professor of internal medicine and director of the Centre for Behavioural and Decision Sciences in Medicine at the U-M Medical School.

'Research takes time and energy, and when young researchers are trying to balance work and family, the major breakthroughs might have to wait a few extra years. New researchers not only need time, they need mentorship. And they need department chairs who understand that scientific success does not require researchers committing every aspect of their lives to their science,' Ubel adds.

The study authors urge strengthening the mentoring component of the K awards and considering an increase to the award amounts.

'We as a society have invested critical resources in these individuals. Our findings suggest dysfunction in the pipeline of physician-scientists,' Jagsi says. 'This is not an easy career path for anyone, and it may be particularly hard for women. We need to figure out how to make this a more tenable career path, and right now both men and women seem to need additional support.'

Source: University of Michigan Health System

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Radiation Exposure From Annual Mammography Increases Breast Cancer ... - Medscape News

Posted: 02 Dec 2009 06:23 AM PST

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Breast Cancer

Wednesday, December 2, 2009