Nav: Home

Breast cancer patients with dense breast tissue more likely to develop contralateral disease

February 07, 2017

HOUSTON - Breast cancer patients with dense breast tissue have almost a two-fold increased risk of developing disease in the contralateral breast, according to new research from The University of Texas MD Anderson Cancer.

The study, published in the journal Cancer, is among the first to find the association between breast density (BD) and contralateral breast cancer (CBC).

According to study author Isabelle Bedrosian, M.D., a big challenge in the management of this patient population, especially as they are making surgical decisions, is trying to counsel women appropriately on their risk of developing breast cancer in the other breast.

"We know there are a number of well-established influences for developing both primary and secondary breast cancers, such as BRCA mutations, family history, and the tumor's estrogen receptor status," explained Bedrosian, associate professor, Breast Surgical Oncology. "We also know density is a risk factor for the development of primary breast cancer. However, no one has closely looked at it as a risk factor for developing contralateral disease."

The estimated 10-year risk for women with breast cancer developing CBC can be as low as 2 percent, and as high 40 percent, said Bedrosian. The dramatic range is due in large part to the variability of risk factors across the patient population, she explained.

For the retrospective, case-controlled study, the researchers identified 680 stage I, II and III breast cancer patients, all treated at MD Anderson between 1997 and 2012. BRCA patients were excluded from the study, given their known increased risk of CBC.

Women with an additional diagnosis of metachronous CBC - defined as BC in the opposite breast diagnosed more than six months after the initial diagnosis - were the "cases," and patients who had not developed CBC were the "controls." Cases and controls were matched on a 1:2 ratio based on a number of factors, including age, year of diagnosis and hormone receptor status.

"With our research, we wanted to evaluate the relationship between the mammographic breast density of the original disease and the development of metachronous breast cancer," said Carlos Barcenas, M.D., assistant professor, Breast Medical Oncology, and the study's corresponding author.

Of the selected patients, 229 were cases and 451 were controls. The MD Anderson researchers categorized each patient's breast density by mammogram reading, assessed at the time of first diagnosis, as "nondense" or "dense," using the categorizations from the American College of Radiology.

Among the cases, 39.3 percent were classified as having nondense breast tissue and 60.7 percent as having dense breast tissue, compared to 48.3 percent and 51.7 percent, respectively, in the controls.

After adjusting for known breast cancer risk factors, the researchers found almost a two-fold increased risk of developing CBC in breast cancer survivors with dense breasts.

"Our findings have valuable implications for both newly diagnosed patients with dense breasts and for breast cancer survivors as we manage their long-term risk of a secondary diagnosis," said Barcenas. "Our future goal is to develop a risk model incorporating breast density to best assess a breast cancer survivor's risk of developing CBC."

In the long-term, the researchers hope to use this tool to counsel patients on their personal risk and their options for treatment and surveillance, if their risk is sufficiently high.

-end-

In addition to Barcenas and Bedrosian, authors on the all-MD Anderson study include: Debu Tripathy, M.D., Yu Shen, Ph.D., Banu Arun, M.D., Akshara Raghavendra, M.D., Limin Hsu, Modesto Patangan, Jr., and Arup K. Sinha, all of Breast Medical Oncology; Huong Le-Petross, M.D., and Naveen Garg, M.D., Diagnostic Radiology; and Therese Bartholomew Bevers, M.D., Clinical Cancer Prevention.

The study was supported by The University of Texas MD Anderson Cancer Center Young Breast Cancer Survivors Program.

University of Texas M. D. Anderson Cancer Center

Related Breast Cancer Survivors Articles:

Tai chi relieves insomnia in breast cancer survivors
Tai chi relieves insomnia in breast cancer survivors. New research shows that the slow-moving meditation practice -- frequently offered at community centers and libraries -- works just as well as talk therapy, and better than medication.
Researcher examines effect of exercise on breast cancer survivors
Gwendolyn Thomas, assistant professor of exercise science, is the co-author of a groundbreaking article in the Obesity Journal (The Obesity Society, 2017) about the effects of exercise and physical activity on postmenopausal breast cancer survivors taking AIs -- hormone-therapy drugs that stop the production of estrogen.
Untreated effects of breast cancer care increase depression and anxiety among survivors
For many of the 2.8 million survivors in the United States, the price of survival includes severe physical and psychosocial symptoms -- including joint pain, fatigue, weight gain and insomnia -- that may go untreated and persist for many years after treatment.
Higher vitamin D levels associated with better outcomes in breast cancer survivors
Women with higher vitamin D levels in their blood following a breast cancer diagnosis had significantly better long-term outcomes, according to new research from Kaiser Permanente and Roswell Park Cancer Institute.
A new study explores concerns of African American breast cancer survivors
Researchers examine the biggest challenges for African American women after receiving breast cancer treatment.
Exercise improves memory in breast cancer survivors
Moderate-to-vigorous physical activity is related to improved subjective memory in breast cancer survivors, who often complain about memory problems, reports a new study.
Acupressure reduced fatigue in breast cancer survivors
Acupressure helped reduce persistent fatigue in women who had been treated for breast cancer, a new study finds.
Breast cancer survivors could be vulnerable to common viral and bacterial infections
Breast cancer survivors treated with chemotherapy could be lacking sufficient antibodies to protect against common illnesses, as chemotherapy reduces the body's immune response, according to research published in the open access journal Breast Cancer Research.
New guideline addresses long-term needs of breast cancer survivors
A new breast cancer survivorship care guideline provides guidance to primary care and other clinicians in caring for the estimated 3.1 million female adult survivors of breast cancer in the United States.
Neurotoxic effects of chemotherapies on cognition in breast cancer survivors
Cancer-related cognitive impairment is often referred to as 'chemobrain' and anthracycline-based chemotherapy may have greater negative effects on particular cognitive domains and brain network connections than nonanthracycline-based regimens, according to an article published online by JAMA Oncology.

Best Science Podcasts 2017

We have hand picked the best science podcasts for 2017. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: Radiolab

Radiolab Presents: Anna in Somalia
This week, we are presenting a story from NPR foreign correspondent Gregory Warner and his new globe-trotting podcast Rough Translation. Mohammed was having the best six months of his life - working a job he loved, making mixtapes for his sweetheart - when the communist Somali regime perp-walked him out of his own home, and sentenced him to a lifetime of solitary confinement.  With only concrete walls and cockroaches to keep him company, Mohammed felt miserable, alone, despondent.  But then one day, eight months into his sentence, he heard a whisper, a whisper that would open up a portal to - of all places and times - 19th century Russia, and that would teach him how to live and love again. 
Now Playing: TED Radio Hour

Future Consequences
From data collection to gene editing to AI, what we once considered science fiction is now becoming reality. This hour, TED speakers explore the future consequences of our present actions. Guests include designer Anab Jain, futurist Juan Enriquez, biologist Paul Knoepfler, and neuroscientist and philosopher Sam Harris.