Low breast density worsens prognosis in breast cancerJune 21, 2016
Even though dense breast tissue is a risk factor for breast cancer, very low mammographic breast density is associated with a worse prognosis in breast cancer patients. Patient survival is affected only when low breast density is combined with an abundance of hyaluronan in the tumour, shows recent research from the University of Eastern Finland and Kuopio University Hospital.
The study also found that the existing Nottingham Prognostic Index for breast cancer can be improved by including low mammographic breast density and HER2 status in the index.
Breast cancer is the most common cancer in women and the leading cause of women's cancer deaths. The main established prognostic factors are tumour size and differentiation grade, spreading to armpit lymph nodes, hormone receptor status and HER2-positivity. However, there's a need to define new and more accurate prognostic factors that could also allow for more personalised treatments.
Mammographic breast density (MBD) has been a topic of research and discussion for decades. However, the focus has been mostly on the effect of MBD on screening sensitivity, masking effect and its status as a risk factor for breast cancer formation. Women with very dense breast tissue are known to have a 4- to 6-fold risk of breast cancer. The study concentrated on a less widely studied aspect of MBD - its prognostic effect in women who already have breast cancer.
In a study involving 278 breast cancer patients, researchers examined the prognostic value of MBD and mammographic tumour features and their relationship with the established prognostic factors. Very low MBD was found to be an independent prognostic factor for breast cancer. It was also associated with higher tumour grades and predicted worse survival.
Hyaluronan (HA) is a molecule naturally present in nearly all tissue types, but in cancer the metabolism of HA may change and promote the progression of cancer. The study also assessed the association between HA and its synthetizing enzymes with that of MBD and other mammographic and tumour characteristics. A strong link was found between low breast density and high expressions of HA and its synthesizing enzymes. Moreover, there was a dramatic reduction in patient survival exclusively when HA abundance was combined with low breast density.
In addition to very low MBD, HER2 positivity was also shown to be a prognostic factor for breast cancer, independent of the widely used Nottingham Prognostic Index (NPI). These factors were incorporated into a new prognostic index called the Kuopio-Nottingham Prognostic Index (KNPI), which has a higher predictive power than the original NPI.
According to Amro Masarwah, MBBS, who presented the results in his doctoral thesis, the findings suggest that dense breast tissue carries a more favourable prognosis and the mechanisms of cancer development are different from those of progression and aggressiveness.
"Since measuring density is becoming more common, physicians' expertise with density will increase and this will open up doors for MBD to be used in patient outcome prediction."
"Mammographic breast density is readily available, and can be easily measured and recorded at the time of diagnosis. Given the right training, excellent inter-reader agreement can be achieved and accurate measurements performed without the need of additional complicated, expensive and time consuming software or procedures," Masarwah concludes.
"The new proposed cut-off definition of 'fatty breasts' might explain some of the discrepancies in the literature regarding the effects of density on prognosis," he adds.
For further information, please contact Amro Masarwah, firstname.lastname@example.org, tel. +358458089645
University of Eastern Finland
Related Breast Cancer Articles:
A new article published by JAMA Oncology compares outcomes for combined mammography and MRI or ultrasonography screenings for new breast cancers in women who have previously undergone breast conservation surgery and radiotherapy for breast cancer initially diagnosed at 50 or younger.
A Clinical Breast Cancer study demonstrates Videssa Breast can inform better next steps after abnormal mammogram results and potentially reduce biopsies up to 67 percent.
The proportion of women in the United States undergoing surgery for early-stage breast cancer who have preventive mastectomy to remove the unaffected breast increased significantly in recent years, particularly among younger women, and varied substantially across states.
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.
Breast conserving therapy (BCT) is better than mastectomy for patients with some types of early breast cancer, according to results from the largest study to date, presented at ECC2017.
An annual mammogram is recommended after treatment for breast cancer, but nearly one-third of women diagnosed with breast cancer aren't receiving this follow-up exam, according to new findings presented at the 2016 Annual Clinical Congress of the American College of Surgeons.
Even though dense breast tissue is a risk factor for breast cancer, very low mammographic breast density is associated with a worse prognosis in breast cancer patients.
Young women with early breast cancer face a difficult choice about whether to opt for a mastectomy or breast conserving therapy (BCT).
In a study appearing in the April 26 issue of JAMA, Elizabeth A.
Five years after breast-conserving surgery, radiotherapy focused around the tumor bed is as good at preventing recurrence as irradiating the whole breast, with fewer side effects, researchers from the UK have found in the large IMPORT LOW trial.
Related Breast Cancer Reading:
Chicken Soup for the Soul: Hope & Healing for Your Breast Cancer Journey: Surviving and Thriving During and After Your Diagnosis and Treatment
by Dr. Julie Silver (Author)
Chicken Soup for the Soul: Hope & Healing for Your Breast Cancer Journey will encourage comfort and encourage breast cancer patients and survivors with its inspiring stories and helpful medical information.
A support group from breast cancer diagnosis through treatment to rehabilitation and recovery, this book combines inspiring Chicken Soup for the Soul stories written just for this book and accessible leading-edge medical information from Dr. Julie Silver of Harvard Medical School. Patients and survivors will find comfort, strength and hope. View Details
Dear Friend: Letters of Encouragement, Humor, and Love for Women with Breast Cancer
by Gina L Mulligan (Author)
This beautiful collection of handwritten letters offers strength, encouragement, and comfort to women living with breast cancer. Written by compassionate strangers—many of whom have gone through their own health battles—these heartfelt letters were gathered by Girls Love Mail, an organization that provides support to people diagnosed with breast cancer as seen on NBC Nightly News. Presented in an elegant package with metallic endpapers, and a ribbon marker, and brimming with warm messages of empathy, inspiration, and humor, Dear Friend delivers words of wisdom when they're needed... View Details
Let Me Get This Off My Chest: A Breast Cancer Survivor Over-Shares
by Margaret Lesh (Author)
Tamoxifen hot flashes, mastectomy, reconstruction, breast cancer etiquette, Frankenboobs, bras with special attachments—Margaret Lesh shares all in her funny, heartfelt collection of essays, anecdotes, and life lessons from the perspective of a two-time breast cancer survivor. She’ll tell you when it’s okay to play the cancer card, what you should take to the hospital, and gives suggestions on how to cope in those dark moments of the soul. With practical tips sprinkled throughout, LET ME GET THIS OFF MY CHEST explores how breast cancer changed her outlook on life, offering honest... View Details
The Breast Cancer Survival Manual, Sixth Edition: A Step-by-Step Guide for Women with Newly Diagnosed Breast Cancer
by John Link M.D. (Author), James Waisman M.D. (Author), Nancy Link R.N. (Author)
One of the most comprehensive and bestselling books on breast cancer treatment and survival, completely revised and updated
The sixth edition of Breast Cancer Survival Manual provides essential updates on treatment and care, enhancing the basic information that has made this the most trusted guide for women diagnosed with breast cancer for the past two decades. This edition includes the most current advice on:
· The new genomic classification of breast cancer and its importance in treatment planning
· Cancer gene testing, which determines if a woman will benefit... View Details
Dr. Susan Love's Breast Book (A Merloyd Lawrence Book)
by Susan M. Love (Author), Karen Lindsey (Contributor), Elizabeth Love (Contributor)
For a woman faced with a diagnosis of breast cancer, the information available today is vast, uneven, and confusing. For more than two decades, readers have relied on Dr. Susan Love's Breast Book to guide them through this frightening thicket of research and opinion to find the best possible options for their particular situations. This sixth edition explains exciting advances in targeted treatments, hormonal therapies, safer chemotherapy, and immunologic approaches as well as new forms of surgery and radiation. There is extensive guidance for the increasing number of women living for... View Details
Breast Cancer Smoothies: 100 Delicious, Research-Based Recipes for Prevention and Recovery
by Daniella Chace (Author)
The statistics are staggering. Breast cancer is the most common type of cancer among women--About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime. Second only to heart disease by a mere one percent, every ounce of prevention and every window of opportunity for healing is critical. In order to reduce the risk of developing this common disease, you need a targeted plan to protect yourself from common breast toxins and to strengthen your immune defenses.
In her delightful new book, Daniella breaks down the complex topic of... View Details
Heal Breast Cancer Naturally: 7 Essential Steps to Beating Breast Cancer
by Dr. Veronique Desaulniers (Author)
One out of eight women will be diagnosed with Breast Cancer. One out of 3 women will experience some form of cancer in their life time.
I was one of those statistics even though I was living a healthy lifestyle that consisted of organic foods, regular exercise, massage, Chiropractic care and colonics. How could somebody like me develop Breast Cancer?
That very question led to thousands of hours of research, study, soul-searching and prayer. It all came together as The 7 Essentials – 7 basic steps that are necessary for preventing and healing cancer, or any dis-ease for... View Details
Getting Things Off My Chest: A Survivor's Guide to Staying Fearless and Fabulous in the Face of Breast Cancer
by Melanie Young (Author)
Charge head on into the battle with breast cancer, armed with these outstanding survivors' tips on how to stay sane, focused, and in charge. Written by a breast cancer survivor with expert insights, handy checklists and helpful questions to ask your doctors, all geared toward streamlining your new life. This detailed, upbeat book helps you make informed decisions, eat and exercise to stay strong, look and feel your best, eliminate stress and boost your spirits with positive thinking and a dose of humor. Don't let your cancer control you; empower yourself and ease the transition with this... View Details
Breast Cancer Husband: How to Help Your Wife (and Yourself) during Diagnosis, Treatment and Beyond
by Marc Silver (Author)
A unique guide, like none other on the market-packed with medical information, practical tips, psychological insight, and coping strategies-to help men help the women they love through this trying time.
When Marc Silver became a breast cancer husband three years ago, he learned firsthand how frightened and helpless the breast cancer husband feels. He searched in vain for a book that would give him the information and advice he so desperately sought. Now this award-winning journalist has compiled just the kind of emotionally supportive and useful resource that he wished he had been... View Details
Beat Breast Cancer: 19 Actions to Help You Through Diagnosis, Surgery and Beyond
by M.K. Caldwell (Author)
I am a cancer survivor. This book is for those who are facing the news of cancer, or for someone who knows someone who is fighting this fight and wants to give this book to them as a gift. A diagnosis of cancer is overwhelmingly terrible. However, the outcome can be a very successful one. Surprisingly, conquering cancer can positively change your future life for the better.What? Yes. In the darkest of hours, there is a silver lining, always. I think you will find this book to be true to life. While the news is devastating, attitude and action are everything! After I cried, I ended up... View Details