Annals of Internal Medicine tip sheet Nov. 19, 2002

November 18, 2002

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

1. AAFP and ACP-ASIM Guidelines Show How Migraines Should be Treated --And Can Be Prevented
(Clinical Guidelines, p. 840. News release to follow.)

2. Women Over Age 75 Benefit from Mammography
A new study provides strong, indirect evidence for recommending routine mammography screening to women over age 75 (Article, p. 783). Researchers took data on 12,038 female Medicare beneficiaries who were at least 69 years old and received a new diagnosis of breast cancer between 1995 and 1996. They found that, in general, women 75 years or older had larger tumors at diagnosis and were less likely to have had screening mammography than 69-74 year-old women. However, older women who had regular mammography had similar sized and stage tumors as the younger women, suggesting a benefit of mammography in women after age 75. Although the researchers did not study whether screening women after age 75 improved their breast cancer mortality rates or gave better quality of life, they did determine that regular mammography is associated with detecting earlier-stage disease in older women.

3. Post Menopausal Hormones + Alcohol Substantially Increase Risk of Breast Cancer
Data from the Nurses' Health Study found that the use of postmenopausal therapy (PMH) for five or more years and drinking 1.5 alcoholic drinks or more daily increased risk for breast cancer (Article, p. 798). Women who used both PMH and alcohol had almost twice the risk for breast cancer than women who used neither. The authors concluded that women should consider the increased risk for breast cancer when deciding about drinking alcohol, taking postmenopausal hormones and, especially, both together. The limitations of the study are that the large, ongoing Nurses' Health Study relies on self-reported information and the study questions did not differentiate among the kind of PMH taken, e.g., estrogen alone or estrogen with progesterone.

4. Review of Randomized, Controlled Trials of Complementary and Alternative Medicine (CAM) for Menopausal Systems Finds Little Hard Data
Seeking to evaluate complementary and alternative products used for menopausal symptoms, researchers identified 29 randomized, controlled trials (Academia and Clinic, p. 805). They found that black cohosh and foods that contain phytoestrogens, such as soy, show some promise at relieving hot flashes, but they say that clinical trials do not support the use of other herbs or CAM therapies. Well-designed but small trials found that vitamin E, red clover, evening primrose oil, and dong quai were ineffective for hot flashes. Common problems with even these existing studies on CAM use for menopause are that they are small; they often test for only short periods of time, while the herbs or therapies are presumably taken for long periods of time; safety data on long-term use of herbs are inadequate; and herbs and other CAM therapies in the United States lack adequate product quality control.

5. Task Force's Recommendations for Postmenopausal Therapy Appear in Annals
The U.S. Preventive Services Task Force recommends against the use of combined estrogen and progestin therapy for preventing cardiovascular disease and other chronic conditions in postmenopausal women (Clinical Guidelines, p. 834). These recommendations were originally posted on the Annals of Internal Medicine web site (http://www.acponline.org/journals/annals/hrt.htm) on Oct. 15, 2002, and are published in the Nov. 19, 2002, print version of Annals.
-end-


American College of Physicians

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.