A master breast cancer gene. According to a recent article in the Montreal Gazette and press releases dating back five years or more, geneticists have identified a 'super gene' that causes breast cancer to metastasize. Described as a "master regulator" the SATB1 gene appears to alter the behaviour of at least 1000 other genes within tumour cells. When over-activated, it makes cancer cells proliferate; when neutralized, the gene stops the cells from dividing and migrating. The findings could be significant for future breast cancer therapy but, despite the fact that press releases about SATB1 have been issued since 2002 (see article at www.lbl.gov/Science-Arti-clesArchive/LSD-SATB1-Kohwi-Shige-matsu. html), we have been unable to locate an article about SATB1 in a recognized, peer-reviewed scientific journal. The latest article appeared in the British weekly journal of science, Nature (13 Mar 2008), 452:187-193.

Hormone therapy linked to ovarian cancer risk. Researchers examined the association between menopausal hormone use and the risk of ovarian cancer using data from over 97,000 women who completed questionnaires between 1995 and 1997. They conclude that risk of ovarian cancer is increased in women who take estrogen for ten years or more, and in those taking estrogen + progestin for five years or more. (J Natl Cancer Inst 2006; 98:1397-1405)

Radiation helpful in older women with ductal carcinoma in situ (DCIS). Using data of 3,409 women aged 66 years or more who had had a lumpectomy for DCIS, this study sought to determine if additional radiation conferred a significant benefit. Results indicate that women who had radiation had a 68% lower relative risk for recurrence of DCIS, invasive breast cancer, and/or mastectomy. The study suggests that radiation should be a standard of care for older women treated for DCIS. (J Natl Cancer Inst 2006; 98:1302-1310)

Family history of breast cancer affects risks of ovarian cancer. A detailed family history was taken of almost 50,000 women; of these, 362 ovarian cancers were identified during follow-up. Having a first- or second-degree relative, or two or more first-degree relatives with breast cancer led to significantly increased risk for ovarian cancer. This was even more true of women with a personal history of breast cancer. Knowledge about breast cancer history in one's immediate family can be useful in assessing risk for ovarian cancer. (Cancer 2006; 107:1075-1083)

HRT no help against tamoxifen-related hot flashes. Researchers examined data from a study of 7,100 women at high risk of breast cancer. Half of the women were taking tamoxifen and half were on placebo. The tamoxifen group reported more hot flashes than the placebo group (70.6% vs. 57.1%) but HRT was not effective in reducing hot flashes. The explanation is that tamoxifen almost completely saturates the estrogen receptor, so that increasing HRT has no effect. (J Clin Oncol 2006; 24:3991-3996)

Population differences in breast cancer severity. Data from the ongoing U. S. Surveillance, Epdemiology and End Results (SEER) program illustrate notable differences. Even though African-American, Hispanic and Native American women have a lower incidence of breast cancer compared to non-Hispanic white women, they have a greater risk of mortality after diagnosis. These differences are thought to be due to diverse exposure to environmental risk factors, genetic risk factors, or both. (Pharmacogenomics 2008; 9(3): 323-333)

Sentinel lymph node (SLN) biopsy reviewed. A multicentre randomized trial was undertaken to assess the efficacy and safety of SLN biopsy compared with the standard axillary lymph node dissection. This study which involved 697 patients available for analysis concluded that SLN is an effective and well-tolerated procedure but that its safety should be confirmed by larger randomized trials and meta-analyses. (Ann Surg 2008; 247(2): 207-213)

Estrogen levels linked to risk for breast cancer recurrence. In this study, 153 women — most of whom were postmenopausal — who had early-stage breast cancer were followed to see who had a recurrence of the disease. The mean interval between diagnosis and recurrence was a little over five years. The researchers found that women with a recurrence had an average estradiol (estrogen) concentration that was double the average of those who stayed healthy. Estrogen levels can be reduced by moderate to vigorous exercise and by achieving and maintaining a healthy weight. (Cancer Epidemiol Biomarkers Prev 2008; 17: OF1-OF7)

HRT affects mammograms and breast biopsies. Breast cancer diagnosis is hindered by the use of HRT and these effects persist for at least a year after HRT is discontinued. This is particularly worrisome given the increased incidence of breast cancer for women on HRT — an increase that persists for three years after discontinuation — and the fact that, when diagnosed, the cancers are likely to be at a more advanced stage. These results come from a sub-study of the Women's Health Initiative. (Arch Intern Med 2008; 168:370-377) Another study demonstrates that HRT for as little as three years substantially increases the risk of developing lobular breast cancer. (Cancer Epidemiol Biomarkers Prev 2008; 17:43-50)

Statins and risk of breast cancer. Statins (drugs used for preventing and treating atherosclerosis leading to chest pain, heart attacks, strokes) appear not to affect risk of breast cancer. Because statins had been found to inhibit breast cancer cells both in vitro and in rat studies, the researchers wondered if this applied to women. Data was collected from over 4,000 women aged 50 or older with invasive breast cancer. Of these women, about 7% had ever used a statin (e. g., Mevacor, Zocor, Pravachol, Lescol, etc.) but the overall use of statins — dosage, duration of use — was not associated with breast cancer risk. (Cancer 2008; 112:27-33)

Removal of ovaries increases chances of survival in premenopausal women. Oophorectomy and tamoxifen significantly improve overall and disease-free survival in premenopausal women with operable breast cancer, particularly those with estrogen receptor positive tumours. This finding is especially relevant for women in resource-poor countries where patients often have limited access to chemotherapy. (J Clin Oncol, Jan 10, 2008:253-257)

A saliva test to detect breast cancer? Researchers at the U of Texas Health Science Center in Houston reported that they have identified abnormal proteins in secretions from the salivary glands of women with breast cancer. They recruited 30 volunteers: ten cancer-free women, ten with benign breast tumours and ten diagnosed with invasive breast cancer. They found 49 saliva proteins that were distinctively different in women with tumours and were even able to chemically distinguish between benign and malignant tumours. Work is continuing with the hope that, one day, your dentist could find no cavities and no breast cancer. (Clinical Cancer Research 2000; 6:2363-2370)

Breast cancer surgery in womem aged 65 or older. A British study looked at surgery rates for older women with operable breast cancer and confirmed that patients older than 80 were much less likely to have surgical treatment. Left unanswered were the reasons for this decision: was it influenced by family or patient wishes or was it solely a surgeon's or oncologist's decision? (Brit J Surg 2007; 94:1209-1215)

MRI vs. mammography for detecting DCIS. A comparison was made between mammography and breast magnetic resonance imaging (MRI) to detect ductal carcinoma in situ. The subjects were 7319 British women, of whom 193 had a tissue diagnosis of DCIS and 167 had been tested using both methods. MRI was more effective in detecting DCIS, picking up 92% of cases as compared to 56% by mammography. The results look solid but the researchers are calling for confirmation in a randomized trial because MRIs are so much more expensive than standard mammography. (Lancet 2007; 370:485-492).