Category Archives: Breast Cancer

Texas tries to repair damage it has inflicted on its family planning services

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By Wade Goodwyn
200px-Flag-map_of_TexasNPR

For the past five years, the Texas Legislature has done everything in its power to defund Planned Parenthood. But it’s not so easy to target that organization without hurting family planning clinics around the state generally.

The researchers found that two years after the cuts, Texas’ women’s health program managed to serve fewer than half the number of women it had before.

The Legislature’s own researchers predicted that more than 20,000 resulting unplanned births would cost taxpayers more than a quarter of a billion dollars in federal and state Medicaid support.

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Cancer now leading cause of death in 22 states – Associated Press

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Lung CancerCancer is becoming the No. 1 killer in more and more states as deaths from heart disease have declined, new health statistics show.

Nationwide, heart disease is still the leading cause of death, just ahead of cancer.

While death rates for both have been falling for nearly 25 years, heart disease has dropped at a steeper rate.As a result, cancer moved up to the top slot in 22 states in 2014, according to the latest government figures.

Source: News from The Associated Press

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More getting mammograms under Medicaid expansion

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Doctor inspects mammogram. Photo by Bill Branson/NCI

Doctor inspects mammogram. Photo by Bill Branson/NCI

By Lynne Shallcross
KHN

If you’re a low-income woman, you’re more likely to get screened for breast cancer if you live in a state that expanded Medicaid under the Affordable Care Act than in a state that didn’t.

According to new research, low-income women who lived in a handful of early-adopter states that implemented Medicaid expansion by 2011 were 25 percent more likely to be screened for breast cancer in 2012 than women in non-expansion states.

That’s a big change from 2008, when low-income women in both sets of states had similar odds of being screened. The study was presented Monday at the annual meeting of the Radiological Society of North America. Continue reading

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Buyer Beware: a mammogram’s price can vary by nearly $1,000, study finds

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Doctor views mammograms

By Jordan Rau
KHN

Thinking about getting a mammogram in the Dallas-Fort Worth area? You might check carefully because the cost can vary from $50 to as much as $1,045.

How about an initial routine gynecological exam? Around Phoenix, those prices can range from $72 to $388.

According to an analysis released Wednesday, it can pay to shop around for women’s health care, with mammograms and other routine services often costing far more in one office than in another. Continue reading

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Video explains panel’s new mammography recommendations

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FACTS AND MYTHS –

By the US Preventive Services Task Force

MYTH: The Task Force recommends against screening for breast cancer in women younger than 50.

FACT: Evidence shows that mammography screening can be effective for women in their 40s. Based on the science, the Task Force’s draft recommendation states that the decision to start regular mammography screening before age 50 is an individual one and should be made by a woman in partnership with her doctor. Continue reading

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So you have dense breasts. Now what?

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Catharine Becker at her home in Fullerton, California on April 14, 2014. Becker started to get mammograms at age 35 because she had a family history of breast cancer (Photo by Heidi de Marco/Kaiser Health News).

By Barbara Feder Ostrov
KHN

Earlier this year, Caryn Hoadley received an unexpected letter after a routine mammogram.

The letter said her mammogram was clean but that she has dense breast tissue, which has been linked to higher rates of breast cancer and could make her mammogram harder to read.

“I honestly don’t know what to think about the letter,” said Hoadley, 45, who lives in Alameda, Calif. “What do I do with that information?”

Millions of women like Hoadley may be wondering the same thing. Twenty-one states, including California, have passed laws requiring health facilities to notify women when they have dense breasts. Eleven other states are considering similar laws and a nationwide version has been introduced in Congress.

The laws have been hailed by advocates as empowering women to take charge of their own health. About 40 percent of women have dense or extremely dense breast tissue, which can obscure cancer that might otherwise be detected on a mammogram.

But critics say the laws cause women unnecessary anxiety and can lead to higher costs and treatment that doesn’t save lives or otherwise benefit patients. Continue reading

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Inviting patients to help decide their own treatment

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By Anna Gorman
KHN

SAN FRANCISCO — Rose Gutierrez has a big decision to make.

Gutierrez, who was diagnosed with breast cancer last spring, had surgery and 10 weeks of chemotherapy. But the cancer is still there.

Now Dr. Jasmine Wong, a surgeon at UC San Francisco, is explaining the choices – Gutierrez can either have another lumpectomy followed by radiation, or she can get a total mastectomy.

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Rose Gutierrez (Photo by Heidi de Marco/KHN).

 

“I think both options are reasonable,” Wong said. “It’s just a matter of how you feel personally about preserving your breast, how you feel about having radiation therapy.”

“I’m kind of scared about that,” said Gutierrez, 52, sitting on an exam table with her daughter on a chair beside her.

“Well if you made it through chemo, radiation is going to be a lot easier,” Wong told Gutierrez, who is from Merced, Calif.

In many hospitals and clinics around the country, oncologists and surgeons simply tell cancer patients what treatments they should have, or at least give them strong recommendations.

But here, under a formal process called “shared decision making,” doctors and patients are working together to make choices about care. Continue reading

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Two out of 3 people diagnosed with cancer survive 5 years or more – CDC

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A Norwegian study estimates that a many as 25 percent of cases of invasive breast cancers diagnosed by mammography screening are cases of overdiagnosis. (Photo/NCI)Two out of 3 people diagnosed with cancer survive five years or more, according to a study by the US Centers for Disease Control and Prevention published in today’s Morbidity and Mortality Weekly Report.

The report found that the most common cancer sites continue to be prostate, breast, lung, and colorectal cancer.

Among these common cancer sites 5-year relative survival was:

  • 97 percent for prostate cancer,
  • 88 percent for breast cancer,
  • 63 percent for colorectal cancer, and
  • 18 percent for lung cancer.

The authors noted that disparities in cancer incidence still persist, with greater rates among men than women and the highest rates among blacks.

Additionally, 5-year relative survival after any cancer diagnosis was lower for blacks (60 percent) than for whites (65 percent).

Data by state show incidence rates for all cancer sites ranged from 374 cases per 100,000 persons in New Mexico to 509 cases per 100,000 persons in the District of Columbia.

“These data are an important reminder that a key to surviving with cancer is making sure everyone has access to care from early diagnosis to treatment,” said Lisa Richardson, M.D., director of CDC’s Division of Cancer Prevention and Control.  “We know, for example, that early detection of colorectal cancer has had the largest impact on long-term survival rates.”’

Through the Affordable Care Act, more Americans will qualify to get health care coverage that fits their needs and budget, including important preventive services, including screening for some cancers, that may be covered with no additional costs.

Visit Healthcare.gov or call 1-800-318-2596 (TTY/TDD 1-855-889-4325) to learn more.

The full report, “Invasive Cancer Incidence and Survival – United States, 2011,” can be found at www.cdc.gov/mmwr. For more information about CDC’s efforts in cancer prevention and control, visit www.cdc.gov/cancer.

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Washington state to offer breast cancer license plates

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BC-MountainRibbonOLYMPIA – There’s a new way to donate and show your support for breast cancer screening and testing. Starting Oct. 16, you have a chance to bid on the first batch of breast cancer license plates before they go on sale to everyone, starting in January.

Money raised from the sale of the plates will pay for breast cancer screenings and follow up tests for women with limited or no insurance through the state Department of Health’s Breast, Cervical, and Colon Health Program.

Money raised from the sale of the plates will pay for breast cancer screenings and follow up tests for women with limited or no insurance.

The auction runs through the end of the month. More information about the auction and how to bid can be found online. After this month’s auction, breast cancer license plates will be available for purchase in January 2015 for $60 through the state Department of Licensing. Continue reading

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Quantifying the ‘Angelina Jolie effect’

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Actress’ impact on genetic testing for breast, ovarian cancer is ‘global and long lasting’

Angelina Jolie - Photo courtesy of the UK Foreign and Commonwealth Office

Angelina Jolie – Photo courtesy of the UK Foreign and Commonwealth Office

By Mary Engel / Fred Hutch News Service

Sept. 18, 2014

The so-called Angelina Jolie effect not only is real but has been “global and long lasting,” leading to a twofold increase in the number of women getting genetic testing to help determine their risk for hereditary breast cancer, according to new studies from the United Kingdom and Canada.

The number of women found to have a genetic mutation that increased their risk also has doubled.

And contrary to concerns that women at low risk for hereditary breast cancer would flood testing centers, researchers said that those being tested are women like Jolie who have a family history of breast cancer or who have personal risk factors such as ethnicity.

Certain ethnic groups, including Ashkenazi Jews, have a higher prevalence of BCRA mutations, which significantly increase breast cancer risk.

Women got the correct message

“What surprised us was that we didn’t get the worried well,” said Dr. Andrea Eisen, head of preventive oncology for breast cancer care at the Sunnybrook Odette Cancer Centre in Toronto and an author of the Canadian study, in a phone interview.  “We got women who got the correct message. That was gratifying.”

Jolie disclosed in a May 2013 op-ed in The New York Times that she had undergone a preventive double mastectomy after finding that she carries the rare BRCA1 gene mutation, which dramatically raises her risk of breast and ovarian cancers. Continue reading

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Nipple aspirator

Nipple aspirate test is no substitute for mammogram – FDA

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Consumer Update from the US Food and Drug Administration

ucm378297Many women admit that getting a mammogram is no fun, and may wish there was an easier, more comfortable way to screen for breast cancer in its earliest and most treatable stages.

Some companies today are promoting a test in which a breast pump is used to collect fluid from a woman’s nipple to screen for abnormal and potentially cancerous cells. This test—called a nipple aspirate—is being marketed as the latest and greatest tool in early breast cancer screening, one that is easier, more comfortable and less painful than the mammogram.

However, there is no clinical evidence to support these claims, says David L. Lerner, M.D., a medical officer at the Food and Drug Administration (FDA) and a specialist in breast imaging.

“FDA’s concern is that the nipple aspirate test is being touted as a stand-alone tool to screen for and diagnose breast cancer as an alternative to mammography,” Lerner explains. “Our fear is that women will forgo a mammogram and have this test instead.” This could result in serious health consequences if breast cancer goes undetected, he notes.

FDA is unaware of any valid scientific data to show that nipple aspirate tests, when used on their own, are an effective screening tool for any medical condition, including the detection of breast cancer or other breast disease, Lerner says. Researchers are still studying whether these tests may one day be used, in conjunction with other medical devices, to screen for disease.

In February 2013 FDA issued a warning letter to Atossa Genetics, Inc. that, among other things, informed the company that their test was misbranded in that its labeling was false or misleading. The agency asked the firm to take prompt action to correct the violations addressed in the warning letter. In October 2013, Atossa initiated a voluntary recall to remove the ForeCYTE Breast Health Test from the market.

Unsubstantiated Claims

In addition to stating that the test can help women 18 years and older determine their risk level for breast cancer, Atossa claimed that its test was “literally a Pap smear for breast cancer.” According to FDA medical officer Michael Cummings, M.D., who reviews obstetrical and gynecological devices for the agency, this claim is unsubstantiated.

“The cervical Pap smear has a known clinical benefit supported by extensive clinical studies over many years,” Cummings says. “Its scientific ability to screen for cervical cancer is unquestioned.” The nipple aspiration test has no such evidence supporting it, he attests.

In addition, Lerner explains that if a Pap smear shows abnormal cells of the cervix, there are follow-up procedures that can be done to try to identify the location of those cells, after which a biopsy of the area is possible. With a breast nipple aspirate, if there are abnormal cells, the test does not target where those cells are coming from, so a biopsy may not be possible. Moreover, while the risk of abnormal cervical cells progressing to cancer is known, the risk of abnormal breast cells progressing to cancer is not.

Lerner says the test may produce results that are falsely positive or falsely negative. “False positives are possible because cells can be damaged in the aspiration process and look abnormal,” he notes. “We are even more concerned about false negatives,” he adds. Companies acknowledge that over 90% of their fluid samples may contain either very scant cells or no cells at all. Yet the companies call such results “diagnostically useful” and even conclude that a patient is healthy based on a cell-free sample, he says. “The test may be missing cancers and giving women dangerous false assurance,” Lerner says.

Mammography Still the Best

The mammogram can be uncomfortable for the woman being screened because it compresses the breast to flatten out the breast tissue and increase the clarity of the X-ray image. Still, FDA is not alone in believing that mammography is the most effective method for screening for breast cancer. Other organizations agree, including the American Cancer Society, the American College of Radiology (the professional society of physicians who specialize in medical imaging) and the National Cancer Institute, a division of the National Institutes of Health.

The National Cancer Institute states that screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 70. The National Comprehensive Cancer Network (NCCN) 2013 guidelines state that the clinical utility of nipple aspiration is still being evaluated and that it should not be used as a breast cancer screening technique.

FDA recommends that women who have received a nipple aspirate test as a form of breast cancer screening should also have a mammogram according to screening guidelines or as recommended by their doctor, and should talk to their health care professional about whether additional tests are needed.

“The bottom line is that women should not rely solely on these nipple aspirate tests for the screening or diagnosis of breast cancer, “Lerner says. “Mammography is still the gold standard.”

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Dec. 12, 2013

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