A study published this week in the Journal of the American Medical Association has received extensive media attention because it found that ultrasound was able to find some cancers that mammography missed. 

But, as always, there were caveats.

One: ultrasound found a lot of things that were not breast cancer, leading to many unnecessary tests. The study found that by adding screening ultrasound (using ultrasound to look at the whole breast) to mammography, 55% more cancers were found in high risk women. That sounds like a lot. But in fact there were only 12 more cancers in the whole study that were detected only by ultrasound.  But of  the additional 233 women who needed biopsies because their additional ultrasound “saw something” only 20 had cancer. 

Two: As I point out in Deborah Kotz’s blog On Women on the U.S News & World Report website, there is no evidence that adding ultrasound to mammography will actually reduce your risk of dying of breast cancer.

We’ve long assumed that finding a cancer early will reduce your chance of dying. However, recent data suggests that not all cancers are the same. Some are more aggressive than others and just finding them early may not be enough.  Likewise, some cancers are so slow growing that finding them early isn’t as important in terms of survival. The researchers haven’t followed these women long enough–and it would take years–to know if adding ultrasound really did save lives.

Three: Breast ultrasound is expensive, takes a lot of time to do, and is not available at all medical centers.

Four: MRI is better than ultrasound. In March 2007 the American Cancer Society released new breast cancer screening guidelines which recommend that high-risk women receive an MRI and a mammogram. 

Bottom-line: Mammography, which is far from perfect, remains the best test for women at average risk of getting breast cancer. For those who are high-risk, adding MRI to mammography is a good choice, but MRI cannot be used instead of mammography.

Tara Parker-Pope wrote a good piece in the May 13 New York Times on osteoporosis, osteopenia, and bone health. You can read the piece (in which I’m quoted) here.
You also might want to visit the Bone Health section of our website. There you can find information about osteopenia, osteoporosis, clinical trials, and more.

If you have questions you’d like to see us answer in this section, please let us know!

The National Breast Cancer Coalition Fund will hold its intensive science training program, Project LEAD. Institute in Denver, Colorado this summer. Since 1995, NBCCF has trained more than 1,300 advocates through Project LEAD to take meaningful seats at all research and public policy tables where decisions about breast cancer are made. The five day intensive program includes sessions on molecular biology, genetics, proteomics, research design, epidemiology and critical appraisal skill building.  The next course will be July 29 - August 3 in Denver, Colorado.  The Application Deadline is May 30. 

You can  learn more on the NBCCF website. Click on Education/Training. Limited scholarships are available for those in financial need.

For more information and an application, visit www.StopBreastCancer.org, and click on Education/Training.

A research paper presented last month at the American Association for Cancer Research attracted significant media attention because it linked alcohol use to breast cancer risk.

Previous studies have also provided some evidence that alcohol may increase breast cancer risk, and laboratory studies have shown us the mechanism by which alcohol could promote breast cell growth, so this is not really “new news.” However, the new finding does come from the NIH-AARP Diet and Health Study, which is one of the largest studies to ever look at the relationship between diet and health.

The Diet and Health study, which began in 1995, includes 184,418 postmenopausal women. The women answered questions about their daily alcohol use. About 70 percent of the women in the study said they drank alcohol, on average less than a drink a day. About 5400 women in the study have developed invasive breast cancer and the researchers had information about the type of tumor 2391 of these women developed. (Specifically, there were 1,641 who developed ER+/PR+ tumors; 366 women with ER-/PR- tumors; 336 women with ER+/PR- tumors; and 48 women with ER-/PR+ tumors.

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Want to learn more about evidence-based healthcare? Then take a look at the new web course, “Understanding Evidence-Based Healthcare: A Foundation for Action,” which was developed by Kay Dickersin,  director of the US Cochrane Center, and breast cancer consumer advocate Musa Mayer.The course, a project of Consumers United for Evidence-based Healthcare, was designed for patient advocates, but it would also be helpful for anyone interested in learning more about statistics and risk, how studies are designed, and the type of evidence that is needed to change clinical practice. 

Overall, the course takes about six hours, but it is divided into 10-20 minute segments meant to be taken over several weeks. The course is free, but you need to register to access the materials.

You can learn more about the course here.  

There’s now yet another reason not to use hormone therapy to treat menopausal symptoms any longer than necessary–if at all.

A new study published in this week’s Journal of the National Cancer Institutefound that women who use estrogen alone to decrease menopausal symptoms may be at increased risk of developing benign breast lumps.

The study analyzed data collected in the Women’s Health Initiative (WHI)–the large study that led us to realize that, overall, the risks of hormone therapy outweighed any benefits.

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As the Cruise for the Cause headed from Grand Cayman to Grand Turk, 500 women joined Dr. Susan Love and Olivia Founder Judy Dlugacz to “Walk the Decks for Love” in honor of all the women who have faced a breast cancer diagnosis. Watching hundreds of women walk four laps around the decks was nothing less than awe-inspiring, and their amazing efforts raised more than $18,500 for the Foundation’s research program. Go Olivians!A few hours after the walk, breast cancer survivors and their caregivers joined Dr. Love and Dr. Lisa Weissmann, a medical oncologist specializing in breast cancer, to discuss the issues facing women diagnosed with breast cancer today. The informal conversation addressed topics ranging from treatments for women with metastatic disease and cancer markers to hormone therapy options for premenopausal women and genetic testing.The day closed with the panel presentation “Cruising for Our Cause,”where Dr. Love, Dr. Weissmann, Dr. Valerie Fein-Zachary, and Dr. Mhel Kavanaugh-Lynch explored the question: Can we prevent breast cancer?