Posted by on October 16, 2012 - 10:18am

Moderate to intense exercise and maintaining a healthy weight has been linked to a lower risk of breast cancer found a study conducted by the University of North Carolina’s Gillings School of Global Public Health and published in the journal Cancer.  The results still held up if women did not actively exercise in their younger years, but started a regimen later in life.

The Long Island Breast Cancer Study Project looked at the relationship between breast cancer and the environment.  Researchers studied more than 3,000 women between the ages of 20 to 98, half with and half without breast cancer.  Women who exercised 10-19 hours a week were 30% less likely to have breast cancer versus those who did not exercise.  Women who exercised during their reproductive years had the greatest benefit: a 33% reduction of breast cancer risk compared to those who did not exercise during their reproductive years.  Postmenopausal women who exercised experienced a 30% reduction in breast cancer risk compared to postmenopausal women who did not exercise.

More exercise even further reduces the risk of breast cancer.

Researchers have not definitively concluded how the link works, but they point to the decreased weight that occurs with regular exercise.  Being overweight is linked to higher rates of cancer potentially because hormone levels and inflammation is increased in overweight people.

Conversely, gaining weight increases the risk of breast cancer.  Non-active women who gained more than 6.5 pounds during their adult years raised their risk of breast cancer by 28% versus non-active women that did not gain weight.  Women who did exercise, but still gained weight had an increased risk of breast cancer compared to non-active, normal weight women meaning that gaining too much weight negates the benefits of exercise.

The results held up even when factors that may affect a participant’s breast cancer risk were accounted for.  These include the use of oral contraceptives, smoking, number of pregnancies and a family history of breast cancer.

“If you’re postmenopausal, and you have not been active, it’s not too late to get started,” lead researcher Lauren McCullough says.

You can still reduce your risk of breast cancer.  Exercise can benefit any age even if weight loss does not occur.

Researchers conclude that physical activity 10-19 hours per week during reproductive and postmenopausal years may have the greatest benefit in decreasing the risk of breast cancer.




Posted by on September 7, 2012 - 8:02am

An analysis among more than 40,000 postmenopausal women who were in the California Teachers Study was carried out to determine if there were differences in risk of breast cancer among women consuming alcohol according to their previous or current use of hormone therapy (HT).  In the cohort, 660 women were diagnosed with invasive breast cancer during follow up.

Results showed an increase in risk of breast cancer among alcohol consumers of more than 20 grams of alcohol per day (about 1 ½ to 2 typical drinks) who were current users of HT but not among those who were ex-users of HT.  The authors conclude: “Following the cessation of HT use, alcohol consumption is not significantly associated with breast cancer risk, although a non-significant increased risk was observed among women who never used HT.  Our findings confirm that concurrent exposure to HT and alcohol has a substantial adverse impact on breast cancer risk.  However, after HT cessation, this risk is reduced.”

Forum reviewers considered this to be a very well done analysis on a large group of post-menopausal women with repeated assessments of alcohol consumption and HT use.  However, results from even very large studies on the relation between alcohol, HT, and breast cancer risk have often been conflicting.  Even with numerous studies on this topic, we still have very poor predictors of which women will develop breast cancer.  There is some increase in risk for women with a family history of such cancers and those who are obese.  However, the percentage increases in risk associated with HT, alcohol consumption, and other environmental factors are generally small (unlike the many-fold increase in the risk of lung cancer among smokers in comparison with never smokers).  This may explain why the results of individual studies may reach apparently conflicting conclusions.  While the present study suggests that women who consume alcohol may have a decrease in their risk of breast cancer if they stop taking hormone replacement therapy, our current understanding of factors affecting breast cancer risk remains quite inadequate.

Reference:  Horn-Ross PL, Canchola AJ, Bernstein L, Clarke CA, Lacey JV, Neuhausen SL, Reynolds P, Ursin G.  Alcohol consumption and breast cancer risk among postmenopausal women following the cessation of hormone therapy use: the California Teachers Study.  Cancer Epidemiol Biomarkers Prev 2012. [Epub ahead of print]

Posted by on July 9, 2012 - 2:39pm

In many women with recurrent breast cancer, the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status of their tumors changes between treatment for the primary tumor and relapse, a large retrospective study has found. The findings, published June 18 in the Journal of Clinical Oncology, support previous studies that have also detected changes in these biomarkers during cancer progression.

These three biomarkers help doctors choose the best treatments for individual women. Therefore, tumors that recur in the breast or appear elsewhere in the body should be biopsied “as a routine procedure” because the results may influence treatment decisions, recommended the authors led by Dr. Linda Lindström of Cancer Center Karolinska in Sweden.

Dr. Lindström and her colleagues used information from pathology reports for 1,010 women treated at three hospitals in Stockholm, all of whom had biopsies taken from their primary and recurrent breast tumors.

Primary and recurrent tumors from 459 women were tested for ER expression. In almost 33 percent of those women, the ER status of the tumor changed (ER expression started or stopped) between treatment and relapse. More than 40 percent of the 430 women whose tumors were tested for PR expression had a change in PR status between treatment and relapse. And almost 15 percent of the 104 women whose primary and recurrent tumors were tested for HER2 expression had a change in HER2 status between treatment and relapse.

In women whose cancers relapsed multiple times, similar proportions of changes to biomarkers were observed.

Prior treatment appeared to influence some biomarker changes. For example, women previously treated with hormone therapy were more likely than women who did not receive hormone therapy to have changes in tumor ER expression. The authors also found that women with ER-positive primary tumors that lost ER expression at relapse had a higher risk of death than women with stable tumor ER expression.

Treatment for metastatic breast cancer is often based on primary tumor characteristics. For some patients, biopsy results will show that the tumor has changed. Therefore, “verifications will be important and may change management options,” concluded the authors.

Posted by on June 22, 2012 - 1:48pm

The American Medical Association's House of Delegates has come out in support of routine screening mammography for women starting at age 40.

The new policy is in direct conflict with the controversial 2009 recommendation of the United States Preventive Services Task Force (USPSTF) that routine screening mammography for breast cancer was unnecessary in women younger than 50.

The House of Delegates stopped short of recommending that "every woman should get routine screening mammograms every year starting at age 40". Strongly debated in Tuesday morning's session, that language was rejected by the delegates in favor of a lighter "should be eligible" phrasing.

In a further slap at the federal task force, the House of Delegates voted to adopt a resolution stating that the AMA "expresses concern regarding recent recommendations by the USPSTF on screening mammography and prostate specific antigen (PSA) screening and the effects these recommendations have on limiting access to preventive care for Americans."

The firestorm that followed the USPSTF recommendations attracted congressional attention from legislators and HHS secretary Kathleen Sebelius eventually issued a statement emphasizing that the USPSTF does not set health policy (Editorial comment:  Then why do it?)

A number of medical groups, including the American Cancer Society, the American College of Radiology , and the American Congress of Obstetricians and Gynecologists disagreed with the USPSTF recommendations and said women younger than 50 benefit from having routine mammograms.

The USPSTF again set off a controversy in 2011 when it said that healthy men do not need prostate cancer screening with prostate specific antigen (PSA) because the test does not save lives and often leads to unnecessary testing, interventions, and treatment. The conclusion came after the USPSTF reviewed data from five large randomized clinical trials of PSA testing, which all found found no mortality benefit among men who underwent screening PSA testing and were followed for 10 years.

The PSA recommendation has been controversial in the medical community, especially after a major European trial showed routine testing in healthy men resulted in about a 21% reduction in the rate of prostate cancer deaths after 11 years of follow-up.

In both instances, speciality medical societies were not happy that they weren't involved in drafting the cancer screening guidelines, and on Tuesday, the AMA adopted another policy encouraging the USPSTF to implement procedures that "allow for meaningful input" from specialists.

The USPSTF is an independent panel 16 volunteer members, most of whom are clinicians in primary care or preventive medicine.

Posted by on April 17, 2012 - 3:31pm

Edie Falco, 9 year survivor

An overwhelming number of breast cancer patients and survivors say that talking to other survivors is key to dealing with the disease.  The findings, the result of a new national poll of breast cancer patients and survivors, inspired Edie Falco, the award-winning actress of the hit series Nurse Jackie and 9-year cancer survivor to join forces with Y-ME, a national breast cancer organization focused on the needs of survivors and patients.

“I didn’t know that it mattered so much to speak with someone who had been through it.  I was like a deer in the headlights,” said Ms. Falco.  “I kept my diagnosis private but could have used an anonymous friend who’d been there to talk about the stuff you are left to deal with because the doctors don’t talk about it.  ‘Am I going to lose my hair?  When will it happen?  Were you scared?  Does your family know?’  I’m helping Y-ME because its mission is near to my heart.”

The poll, conducted by Whitman Insight Strategies for Y-ME, found that 84% of breast cancer patients and survivors say talking to another survivor is one of the most important ways of dealing with the disease, and 68% wish that they could have been connected to other survivors.  A whopping 95% said it was important to have a 24-hour hotline for fellow survivors yet only 14 % were aware that such an organization exists today.

The CEO of Y-ME and cancer survivor, Cindy Geoghegan, says she hopes these findings will shift the focus of the breast cancer movement to patient-focused support and advocacy.   Y-ME runs a 24/7 helpline that is answered by trained peer breast cancer survivors.  They can be reached at  800-221-2141 or visit their website. (

Posted by on February 8, 2012 - 3:51pm

Researchers at UCLA's Jonsson Comprehensive Cancer Center found that the quality of life (QOL) in younger breast cancer patients is  seriously compromised and these women often suffer from severe psychological distress, infertility, premature menopause, a decrease in physical activity and weight gain.   The study found that the mental issues faced by younger breast cancer survivors were more serious than the physical impacts compared to a general age-matched population of women who didn’t have cancer and those more than 50 years old who did.

The study points to the need for oncologists to let these younger patients know from the beginning of their therapy what may happen to them after it’s finished, said study lead author Dr. Patricia Ganz, director of cancer prevention and control research at UCLA’s Jonsson Comprehensive Cancer Center.   “We know that educating and providing younger breast cancer patients with information about what they might experience once their treatment ends is very helpful,” said Ganz, who has been conducting research on quality of life after cancer treatment for 25 years. “If they know what to expect, their anxiety level will be greatly reduced. Up to now, oncologists have not done a good job of preparing these women for what will come.”

Reducing anxiety is crucial, Ganz said, as pre-clinical studies have shown that stress can promote cancer growth and spread in animal models. A study by Jonsson Cancer Center researchers published in 2010 in Cancer Research showed that chronic stress acted as a sort of fertilizer that fed breast cancer progression, significantly accelerating the spread of disease.   The need to prepare younger breast cancer survivors for any adverse effects they may experience and seek ways to address those problems is vital as more and more younger women are surviving their cancer diagnosis due to improvements in early detection and treatment, Ganz said.

“A cancer diagnosis can challenge younger women with issues that don’t impact older patients,” she said. “A younger breast cancer patient may have young children and may be worried about living to raise them to adulthood. A younger breast cancer patient may not have had children yet and may be faced with infertility following her treatment or may return to the dating scene following treatment. We need to find ways to reduce the stress and anxiety that dealing with these issues may create.”

For the Journal of the National Cancer Institute study, Ganz and her team did a review of studies that focused on overall quality of life, psychosocial effects, menopause and fertility-related concerns and behavioral outcomes related to weight gain and physical activity. The 28 studies reviewed were published between January 1990 and July 2010.  Ganz said that weighing therapies with the thought of quality of life after treatment in mind may help reduce some of the issues these younger women face.   “By tailoring adjuvant therapy regimens and giving cytotoxic therapy only to those who may benefit, we can mitigate some of these side effects, but the long life expectancy for these young women also provides a window of opportunity for cancer prevention and health promotion activities,” the study states.

Source:  UCLA Newsroom

Posted by on December 21, 2011 - 8:34am

Why do so many postmenopausal women who are treated for estrogen-sensitive breast cancer quit using drugs that help prevent the disease from recurring?

The first study to actually ask the women themselves -- as well as the largest, most scientifically rigorous study to examine the question -- reports 36 percent of women quit early because of the medications’ side effects, which are more severe and widespread than previously known. The Northwestern Medicine research also reveals a big gap between what women tell their doctors about side effects and what they actually experience.

“Clinicians consistently underestimate the side effects associated with treatment,” said lead investigator Lynne Wagner, an associate professor in medical social sciences at Northwestern University Feinberg School of Medicine and a clinical psychologist at Robert H. Lurie Comprehensive Cancer Center. “They give patients a drug they hope will help them, so they have a motivation to underrate the negative effects. Patients don’t want to be complainers and don’t want their doctor to discontinue treatment. So no one knew how bad it really was for patients.”

The symptom most likely to cause women to stop using the drugs was joint pain. Other side effects women reported as compromising their quality of life were hot flashes, decreased libido, weight gain, feeling bloated, breast sensitivity, mood swings, irritability and nausea.  The drugs, aromatase inhibitors, stop the production of estrogen in postmenopausal women, whose breast cancer cells are stimulated by estrogen. About two-thirds of breast cancers are estrogen sensitive, and aromatase inhibitors reduce the recurrence of cancer in postmenopausal women.

The women at highest risk for quitting the medications before the recommended five years are those who still are experiencing residual side effects from recent chemotherapy or radiation therapy when they start the aromatase therapy, according to the study. Women who had surgery for breast cancer but not chemotherapy or radiation therapy, or who weren’t taking many other medications, were more likely to keep taking the aromatase medication.

“The more miserable they were before they started, the more likely they were to quit,” Wagner said. “By the time they get through chemotherapy or radiation, they have to face five more years of another medication that will make them feel lousy. They feel like they already lost enough time to cancer and have reached their threshold for feeling bad.”

“This is a wake-up call to physicians that says if your patient is feeling really beaten up by treatment, the risk of her quitting early is high,” Wagner said. “We need to be better at managing the symptoms of our patients to improve their quality of life.”

The new research exposes the disparity between clinicians’ reporting of side effects and women’s actual experiences. In a previous study, clinicians reported 5 percent of their patients experienced moderate to severe symptoms as a result of taking aromatase inhibitors. The new Northwestern study surveyed 686 women with a detailed questionnaire about their symptoms before treatment and at three, six, 12 and 24 months after starting treatment. The researchers found after three months of treatment that 33 to 35 percent of women had severe joint pain, 28 to 29 percent had hot flashes, 24 percent had decreased libido, 15 to 24 percent had fatigue, 16 to 17 percent had night sweats and 14 to 17 percent had anxiety. These numbers increased as women were on treatment longer.

Earlier studies also asked women to recall their symptoms after treatment ended, which is less accurate than reporting them at regular intervals while taking the drugs.

As a result of the side effects, 36 percent of women ended treatment before an average of 4.1 years. After two years, 10 percent had quit; the remainder quit between 25 months and the 4.1 years.

“These findings can help us identify women at risk for quitting the therapy, counsel them about the importance of staying on it and provide treatment for troubling side effects,” Wagner noted.

Weight gain can be addressed with nutritional counseling, while mood swings and irritability can be treated with cognitive behavioral therapy or mind-body techniques, Wagner said. Joint pain can be tempered with nonsteroidal anti-inflammatory drugs, or women may be switched to a different hormonal medication. Nausea can be reduced with medication.

This multi-site trial was conducted by the Eastern Cooperative Oncology Group, a national clinical cancer research organization funded by the National Cancer Institute.  Wagner’s research was presented Dec. 9 at the 34th Annual San Antonio Breast Cancer Symposium.

Posted by on December 12, 2011 - 6:08am

While mammograms certainly play an important role in the early detection of breast cancer (and women have responded to this selling point), when weighed against other issues related to quality of life, this benefit  becomes the question of debate among the scientific community.  While researchers have ways to measure quality of life via quality-adjusted life years (QALYS), how do women measure quality of life?  Some recent research done in the UK has caught my attention that found:    after 10 years of mammograms, a woman may get more harm than good from the screening.    When false positive diagnoses and unnecessary surgeries were taken into account, the quality-adjusted life years (QALYs) gained were significantly reduced, James Raftery, PhD, of the University of Southampton, and colleagues reported online in the British Medical Journal.

"Inclusion of the harms from false-positive results and unnecessary surgery reduced the benefits of screening by about half, with negative net QALYs in the early years after the introduction of screening," they wrote.   In 1986, the Forrest report led to breast screening in the U.K., suggesting it would reduce the death rate from breast cancer by almost a third, and with few harms and at low cost.  Since then, a number of harms associated with screening have been acknowledged, particularly false positives and overdiagnosis of cancers that would never have caused symptoms. Also, a recent Cochrane review noted that mortality reductions may be smaller than initially expected, the researchers said.

They looked at data from eight trials involving 100,000 women from the U.K., ages 50 and up, who had breast screening and found that taking the effects of those harms into account reduced the estimate of net cumulative QALYs gained after 20 years by more than half, from 3,301 to 1,536.  And when they changed the reduction in mortality from that suggested by the Forrest study to that suggested by the recent Cochrane review, the net QALYs after twenty years fell even more. .

So how does this finding relate to the everyday woman who, responsibility, has her annual mammogram and feels good about it?    Who finds a small cancer before it is felt?   How do these feelings weigh against the possibility of going through a biopsy (and finding it negative--to her relief).      On the negative side, what if having ten mammograms over the years actually creates a cancer?   These ideas and concepts are hard to understand for the layperson.

Means of reducing the harms from screening might include less frequent screens, particularly for younger women, the researchers said.  Maybe they are right.   Another solution is finding 100% safe ways to detect breast cancer at an early stage.

It is refreshing that Raftery and colleagues recognized this dilemma and wrote that more research is needed on the extent of unnecessary treatment and its impact on quality of life.  Maybe women are not that upset about these procedures vs. missing a cancer.     Further study should also focus on identifying patients who stand to benefit most from surgery, they added.

"From a public perspective, the meaning and implications of overdiagnosis and overtreatment need to be much better explained and communicated to any woman considering screening," they concluded.

So, reader, what do YOU think?

Posted by on August 22, 2011 - 6:35am

High-dose vitamin D relieves joint and muscle pain for many breast cancer patients taking estrogen-lowering drugs, according to a new study from Washington University School of Medicine in St. Louis.

The drugs, known as aromatase inhibitors, are commonly prescribed to shrink breast tumors fueled by the hormone estrogen and help prevent cancer recurrence. They are less toxic than chemotherapy, but for many patients, the drugs may cause severe musculoskeletal discomfort, including pain and stiffness in the hands, wrists, knees, hips, lower back, shoulders and feet.

"About half of patients can experience these symptoms," says Antonella L. Rastelli, MD, assistant professor of medicine and first author of the study published online in the journal Breast Cancer Research and Treatment. "We don't know exactly why the pain occurs, but it can be very debilitating to the point that patients decide to stop taking aromatase inhibitors."

Because the drugs reduce cancer recurrence, finding a way to help patients stay on them is important for long-term, relapse-free survival, according to Rastelli. Aromatase inhibitors are prescribed to post-menopausal women for at least five years and often longer after a breast cancer diagnosis. There is some evidence that patients who experience the drugs' side effects are less likely to see their cancer return, providing even more incentive to help these patients continue taking them.

It was Rastelli's colleague, Marie E. Taylor, MD, assistant professor of radiation oncology, who first noticed that patients on aromatase inhibitors who experienced this pain found some relief from high doses of vitamin D.

So Rastelli's group recruited 60 patients who reported pain and discomfort associated with anastrozole, one of three FDA-approved aromatase inhibitors. The patients they studied also had low vitamin D levels. Half the group was randomly assigned to receive the recommended daily dose of vitamin D (400 international units) plus a 50,000-unit vitamin D capsule once a week. The other half received the daily dose of 400 units of vitamin D plus a weekly placebo. All subjects received 1,000 milligrams of calcium daily throughout the study.

Patients in the study reported any pain they experienced through three different questionnaires. They were asked to quantify their pain intensity, as well as report how much the pain altered their mood, affected their work and interfered with relationships and daily activities. The results show that patients receiving high-dose vitamin D every week reported significantly less musculoskeletal pain and also were less likely to experience pain that interfered with daily living.

"High-dose vitamin D seems to be really effective in reducing the musculoskeletal pain caused by aromatase inhibitors," Rastelli says. "Patients who get the vitamin D weekly feel better because their pain is reduced and sometimes goes away completely. This makes the drugs much more tolerable. Millions of women worldwide take aromatase inhibitor therapy, and we may have another 'tool' to help them remain on it longer."

Like anastrozole used in this study, the other two FDA-approved aromatase inhibitors, letrozole and exemestane, also cause musculoskeletal pain. Given the similar side effects, Rastelli says patients on these drugs may also benefit from high-dose vitamin D.

The vitamin used in this study is a plant-derived type called vitamin D2. Rastelli says it achieves the best results when given weekly because the body metabolizes it within seven to 10 days. Rastelli and her colleagues did not use high-dose vitamin D3, which remains in the body longer.

"This was a very carefully conducted study, and the placebo control makes the findings quite compelling," says Matthew J. Ellis, MD, PhD, the study's senior author and director of the Breast Cancer Program at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. "We should follow up these findings further to determine the most efficacious and safe approach to vitamin D supplementation in our breast cancer patients."

Since vitamin D helps the body absorb calcium, too much of it can cause high levels of calcium in the urine, which may increase the risk of kidney stones. Such possible side effects emphasize the importance of tracking patients' urine calcium levels while taking high-dose vitamin D.

"It's important to monitor the patients, but overall it appears to be very safe," Rastelli says. "Because vitamin D2 is eliminated from the body so quickly, it's very hard to overdose."

In addition to relieving pain, the group wanted to examine whether vitamin D could protect against the bone loss often seen in patients taking aromatase inhibitors. The researchers measured each patient's bone density at the beginning of the study and again after six months.

Perhaps because of its role in calcium absorption, high-dose vitamin D did appear to help maintain bone density at the neck of the femur, the top of the thighbone near the hip joint. Although the result did not reach statistical significance, Rastelli calls the result promising and worth further studies.

"It's great that we have something as simple as vitamin D to help patients alleviate some of this pain," Rastelli says. "It's not toxic it doesn't cause major side effects. And if it is actually protecting against bone loss, that's even better."

Rastelli AL, Taylor ME, Gao F, Armamento-Villareal R, Jamalabadi-Majidi S, Napoli N, Ellis MJ. Vitamin D and aromatase inhibitor-induced musculoskeletal symptoms (AIMSS): a phase II, double-blind, placebo-controlled, randomized trial. Breast Cancer Research and Treatment. Online June 2011.

Source: Washington University in St. Louis




Posted by on July 5, 2011 - 10:00am

A clinical trial to see if a gel containing an active form of tamoxifen, an anti-estrogen therapy, can provide the drug's benefits with decreased risk of adverse health effects compared to those who take the oral tamoxifen is being conducted at Northwestern Medicine.

The new study drug is being tested on participants recently diagnosed with the earliest form of non-invasive breast cancer. Women who are treated for this kind of cancer (called ductal carcinoma in situ or DCIS) are usually advised to take oral tamoxifen for five years if their DCIS is hormone sensitive. In this research study, half the women receive the study gel and half the women receive the oral tamoxifen.

Tamoxifen, when taken as a pill for five years, reduces the risk of cancer recurrence in the same spot by a third and prevents the occurrence of half of new breast cancers. The therapy, however, has an increased risk of blood clots, uterine cancer and hot flashes. As a result, many women decline the treatment.

“The gel is a way to minimize exposure to the rest of the body and concentrate the drug in the breast where it is needed," said principal investigator Seema Khan, M.D., co-leader of the breast cancer program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and a surgical oncologist at Northwestern Memorial Hospital. "Delivery of the drug through the skin of the breast means there will be very little drug circulating through the bloodstream and the body. This should reduce the possibility of blood clots."

Khan compared it to the current practice of delivering estrogen  via a skin patch to avoid the risk of blood clots. And because the circulating levels of the topical drug are very low, the gel should be unlikely to cause other side effects such as hot flashes and the increased risk of uterine cancer.

Another problem with oral tamoxifen is that it does not help all women who take it, because it needs to be activated in the liver by specific enzymes, and about a third of women lack these enzymes. These women may not receive full benefits from the pill, and the gel may be more effective for these women because the active form of the topical drug is being delivered directly into the breast tissue, noted Khan.

The participants in the trial must have a recent diagnosis of DCIS. In this form of breast cancer, abnormal cells multiply and form a growth within a milk duct. This form of cancer is noninvasive, meaning it hasn't spread from the milk duct to other parts of the breast.

Because of increased screening with mammograms, diagnoses of this early breast cancer have increased dramatically in recent years. While the cancer isn't life threatening when caught early, it requires treatment to prevent the condition from becoming invasive. Most women with this type of breast cancer are effectively treated with breast-conserving surgery and radiation.

The study is funded by the National Cancer Institute, and the study design has been approved by the FDA. Trial sites are at Northwestern University and Washington University. Participants will be randomized to take the tamoxifen pill or the active form of tamoxifen topical gel for six weeks prior to scheduled routine surgery. Researchers will measure the tumor growth rate to see if the reduction in growth rate is equally good in women who receive the gel and those who receive the pill.

Participants are currently being enrolled in the trial. For more information, visit or call Katherine Page at (312) 695-1408.

By Marla Paul