On the pulse 25 September 2014

  • Young Women’s Support Group 6 October 2014
  • Study shows that women who go up a skirt size every decade are more likely to develop breast cancer
  • Study finds “Angelina Jolie effect” led to twice as many referrals for genetic testing

Young Women’s Support Group 6 October 2014

The next Young Women’s Support Group will take place on Wednesday 8 October 2014 from 4pm until 6pm.

The group will be joined by Claudia Manchanda, previously a Healthy Eating and Nutrition Development Manager for Shoreditch Trust, a Hackney based charity. Claudia has project managed NHS-funded healthy eating projects and has lectured at Westminster University and City and Islington College. She will discuss nutrition and healthy eating and the aim of this session is for people to feel empowered about making sustainable healthier choices.

If you would like attend, or want any more information, please call Reema on 0207 830 2323 or email r.ved@cancerkin.org.uk.

Study shows that women who go up a skirt size every decade are more likely to develop breast cancer
A study published in BMJ Open has found that women who went up skirt size every decade from their mid-20s increased their risk of developing breast cancer by 33%.

A number of previous studies have found that both overall obesity and central obesity (midriff fat) increase the risk of breast cancer in post-menopausal women. However, there have been no studies investigating whether changes in central obesity affect breast cancer risk. Researchers from University of London therefore conducted this study, using skirt size as a proxy for waist circumference.

Over 90,000 women gave information on their current skirt size and their skirt size in their mid-20s, as well as detailed information on other factors which can affect breast cancer risk. The women were then followed for three years. Over this period, 1,090 women developed breast cancer.

Women whose skirt size had increased by one size every decade were found to have a 33% higher chance of developing post-menopausal breast cancer, while women whose skirt size had increased by two sizes every decade increased their risk by 77%. Reductions in skirt size also decreased the risk of breast cancer. This association was found regardless of a woman’s overall weight.

The researchers did note that the study has some limitations, including relying on women being able to recall accurately what skirt size they wore in their twenties. Dress sizes have also changed over the previous 40 years, which was not taken into account.

Usha Menon, study a co-author, said: “Given that obesity is now emerging as a global epidemic, from a public health perspective our findings are significant as they provide women with a simple and easy to understand message. It needs effort to calculate the BMI from height and weight and most of us do not remember what it might have been some years ago. In that respect … skirt size as a proxy for waist circumference is easily remembered over time.”

Simon Vincent, assistant director of research at Breakthrough Breast Cancer said: “We know that 40 per cent of breast cancers could be prevented by changes to lifestyle such as being regularly active and maintaining a healthy weight. This study highlights an easy way to monitor your weight gain over time. Women are more likely to remember their skirt size when they were younger than their Body Mass Index.

“Here at Breakthrough Breast Cancer, we encourage all women to raise their pulse and reduce their risk. Women should take part in regular physical activity of moderate intensity for 3.5 hours per week.”

For the full study, please see BMJ Open.  For more information, please see BBC News, the Telegraph or the Guardian.

Study finds “Angelina Jolie effect” led to twice as many referrals for genetic testing
A study in Breast Cancer Research has found evidence of the previously anecdotal “Angelina Jolie effect” – a significant increase in the number of NHS referrals for genetic tests of breast cancer risk after the actress announced she had a preventative double mastectomy last year.

US actress Angelina Jolie announced in May 2013 that she had tested positive for a mutated BRCA1 gene and so had chosen to have a preventative double mastectomy. A female BRCA1 carrier has between a 60 and 90 per cent chance of developing the disease, with the precise figure for an individual depending on various factors. Approximately 5% of breast cancers are thought to be due to inherited genetic faults, such as BRCA1 or BRCA2. In speaking out, she hoped to raise awareness of the genetic risks of breast cancer, and the options that are available to those who are found to have a greatly increased risk of developing the disease.

This study calculated monthly referral data to 12 family history clinics and 9 regional genetics services across the UK from 2012 to 2013. It found that NHS referrals more than doubled after May 2013, with an increase of over 250% in June and July 2013 compared to the same period the year before (from 1,981 in 2012 to 4,847 in 2013). From August to October 2013, the referral rate continued to remain approximately 200% higher than the previous year.

The researchers also compared the appropriateness of the referrals with the recommended guidelines and found that the media coverage had not led to inappropriate referrals, meaning that only those with a suitable family history were referred.

Professor Gareth Evans, team leader said: “The Angelina Jolie effect has been long-lasting and global, and appears to have increased referrals to centres appropriately”.

Sally Greenbrook, Senior Policy Officer at Breakthrough Breast Cancer, said: “We have heard anecdotally that referrals to family history and genetics services had increased since Angelina Jolie’s announcement but it’s interesting to see evidence to support this. We’re also encouraged to learn that women with a family history of breast cancer are recognising that they may be at increased risk of developing the disease and taking a proactive approach to their health.

“It’s important to remember however that only one in five breast cancer cases are linked to having a family history of the disease, and faults in known breast cancer genes are very rare. This is why genetic testing is only offered to those considered to be at higher risk following a family history assessment.

For the full study please visit Breast Cancer Research. More information can also be found on BBC Online and Breakthrough Breast Cancer.

On the pulse 19 September 2014

  • Hampstead Theatre Performance of Seminar on 6 October 2014
  • Mr Mosahebi at September’s Patient Support Group
  • Study finds that breast cancer screening is not effective in women over 70 years of age

Hampstead theatre performance of Seminar on Monday 6 October at 7.30pm
Tickets are still available at £45 for Seminar starring Roger Allam. To get your tickets email h.lovering@cancerkin.org.uk or phone Holly on 02078302323.

Mr Mosahebi at September’s Patient Support Group
The next Patient Support Group will take place on Wednesday 24 September 2014 at 11AM to 12.30PM, where we will be joined by Mr Ash Mosahebi MBBS FRCS PhD MBA FRCS (Plast) a Consultant Plastic Surgeon at the Royal Free, and senior lecturer in plastic surgery at University College Hospital.

Mr Mosahebi will give a talk on Breast reconstruction and new developments. He qualified at Guy’s & St Thomas Medical School in London and his Plastic surgical training was in London Deanery in some of the largest and busiest hospitals in UK. He was the first UK plastic surgery fellow at the world famous Memorial Sloan Kettering Cancer Centre, Manhattan New York City and is widely invited to lecture on plastic surgery at meetings worldwide and has published extensively. He is involved in pioneering research in the use of stem cell for tissue regeneration.

As one of the leading plastic surgeons, he teaches cosmetic surgery to other plastic surgeons at the Royal College of Surgeons. He is a member of the breast multidisciplinary meeting at Royal Free and is involved in reconstruction of the breast following cancer surgery specialising in using only the patient’s own tissue.

It is sure to be a fascinating talk and only a few places remain. To book your place, please contact Reema on r.ved@cancerkin.org.uk or 0207 830 2323.

Study finds that breast cancer screening is not effective in women over 70 years of age
A Dutch study published in the British Medical Journal has found that screening for breast cancer in women over the age of 70 did not lead to fewer older women being diagnosed with advanced breast cancers.

There is an ongoing debate on the effectiveness of breast screening programme, and the age range over which it is effective. In 1998, the mass breast screening programme in the Netherlands was extended to screen women up to the age of 75 (previously it screened women up to the age of 69). However, there is no strong evidence on the effectiveness of breast cancer screening in older women as few trials include women over 60.

This study looked at over 25,000 women who were diagnosed with breast cancer aged between 70 and 75, between 1995 and 2011. This enabled them to compare the number of women diagnosed before 1998 with those diagnosed after to see what effect extending the age range of screening programme had had. If the screening programme had been effective, it would be expected that the incidence of cancers diagnosed at an advanced stage would decrease, whilst the incidence of early stage breast cancer would increase. This is because a screening programme aims to diagnose cancers at an earlier stage when they are easier to treat.

The researchers found that the incidence of early stage breast cancers significantly increased after the screening age was raised, with the combined incidence of ductal carcinoma in situ and stage 1 tumours more than doubling from 107 cases per 100,000 women in 1995 to 274 cases per 100,000 women in 2011. However, there was only a very small decrease in cancers diagnosed at an advanced stage. This means that for every advanced stage tumour that was prevented by screening, 20 early stage tumours which might never have affected the patient’s life expectancy were diagnosed and treated. This is known as overdiagnosis, and the scientists noted that overdiagnosis could have a great impact on the quality of life and physical function of older women, as they are at an increased risk of adverse outcomes of breast cancer treatment.

Dr Caitlin Palframan, Head of Policy at Breakthrough Breast Cancer, said: “This study provides some useful insights as women over 70 were not included in the original breast screening trials on which modern screening programmes are based. It’s very important we learn more about the benefits and risks for this particular age group before we decide whether to offer these women routine screening.

“No conclusive results should be taken from this study, however, until we see the results from the comprehensive and well-designed UK age extension trial. This is a very large randomised controlled trial looking at the benefits and risks of screening women aged 70-73, the results of which will be directly applicable to UK women.

“Whilst we await these results, women over 70 who would like to be screened can make an appointment with their local screening service. It’s important that they make their decision whether or not to go for screening with an understanding that we don’t yet know all the benefits and risks of screening for this age group.”

For the full study, please visit the British Medical Journal website. For more information, please see Breakthrough Breast Cancer or the Mail Online.

On the pulse 12 September 2014

  • Seminar at Hampstead Theatre: 6th October 2014
  • Young Women’s Support Group
  • Study finds that wearing a bra does not increase your risk of breast cancer
  • Breast cancer patients who undergo a bilateral mastectomy have the same survival rate as those who opt for a lumpectomy with radiation

Seminar at Hampstead Theatre: 6th October 2014
After the early bird deadline was extended to 22nd September, some of our supporters have requested further booking forms. Please find the form attached to this email.

Young Women’s Support Group

September’s Young Women’s Support Group took place on this week. This month’s group was facilitated by Una Reynolds, counselling psychologist in private practice, and the session focused on emotional wellbeing, an important element during and after cancer treatment which is so often overlooked when the focus is on your physical and medical needs.  As dealing with stress is a common experience, Una also focused on identifying and managing signs of stress using specific skills to increase a sense of wellbeing.

Ten women attended and they all spoke very highly of the session, highlighting how useful meeting other patients was and how helpful a session on emotional wellbeing was. As one patient noted “[Una was] an outstanding facilitator – dealing with the emotional aspects of cancer. Very supportive group”.

The next Young Women’s Support Group takes place on Wednesday 8th October 2014, from 4.00pm to 6.00pm and we will be joined by Claudia Manchanda to discuss nutrition. For more information or to book your place please contact Reema on r.ved@cancerkin.org.uk or 0207 830 2323.

Study finds that wearing a bra does not increase your risk of breast cancer

A study published in Cancer Epidemiology, Biomarkers & Prevention has found that wearing a bra does not increase the risk of breast cancer.

It is often reported in the media that wearing a bra increases your risk of breast cancer, despite there being no rigorous scientific evidence to show this. Therefore a team from the University of Washington conducted a study into whether wearing a bra increased the risk of breast cancer. As research leader Lu Chen, said: “There have been some concerns one of the reasons why breast cancer may be more common in developed countries compared with developing countries is differences in bra wearing patterns. Given how common bra wearing is, we thought this was an important question to address.”

The study compared the bra-wearing habits of 1,044 postmenopausal women who had breast cancer with those of 469 women who did not have breast cancer. Each woman was interviewed about her bra-wearing habits, which included their bra size, the age when they first wore a bra, the amount of hours a day and days per week they wore a bra and whether they wore underwired bras. They were also asked if their bra-wearing habits had ever changed.

The women were then asked about other factors which could affect their breast cancer risk such as their BMI, their family history of cancer and whether they had used hormone replacement therapy.

The researchers found that there was no relationship between any of the bra-wearing characteristics and an increased risk of developing breast cancer. Mr Chen said: “Our study found no evidence wearing a bra increases a woman’s risk for breast cancer. The risk was similar no matter how many hours per day women wore a bra, whether they wore a bra with an underwire, or at what age they first began wearing a bra.”

Whilst the study does have limitations (for example, only one woman in the study reported never wearing a bra and so it was not possible to compare the effect of wearing a bra versus never wearing a bra), the study concludes that “[these] findings provide reassurance to women that wearing a bra does not appear to increase the risk for the most common histological types of postmenopausal breast cancer.”

For more information please see the Daily Telegraph or NHS Choices.

Breast cancer patients who undergo a bilateral mastectomy have the same survival rate as those who opt for a lumpectomy with radiation
A US study which found that women with breast cancer who undergo a bilateral mastectomy have the same outlook as those who have a lumpectomy with radiotherapy has been widely reported in the media this week.

The study considered 189,734 women in California who had been diagnosed with breast cancer between 1998 and 2011. 55% of the women had a lumpectomy – where malignant lumps are removed – followed by radiation, almost 40% had a single mastectomy – where one breast is removed – and the remainder had a double mastectomy, where both breasts are removed. The proportion of women who chose to have a bilateral mastectomy increased hugely over the study period from 2% in 1998 to 12.3% in 2011. In women under 40, it rose from 3.6% in 1998 to 33% in 2011.

The study found that 18.8% of patients who had had a double mastectomy died within ten years, compared with 16.7% of women who had had a lumpectomy followed by radiation. The highest proportion of deaths was in women who had a single mastectomy, with 20.1% of women dying within ten years.

Dr Allison Kurian, lead scientist for the project, said: “We can now say that the average breast cancer patient who has bilateral mastectomy will have no better survival than the average patient who has lumpectomy plus radiation.

“A mastectomy is a major procedure that can require significant recovery time and may entail breast reconstruction, whereas a lumpectomy is much less invasive, with a shorter recovery period.”

It is important to note that this study was based in the US, which has different health care procedures from the UK.

Martin Ledwick, the head information nurse at Cancer Research UK, said: “In the UK, a double mastectomy is not routinely offered to women with the most common forms of breast cancer when it’s only in one breast. Usually women are offered surveillance with regular mammograms after their surgery.

“A double mastectomy is still considered an option for women with a high risk of breast cancer due to an inherited faulty gene”.

For more information, please see the Guardian Online.