Recently Released Studies Examine Breast Cancer

"Recurrences and Second Primary Breast Cancers in Older Women With Initial Early-Stage Disease," Cancer: Ann Geiger, an associate professor of public health sciences at Wake Forest University, and colleagues looked at the records of 1,837 patients with stage I or stage II breast cancer for 10 years to determine the effect of radiation, lumpectomy and mastectomy on the risk of recurrence or a new tumor, USA Today reports. All of the patients had a lumpectomy or mastectomy between 1990 and 1994 at hospitals in six states, and 363, or 20%, of the women had a new tumor or recurrence during the follow-up period. Women who had a lumpectomy followed by radiation were as likely as women who had a mastectomy followed by radiation to have a recurrence or new tumor, but women who had a lumpectomy with no radiation were about 60% more likely to have a recurrence or tumor, the study found. Geiger said the study did not address survival rates, adding, "The message we want to get out to women is that radiation therapy does decrease the risk of recurrence" (Rubin, USA Today, 1/22).

"Dietary Fiber and Risk of Breast Cancer in the U.K. Women's Cohort Study," International Journal of Epidemiology: Janet Cade, a professor at the University of Leeds' Centre for Epidemiology and Biostatistics, and colleagues monitored the eating habits and health of about 16,000 premenopausal women and 18,000 postmenopausal women ages 35 to 69 participating in the U.K. Women's Cohort Study for seven years to determine associations between breast cancer and a woman's diet, BBC News reports. The women's diets were assessed using a 217-item food questionnaire (BBC News, 1/24). The study, funded by the World Cancer Research Fund and Kellogg's, found that in premenopausal women who ate 30 grams of fiber daily had a 50% lower incidence of breast cancer, compared with premenopausal women who ate 20 grams or less daily. The researchers did not find a significant association between fiber intake and breast cancer incidence among postmenopausal women. The strongest protective link for premenopausal women was recorded in cereal fiber -- including wheat and oats found in bread, pasta and breakfast cereals -- but there was also a link with fruit fiber, the study found (Laurance, Independent, 1/24). "The relevant exposure [to fiber] may be earlier in life, explaining why the protective effect was not shown in the postmenopausal group," Cade said, adding that the results "g[o] along with the general healthy eating advice to make sure that you are getting plenty of fiber in your diet" (BBC News, 1/24).

"Effect of Patient Socioeconomic Status and Body Mass Index on the Quality of Breast Cancer Adjuvant Chemotherapy," Journal of Clinical Oncology: Jennifer Griggs, an associate professor of internal medicine at the University of Michigan, and colleagues analyzed 764 randomly selected women diagnosed with early-stage breast cancer at 115 private oncology practices in the U.S. who were scheduled for treatment but had not started it, the New York Times reports. The researchers collected information on age, level of education, marital status, ZIP code, tumor characteristics, height, weight and other diseases, and they examined medical records to determine the planned and actual chemotherapy received. There were no differences in chemotherapy dosage based on race, age, tumor stage and type of insurance the woman had, the study found (Bakalar, New York Times, 1/23). About 21% of obese women received less than 85% of the standard dose of chemotherapy for their weight, compared with 10% of lean women. The study also found that more than 32% of women who did not graduate high school received lower-than-recommended doses, compared with 14% of high school and college graduates (Reuters Health, 1/19). Nearly 20% of women who lived in the poorest ZIP codes received lower doses of chemotherapy, compared with 8% of those who lived in the wealthiest areas, according to the study. The study found, after adjusting for variables, that women living in the Southeast U.S. received lower chemotherapy doses five times as often as women living in the Northeast or West Coast. Researchers said that physicians might have anticipated that lower income and less educated women would fail to understand and continue chemotherapy, so they preemptively reduced the dosage to encourage compliance to the treatment (New York Times, 1/23). Gary Lyman, co-author of the study, said some low-income and less-educated women also might unknowingly contribute to their own undertreatment due to a lack of understanding of the health care system or the importance of complying with prescribed therapy. He added that physicians also might be hesitant to give proper chemotherapy doses to obese women because of possible side effects. According to Long Island Newsday, researchers are looking for possible explanations for the geographic disparity, including a physician's training, patient occupation and environmental factors (Talan, Long Island Newsday, 1/18).

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