Questions about Gadolinium Safety – MRI Contrast Dye

18 September 2017 Breast MRIs are used in some newly diagnosed breast cancer patients, especially those with dense breast tissue. In addition, they are used as a supplement to mammography in women who are found to be at high risk. In order to distinguish between normal and cancerous tissue, an intravenous contrast dye is used. For MRI studies, the contrast…

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Genetic Testing in Women with a History of Breast or Ovarian Cancer

18 August 2017 Approximately 15%  of women diagnosed with breast or ovarian cancer will be found to carry a mutation in one or more genes that predisposes to the cancer. The most familiar are the BRCA 1 and BRCA 2 genes. These are tumor suppressor genes, if mutated, they do not function properly and can result in a higher likelihood…

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Active Surveillance for DCIS

20 March 2017 Over 50,000 women in the US are diagnosed every year with ductal carcinoma in-situ (DCIS), also known as Stage 0 breast cancer. DCIS is most often diagnosed on screening mammography and usually presents as a cluster of calcium deposits rather than a lump. In cases of DCIS, malignant appearing cells grow within the milk duct, but do not invade…

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Genetic Testing for Breast Cancer

7 February 2017 A research letter recently published in the Journal of the American Medical Association found that patients diagnosed with breast cancer were not appropriately referred for genetic counseling and testing. The researchers used the SEER Registry to study the records of patients diagnosed between July 2013 – September 2014. Registry patients in the state of Georgia and Los…

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Extended Endocrine Therapy – Not So Fast?

26 December 2016 Approximately 75% of breast cancers express the estrogen receptor – we term these breast cancers ER positive (ER+) or hormone-sensitive. Endocrine therapy refers to using medications to exploit this cancer cell property. Tamoxifen is used in premenopausal women and it blocks the estrogen receptor. In post-menopausal women, aromatase inhibitors (AI) are used which prevent estrogen from being produced…

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Do Social Connections Predict Breast Cancer Outcomes?

13 December 2016 A study published in the journal Cancer concluded that women with larger social networks have better breast cancer (BC) outcomes. In noting that large social networks predict lower overall mortality in healthy populations, the researchers analyzed a group of women who were already participating in four cohort studies. They evaluated associations between social networks within 2 years…

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Surveillance in Patients with Metastatic Breast Cancer

25 August 2016 Patients with metastatic (Stage IV) breast cancer often undergo frequent blood tests and scans to monitor for disease progression. But is there such a thing as too much testing? A study recently published in the Journal of the American Society of Clinical Oncology evaluated the use of blood tests (tumor markers) and body imaging scans (such as PET,…

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Do I Need Chemotherapy?

25 August 2016 A study published today in the New England Journal of Medicine reports on the 5 year results of the MINDACT (Microarray In Node-negative and 1 to 3 positive lymph node Disease may Avoid ChemoTherapy) trial. This study was designed to evaluate the use of a tumor gene signature test (MammaPrint) compared with standard factors to assess the…

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Did a 3D Mammogram Save Her Life?

An Oklahoma mayor underwent a 3D mammogram (tomosynthesis) as part of a hospital promotion. She was diagnosed with ductal carcinoma in-situ (DCIS, also known as Stage 0 breast cancer) and she stated that the study “…saved my life.” She also recommended that women make sure to obtain a 3D mammogram. The story noted that tomosynthesis “virtually eliminates” the need for…

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Choosing Wisely

27 June 2016 Choosing Wisely is an initiative of the American Board of Internal Medicine Foundation. Things Providers and Patients Should Question have been chosen by various medical societies based on review of the evidence-based literature. The American Society of Breast Surgeons (ASBrS) has published their contributions to the campaign (open access) in the Annals of Surgical Oncology. The 5 ASBrS measures include: 1.) Don’t…

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