Starch Intake May Influence Risk For Breast Cancer Recurrence

Main Category: Breast Cancer
Also Included In: Nutrition / Diet
Article Date: 12 Dec 2011 - 0:00 PST

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Researchers have linked increased starch intake to a greater risk for breast cancer recurrence, according to results presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"The results show that it's not just overall carbohydrates, but particularly starch," said Jennifer A. Emond, M.S., a public health doctoral student at the University of California, San Diego. "Women who increased their starch intake over one year were at a much likelier risk for recurring."

Researchers conducted a subset analysis of 2,651 women who participated in the Women's Healthy Eating and Living (WHEL) Dietary Intervention Trial, a plant-based intervention trial that enrolled about 3,088 survivors of breast cancer. WHEL researchers studied breast cancer recurrence and followed the participants for an average of seven years.

The subset analysis involved an examination of how changes in carbohydrate intake influenced breast cancer recurrence. "The WHEL dietary trial, even though it focused on fruits and vegetables, fiber and fat, didn't really have a specific carbohydrate goal," Emond said.

She and her colleagues obtained carbohydrate intake information from multiple 24-hour dietary recalls at baseline and at one year. In an annual phone interview, participants reported everything they had eaten during the last 24 hours.

At baseline, carbohydrate intake was 233 grams per day. Results showed that women whose cancer recurred had a mean increase in carbohydrate intake of 2.3 grams per day during the first year, while women whose cancer did not recur reported a mean decrease of 2.7 grams per day during the first year.

Starches were particularly important, Emond said. Changes in starch intake accounted for 48 percent of the change in carbohydrate intake. Mean change in starch intake during the first year was 0.1 grams per day among women whose cancer recurred vs. 0.7 grams per day among women whose cancer did not recur.

When change in starch intake during one year was grouped into quartiles of change, the rate of an additional breast cancer event was 9.7 percent among women who decreased their starch intake the most during one year, compared with an event rate of 14.2 percent among women who increased their starch intake the most during one year.

The change in starch intake was "independent of dietary changes that happened in the intervention arm," Emond said. "It is independent of more global changes in diet quality."

After stratifying patients by tumor grade, Emond and colleagues found that the increased risk was limited to women with lower-grade tumors.

These results indicate a need for more research on dietary recommendations that consider limited starch intake among women with breast cancer.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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American Association for Cancer Research. "Starch Intake May Influence Risk For Breast Cancer Recurrence." Medical News Today. MediLexicon, Intl., 12 Dec. 2011. Web.
12 Dec. 2011. APA

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Starch Intake May Influence Risk For Breast Cancer Recurrence

Main Category: Breast Cancer
Also Included In: Preventive Medicine
Article Date: 10 Dec 2011 - 1:00 PST

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Researchers have linked increased starch intake to a greater risk for breast cancer recurrence, according to results presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"The results show that it's not just overall carbohydrates, but particularly starch," said Jennifer A. Emond, M.S., a public health doctoral student at the University of California, San Diego. "Women who increased their starch intake over one year were at a much likelier risk for recurring."

Researchers conducted a subset analysis of 2,651 women who participated in the Women's Healthy Eating and Living (WHEL) Dietary Intervention Trial, a plant-based intervention trial that enrolled about 3,088 survivors of breast cancer. WHEL researchers studied breast cancer recurrence and followed the participants for an average of seven years.

The subset analysis involved an examination of how changes in carbohydrate intake influenced breast cancer recurrence. "The WHEL dietary trial, even though it focused on fruits and vegetables, fiber and fat, didn't really have a specific carbohydrate goal," Emond said.

She and her colleagues obtained carbohydrate intake information from multiple 24-hour dietary recalls at baseline and at one year. In an annual phone interview, participants reported everything they had eaten during the last 24 hours.

At baseline, carbohydrate intake was 233 grams per day. Results showed that women whose cancer recurred had a mean increase in carbohydrate intake of 2.3 grams per day during the first year, while women whose cancer did not recur reported a mean decrease of 2.7 grams per day during the first year.

Starches were particularly important, Emond said. Changes in starch intake accounted for 48 percent of the change in carbohydrate intake. Mean change in starch intake during the first year was 4.1 grams per day among women whose cancer recurred vs 8.7 grams per day among women whose cancer did not recur.

When change in starch intake during one year was grouped into quartiles of change, the rate of an additional breast cancer event was 9.7 percent among women who decreased their starch intake the most during one year, compared with an event rate of 14.2 percent among women who increased their starch intake the most during one year.

The change in starch intake was "independent of dietary changes that happened in the intervention arm," Emond said. "It is independent of more global changes in diet quality."

After stratifying patients by tumor grade, Emond and colleagues found that the increased risk was limited to women with lower-grade tumors.

These results indicate a need for more research on dietary recommendations that consider limited starch intake among women with breast cancer.

Article adapted by Medical News Today from original press release. Source: Mayo Clinic
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American Association for Cancer Research. "Starch Intake May Influence Risk For Breast Cancer Recurrence." Medical News Today. MediLexicon, Intl., 10 Dec. 2011. Web.
10 Dec. 2011. APA

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Immediate Bisphosphonate Use With Endocrine Therapy Reduced Recurrence And Increased Survival In Postmenopausal Early Breast Cancer

Starch Intake May Influence Risk For Breast Cancer Recurrence

Main Category: Breast Cancer
Article Date: 09 Dec 2011 - 2:00 PST

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Researchers have linked increased starch intake to a greater risk for breast cancer recurrence, according to results presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"The results show that it's not just overall carbohydrates, but particularly starch," said Jennifer A. Emond, M.S., a public health doctoral student at the University of California, San Diego. "Women who increased their starch intake over one year were at a much likelier risk for recurring."

Researchers conducted a subset analysis of 2,651 women who participated in the Women's Healthy Eating and Living (WHEL) Dietary Intervention Trial, a plant-based intervention trial that enrolled about 3,088 survivors of breast cancer. WHEL researchers studied breast cancer recurrence and followed the participants for an average of seven years.

The subset analysis involved an examination of how changes in carbohydrate intake influenced breast cancer recurrence. "The WHEL dietary trial, even though it focused on fruits and vegetables, fiber and fat, didn't really have a specific carbohydrate goal," Emond said.

She and her colleagues obtained carbohydrate intake information from multiple 24-hour dietary recalls at baseline and at one year. In an annual phone interview, participants reported everything they had eaten during the last 24 hours.

At baseline, carbohydrate intake was 233 grams per day. Results showed that women whose cancer recurred had a mean increase in carbohydrate intake of 2.3 grams per day during the first year, while women whose cancer did not recur reported a mean decrease of 2.7 grams per day during the first year.

Starches were particularly important, Emond said. Changes in starch intake accounted for 48 percent of the change in carbohydrate intake. Mean change in starch intake during the first year was 4.1 grams per day among women whose cancer recurred vs. 8.7 grams per day among women whose cancer did not recur.

When change in starch intake during one year was grouped into quartiles of change, the rate of an additional breast cancer event was 9.7 percent among women who decreased their starch intake the most during one year, compared with an event rate of 14.2 percent among women who increased their starch intake the most during one year.

The change in starch intake was "independent of dietary changes that happened in the intervention arm," Emond said. "It is independent of more global changes in diet quality."

After stratifying patients by tumor grade, Emond and colleagues found that the increased risk was limited to women with lower-grade tumors.

These results indicate a need for more research on dietary recommendations that consider limited starch intake among women with breast cancer.

Article adapted by Medical News Today from original press release. Source: American Association for Cancer Research
Visit our breast cancer section for the latest news on this subject. American Association for Cancer Research Please use one of the following formats to cite this article in your essay, paper or report:

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American Association for Cancer Research. "Starch Intake May Influence Risk For Breast Cancer Recurrence." Medical News Today. MediLexicon, Intl., 9 Dec. 2011. Web.
9 Dec. 2011. APA

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Predicting Risk For Recurrence For Patients With DCIS Breast Cancer

Main Category: Breast Cancer
Article Date: 08 Dec 2011 - 0:00 PST

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In a significant advance for patients with ductal carcinoma in situ, researchers have developed and prospectively validated a multigene test to identify the risk for recurrence of breast cancer.

The method combines measuring tumor gene expression with a gene expression algorithm to decipher the genetic underpinnings of a patient's cancer and determine whether the individual patient should be treated with surgery (usually lumpectomy) or a combination of surgery and radiation.

This is the first time a multigene test has been used to differentiate lower-risk and more aggressive forms of ductal carcinoma in situ (DCIS) and will allow physicians to spare many patients the need to undergo radiation, according to researchers.

Lawrence J. Solin, M.D., FACR, FASTRO, chair of the department of radiation oncology at Einstein Medical Center in Philadelphia, presented the results at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium (SABCS), held Dec. 6-10, 2011.

"Using a molecular-based assay, we have successfully identified patients at higher risk for recurrence and patients at lower risk," said Solin. "This is an important advance for women with newly diagnosed DCIS. By predicting individual risk, physicians can provide a more tailored treatment program for each patient."

The validation study of the DCIS Score was a collaboration among the Eastern Cooperative Oncology Group (ECOG), North Central Cancer Treatment Group and Genomic Health. The validation utilized patient tumor samples from E5194, an ECOG-led, multi-institutional study of patients with low-, intermediate- or high-grade DCIS who had been treated surgically but had not received radiation. E5194 was the first prospective study of local excision alone for DCIS, and its five-year results were reported at SABCS in 2006 (L. Hughes).

Researchers tested and scored tumors from 327 patients to determine their risk for recurrence. The DCIS validation study team used the Oncotype DX breast cancer assay, which has been available for invasive breast cancer since 2004, and a DCIS Score algorithm to study these tumor samples.

The test uses reverse transcriptase-polymerase chain reaction technology, which quantitates the level of RNA in the individual tumor sample to reveal its underlying biology. The level of RNA is then used by a prespecified algorithm to calculate a DCIS Score, which predicts the likelihood of local recurrence, defined as either the development of a new invasive breast cancer or the recurrence of DCIS.

Solin also reported 10-year results of E5194, in which 46 patients had an ipsilateral breast event (IBE; defined as ipsilateral local recurrence of DCIS or invasive cancer) at a median follow-up of 8.8 years. Continuous DCIS Score was significantly associated with IBE when adjusted for tamoxifen use and provided value beyond the traditional measures of tumor size, tumor grade and margin status.

Numerous studies, including the current study, have shown that routine, microscopic pathology grading is not a reliable indicator of the risk for recurrence.

"The DCIS Score will help physicians understand the underlying biology of DCIS for an individual patient and accurately gauge the risk for that person," said Solin. "As a result, the patient and physician can decide on the appropriate course of treatment based on a more complete understanding of the risk involved."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our breast cancer section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:

MLA

American Association for Cancer Research. "Predicting Risk For Recurrence For Patients With DCIS Breast Cancer." Medical News Today. MediLexicon, Intl., 8 Dec. 2011. Web.
8 Dec. 2011. APA

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In Early Vs. Late Hormone Receptor-Positive Breast Cancer, Molecular Differences May Be Used To Predict Breast Cancer Recurrence

Main Category: Breast Cancer
Also Included In: Genetics
Article Date: 08 Dec 2011 - 0:00 PST

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Researchers may have discovered a series of genes that will help predict whether or not a woman with hormone receptor-positive invasive breast cancer will experience early, late or no recurrence of her disease.

Minetta C. Liu, M.D., associate professor of medicine and oncology and director of translational breast cancer research at Georgetown Lombardi Comprehensive Cancer Center, presented the findings at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

"There are clear biological differences within the supposedly unified group of hormone receptor (HR)-positive breast cancers, and these differences distinguish subtypes relative to the time at which they recur," Liu said. "Understanding what drives these distinctions will allow us to tailor treatment and improve patient outcomes."

Women with HR-positive breast cancer are frequently treated with tamoxifen, which is credited with saving the lives of hundreds of thousands of women. Although tamoxifen prevents or delays cancer recurrence in many women, some will recur 10 years or more from their original diagnosis. Until now, the molecular basis for this recurrence pattern was unknown.

Liu and colleagues, in collaboration with investigators from the University of Edinburgh, evaluated high-quality frozen tumor samples obtained at the time of breast cancer diagnosis. These tissue samples were linked to data on treatment and clinical outcomes, allowing researchers to analyze gene expression patterns present before the initiation of any systemic therapy.

Together with engineers at Virginia Polytechnic Institute, Liu and colleagues identified significant gene expression patterns among the tumor samples. These patterns correlated strongly with the development of distant metastatic disease.

"We confirmed what many have already suspected," said Liu. "There are biological drivers that define - at the time of tumor development - whether or not breast cancer will recur early, late or not at all. Now we need to validate these findings and take our knowledge to the next step."

Liu hopes that this research can be used to help personalize treatment in day-to-day clinical practice. "Endocrine therapy and chemotherapy are not without toxicity," she said. "The ability to predict which patients will recur early in their treatment course can lead to more appropriate recommendations for adjuvant chemotherapy. It might also identify those women who would benefit most from studies using investigational agents to enhance the effects of tamoxifen or aromatase inhibitors."

She added: "At the other extreme are those patients with HR-positive tumors who recur long after completing five years of endocrine therapy. These are the patients for whom extended endocrine therapy and its related side effects are really worth it."

The team's next step is to validate their predictive model for the timing of recurrences on tamoxifen so that physicians and patients can make more informed decisions about the potential added benefits of adjuvant chemotherapy, extended endocrine therapy and involvement in clinical trials. They will also investigate combinations of molecular targets with the ultimate goal of delaying or preventing the development of metastatic breast cancer, Liu said.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our breast cancer section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:

MLA

American Association for Cancer Research. "In Early Vs. Late Hormone Receptor-Positive Breast Cancer, Molecular Differences May Be Used To Predict Breast Cancer Recurrence." Medical News Today. MediLexicon, Intl., 8 Dec. 2011. Web.
8 Dec. 2011. APA
American Association for Cancer Research. (2011, December 8). "In Early Vs. Late Hormone Receptor-Positive Breast Cancer, Molecular Differences May Be Used To Predict Breast Cancer Recurrence." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/238755.php.

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