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gt;gt;gt;gt;A quick and easy breast-cancer testgt;gt;gt;gt;Soon, a look at your breast fluids (including breast milk!) may reveal your chances of developing cancer—alerting you if you need to go in for screenings earlier, and possibly helping you catch the disease sooner. Nipple fluid is especially telling because it contains cells from the mammary glands, where approximately 95% of all breast cancers originate. While a procedure called ductal lavage is already available to high-risk women, tests for the general population are in the works, including an at-home risk kit scientists at the gt;Dr. Susan Love Research Foundationgt; are developing, which captures fluid on a Band-Aid–like strip. The foundation’s president, Susan Love, MD, who’s also a clinical professor of surgery at the David Geffen School of Medicine at UCLA, hopes to make the kit as accessible as a home pregnancy test. "If a woman sees a positive test result and it prompts her to get screened, that could be transformative," she says.gt;gt;gt;gt;The promise of radiation-free screeninggt;gt;gt;gt; "Nanotechnology" isn’t just sci-fi mumbo-jumbo: It could be a way to spot cancer far earlier than ever before. A diagnostic test based on this technology uses zero radiation and, unlike mammography, has no risk of false positives, because the nanoparticles used in the test only bind to known cancer cells; magnetic sensors (which work like an MRI scan) pick up the location of the particles, giving an accurate picture of where the cancer lies. "It’s 1,000 times more sensitive than a mammogram," says test pioneer Edward R. Flynn, PhD, chief scientist of the Senior Scientific Division, Manhattan Scientifics Inc. "I believe it has the potential to catch breast cancer an estimated two and a half years earlier than mammograms." The test is currently being studied at a number of major research hospitals and could be available within three to five years.gt;gt;gt;gt;gt;gt;A risk-reducing druggt;gt;gt;gt;For the past 10 years, a drug called tamoxifen has been the gold standard for helping to prevent breast cancer from developing in women at high risk. Now there’s another option: In findings presented in June, a drug called exemestane slashed the incidence of breast cancer by a whopping 65% in post-menopausal women at high risk for the disease. Exemestane works by decreasing the amount of estrogen produced by the body, and unlike tamoxifen, it doesn’t seem to increase your likelihood of developing blood clots and uterine cancer. "For a woman who can’t take tamoxifen because of a personal history of blood clots," says Dr. Schnabel, "there’s now a prevention option."gt;gt; gt;gt;Treatment that’s customized for YOUgt;gt;gt;gt;No assembly-line regimens here: Therapies developed over the last decade (and being developed still) are more fine-tuned to patients’ unique needs than ever before. Several new tests—to see if cancer is estrogen-sensitive, which types of genes are involved, and more—are helping doctors match patients with the treatments that will work best for them. "Breast cancer is at least three, if not six or eight, different diseases," says Laura J. Esserman, MD, director of the Carol Franc Buck Breast Care Center at the University of California, San Francisco School of Medicine. "We have to treat patients according to their tumor type." For example, it’s generally accepted among doctors that women whose test results show a low risk of cancer recurrence do not usually need chemo on top of hormone therapy; a National Cancer Institute study is now investigating whether women with a medium risk of recurrence might also be spared. Scientists are also looking beyond the tumor cells to their environments. "If you do autopsy studies, it turns out that 30% of women have microscopic cancer cells that never become problematic," Dr. Love says. "So, what keeps them from going rogue?" She likens the situation to kids in a bad neighborhood exposed to drug pushers and gang violence. "One aspect of prevention is trying to clean up that neighborhood, whether it’s through exercise, improving metabolism, changing the hormones—whatever it takes."gt;gt;gt;gt;Less radiation, better living gt;gt;gt;gt;Currently, many breast cancer patients get a fairly grueling five-to seven-week course of daily radiation. That process may soon be shorter and safer, causing fewer harsh side effects (which can include intense nausea and hair loss). Two recent trials, for instance, suggest that using half as many radiation treatments—15 or 16 instead of 30—is as effective as the full regimen. "Reducing treatments can make a big difference in women’s quality of life," says Silvia Formenti, MD, chair of the department of radiation oncology at NYU Langone Medical Center. Meanwhile, a new procedure offered in select hospitals around the country offers a full course of radiation in a single zap. Intra-operative radiation therapy delivers one focused blast to the tumor site during surgery, sparing underlying organs like the heart and lungs from radiation. Zero follow-up treatments post-surgery means women can get back to their lives sooner.gt;gt;gt;gt;gt;gt;The surprising way you can make a differencegt;gt;gt;gt;Women diagnosed with breast cancer often participate in clinical trials to receive cutting-edge treatments that may up their odds of survival. But studies rely on healthy women, too—perhaps like you. "Comparing healthy tissue with cancerous tissue will help unlock the secrets to how breast cancer develops," says Nancy G. Brinker, founder and CEO of Susan G. Komen for the Cure. What’s more, volunteers are desperately needed. More than 90% of all clinical trials are delayed largely because of difficulty finding volunteers, according to 2008 statistics from the Center for Information and Study on Clinical Research Participation. Here’s how you can pitch in for prevention:gt;gt;• gt;Breastcancertrials.orggt; pairs potential subjects with open studies; enter your zip code to find one near you.gt;gt;• Join the gt;Love/Avon Army of Womengt; to help breast-cancer researchers find matches for their clinical trials. More than 45,000 women are currently participating in more than 40 breast-cancer studies.gt;gt;• The Susan G. Komen Tissue Bank at the Indiana University Simon Cancer Center is the first and only healthy breast-tissue bank in the world. All the tissue collected—they’ve got samples from more than 1,500 women so far—will be put online for scientists worldwide to use in their research. Visit gt;komentissuebank.iu.edugt; to donate yours, and be part of the cure.gt;gt;]]> Karen Pearson

gt;gt; gt;Q:gt; gt;What is breast-cancer-related lymphedema?gt; gt;gt; gt;A:gt; gt;Breast-cancer-related lymphedema is a chronic, debilitating disorder following surgery, chemotherapy, or radiation therapy that causes arm swelling and chronic inflammation. Lymphedema can have devastating consequences for breast cancer survivors, including infection, loss of strength, and limitation of movement, as well as body-image and self-esteem issues and anxiety. The swelling, which can happen after lymph node removal, is caused by lymph, the colorless liquid that normally circulates in the body.gt; gt;gt; gt;Q:gt; gt;Who is at risk of getting breast-cancer-related lymphedema?gt; gt;gt; gt;A:gt; gt;Anyone with a breast cancer diagnosis who undergoes surgery, chemotherapy, or radiation therapy is at risk. Approximately 19% to 33% of survivors who have auxiliary lymph node dissection (the removal of lymph nodes in the armpit region) and radiation, and between 4% and 22% of survivors who have gt;sentinel lymph node biopsygt; and radiation, develop lymphedema. Lymphedema risk appears to increase with obesity and higher body mass index.gt; gt;gt; gt;Q:gt; gt;Are there other types of lymphedema besides breast-cancer-related lymphedema?gt; gt;gt; gt;A:gt; gt;Yes, lymphedema can develop as a result of surgery, radiation therapy, infection, or trauma. It is common in patients following treatment for cancers other than breast cancer, including melanoma, gynecological, head and neck, prostate, testicular, bladder, and colon cancers. Surgery for these cancers currently requires the removal of lymph nodes, and lymph node removal can put patients at risk of developing lymphedema.gt; gt;gt; gt;Q:gt; gt;How many people are currently suffering from lymphedema?gt; gt;gt; gt;A:gt; gt;Lymphedema is very prevalent. Experts estimate there are 10 million people in the United States who have lymphedema resulting from cancer therapy, recurrent infections, injury, or vascular surgery.gt; gt;gt; gt;Q:gt; gt;When does breast-cancer-related lymphedema first develop?gt; gt;gt; gt;A:gt; gt;Lymphedema commonly occurs quite early after the course of breast cancer treatment. Experts advise that women be monitored closely for up to five years following treatment and receive additional surveillance for 10 years or beyond.gt; gt;gt; gt; gt;Q:gt; gt;How is lymphedema detected?gt; gt;gt; gt;A:gt; gt;Traditionally, lymphedema has been diagnosed by a doctor measuring a patient's arm circumference with a tape measure or by a patient's own assessment of her arm. However, by the time lymphedema is visually detectable, it has already evolved into advanced stages of the disorder. gt;gt; New tools—such as bioimpedance spectroscopy (BIS), which is a way to measure body composition—are now available and provide an accurate lymphedema assessment. Experts recommend that doctors measure a patient's arm volume with BIS prior to breast cancer treatment and follow up with measurements at regular intervals once the treatment is completed.gt; gt;gt; gt;Q:gt; gt;How can I minimize my risk?gt; gt;gt; gt;A:gt; gt;Breast cancer patients and survivors should try to prevent any physical trauma— such as cuts, burns, or wearing tight jewelry, as well as excessive sun exposure—to the fingers or hands.gt;gt; Being overweight can also increase your risk. Recent studies have shown that weight lifting, exercise, and weight loss can help prevent lymphedema. Lymphedema patients who stretched, did aerobics, and lifted weights had fewer flare-ups, and at-risk patients reduced the chance of developing the condition by 70%.gt; gt;gt; gt;Q:gt; gt;Can lymphedema be prevented?gt; gt;gt; gt;A:gt; gt;No. Currently, doctors are not able to prevent lymphedema or definitively determine who will develop the disorder. However, research shows that early stage lymphedema (stage 0–1) can often be resolved with simple interventions, while later stage lymphedema (stage 2–3) is irreversible.gt; gt;gt; gt;Q:gt; gt;What is the treatment if I'm diagnosed with lymphedema?gt; gt;gt; gt;A:gt; gt;At the earliest stages of lymphedema your doctor will treat you with a compression sleeve or garment until the symptoms are resolved. Compression therapy can be used again if your symptoms recur. At advanced stages of lymphedema, complex decongestive therapy or possible drug therapies may be needed. Enlist the help of certified or well-trained and experienced lymphedema therapists.gt; gt;gt; gt;Q:gt; gt;Where can I get more information on breast-cancer-related lymphedema?gt; gt;gt; gt;A:gt; gt;Visit the gt;Avon Foundation websitegt;.gt; gt;gt; gt;Q:gt; gt;How can people get involved in the fight against breast cancer?gt; gt;gt; gt;A:gt; gt;Participate in one of the nine annual gt;Avon Walk for Breast Cancergt; events. Registration is open for the 2012 season. I'm pleased to offer a $10 registration discount for Health.com readers. When registering at www.avonwalk.org, just enter the code 'WALK2' at checkout. If you can't commit to participating in a walk but want to get involved, purchase pink products that give back 100% of net profits to the Avon Breast Cancer Crusade. Go to gt;Avon.comgt; to purchase pink nail polish, tote bags, tennis bracelets, socks, and more. Lastly, sign up for the gt;Love/Avon Army of Womengt; to help breast cancer researchers in their work to end this deadly disease. The Army recruits healthy women of every age and ethnicity, as well as breast cancer survivors and women at high risk for the disease, to partner with breast cancer researchers.gt; gt;gt; ]]>

gt;gt;"The treatment is so intense—it actually strips everything away. You’re physically and completely changed," says Holmgren, 40. "I was trying to retain some sense of normalcy. And truthfully, I felt a little badass being on my bike during treatment. I was giving cancer the middle finger."gt;gt;Tooling around on a mountain bike during chemotherapy sounds intense, maybe even unadvisable. But just the opposite is true: Holmgren was being a model patient.gt;gt;In the past, doctors often told cancer patients to take it easy during treatment. Although the appropriate amount of exercise varies from patient to patient, that conventional wisdom is now considered old hat. In fact, new guidelines on cancer and exercise from the American College of Sports Medicine (ACSM) urge cancer patients to be as physically active as possible both during and after their treatment. gt;gt;gt;"The idea that you should be staying put and resting is ultimately doing more harm than good," says Kathryn Schmitz, PhD, an epidemiologist at the University of Pennsylvania School of Medicine, in Philadelphia, who studies the role of physical activity in chronic diseases. Schmitz presented the guidelines at the American Society of Clinical Oncology’s annual meeting last week.gt;gt;It’s true that the last thing people overwhelmed by cancer’s psychological and physical impact may want to hear is "exercise more." During treatment, bone-crushing fatigue, nausea, and body-changing surgery, not to mention the emotional drain of coping with worried children, friends, and life partners, often puts exercise very last on the list of priorities.gt;gt;Still, experts now say that exercise may help with—not add to—those problems. It boosts energy, helps stave off the weight gain often associated with treatment, and provides a psychological pick-me-up at a time when a person’s morale is likely to be battered. gt;gt;gt;gt;Even small amounts helpgt;gt;How much exercise is enough? The ACSM recommends 150 minutes of moderate-intensity aerobic exercise per week, which works out to about 20 minutes a day—the same amount recommended to the general public. gt;gt;But that said, the organization is realistic about how cancer and its treatment can alter mood and energy levels. Any kind of activity—even a short walk—is better than none, ACSM says.gt;gt;"The risk of inactivity for cancer patients is so great that it’s best to just get started with something," says Schmitz. If you begin to feel worse or overtired, Schmitz recommends discussing it with your doctor.gt;gt;People who were sedentary before their diagnosis should commence by walking for 10 minutes each day, says Schmitz, and gradually increase their time by 10% to 15% each week until they can do 30 minutes at a stretch, five times per week.gt;gt; There may be days when you feel nauseous, exhausted, or utterly despondent. But friends or family can help. "A lot of it will be up to the caregivers because they are the ones who will know how to motivate patients facing an uphill battle," says Schmitz. "They’re the ones who can say, ‘Hey, let’s get dressed today,’ and then, ‘Hey, let’s get dressed and walk around the house.’ "gt;gt;It’s important to pick an activity you enjoy, says Alyson Moadel, PhD, the director of the psychosocial oncology program at the Albert Einstein Cancer Center, in the Bronx, N.Y. "It is not a one-size-fits-all answer, since patients may be more responsive and adherent to different fitness programs," she says. "It’s important to allow patients a choice and to tailor a fitness program to each patient."gt;gt;Fortunately the options are greater than ever before, as exercise programs for cancer patients have become increasingly popular nationwide. In 2007 the Lance Armstrong Foundation partnered with the YMCA to provide physical activities designed specifically for survivors, and more and more hospitals are creating their own programs as well. Cancer patients who aren’t willing or able to travel to a facility on a regular basis can sign up for programs that can be delivered by mail, phone, or the Internet. gt;gt;"Right now we’re working to develop a variety in the types of programs available," says Schmitz.gt;gt;Holmgren—a longtime mountain biker—took to the San Francisco hills with a group of women who ride with the Bay Area chapter of gt;Team LUNA Chixgt;, a program that brings together amateur bikers, runners, and triathletes, and is affiliated with the Breast Cancer Fund, a nonprofit advocacy organization based in San Francisco. gt;gt;"I had no hair, no eyelashes, and no eyebrows, and yet I didn’t think they would know I had cancer," says Holmgren. "The women were so fun and inspiring, and they never babied me. They just let me do my thing at my own pace."gt;gt;gt;gt;How exercise helpsgt;gt;Dozens of studies have demonstrated the benefits of staying active both during and after treatment. gt;gt;Regular exercise can help fight the weight gain that often comes with cancer treatment, including breast cancer. "It’s about what the typical American could expect to gain over the course of a couple of years, but it’s happening all at once," says Schmitz.gt;gt;But exercise is also important for cancer patients whose treatment can cause them to lose weight. Prostate cancer, cancers of the stomach and gut, and head and neck cancers can all lead to a significant decrease in muscle mass, as well as a loss of taste and an inability to process certain foods.gt;gt; "Those patients really need to focus on resistance exercises," says Schmitz. "That will help them increase their muscle mass and gain that functional tissue that they need."gt;gt;Even though most patients won’t be able to accomplish the same physical feats they were capable of before their diagnoses, adds Schmitz, staying active helps them achieve "a whole lot more than they would have been able to if they hadn’t been exercising."gt;gt;Exercising has more intangible benefits as well. In a 2007 study that followed advanced cancer patients who exercised while undergoing chemo, the participants were asked to keep diaries. Many of them noted the positive mental aspects of exercise. "It feels good to have a sense of an everyday life again," wrote one participant. "I have become incredibly energetic," wrote another.gt;gt;In addition to making patients feel normal again, staying active is a way for patients to measure the progress of their recovery. Holmgren stuck with her rides all summer while she was undergoing chemo. "They became a real benchmark for me," she says. "The more I would ride, the more I felt like I was getting back to my old self."gt;gt;Though Holmgren still can’t handle some of the climbs she conquered pre-diagnosis, mountain biking has helped her make peace with her changed body.gt;gt;"The hormone treatment, early menopause, early arthritis, the weight gain, the surgeries—breast cancer takes a huge toll on your body," she says. "I knew I was going to feel bad no matter what, so I figured I might as well be feeling bad on my bike doing something that I used to do—and something that people not going through cancer might not be able to do." ]]> Yvette Gonzalez

gt;THURSDAY, Dec. 10, 2009  (Health.com) — Breast cancer survivors who have just a few alcoholic drinks per week are more likely than women who drink little or no alcohol to see their gt;breast cancergt; return, according to research presented today at an annual meeting of breast cancer specialists.gt;gt;The study, which followed about 1,900 early-stage breast cancer survivors for eight years, found that women who consumed an average of at least three to four alcoholic drinks in a week had a 34% higher risk of breast cancer recurrence. (One drink equals a 5-ounce glass of wine, a 12-ounce beer, or a 1.5-ounce shot of liquor.)gt;gt;The increased risk was more pronounced among breast cancer survivors who had gone through menopause and those who were overweight or gt;obesegt;, the study found.gt;gt;Wine was by far the most common drink among women in the study, followed by liquor and beer, but no one type of alcohol was found to be significantly more or less associated with the risk of recurrence.gt;gt;In all, there were 349 breast cancer recurrences and 332 deaths during the follow-up period. Alcohol use was not linked to the risk of death from breast cancer, however.gt;gt;“More research should be done, but there is a growing body of evidence which suggests that women previously diagnosed with breast cancer should speak with their doctor about possibly limiting their consumption of alcohol,” says the lead researcher on the study, Marilyn L. Kwan, PhD, a staff scientist at Kaiser Permanente in Oakland.gt;gt;Previous research has suggested that alcohol consumption may increase the risk of developing breast cancer in the first place. Kwan's research extends these findings to include the risk of recurrence among women who have already been diagnosed and treated for breast cancer, a population that numbers about 2.5 million in the United States, according to the American Cancer Society.gt;gt;“Cutting back on alcohol represents a real step that a breast cancer survivor can take to reduce her risk of recurrence,” says Marisa Weiss, MD, the president and founder of the advocacy group Breastcancer.org. “You don’t have to give up alcohol, but use it more carefully and in moderation,” she says.gt;gt;Limiting alcohol intake can improve the overall health of breast cancer survivors, according to Dr. Weiss, the author of the forthcoming book . “Alcohol is liquid calories, and being overweight is a risk factor for breast cancer,” she says.  “If you consume a lot of alcohol, you tend to be less physically active and/or smoke. So, for a number of reasons, that one step of cutting back on alcohol does have a number of health benefits."gt;gt;Exactly how alcohol consumption affects breast cancer risk is not fully understood, says Kwan, although estrogen, which fuels the growth of most types of breast cancer, is likely involved.gt;gt;“It has been suggested that alcohol could increase the risk of breast cancer by increasing estrogen metabolism and circulating levels of estrogen, thus promoting growth of the tumor,” she says.  “A similar mechanism might be responsible for increasing the risk of breast cancer recurrence.”gt;gt;Drinking-related weight gain could also play a role, Kwan adds. “Obesity may…promote estrogen production and breast cell proliferation, in addition to the direct effect alcohol can have on estrogen metabolism and levels in the body,” she explains.gt;gt;The study, which was funded by the National Cancer Institute, was presented at the San Antonio Breast Cancer Symposium, an annual meeting for oncologists, surgeons, and other breast cancer specialists. The symposium is co-hosted by the American Association for Cancer Research and the Cancer Therapy & Research Center at the University of Texas Health Science Center at San Antonio.]]> Istockphoto

gt;breast cancergt; who eat more soy are less likely to die or have a recurrence of cancer than women who eat few or no soy products, according to a new study.gt;gt;In the past, physicians have often warned breast cancer patients to eat soy. The new research represents "a complete turnaround" from the previous understanding about the link between soy consumption and breast cancer, says Sally Scroggs, a registered dietician and senior health education specialist at M.D. Anderson's Cancer Prevention Center in Houston.gt;gt;"We have gone from saying, 'No soy for breast cancer survivors' to, 'It's not going to hurt,'" Scroggs says. "Now it looks like we can say, 'It may help.'"gt;gt;The study followed more than 5,000 women in China who had undergone a gt;mastectomygt; for about four years. The women who consumed the most soy protein (about 15 grams or more a day) had a 29% lower risk of dying and a 32% decreased risk of breast cancer recurrence compared to the women who consumed less than about 5 grams of soy protein a day, according to the study, which appears in the December 9 issue of the . The National Cancer Institute and the U.S. Department of Defense's Breast Cancer Research Program funded the study.gt;gt;Women who ate between 9.5 and 15 grams of soy protein saw nearly the same decrease in risk as the women who ate more than 15 grams. In fact, the researchers found no additional benefits to eating more than 11 grams of soy protein a day. (An 8-ounce glass of soy milk and a cup of shelled edamame contain about 7 and 14 grams of soy protein, respectively.)gt;gt;In all, 534 women had a breast cancer recurrence or died from breast cancer during the study period.gt;gt;gt;Soy foodsgt;—such as milk, tofu, and edamame—are rich in naturally occurring estrogens (especially isoflavones) that can mimic the effects of gt;estrogengt; in the female body. Because the most common types of breast cancer depend on estrogen to grow, experts once feared that soy isoflavones could stimulate the estrogen receptors in breast-cancer cells, even though the estrogens in soy are much weaker than those produced by the body.gt;gt;The current study suggests the exact opposite: Soy may actually reduce the amount of estrogen that's available to the body.gt;gt;"Soy isoflavones may compete with estrogens produced by the body. Soy isoflavones may also reduce the body's production of estrogen, and increase clearance of these hormones from the circulation—all of which together reduce the overall amount of estrogen in the body," says the lead author of the study, Xiao Ou Shu, MD, PhD, a cancer epidemiologist at the Vanderbilt-Ingram Cancer Center of Vanderbilt University Medical Center in Nashville, Tenn.gt;gt;Dr. Shu says, however, that factors beyond estrogen may be at work. Other components of soy foods, such as folate, protein, calcium, or fiber (or some combination thereof) may also be responsible for the health benefits reported in the study, she says.gt;gt; gt; The new findings, which seem to contradict what many women have heard from their doctors over the years, could prove perplexing for women such as Andrea Mulrain, 44, a former music executive who was first diagnosed with breast cancer 10 years ago.gt;gt;After her diagnosis, Mulrain's doctors told her to steer clear of all soy foods because these foods could encourage the growth of cancer cells. Mulrain had estrogen-sensitive breast cancer, which means that estrogen helps the cancer grow.gt;gt;Her doctors eventually softened their stance a bit, and said she could consume soy in moderation. "I pretty much avoided soy for 10 years after diagnosis but recently was told it was OK to have soy in moderation as long as I read the labels and make sure it's not the main ingredient in any food," says Mulrain, who is currently being treated for a recurrence.gt;gt;In the study, the association between soy consumption and lower risk of death and cancer recurrence was seen in women like Mulrain with estrogen-sensitive breast cancers, and in women taking tamoxifen, a drug designed to prevent cancer recurrence by blocking the effects of estrogen in the breast tissue.gt;gt;Despite the study's findings, the final verdict on soy and breast-cancer recurrence is not yet in, according to an accompanying editorial written by Rachel Ballard-Barbash, MD, of the National Cancer Institute in Bethesda, Md., and Marian L. Neuhouser, PhD, of the Fred Hutchinson Cancer Research Center in Seattle.gt;gt;The follow-up period in the new study was relatively short, they say, and breast-cancer diagnosis and treatment may be different in China compared to the United States. Similarly, there may be differences in the types of soy foods that Chinese and American women eat. (In general, Chinese women consume significantly more soy than American women.)gt;gt;More studies are needed to confirm these findings, especially as they apply to women with estrogen-sensitive breast cancer or those who take drugs such as tamoxifen to keep breast cancer at bay, say Ballard-Barbash and Neuhouser. Still, they say, "Patients with breast cancer can be assured that enjoying a soy latte or indulging in pad thai with tofu causes no harm, and when consumed in plentiful amounts may reduce risk of disease recurrence."gt;gt;The study should be reassuring to women who have been trained to steer clear of soy, says Scroggs. "Don't freak out if there is some tofu mixed in with your vegetables at an Asian restaurant," she says.gt;gt;Her soy prescription for breast-cancer survivors? "Eat soy in moderation, and your soy proteins should come from foods, not concentrated supplements," she says. "Soy is a complete protein so it is high in fiber and has a place in a healthy, balanced diet."gt;gt;gt;Eating more soygt; is beneficial because it tends to replace less healthy foods in people's diets, Scroggs says. "When people are eating soy protein, they are likely eating less of something else, such as red meat," she says.]]> Istockphoto

gt;gt; However, a number of prominent groups say they strongly disagree with the new advice, which was issued by the U.S. Preventive Services Task Force (USPSTF) on Monday.gt;gt; The USPSTF panel has backed off a 2002 statement advising women to have a routine mammogram every year or two beginning at age 40. The panel now recommends that women undergo mammography screening every two years starting at age 50 and continue being screened through age 74.gt;gt; The USPSTF concluded that the benefit gained by starting screening at 40 versus 50 is “small” and that the decision to start screening before 50 should be an individual one.gt;gt; The new guidelines would seem to reopen a debate that raged in the 1990s, but seemed to have been settled years ago. The American Cancer Society (ACS) now recommends that women get an annual mammogram and have a clinical breast examination beginning at age 40.gt;gt; Otis W. Brawley, MD, the chief medical officer of the ACS, said in a statement that the ACS would stick to its current guidelines.gt;gt; Mammograms are the “one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member,” Dr. Brawley said. The USPSTF is an independent panel, sponsored by the federal Agency for Healthcare Research and Quality, whose members make recommendations about preventive-care services and published the new recommendations in the .gt;gt; The panel’s recommendations are based, in part, on a review of the latest scientific evidence on the benefits and harms of breast cancer screening. The pooled data show that mammography screening does reduce breast cancer death—by 15% for women ages 39 to 49. To prevent one cancer death in this group, 1,904 women would have to be screened. Among women 50 to 59, one death is avoided per 1,339 screenings.gt;gt; Because breast cancer risk increases with age, younger women are at a somewhat lower risk of developing the disease, explains George W. Sledge Jr., MD, a professor of oncology at Indiana University’s Melvin and Bren Simon Cancer Center, in Indianapolis, and president-elect of the American Society of Clinical Oncology.gt;gt; They’re also somewhat more likely to have a false-positive mammogram—a test result that triggers a biopsy or other tests, but turns out not to be cancer—because they tend to have denser breasts, he says.gt;gt; “No one is saying, or no one should say, that screening mammography has no value for younger women,” he says.gt;gt; What the task force is saying is that the absolute reduction in breast cancer deaths is much greater in an older population.gt;gt; But the American Cancer Society’s Dr. Brawley reasoned that “the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”gt;gt; gt; The panel also considered data from a study using computer simulation models to compare expected outcomes of starting and stopping screening at different ages and screening at different intervals. The models suggest that screening average-risk women ages 50 to 74 every two years achieves most of the benefit of annual screening, but with less harm due to factors such as false-positive results, unnecessary biopsies, and “overdiagnosis” of cancers that wouldn’t have progressed or would have not led to the person’s death.gt;gt; “[The models] only tell us what happens on average in the population. They do not tell us what will happen for an individual woman,” says Jeanne S. Mandelblatt, MD, the lead author of one of the studies commissioned by the USPSTF and a professor of oncology and medicine at Georgetown University’s Lombardi Comprehensive Cancer Center.gt;gt; For an individual woman, the decision to have a mammogram “is one that she needs to consider with her providers based on her risks and her values for the balance of harms and benefits,” she adds.gt;gt; But W. Phil Evans, MD, the president of the Society of Breast Imaging, questions the wisdom of biennial screening. “It doesn’t make any sense when you know more cancers can be found in the 50-year-old age group to lengthen the screening time, because the idea is to find the cancer early and to treat it while it’s small, because treatment can be less when the cancer is detected early,” says Dr. Evans, a professor of radiology and the associate vice president for clinical imaging services at the University of Texas Southwestern Medical Center, in Dallas.gt;gt; “The Society of Breast Imaging and the American College of Radiology are not going to change their guidelines because of this,” he says. “We think it’s very important to begin screening at age 40 and screen yearly thereafter.”gt;gt; The USPSTF panel did not make recommendations on screening women 75 and older because the current evidence is insufficient to weigh the additional benefits and harms. For the same reason, it did not weigh in on the value of clinical breast examinations, beyond mammography, in women 40 and older or on the value of other imaging techniques, such as digital mammography or magnetic resonance imaging.gt;gt; However, it did recommend against teaching women how to perform breast self-examination, saying there’s no evidence that it reduces breast cancer deaths.gt;gt; The critical thing is not to ignore this lifesaving procedure, says Dr. Sledge, who urges all women to discuss mammography with their doctor, beginning at age 40.gt;gt; “What’s not mentioned in these discussions, but what’s incredibly important, is that in the United States, perhaps as many as even a third of all women just simply don’t follow even the most conservative of screening mammogram recommendations, just as a significant portion of the population doesn’t get screening for colorectal cancer or screening for cervical cancer,” Dr. Sledge notes.gt;gt; “We could significantly reduce the number of cancer deaths if we applied even the most conservative of screening guidelines,” he says.gt;gt; Breast cancer is the second-leading cause of cancer death in women, after lung cancer. In 2009, an estimated 254,650 breast cancer cases will be diagnosed, and 40,170 women will die from the disease.]]> Getty Images

gt;breast cancer surgerygt; still have pain or numbness two to three years later, according to a new study. Women younger than 40 who receive lumpectomies are at the greatest risk.gt;gt;In general, women are most likely to have pain or a loss of sensation in the breast region, followed by the armpit, the arm, and their sides. However, 40% of women with lingering symptoms have pain in parts of the body not affected by treatment, according to a report in the .gt;gt;“This is a very well-done study by very well-respected surgeons in Denmark,” says Allen Burton, MD, a professor and the chair of the department of pain medicine in the division of anesthesiology and critical care at M.D. Anderson Cancer Center, in Houston.gt;gt;“This is a known phenomenon,” says Dr. Burton, who wasn’t involved in the study. “These women have pain and huge numb patches in their chest, underarm, down their arm, and in their back that never feels normal again.”gt;gt;None of the women in the study had reconstructive breast surgery, which is commonplace in the United States. “It would be interesting to see if that changes the outcome,” Dr. Burton says. “Would they have more pain? Less pain? Different kinds of pain?”gt;gt;In the study of 3,754 breast cancer survivors ages 18 to 70, 47% had pain in one or more area, and 58% reported problems in the treated breast, including burning and a loss of sensation for one to three years after their surgery. Overall, 13% of women with lingering problems said their pain was severe, 39% said it was moderate, and 48% reported light pain. And 76% of patients with severe pain said they ached every day.gt;gt;Women at the greatest risk for chronic pain were ages 18 to 39 and had undergone breast-conserving surgery, or lumpectomy, in which doctors remove only the tumor and some surrounding tissue. Other risk factors for persistent pain included radiation therapy, which is directed at the breast area to destroy any remaining cancer cells after surgery.gt;gt;gt;There are several reasons that breast cancer survivors experience pain such as nerve damage or injury from the surgery or radiation, but in the future, nerve-sparing surgery may help take the sting out of this persistent pain, according to study authors led by Rune Gärtner, MD, of the University of Copenhagen.gt;gt;The first priority is to always treat the breast cancer as effectively and aggressively as possible, Dr. Burton says. That said, a paravertebral block, which is an injection of local anesthetic into nerves of the spine to block the pain, may also help cut the risk of postsurgical breast cancer pain.gt;gt; “We are studying it and trying to determine whether or not it impacts the prevalence of long-term chronic pain after breast cancer surgery,” he says. “We think it does because it makes sense that the better you control acute pain around the surgery, the less likely you are to get chronic pain syndrome later.”gt;gt;For women who already have chronic pain from breast cancer surgery, help is available now, says Judy C. Kneece, RN, an oncology-certified nurse and the president of EduCare, a breast health education company in Columbia, S.C.gt;gt; “Pain decreases quality of life and should be a cause to reach back out to the surgeon or radiologist and ask for a referral to a physical therapist for intervention,” says Kneece, who is also the author of . “Most pain can be addressed and reduced or eliminated.”gt;gt;Physical therapists can help women develop a plan to reduce or eliminate pain. In general, range-of-motion exercises after surgery can help reduce the risk of pain, according to Kneece. “If not performed, there will be a fibrous tissue which forms in the area restricting motion and causing pain when the arm is stretched,” she says.gt;gt; One potential cause of pain is lymphedema, a swelling of the arm and hands. Lymphedema can occur after breast surgeons remove lymph nodes from a woman’s underarm region to test them for cancer.gt;gt; Some women are candidates for sentinel node mapping, a technique that reduces the risk of lymphedema; dye is injected to see which lymph node is closest to the breast tissue (and therefore most likely to contain cancer cells.) If this node is cancer free, doctors don’t have to remove multiple lymph nodes, which reduces the risk of pain and swelling.gt;gt;“If one notices increasing swelling accumulating in the affected limbs or trunk, it is likely an early warning sign of lymphedema and she should be evaluated by a fully certified lymphatic drainage therapist,” says occupational therapist Cathy Kleinman-Barnett, a lymphedema specialist at Northwest Medical Center, in Margate, Fla.gt;gt; “The additional fluid buildup can cause abnormal sensations such as tingling, aching, [and] heaviness, and should diminish or stop with range-of-motion exercises, stretching, and massage to stimulate lymphatic flow,” she says. “There is help available, and women should not have to live in pain.”]]> Getty Images

gt;gt; But Laurie Brosius, 31, isn’t buying it. Brosius, a business analyst in Dallas, used Twitter to raise $6,000 for a walk for breast cancer research in 2008. “Fifty percent of that came from online strangers,” she says. She was able to reach those people in part because her Twitter followers re-tweeted her messages.gt;gt; In 2004, Brosius started gt;blogginggt; about her upcoming wedding. But after she married, she felt a key person was missing from the happy picture—her husband’s mother, who had died of breast cancer at age 48 when her husband was 20 years old. “I felt like I missed out on having her in my life,” says Brosius. “I felt cheated.”gt;gt; She wanted to raise money for breast cancer research, so she participated in a three-day walk and fund-raiser, but felt she could do more. She had used Twitter to raise a small sum for that first walk, but for the second walk she relied mainly on tweets to direct people to the donation website.gt;gt; (Anyone can see breast cancer–related tweets by typing gt;#breastcancergt; into Twitter’s search field.)gt;gt; Brosius still blogs and says that breast cancer organizations’ websites are great places to donate. However, Brosius says, they only reach a specific crowd—those already interested in the topic.gt;gt; “[Social media sites] are reaching people who might not be specifically looking for that kind of information,” she explains. “They’re reaching everyone.”gt;gt;gt;gt; gt;Is brevity the key to charity?gt;gt;In a busy world, Twitter posts are succinct and to the point, and that’s one of the main reasons they’re so successful in charity promotion, says Adam Hirsch, the chief operations officer of gt;Mashable.comgt;, a social media blog. Navigating websites can be time-consuming, notes Hirsch. Twitter, however, states a user’s case in no more than 140 characters. “It’s a message you know people will read because, face it, it’s only 140 characters,” he says.gt;gt; With Twitter, users can interact one-on-one, but they can also broadcast a message to many followers. Even if an individual doesn’t have a lot of followers (say, just family and friends), those people can re-tweet that message in outgoing concentric circles of social contacts—potentially reaching thousands.gt;gt; “With social media, you have the ability to spread a message with like-minded individuals pretty rapidly and virally to a targeted audience that is receptive to this message,” Hirsch explains.gt;gt; Mashable.com is leveraging its social media savvy through its gt;Summer of Social Goodgt;, which is an online charitable campaign. The site is raising money for four big charities: the gt;Humane Societygt; (you can search for @HumaneSociety on Twitter): gt;LiveStronggt;, the Lance Armstrong Foundation (@LiveSTRONG); gt;OxfamAmericagt;, which seeks to end poverty (@OxfamAmerica); and the World Wildlife Fund (@WWF_Climate).gt;gt; The idea got started last year when Mashable founder Pete Cashmore tweeted on his birthday, asking followers to donate to gt;Charity: Watergt; in lieu of birthday gifts. He raised $10,000 in a little over a day.gt;gt; “I thought, ‘This is definitely an interesting way to use social media,’” says Hirsch. “It’s time to give back and to really try to make a big difference.” Mashable’s Social Media for Social Good campaign ends on August 28.gt;gt; Peg Mulligan, 40, is a content developer in Beverly, Mass., who raises awareness of breast cancer via Twitter, by tweeting (or re-tweeting) fundraising initiatives, gt;blog postsgt;, and other relevant links. Although she has breast cancer in her family and cares about the topic, she says she doesn’t necessarily want to think about it all the time. That’s one reason people may not seek out traditional breast cancer donation channels, she says.gt;gt;Unlike such message boards and topic-specific websites, Mulligan says, Twitter is a “gentler way of reaching people” because it indirectly grabs users’ attention in a stream of other topics.gt;gt; gt;gt; gt;Facebook vs. Twittergt;gt;Mashable’s Hirsch prefers Twitter to Facebook for social causes because anyone can choose to follow someone on Twitter, which leads to broader, looser networks of people. “Facebook is inherently different because it’s more built around friends,” he says.gt;gt; However, some people are using Facebook to communicate their personal messages to their immediate social circle—though it’s not always smooth sailing.gt;gt; Earlier this year, a breast cancer survivor named Sharon Adams posted pictures of her ropy red mastectomy scars on Facebook. She hoped to shock friends in her suburban England network into checking their own breasts for cancer. “I wanted to take something positive out of a bad situation,” says the 45-year-old, who posed for the shots just six days after having surgery.gt;gt; Instead, Facebook management took down the photos in a routine purge of “sexual” images. The result? An avalanche of media attention and a gt;900-member protestgt; that quickly grew to 3,000, even as the company rapidly apologized and backpedaled. Facebook said they had “made a mistake” and Adams put the images back up.gt;gt; Adams says that despite the setback, she realized her goal—extra online chitchat about the issue and maybe more checked breasts. In her own circle alone, several friends and a niece made the extra effort. “It turned out to be a good thing in a way,” she says. “This amount of publicity would never have arisen if they had not [removed the photographs].”gt;gt; The gt;largest breast cancer–related groupgt; on Facebook is LookPink, a search engine that aims to provide free mammograms for women. It has 850,000 members and acts as a fund-raising and awareness hub with round-the-clock discussion—especially during October, breast cancer awareness month. It’s one of several Facebook gateways to the corresponding gt;LookPinkgt; website.gt;gt; But there are hundreds of breast cancer groups on Facebook, many no bigger than the page of eight women from the Persian Gulf city of Doha, Qatar.gt;gt; The Facebook page that hosts Sharon Adams’s protest group has a link to her own efforts to gt;raise cash for breast cancer researchgt; in the U.K., for instance, and a petition to the U.S. Department of Health & Human Services to get gt;gene tests covered by insurancegt;.gt;gt; “There is a huge presence of women who have battled or are battling breast cancer who are connecting online,” says Alison Gordon, the vice president of strategy, marketing, and communications for gt;Rethink Breast Cancergt;, a Canadian nonprofit that encourages breast self-exams.gt;gt; “Social media offers an incredible forum for women to expand their online communities from around the world and share their stories,” she says.gt;gt; Part of Brosius’s story—and another reason she started using Twitter to raise funds—is her concern for her husband’s sister and her sister-in-law’s three daughters. “I wanted to do all I could to find a cure before they grow up,” she says.]]>

gt;hormone therapygt; (HT), which may increase your risk of breast cancer. If you can, consider nondrug remedies first, says JoAnn Manson, MD, a professor of medicine at Harvard Medical School and the author of .gt;gt;Dr. Manson has several suggestions for managing hot flashes and night sweats:gt;gt;gt; 
gt;gt;Wear layered clothing.gt;gt;Lower the thermostat.gt;gt;Use portable fans.gt;gt;Avoid dietary triggers such as caffeine, spicy foods, and alcohol.gt;gt;Avoid tobacco.gt;gt;Increase your intake of soy-based foods.gt;gt;Consider trying the herb black cohosh.gt;gt; A low dose of a selective serotonin-reuptake inhibitor (SSRI) or the antiseizure medication gabapentin may also be useful, according to Kala Visvanathan, MBBS, assistant professor of epidemiology and oncology at Johns Hopkins Bloomberg School of Public Health, in Baltimore.gt;gt; "If a woman has only vaginal dryness and discomfort with intercourse and no other symptoms, she can use a topical estrogen or a vaginal estrogen ring, which have a much lower absorption of estrogen," adds Dr. Manson, who notes that relaxation and breathing techniques have worked for some women as well. "I would encourage women to try lifestyle modifications before going with estrogen, especially if they have mild symptoms," she says.gt;gt; Dr. Visvanathan agrees: "You definitely want to try simple things first, then go to [HT] if you need to. It used to be that hormones were the first thing you tried, but the paradigm is changing because we’ve determined the long-term breast cancer and cardiovascular risk associated with HT, and because the benefits of HT have been shown to be less effective than previously thought. Women with modest menopausal symptoms can often treat their symptoms effectively with nonmedical therapies."gt;gt;If you end up needing estrogen or combination HT, though, and you want to keep your breast cancer risk low while still keeping menopause symptoms in check, ask your doctor about transdermal patches, gels, and sprays, which deliver low doses of estrogen through the skin and may have fewer risks than pills. "Transdermal estrogen may be less likely to cause blood clots and gallbladder disease," Dr. Manson explains. "And lower doses may be less likely to increase the risk of breast cancer or other cancers."gt;gt; Consider alternative approaches to see if one or several together can control your menopause symptoms before turning to oral estrogen or combination HT.]]> Taking estrogen may increase a woman's risk of getting breast cancer. (ISTOCKPHOTO/HEALTH)

gt;gt;• gt;Combination hormone therapy (HT):gt; If you’re considering taking estrogen and progestin (a synthetic form of the hormone progesterone) to give you relief from annoying menopause symptoms like hot flashes and night sweats, be sure to limit the time you’re on the drugs. That’s because over time your breast cancer risk climbs, says JoAnn Manson, MD, professor of medicine at Harvard Medical School and author of .gt;gt; "In the Women’s Health Initiative (WHI) trial, when women got seven years of estrogen alone, there was no increased risk of breast cancer, but after four to five years on combined hormone therapy, the risk emerges," she says. In fact, over time, estrogen plus progestin can raise a woman’s risk for breast cancer by 24%; even if you take estrogen on its own for more than 10 to 15 years, your risk may still go up.gt;gt; Dr. Manson was a coauthor on a March 2008 study in the that followed up on the WHI trial. It showed that even after the women gt;stopped taking combination HTgt;, their breast cancer risk remained elevated. "The risk of breast cancer does decline after stopping hormone therapy," she stresses, "but if a tumor has formed while a woman is on hormones it’s very likely to come to light even after she stops hormones, so there is some residual risk. Stopping drug therapy doesn’t mean a tumor evaporates, but the risk gradually declines."gt;gt;• gt;HT and early diagnosis of breast cancer:gt; If you have no family history of the disease, you’ve probably been encouraged to get your first mammogram by age 40 and every one to two years after that to help ensure that any tumor is caught early, when it’s most treatable. That’s good advice, but taking HT may complicate things. "Estrogen-and-progestin HT can lead to increased mammographic density"—denser breast tissue—"that can obscure breast tumors and delay diagnosis," says Dr. Manson. Denser breasts are believed to be an independent risk factor for breast cancer, but they also make it harder to accurately read a mammogram and that "can lead to abnormal mammograms that may require extensive follow-up and anxiety about repeat testing and even unnecessary biopsies," Dr. Manson adds.gt;gt; • gt;HT and risk for benign breast disease:gt; In April 2008, the found that postmenopausal women who’d taken estrogen on its own doubled their risk of a noncancerous type of breast disease, but one that’s associated with a higher risk of breast cancer. A September 2008 study led by the same author, Thomas E. Rohan, MD, PhD, an epidemiologist at the Albert Einstein College of Medicine, in New York City, found similarly disturbing evidence in a study of women taking estrogen and progestin: Combined HT raised a woman’s risk of benign breast disease by 74%.gt;gt;gt;• gt;Estrogen, testosterone, and breast cancer risk:gt; Low sexual desire and vaginal dryness are two common—not to mention very unpleasant—hallmarks of menopause for many women. Estrogen can help ease the latter and researchers have looked at whether adding testosterone—another hormone that’s crucial to libido, even in women—into the mix might help. The extent to which testosterone will perk up your love life is uncertain, but combining estrogen and testosterone may increase your breast cancer risk. A 2006 study collected data from more than 121,000 women who were part of the Nurses' Health Study and found that for the women who'd gt;taken estrogen and testosteronegt;, the risk of developing breast cancer went up 17% for every year they took the combo, compared to those who’d never taken hormones for menopause symptoms.gt;gt; "The recommendation for hormone therapy is for the lowest effective dose for the shortest duration, to minimize the risk of breast cancer and to minimize risk overall," sums up Dr. Manson.gt;gt; Talk to your doctor about whether HT is right for you in the first place and, if it is, annually revisit the decision to stay on hormones. "If they develop hot flashes or irregular periods, women don’t automatically go on hormones for their lifetimes anymore; they go on them if they have symptoms that are severe and aren’t controlled by other approaches," explains Kala Visvanathan, MBBS, assistant professor of epidemiology and oncology at Johns Hopkins Bloomberg School of Public Health, in Baltimore. "After a period of time you can reduce the dose and see if you’re still getting symptoms. Rethink it on a yearly basis, asking your doctor, 'Should I continue on it, do I need it?'"gt;gt;Dr. Manson suggests trying to limit combination HT to two to three years, and to no more than five years, if possible. If you have dense breasts (your doctor can tell whether you do), ask about ways to lower your cancer risk and make sure your annual mammogram and clinical breast exams are thorough and regular. You may also want to consider gt;alternatives to HTgt; and/or switch to a lower dose. Skip the supplemental testosterone too.gt;gt;gt;If you’re in treatment for breast cancergt;gt;To keep breast cancer from coming back, your oncologist will want to keep the level of natural estrogen in your body at an all-time low; it’s unlikely he’ll OK either estrogen or combination HT while you’re still in treatment. "It’s very controversial and I would try to avoid it," Dr. Manson says. Instead, you’re more likely to be put on medications that do just the opposite—deplete the estrogen you do have in order to prevent a recurrence. If you’re prescribed raloxifene (Evista) or tamoxifen, these not only block estrogen receptors to stop a tumor from growing, but they can also do a lot to stave off another cancer. Aromatase inhibitors such as Arimidex and Femara—mainly used by postmenopausal women—keep your body from making the hormone in the first place, significantly lowering the chances that breast cancer will return.gt;gt; If at all possible, pass up HT while you’re still in treatment. If your symptoms are still poor after treatment, reevaluate the decision with your doctor.gt;gt; gt;If you’re at increased risk of breast cancergt;gt;If your odds of getting breast cancer are higher than average—because you have a family history or because you carry a mutation of the BRCA-1 or BRCA-2 genes (which puts you at a much higher risk)—you’re bound to wonder whether taking hormones to relieve menopause symptoms is worth it.gt;gt;"If a woman is at very high risk for breast cancer, I’ll try to avoid using HT," says Dr. Manson. "But if she doesn’t respond to gt;other treatmentsgt; and she’s highly symptomatic—disrupted sleep, severe hot flashes, vaginal dryness—and she’s not getting adequate relief, a short course of hormones for two to three years should not really increase her risk." Talk to your doctor about what’s right for you; you may be able to find nonhormonal relief before turning to drugs. Dr. Visvanathan notes that if you’ve had your uterus removed, your physician may suggest estrogen alone, which is associated with lower odds for breast cancer as are other alternatives to HT.gt;gt;Keep in mind too that when it comes to breast cancer risk and hormones, researchers definitely don’t have all the answers. An October 2008 study of postmenopausal women who’d taken hormones actually offered reassuring news, at least for BRCA-1 carriers: The researchers found that the BRCA-1 women who’d taken estrogen alone or combined estrogen and progesterone actually had a gt;decreased risk of breast cancergt; compared with those who hadn’t had HT. Why? That’s not clear, says Steven Narod, MD, one of the study’s authors and director of the familial breast cancer research unit at the Women’s College Research Institute in Toronto.gt;gt; Skip or postpone HT, if possible, or talk to your doctor about a short course of hormones while menopause symptoms are at their worst.]]> Taking estrogen may increase a woman's risk of getting breast cancer. (GETTY IMAGES/HEALTH)