Breast Tumors: Study Shows New Drugs Expose Vulnerability

Posted by Brigham and Women's Hospital January 4, 2017

Researchers at Dana-Farber/Brigham and Women’s Cancer Center led a study of a drug agent that can make some breast tumors vulnerable to drugs known as PARP inhibitors. Photo by Sam Ogden.

“If it’s not broke, don’t fix it” may be a valid philosophy in general, but not in dealing with the molecular machinery of cancer cells. There, the applicable motto might be might be, “If it’s broke, keep it that way.”

That’s the approach taken by a class of targeted drugs known as PARP inhibitors, which hinder cancer cells from repairing certain kinds of damage to their DNA. In tumor cells whose DNA-repair system is already hobbled, PARP inhibitors can lead to such a buildup of DNA damage that the cells can no longer survive.

But the drugs have limitations: they are effective only in cancers that already are poor at DNA repair, and their effectiveness tends to lessen over time, as cancer cells find alternate routes for fixing DNA damage. This has prompted scientists to look for other compounds capable of disrupting DNA repair, potentially by interfering with cell proteins that play a role in the process. These drugs could potentially turn PARP inhibitor-resistant cancers into inhibitor-sensitive ones.

In a recent study, scientists at Dana-Farber reported success with one such agent, the chemically unique drug dinaciclib. The research was conducted in laboratory samples of triple-negative breast cancer and in mice carrying tumor tissue from human patients. When investigators treated the samples and the animals with a PARP inhibitor and dinaciclib, tumors that previously hadn’t responded to PARP inhibitors stopped growing, as did tumors that initially did respond to the drugs but had become resistant to them. Read More »

Breast Reconstruction – New Surgical Approaches

Posted by Brigham and Women's Hospital November 11, 2016

Innovative flap procedures offer breast reconstruction options to patients who are not candidates for implant-based breast reconstruction.

Contributor: Dr. Matthew Carty is Co-Director of the Microsurgical Breast Reconstruction Program at Brigham and Women’s Hospital and Associate Professor of Surgery at Harvard Medical School. His clinical interests include advanced reconstructive and cosmetic procedures of the body and face.

Many women who have lost a breast to cancer cannot undergo common breast reconstruction procedures, because they have had abdominal surgery, or lack sufficient donor tissue in their abdomen.

However, with advances in surgical reconstruction, many have new options. “We can now use the patient’s own tissue to rebuild the breast,” says Dr. Matthew Carty.

The innovative reconstructive options involve transferring tissue, known as flaps, from one part of the body to the chest without compromising muscle functioning.

“After the surgical procedure, patients can still run, ride bikes, swim, do ballet, yoga, all the general activities that people like to do,” says Dr. Carty. Read More »

Why is Breast Density Important?

Posted by Brigham and Women's Hospital October 31, 2016

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This image shows a negative screening mammogram of 45-year-old woman with dense breast tissue.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). In recognition of Breast Cancer Awareness Month, we are publishing a three-part Breast Imaging Series throughout October. Today’s post, the final in our series, discusses breast density.

Breasts contain fibrous, glandular, and fatty tissue. Generally, breasts are considered dense if they contain a lot of fibrous and glandular tissue and less fat. Breast density is classified on a mammogram report in one of four ways:

  • Almost entirely fatty
  • Scattered areas of fibroglandular density
  • Heterogenously dense
  • Extremely dense

According to the American College of Radiology, 80 percent of women in the United States fall into one of the middle two categories, 10 percent have almost entirely fatty breasts, and the remaining 10 percent have extremely dense breast tissue.

Breast density is important for several reasons. Dense breast tissue may increase a woman’s chance of developing breast cancer. Also, detection of breast cancer using mammography is more difficult in women with dense breast tissue. Read More »

Breast Cancer Screening: Understanding the Guidelines

Posted by Brigham and Women's Hospital October 4, 2016

Digital 3D mammography (digital breast tomosynthesis), the latest technology used in mammography, takes multiple images of each breast from different angles. It has been shown to improve earlier detection of breast cancers and reduce the number of call backs for repeat imaging.

Contributor: Dr. Catherine Giess is Chief of the Division of Breast Imaging at Brigham and Women’s Hospital and Assistant Professor of Radiology at Harvard Medical School.

Approximately one in eight women will develop invasive breast cancer during her lifetime, according to the American Cancer Society (ACS). This post is designed to outline breast cancer screening guidelines.

“Mammography is a very important screening tool for early breast cancer detection, but there are several different guidelines for when to start and how often to undergo mammography,” says Dr. Giess.  “This can be confusing for many women.”

The American College of Radiology recommends annual screening mammography beginning at age 40.  The ACS guidelines (outlined below) emphasize screening based on a woman’s individual risk of developing breast cancer and her personal preferences.

 

When should I start?

A woman’s first mammogram serves as a baseline to compare results of subsequent mammograms.

  • Women should begin discussing breast cancer screening with their health care providers at age 40. From 40-44 years of age, women have the option to begin annual screening if they choose to do so.  All women should begin yearly mammograms by age 45.
  • Women who are at higher risk for developing breast cancer, such as women with a family history of breast or ovarian cancer, should discuss their own personal risk factors with their health care providers, and may need to start screening earlier.

Read More »

Mom with Breast Cancer Finds Care Close to Home

Posted by Brigham and Women's Hospital August 23, 2016

Breast cancer patient Cathy McCue (consent # 8413). Photographed at Dana Farber South Shore in Weymouth for Turning Point magazine Spring Summer 2016. Cathy McCue is a patient at South Shore who benefits from the expanded Young Women with Breast Cancer program.

Cathy, a 44-year-old mom from Hanover, Massachusetts, received breast cancer care close to her home through Dana-Farber/Brigham and Women’s Cancer Center in clinical affiliation with South Shore Hospital.

When Cathy McCue, 44, tried to find words to tell her 8-year-old twin boys about her cancer, she turned to books like “Mom Has Cancer” and “Nowhere Hair.”

Her own story began in June 2015, when she felt a pain in her right breast while at the gym. After finding a lump later that night, Cathy, a homemaker in Hanover, Massachusetts, went to see her primary care physician, and was guided quickly through detection to diagnosis.

A biopsy revealed that she had triple negative breast cancer, in which the cancer cells do not have estrogen, progesterone, or HER2 receptors, and therefore do not respond to some commonly used breast cancer drugs.

Read More »

Breast Cancer – New Surgical Advances

Posted by Brigham and Women's Hospital May 3, 2016

Ann Partridge and Tari King,

Dr. Tari King, Chief of Breast Surgery, and Dr. Ann Partridge, Director of the Program for Young Women with Breast Cancer, discuss a case.

Current trends in breast cancer management incorporate a “less is more” approach in many cases. This includes surgical treatment for breast cancer.

“We are finding that we can perform less extensive surgery and offer easier approaches for many patients with breast cancer, while still achieving excellent outcomes,” says Dr. Tari A. King, Chief of Breast Surgery and a member of the Breast Oncology Center at Dana-Farber/Brigham and Women’s Cancer Center.

Previous surgical treatment plans, for example, included full lymph node surgery for the presence of any cancer in the lymph nodes located under the arm. This can result in long-term arm swelling, a condition known as lymphedema. Recent studies have shown that, in patients with a limited amount of cancer in the lymph nodes (cancer in one or two nodes), it is not necessary to remove all of the remaining nodes.  The lymph nodes can remain in place and the cancer can be successfully treated with other modalities, such as medical and radiation therapies.

Read More »

New Options for Natural Breast Reconstruction

Posted by Brigham and Women's Hospital October 13, 2015

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BWH plastic surgeons are offering new breast reconstruction options that use a patient’s own thigh tissue.

Plastic surgeons at Brigham and Women’s Hospital (BWH) are now offering women several new options for natural breast reconstruction after a mastectomy.

These new autologous (own tissue) procedures – PAP (profunda artery perforator), TUG (transverse upper gracilis), and DUG (diagonal upper gracilis) flap reconstruction – are typically reserved for patients who do not have enough tissue in their abdomen for reconstruction or who have already had abdominal surgery. Each option involves taking a complete flap of tissue – including skin, fat, and its accompanying blood supply – from the patient’s own leg and transferring it to the chest to create a new breast.

Women are increasingly turning to these and other types of autologous reconstruction as alternatives to reconstruction with artificial implants. Chief among the reasons for this trend is that flap procedures give women the opportunity to have a reconstructed breast with a natural look and feel that lasts. Because they’re biologic, soft tissue reconstructions evolve with the patient. As a woman loses weight, gains weight, or ages, the reconstructed breast tends to respond in proportion to the rest of the body.

Read More »

Benefits of Breastfeeding

Posted by Brigham and Women's Hospital July 29, 2015

Breastfeeding provides benefits to babies and their mothers.

August is National Breastfeeding Month, a good time to talk about the significant short- and long-term benefits that breastfeeding provides to babies and their mothers. This includes lower risk of ear infections, pneumonia, leukemia, and sudden infant death syndrome for babies and lower risk of cardiovascular disease, type 2 diabetes, and ovarian and breast cancers for mothers.

In 1991, the World Health Organization and the United Nations Children’s Fund launched the Baby-friendly Hospital Initiative to establish practices that protect, promote, and support breastfeeding. Brigham and Women’s Hospital is participating in this global effort. Below is an overview of the baby-friendly practices that we follow and promote at the Brigham and Women’s Center for Women and Newborns to help initiate and extend the duration of breastfeeding.

Read More »

Five Things Young Women Should Know about Breast Cancer

Posted by Brigham and Women's Hospital October 29, 2014

Cancer experts from Brigham and Women’s Hospital and Dana-Farber Cancer Institute (DFCI) work together to provide cancer patients the latest therapies, including access to innovative clinical trials through Dana-Farber/Brigham and Women’s Cancer Center. Today’s post originally appeared on Insight, the blog of DFCI.

While the majority of women diagnosed with breast cancer are age 55 or older, about 14,500 women age 45 and younger are diagnosed with breast cancer in the U.S. each year. Here are some facts about breast cancer all young women should know.

Read More »

Imaging Technique May Reduce Need for Follow-Up Breast Cancer Surgery

Posted by Brigham and Women's Hospital October 2, 2014

The researchers' new breast imaging approach will be tested in the AMIGO suite.

Currently, up to 40 percent of patients undergoing breast-conserving surgery to treat cancer require re-operation because of a failure to remove all of the cancerous tissue during the initial operation. Brigham and Women’s Hospital (BWH) researchers, however, have successfully tested an innovative tissue imaging approach that accurately distinguishes cancerous breast tissue from normal breast tissue and precisely defines the margins between the two – an advance that could significantly decrease the need for follow-up surgery.

The tool the researchers used for their study is called desorption electrospray ionization (DESI) mass spectrometry imaging, a technology that allows physicians and researchers to promptly evaluate human tissue. It works by electrically charging (ionizing) molecules in a tissue sample through the application of a microscopic stream of solvent. The mass of these ionized molecules is then measured and their distribution within the tissue is mapped.

Read More »