a smiling young Asian woman with shaven head representing cancer patient after chemo therapy

SAN ANTONIO — Mayo Clinic researchers will present findings at the San Antonio Breast Cancer Symposium Dec. 10–14 in San Antonio.

New Mayo
Clinic studies to be presented include:

“Women at Elevated Risk of Developing
Breast Cancer May Benefit From Taking Anti-inflammatory Drugs”

Embargoed until Friday, Dec. 13,
at 6 p.m. EST

Research
from Mayo Clinic investigators suggest that some women with an elevated risk of
developing breast cancer may benefit from taking anti-inflammatory medications.

“Several studies have evaluated whether the use of anti-inflammatory medications such as aspirin, ibuprofen and naproxen affect a woman’s risk of developing breast cancer,” says Amy Degnim, M.D., a breast surgical oncologist at Mayo Clinic in Minnesota, “but little is known about how use of these drugs might affect their risk after a benign breast biopsy.” Dr. Degnim says about one million women receive a diagnosis of benign breast disease annually in the U.S. and having this history increases their risk of developing breast cancer.

Researchers
surveyed women who had undergone a benign breast biopsy at Mayo Clinic between 1992
and 2001, and asked them to report which types of these medications they had
used and for how long. Researchers also obtained information on which women had
developed breast cancer at any point in the years after their initial benign
biopsy.

“We found
that women who reported using ibuprofen or naproxen had an approximately 40%
reduction in breast cancer risk, while women who reported using aspirin had no
reduction in breast cancer risk,” says
Dr. Degnim. “Women
who used the drugs more frequently on a regular basis also had greater
protection from breast cancer.”

Dr.
Degnim says the findings suggest that women who have had a benign breast biopsy
may benefit from medications that reduce inflammation, except for aspirin, in
terms of reducing later breast cancer risk. She cautions that this study was
not a clinical trial and she does not recommend that all women should take
these medications to reduce their breast cancer risk. “Our
results support the need for a clinical trial to further investigate the risks
and benefits of taking these medications to lower breast cancer risk.”

“Young Women With Breast Cancer May Help Preserve Fertility by Avoiding Intensive Chemotherapy”

Embargoed until Thursday, Dec. 12,
at 8 a.m. EST

Young women with HER 2-positive breast cancer may help preserve their
fertility by choosing one type of chemotherapy over another
according to the findings of a study led by Kathryn
Ruddy, M.D.
, an oncologist at Mayo Clinic. 

“Ovarian
dysfunction is an important issue after cancer treatment because it can be
associated with infertility and menopausal symptoms, such as hot flashes and
impaired sexual function,” says Dr. Ruddy.

Dr. Ruddy and her team surveyed study
participants taking part in a randomized clinical trial testing the
efficacy of T-DM1 versus a combination of paclitaxel and trastuzumab.
Participants were asked questions about menstrual periods. “We
found
that young women with HER 2-positive breast cancer may be more
likely to resume menstruation after receipt of two relatively new treatments,
T-DM1 or a combination of paclitaxel and trastuzumab,
than we have seen previously in young women who received older, more intensive
chemotherapy regimens.”

Dr. Ruddy says the findings should be good news for women who want to maintain
fertility after treatment for breast cancer and that menopausal symptoms such as hot flashes may be less burdensome for
patients treated with the
newer regimens. Dr. Ruddy and her colleagues will perform
additional analyses on the effect of tamoxifen on these results before
publishing a paper on this study. 

“Researchers
Develop Tool to Identify Patients at Higher Risk of Heart Damage From Breast Cancer
Therapy”

Embargoed until Friday, Dec. 13, at 6 p.m. EST

Researchers at Mayo Clinic in Florida have developed a tool to help identify
patients who
may be at higher risk of developing heart damage from anti HER 2 breast cancer
therapy at an early stage.

“Cardiac
toxicity is a known complication of anti-HER 2 therapy,”
says Pooja Advani, M.B.B.S., M.D., a Mayo Clinic oncologist. Dr. Advani says clinical studies have confirmed that the use
of anti-HER 2 therapy in breast cancer patients can have a profound effect on patient
survival.

“The
most common manifestation of cardiac toxicity in breast cancer
patients receiving anti-HER
2 therapy is
a reduction in the ejection fraction without any symptoms,”
says Dr.
Advani. Ejection fraction is a
measurement of the percentage of blood leaving the heart each time it
contracts.

Dr. Advani says risk factors, such as older age; a lower ejection fraction prior to the start of treatment; and the use of anthracycline chemotherapy, such as doxorubicin or Adriamycin, have been consistently associated with a higher risk of cardiac toxicity from anti-HER 2 therapy.

Dr. Advani and her colleagues followed 604 breast cancer patients who were treated
with anti-HER 2 agents at Mayo Clinic. They
collected patient data, including, age, race, gender, body mass index, smoking history,
medical comorbidities, use of heart medications, baseline heart function,
thickness of the heart muscle and prior use of anthracycline chemotherapy.

Researchers identified patients who developed cardiac toxicity —
asymptomatic, symptomatic,
or both. They performed a statistical
analysis to identify risk factors that were associated with a high risk of
developing cardiac dysfunction. 

“We
found that patients with certain risk factors including
being over the age of 55, having a lower baseline heart function (ejection
fraction less than 60 percent), having received anthracycline
chemotherapy or patients having enlargement
and thickening of the heart walls
were most significantly associated with an increased risk of developing cardiac
toxicity,” says Dr. Advani. “This is consistent with previously reported
studies.”

Dr. Advani says patients receiving radiation therapy as a part
of their breast cancer treatment were not found to be at a significantly higher
risk of developing cardiac toxicity from anti-HER 2 therapy based on their
findings.

Dr. Advani and her colleagues created a risk prediction model by
assigning a score to each
factor mentioned above and found that the cumulative risk score was a highly
significant predictor of cardiac toxicity in patients.

“Using
a risk
prediction model at therapy initiation may help us identify patients who may benefit from an
early referral to a cardiologist
for close cardiac monitoring and treatment with medications to protect their
heart function,” says Dr. Advani.

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About Mayo Clinic
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