Women diagnosed with breast cancer often face a crucial decision about the extent of their surgical treatment. Many meet national guidelines recommending testing for mutations in the BRCA 1 and 2 genes, which carry a substantial risk of future cancer. A new study reports that among women with breast cancer who undergo recommended testing before surgery, more than 7 in 10 who test positive will change their surgical plan, typically opting for a more extensive procedure such as a double mastectomy and sometimes ovary removal.
‘As soon as somebody hears they have a 65 percent chance of a new breast cancer in the future or an up to 60 percent chance of ovarian cancer, they are likely to do whatever they can to prevent that,’ said lead author Dr. Elizabeth Lokich, an obstetrics and gynecology fellow in the Warren Alpert Medical School of Brown University and at Women & Infants Hospital.
The study appears with the recommendation that women who meet National Comprehensive Cancer Network guidelines for genetic testing (nccn.org) get the test before deciding on their surgery.
‘Particularly because of what we found
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Inhibiting enzymes that cause changes in gene expression could decrease chemotherapy resistance in ovarian cancer patients, researchers at Georgia State University and the University of Georgia say.
Dr. Susanna Greer, associate professor of biology, and research partners at the University of Georgia have identified two enzymes that suppress proteins that are important for regulating cell survival and chemoresistance in ovarian cancer.
Ovarian cancer is one of the deadliest gynaecological cancers, with a 60 percent mortality rate and a five-year survival rate for less than 30 percent of women in the advanced stage of the disease. The high mortality rate is largely due to the development of resistance to chemotherapeutic drugs. Understanding the molecular and genetic mechanisms that drive the development of acquired chemoresistance can help improve therapeutic agents for ovarian cancer treatment.
‘Ovarian cancer is usually treated by surgery followed by chemotherapy,’ Greer said, ‘but because it’s typically found fairly late, ovarian cancer is often refractory to chemotherapy. You have tumours that initially respond to chemotherapy and then don’t. Ovarian cancer is the 8th most commonly diagnosed cancer in U.S. women, but due to its late diagnosis, causes more deaths than any other cancer of the female reproductive system.’
In a previous study, Greer found the expression of the protein RGS10, which regulates ovarian cancer cell growth and survival, is suppressed in ovarian cancer cells that are chemoresistant. The suppression was caused by two important mechanisms that silence genes and contribute to the progression of many cancers – DNA methylation, a biochemical process in which a methyl group is added to specific building blocks of DNA, and histone deacetylation, a process in which enzymes remove functional groups of atoms from proteins associated with DNA.
In their study, the researchers investigate the silencing of RGS10 expression in ovarian cancer cells by epigenetics, which is heritable changes in genes and gene expression that are not caused by changes in the DNA sequence, but rather by reversible and self-perpetuating mechanisms of DNA programming.
They identified two epigenetic regulators, HDAC1, a histone deacetylase, and DNMT1, a DNA methyl transferase. Decreasing the expression of HDAC1 and DNMT1 and blocking their activity significantly increased RGS10 expression and cell death. This also decreased the binding of HDAC1 to RGS10 in chemoresistant cells.
The research suggests that inhibiting HDAC1 and DNMT1 could be a novel therapeutic approach to overcoming chemoresistance in ovarian cancer.
EurekAlert
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As long as inexpensive statins, which lower cholesterol, are readily available and patients don
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Cancer patients could one day experience fewer side effects from chemotherapy following a discovery that opens the door for more targeted treatments.
Researchers have identified a possible way of treating tumours that would see doctors place harmless metal implants at the cancer site.
The discovery could make treatment more targeted than existing therapies, avoiding unwanted side effects, such as hair loss, tiredness and nausea. These occur when chemotherapy drugs carried in the blood kill healthy cells as well as cancer cells.
The scientists found that they could alter the chemical composition of commonly used chemotherapy drugs so that they only become active when they come into contact with a metal called palladium.
Researchers hope that by implanting small devices coated with palladium into patients
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Scientists at Cold Spring Harbor Laboratory (CSHL) today report a discovery that they hope will lead to the development of a powerful new way of treating an aggressive form of breast cancer.
The breast cancer subtype in question is commonly called ‘HER2-positive’; it
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Four young men who have been paralysed for years achieved groundbreaking progress
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Nine years after an accident caused the loss of his left hand, Dennis Aabo S
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Johns Hopkins researchers have devised a computerised process that could make minimally invasive surgery more accurate and streamlined using equipment already common in the operating room.
In a report the researchers say initial testing of the algorithm shows that their image-based guidance system is potentially superior to conventional tracking systems that have been the mainstay of surgical navigation over the last decade.
‘Imaging in the operating room opens new possibilities for patient safety and high-precision surgical guidance,’ says Jeffrey Siewerdsen, Ph.D., a professor of biomedical engineering in the Johns Hopkins University School of Medicine. ‘In this work, we devised an imaging method that could overcome traditional barriers in precision and workflow. Rather than adding complicated tracking systems and special markers to the already busy surgical scene, we realised a method in which the imaging system is the tracker and the patient is the marker.’
Siewerdsen explains that current state-of-the-art surgical navigation involves an often cumbersome process in which someone
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Conventional digital mammography is the most widely-used screening modality for breast cancer, but may yield suspicious findings that turn out not to be cancer, known as false-positives. Such findings are associated with a higher recall rate, or the rate at which women are called back for additional imaging or biopsy that may be deemed unnecessary. Tomosynthesis, however, allows for 3-D reconstruction of the breast tissue, giving radiologists a clearer view of the overlapping slices of breast tissue. And though a relatively new technology, it has shown promise at reducing recall rates in all groups of patients, including younger women and those with dense breast tissue. This study, presented by Emily F. Conant, MD, chief of Breast Imaging the department of Radiology at the Perelman School of Medicine at the University of Pennsylvania, is one of the largest prospective trials in tomosynthesis to date. For the study, the research team compared imaging results from 15,633 women who underwent tomosynthesis at HUP beginning in 2011 to those of 10,753 patients imaged with digital mammography the prior year. Six radiologists trained in tomosynthesis interpretation reviewed the images. Researchers found that, compared to conventional mammography, the average recall rate using tomosynthesis decreased from 10.40 percent to 8.78 percent, and the cancer detection rate increased from 4.28 to 5.24 per 1,000 patients, a 22 percent increase.
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