The higher BRCA mutation frequency in young black women may contribute to higher rates of aggressive breast cancer

Women who have inherited mutations in the BRCA1 or BRCA2 genes are more likely to develop breast cancer or ovarian cancer, especially at a younger age. Approximately 5 percent of women with breast cancer in the United States have mutations in BRCA1 or BRCA2 based on estimates in non-Hispanic white women. Moffitt Cancer Center researchers recently conducted the largest U.S. based study of BRCA mutation frequency in young black women diagnosed with breast cancer at or below age 50 and discovered they have a much higher BRCA mutation frequency than that previously reported among young white women with breast cancer.

Young black women are more likely to have aggressive types of breast cancer compared to non-Hispanic white women, yet the reason for this disparity remains uncertain. Moffitt researchers wanted to assess if mutations in the BRCA gene could help account for this higher rate of aggressive breast cancers among young black women in the U.S. They analyzed the BRCA mutation frequency and family history of 396 black women in Florida who were diagnosed with invasive breast cancer under the age of 50. They discovered that 12.4 percent of the participants had mutations in either BRCA1 or BRCA2. Furthermore, over 40 percent of those with a mutation had no close relatives with breast or ovarian cancer, which suggests that family history alone, may not identify those at risk for carrying a BRCA mutation.

As personalized medicine becomes more integrated into clinical care, it is becoming increasingly important for physicians to be aware of potential BRCA mutations at the time of diagnosis to be able to recommend the best therapy for their patients. "Our results suggest that it may be appropriate to recommend BRCA testing in all black women with invasive breast cancer diagnosed at or below age 50," said Tuya Pal, M.D., a clinical geneticist at Moffitt, who led this effort.

If a colonoscopy seems like the type of thing you'd like to get done with quickly, think again.

Research by a Veterans Affairs team has confirmed that longer-lasting colonoscopies are associated with lower cancer rates.The findings appear online in the journal Gastroenterology. They were based on nearly 77,000 screening colonoscopies.

Experts already know about the link between colonoscopy withdrawal time and patient outcomes, but the new study provides some of the strongest evidence yet to back clinical guidelines covering this aspect of the procedure.

"Our results support the use of withdrawal time as a quality indicator, as recommended by current guidelines," said lead author Dr. Aasma Shaukat, with the Minneapolis VA Health Care System and the University of Minnesota.

In a colonoscopy, a doctor inserts a long, thin tube with a tiny camera fitted to the end into the patient's colon. After the tube is fully inserted, it is then slowly withdrawn. It is during this "withdrawal time" that the doctor carefully examines the lining of the colon, looking at a view of the colon on a monitor in the exam room. Any small growths, or polyps, are removed with the scope's snipping tool and sent for biopsy. These growths may grow into cancer within a few years.

According to current guidelines, a "normal" colonoscopy - one in which there is no finding of cancer or pre-cancerous growths, and the doctor does not remove any snippets of tissue to be biopsied--should have a withdrawal time of at least six minutes.

Shaukat's team looked at data on colonoscopies performed over six years by 51 gastroenterologists in a large community practice in Minnesota. The team calculated average withdrawal times for each doctor. The average for the practice on the whole was 8.6 minutes--well within guidelines. But about 10 percent of the doctors had individual averages of under six minutes.

Giving patients a drug that blocks part of the immune system from going into overdrive might help prevent cancer coming back in some people, according to research published today in Cancer Research.

Cancer Research UK-funded scientists from the University of Sheffield found that the cancer-killing action of chemotherapy can trigger a swarm of wound-healing, white blood cells to cluster around blood vessels in a treatment-hit tumour. These cells - called M2 macrophages - repair tissue damage and build new blood vessels, a process that sometimes helps the tumour to grow again after treatment.

But by treating mice with cancer with a drug that stops these repair cells from working, the researchers markedly reduced the speed at which tumours grew back after chemotherapy.

The lead scientist on the study, Professor Claire Lewis at the University of Sheffield's Department of Oncology, said: "Scientists already knew that the body's drive to heal itself can sometimes backfire when the immune system reacts to tissue damage. Our research shows that treating tumours with chemotherapy can activate this part of the immune system, and this then helps tumours re-grow afterwards."

"But combining chemotherapy with a drug that switches off this part of the body's repair system, slowed the growth of tumours after chemotherapy. This could be particularly important for patients who can't have surgery and, therefore, need chemotherapy to help them live for as long as possible."