Obesity increases risk of death from breast cancer

Date: 10/25/2012

SPRINGFIELD – There is plenty of good news to report during Breast Cancer Awareness Month this October when it comes to the fight against breast cancer, and it begins with prevention.

According to Baystate Medical Center breast cancer specialist Dr. Grace Makari-Judson, who joined over 20,000 cancer specialists from around the world at the recent American Society of Clinical Oncology (ASCO) Annual Meeting, an entire session was dedicated to obesity and cancer.

"Being overweight increases the likelihood of getting cancer, and once a diagnosis is made, obesity is associated with a higher risk of dying from breast cancer," Dr. Makari-Judson, chair of the Baystate Health Breast Network, said.

Although healthy eating is important, exercise and weight loss appear more important than eating a low-fat diet.

"Attention is currently focused not only on exercise, but on overall levels of activity, in other words, avoid the couch," Makari-Judson said.

In the area of medications, many women with estrogen-positive breast cancer are taking medicines called aromatase inhibitors to prevent breast cancer recurrence. These medications, which include anastrazole, exemestane and letrozole, are extremely effective in the treatment of breast cancer. Unfortunately, a number of women have difficulty tolerating the medicines due to joint pains.

"Exercise is being studied as a means of reducing pain. Vitamin D, at least 2,000 IU daily, also appears to reduce discomfort and may improve fatigue. Because these hormone treatments are so important, much work is occurring to provide tips to help women better tolerate the drugs," Makari-Judson said.

There is also good news in the treatment of advanced breast cancer, Makari-Judson noted.

Twenty percent of breast cancers have too much of a protein known as her2neu that causes aggressive growth of cancer. There are medicines such as trastuzumab (Herceptin) and lapatinib (Tykerb) that are used for treatment in these situations, however, in some women whose disease has recurred despite their use of these medicines, a new drug has been found to be promising.

"Doctors are referring to this new drug, called T-DM1, as a 'magic bullet' for this uncommon type of breast cancer," Makari-Judson said.

The new drug combines a monoclonal antibody (trastuzumab), which is linked to a chemotherapy medicine (emtansine), so that it delivers the drug directly to the cancer cell, improving efficacy and limiting side effects.

According to Makari-Judson, in a study presented at the ASCO annual meeting involving approximately 1,000 women, half received the new T-DM1 and half received a standard treatment consisting of a chemotherapy drug plus lapatinib. The group that received the T-DM1 was more likely to have improvement or stabilization of their cancer and had the disease under control for longer. The new drug has fewer side effects and was safer to administer.

"There was not only excitement about this drug, but about this promising strategy in drug development," she said.

According to 2012 statistics from the American Cancer Society, about 1 in 8 women in the United States will develop invasive breast cancer during their lifetime, with some 226,870 new cases of invasive breast cancer expected to be diagnosed this year.

Also, about 63,300 new cases of carcinoma in situ (CIS) – the earliest form of breast cancer – will be diagnosed. About 39,510 women will die from breast cancer. The good news is that more women are surviving breast cancer with more than 2.9 million survivors in the United States alone.

October 2012 marks the 28th anniversary of Breast Cancer Awareness Month, designed to increase awareness of the disease, its prevention, and early detection, as well as to raise funds for research into prevention, treatment, and an eventual cure.

For more information on the Baystate Regional Cancer Program, visit baystatehealth.org/cancer.