Although October is designated National Breast Cancer Awareness Month, scientists at Fred Hutchinson Cancer Research Center lead the fight every day against this all-too-common disease. Here are some of our latest discoveries related to preventing, detecting and treating breast cancer:

Obesity, alcohol, smoking increase risk of second breast cancer
A study by Dr. Christopher Li and colleagues, published online Sept. 8, 2009, in the Journal of Clinical Oncology, has found that obesity, alcohol use and smoking all significantly increase the risk of second breast cancer among breast cancer survivors. The study found that obese women had a 50 percent increased risk, women who consumed at least one alcoholic drink per day had a 90 percent increased risk, and women who were current smokers had a 120 percent increased risk of developing a second breast cancer. The research also suggests that current smokers who imbibe at least seven drinks a week may be at particularly high risk of second breast cancer.

Tamoxifen ups chances of second breast cancer
While long-term tamoxifen use among breast cancer survivors decreases their risk of developing the most common, less aggressive type of second breast cancer, such use is associated with a more than four-fold increased risk of a more aggressive, difficult-to-treat type of cancer in the breast opposite, or contralateral, to the initial tumor. These findings by Dr. Christopher Li and colleagues were published online Aug. 25, 2009, in the journal Cancer Research.

Migraines linked to reduced breast cancer risk
The relationship between migraine headaches in women and a significant reduction in breast cancer risk has been confirmed in a follow-on study to landmark research published in 2008 and conducted by scientists at Fred Hutchinson Cancer Research Center. The new study found a 26 percent reduced risk of breast cancer among both premenopausal and postmenopausal women with a clinical diagnosis of migraines. The study appears in the July 2009 issue of Cancer Epidemiology, Biomarkers and Prevention.

Markers for inflammation can predict breast cancer survival
A study led by Dr. Cornelia Ulrich and colleagues, published May 18, 2009, in the Journal of Clinical Oncology, has identified two proteins in the blood that could become important prognostic markers for long-term survival in breast cancer patients. The proteins are associated with chronic inflammation, which is known to contribute to cancer development and progression. In a study of more than 700 breast cancer patients, Ulrich found that elevated levels of C-reactive protein (CRP) and serum amyloid A (SAA) were associated with reduced overall survival, regardless of patient age, tumor stage, race and body mass index. For example, women with breast cancer who had SAA levels that were in the highest third were three times more likely to die from their disease within the following seven years compared to patients with the lowest-third amount. Similarly, women with the highest levels of CRP had a two-fold increased risk of death.

Chianti or Chardonnay? Red and white wine boost breast cancer risk
The largest study of its kind to evaluate the effect of red versus white wine on breast-cancer risk concludes that both are equal offenders when it comes to increasing breast-cancer risk. The results of the study, led by Dr. Polly Newcomb and colleagues, were published in the March 2009 issue of Cancer Epidemiology, Biomarkers and Prevention. "We were interested in teasing out red wine's effects on breast-cancer risk. There is reason to suspect that red wine might have beneficial effects based on previous studies of heart disease and prostate cancer," Newcomb said. "The general evidence is that alcohol consumption overall increases breast-cancer risk, but the other studies made us wonder whether red wine might in fact have some positive value." Instead, Newcomb and colleagues found no compelling reason to choose Chianti over Chardonnay.

New best practices for using breast MRI to diagnose disease
Dr. Connie Lehman, director of the Seattle Cancer Care Alliance Breast Imaging Program, co-authored new guidelines for physicians that represent best practices for using magnetic resonance imaging (MRI) to diagnose and determine the best course of treatment for breast cancer. The guidelines were published in February 2009 in the Journal of the National Comprehensive Cancer Network, a nonprofit alliance of the nation’s leading cancer centers.

Breast Health Global Initiative publishes guidelines for developing countries
Dedicated to medically underserved women around the world, the Breast Health Global Initiative—founded by the Hutchinson Center and Susan G. Komen for the Cure—has developed evidence-based, resource-sensitive, expert consensus "Guidelines for International Breast Health and Cancer Control" to outline realistic approaches for breast cancer early detection, diagnosis and treatment in low- and middle-resource countries. The guidelines, published in October 2008 in a special supplement of the journal Cancer, are endorsed by the Institute of Medicine and are intended to assist ministers of health, policy makers, health care institutions and others to prioritize resource allocation in breast care programs in low and middle resource countries. The Guidelines are a freely available, downloadable medical tool.

New statistical model for breast biopsy could reduce unneeded tests
Dr. Wendy DeMartini and colleagues in the breast imaging department at the Seattle Cancer Care Alliance developed a preliminary statistical model that breast radiologists could use eventually when deciding whether a lesion found on breast MRI is likely to be malignant or benign. Their retrospective review of almost 2,600 breast MRI exams performed during a four-year period at the SCCA found three crucial patient and lesion characteristics that, when used in combination, could predict the likelihood of malignancy, including identifying some lesions with probabilities of cancer close to zero.

	Recent Findings