BACKGROUND: A nipple aspirate device is a type of pump used to collect fluid from a woman\’s breast. A nipple aspirate test can determine whether the fluid collected from the breast contains any abnormal cells.
RECOMMENDATION: Do not use a nipple aspirate test as a substitute for mammography or by itself for breast cancer screening or diagnosis.
Cancer
Red Meat Tied to Cancer Risk in Some People
-
Red and processed meat consumption was significantly associated with colorectal cancer risk in patients who had a common gene mutation, researchers found.
- Note that, if replicated, the findings suggest selected individuals at higher risk of colorectal cancer based on genomic profiling could be targeted for screening, diet modification, and other prevention strategies.
To Revert Breast Cancer Cells, Squeeze
While the traditional view of cancer development focuses on the genetic mutations within the cell, Mina Bissell, Distinguished Scientist at the Berkeley Lab, conducted pioneering experiments that showed that a malignant cell is not doomed to become a tumor, but that its fate is dependent on its interaction with the surrounding microenvironment. Her experiments showed that manipulation of this environment, through the introduction of biochemical inhibitors, could tame mutated mammary cells into behaving normally.
CHOP to be Chopped?
Once the most common treatment for indolent non-Hodgkin’s Lymphoma, the combination chemotherapy known as CHOP is rapidly falling to the wayside in Germany – replaced by bendamustine (Treanda), frequently combined with rituximab (Rituxan), researchers reported here.
via New Combo Replaces CHOP for Lymphoma.
NOTE the commercial interests disclosures at the end of the original article.
Melanoma on Rise with Indoor Tanning
Overall, there was a 20% increased risk for melanoma with any indoor tanning (RR 1.20, 95% CI 1.08 to 1.34), according to Mathieu Boniol, PhD, of the International Prevention Research Institute in Lyon, France, and colleagues.
But the risk nearly doubled when sunbed use began before age 35 (RR 1.87, 95% CI 1.41 to 2.48), they reported online in BMJ.
Flex Sigmoidoscopy and Colorectal Cancer
Teaching Topic
Flexible Sigmoidoscopy and Colorectal Cancer
Original Article
R.E. Schoen and Others
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Colorectal-cancer mortality and incidence are reduced with screening by means of fecal occult-blood testing. Endoscopic screening with flexible sigmoidoscopy or colonoscopy is more sensitive than fecal testing for the detection of adenomatous polyps, the precursor lesions of colorectal cancer.
Clinical Pearls
What were the results of this randomized trial comparing flexible sigmoidoscopy to usual care for screening of colorectal cancer?In this randomized study, flexible sigmoidoscopy, as compared with usual care, was associated with a 26% reduction in overall colorectal-cancer mortality and a 21% reduction in the incidence of colorectal cancer. Mortality related to distal colorectal cancer was reduced by 50%, and the incidence was reduced by 29%. A significant 14% reduction in the incidence of proximal colorectal cancer was observed, but there was no significant reduction in mortality related to proximal cancer.
According to the authors, what were the numbers needed to invite for screening via flexible sigmoidoscopy to prevent one diagnosis of colorectal cancer and one colorectal-cancer death?In this study, the number needed to invite for screening in order to prevent 1 case of colorectal cancer was 282 (95% CI, 210 to 427). The number needed to invite for screening to prevent 1 colorectal-cancer death was 871 (95% CI, 567 to 1874).
Morning Report Questions
Q. How did study participants differ from the usual-care group?
A. Participants in the intervention group were offered two screenings with flexible sigmoidoscopy, 3 to 5 years apart. Median follow up was 11.9 years. In the intervention group, 86.6% of participants (67,071) underwent at least one flexible sigmoidoscopic screening, and 50.9% (39,440) underwent two screenings. The estimated rate of endoscopy in the usual-care group during the screening phase was 25.8% (95% CI, 23.6 to 28.0) for flexible sigmoidoscopy, 34.4% (95% CI, 32.0 to 36.8) for colonoscopy, and 46.5% (95% CI, 43.9 to 49.1) for either flexible sigmoidoscopy or colonoscopy.
Q. How did screening-detected cancers differ from those diagnosed among participants who were never screened in terms of location and stage?
A. Screening-detected cancers accounted for 24.1% of colorectal cancers (244 of 1012) in the intervention group. Among participants with screening-detected cancers, 82.8% of the cancers were distal, whereas among participants who were never screened, 52.8% were distal, and among participants with cancers not detected by screening, 31.6% were distal (P<0.001). Participants with screening-detected cancers were more likely to have early-stage cancer (stage I or II) than participants who were never screened or those whose tumors were not detected by screening (75.4% vs. 50.9% and 50.7%, respectively; P<0.001).
Table 3. Colorectal-Cancer Incidence and Stage According to Means of Detection.
Effect of Aspirin on Vascular and Nonvascular Outcomes Meta-analysis
Conclusion: Despite important reductions in nonfatal MI, aspirin prophylaxis in people without prior CVD does not lead to reductions in either cardiovascular death or cancer mortality. Because the benefits are further offset by clinically important bleeding events, routine use of aspirin for primary prevention is not warranted and treatment decisions need to be considered on a case-by-case basis.
NEJM Resident e-Bulletin Teaching Topics 11.03.11
The next time you get asked by a sales professional why you rated her client for ulcerative colitis pull out this cheat sheet for talking points.
Q. What is the risk of cancer in patients with ulcerative colitis?
A. On the basis of data from referral centers, the cumulative risk of colorectal cancer among patients with chronic ulcerative colitis may reach 20 to 30% at 30 years, but the incidence rate is much lower in population-based series (approximately 2%). Risk factors for cancer include a long duration of disease, regardless of clinical activity; extensive involvement; a young age at onset; severe inflammation; the presence of primary sclerosing cholangitis; and a family history of colorectal cancer.
DM Increases Cancer Risk
Diabetes Increases Risk of Cancer Death – NYTimes.com
“Researchers from the National Cancer Institute collected diet, lifestyle and health data from 500,000 people ages 50 to 71 and followed the patients for 11 years. They found that having diabetes was associated with an 11 percent increased risk of dying from cancer among women and a 17 percent increased risk of cancer death among men.”
GoLytely No More…(maybe)
Medical News: CT Colonography Boosts High-Risk Yield – in Oncology, Colon Cancer from MedPage Today
CT colonography identified almost 80% more high-risk lesions compared with optical screening by adding extracolonic findings, a review of more than 2,000 cases showed.
lifeunderwriter.net 
You must be logged in to post a comment.