Diagnostic chest radiation before age 30 may increase breast cancer risk

Choose MRI scan over x-ray and mammogram

The BMJ logo image
Women advised – via the BMJ in 2012 – to choose MRI scan over x-ray and mammogram.

Women carrying a mutation in the BRCA1- or BRCA2- genes (which control the suppression of breast and ovarian cancer) who have undergone diagnostic radiation to the chest before the age of 30 are more likely to develop breast cancer than those who carry the gene mutation but who have not been exposed, a study published on bmj.com today reveals.

The BMJ published a commentary in August which argued that a breast cancer charity was using misleading statistics to persuade women to undergo mammography, concluding that charities should stop generating false hope and that women need and deserve the facts instead.

Exposure to radiation is an established risk factor for breast cancer in the general population. Some studies have suggested that women with a mutated BRCA1/2 gene may have increased radiation sensitivity because BRCA1 and BRCA2 are the genes involved in the repair of DNA breaks, which can be caused by radiation. The benefit from mammographic screening in young BRCA1/2 mutation carriers may therefore not outweigh the radiation risk. Some countries have even gone as far as recommending that women avoid mammographic screening before the age of 30 but results of studies have been inconsistent.

Authors from the Netherlands Cancer Institute therefore looked at 1993 female BRCA1/2 mutation carriers in the Netherlands, France and the UK between 2006 and 2009 to see whether variations in DNA increase the chances of radiation-induced breast cancer risk. Follow-up ended with diagnosis of first breast cancer. All patients were aged 18 or over.

Women were questioned on exposure via x-ray or mammogram, age at first exposure, number of exposures before age 20, at ages 20-29, 30-39 and age at last exposure.

Results showed that 43% (848) of the 1993 women were diagnosed with breast cancer. 48% (926) reported ever having an x-ray and 33% (637) a mammogram. The average age at first mammogram was 29 years. A history of any exposure to diagnostic or screening radiation to the chest at ages 20 to 29 increased breast cancer risk by 43% and any exposure before the age of 20 increased breast cancer risk by 62%. No association with breast cancer was apparent for exposures at ages 30-39.

For every 100 BRCA1/2 mutation carriers aged 30, nine will have developed breast cancer by the age of 40 and the number of cases would increase by five if all had had one mammogram before age 30. The authors do say however that this estimate “should be interpreted with caution because there were few women with breast cancer who had had a mammogram before age 30 in the study”.

The authors conclude that “exposure to diagnostic radiation before age 30 was associated with an increased breast cancer risk in BRCA1/2 mutation carriers”. They say however due to “puzzling” findings in the differences between breast cancer risk for BRCA1 and BRCA2 carriers, larger studies are needed to determine whether a difference does in fact exist. The authors recommend non-ionizing radiation imaging techniques, such as MRI, for mutation carriers.

Sources and More Information:

  • Diagnostic Radiation Exposure May Raise Breast Cancer Risk in Some BRCA1/2 Mutation Carriers, NCI.
  • Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: retrospective cohort study (GENE-RAD-RISK), BMJ 2012;345:e5660, 06 September 2012.
  • Diagnostic chest radiation before age 30 may increase breast cancer risk in BRCA1/2 mutation carriers, BMJ press release, 05 September 2012.

Born Asleep

UK Stillborn Baby Scandal Full Documentary, BBC Panorama 2014

More than half of stillbirths in the UK could be prevented if the NHS implemented additional scans, a leading obstetrician has told Panorama.



Every year in the UK, four thousand babies are stillborn. It’s one of the worst rates in the developed world. Panorama’s Paul Kenyon meets the clinicians who say they could save hundreds of babies’ lives a year, with cheap and simple interventions that the medical establishment appears slow to accept

Sources and more information
  • Video available for 11 months in HD on BBC iPlayer.
  • Read Half of UK stillbirths could be prevented with scans, BBC News Health, 30 September 2014.
  • Read Pledge to end UK ‘scandal’ of 17 stillborn babies a day, Express, 28 September 2014.
  • Read One in five child deaths ‘preventable’, BBC News Health, 5 September 2014.

Diethylstilbestrol Genetics, Teratogenesis, and Tumor Spectrum in Humans

Medical hypotheses, Lynch HT, Reich JW, March 1985

Abstract

Diethylstilbestrol (DES) is the first example of transplacental carcinogenesis in humans, as evidenced by an excess of clear cell adenocarcinoma of the vagina and cervix in exposed women.

We hypothesize that:

image of PubMed NCBI The Endocrine Society logo
DiEthylStilbestrol usage review buttress the need for adequate and rigorous research into the use of drugs in pregnancy and ensure that they do more good than harm before being introduced.
  1. in utero DES exposure will be responsible for a broader spectrum of cancer with variable age of onset as a function of latency effects in exposed humans of both sexes;
  2. teratogenicity of DES will be more far-reaching than currently recognized and will harbor cancer implications in the face of known associations between teratogenesis and carcinogenesis;
  3. and genetic heterogeneity will be a critical etiologic discriminant in DES associated cancer.

This hypothesis embraces a prodigious body of data at the infrahuman level, as well as extant pharmacogenetic and ecogenetic observations in humans which signify heritable variations in response to environmental carcinogenic exposures. This hypothesis has important implications for drug testing with appropriate preventive strategies. Herein, particular restraints with monitoring through governmental legal channels must be employed. Past experience has clearly indicated negligence in shouldering this responsibility by both the pharmaceutical industry and government regulatory bodies.

Sources

  • Diethylstilbestrol, genetics, teratogenesis, and tumor spectrum in humans, NCBI, PMID: 3889564, 1985 Mar;16(3):315-32.
More DES DiEthylStilbestrol Resources

Endocrine Disruption and Immune Dysfunction

By the Collaborative on Health and the Environment

Dr. Rodney Dietert discussed how the immune system is a target for endocrine disrupting chemicals, particularly during development.

On this first in a series of calls on endocrine disrupting chemicals, Dr. Rodney Dietert discussed how the immune system is a target for endocrine disrupting chemicals, particularly during development. Numerous relatively ‘hidden’ effects can ensue from a single risk factor and emerge over a lifetime. He also discussed how current safety testing fails to appropriately assess misregulated inflammation as the greatest immune based health risk.

Sources:

The Hunter’s Moon #FullMoonEngageMe Social Media Event N°6 #EmpireAvenue #SocialNetworking

This Tuesday 7th of October : join our free social media event taking place at each Full Moon – via #EAv – and give a boost to your social networking!

The Hunter’s Moon

This Tuesday 7th of October : join our free social media event taking place at each Full Moon – via #EAv – and give a boost to your social networking!

There are native American names for the full moons that you can find here, here or here.

October month full moon was named Hunter’s Moon because after the fields have been reaped, the leaves begin to fall and the deer are fat and ready for eating. Hunters can ride easily over the fields’ stubble, and the fox and other animals are more easily spotted. October’s full moon is also known as the Travel Moon, the Dying Moon, the Moon of Falling Leaves and/or the Blood Moon or Sanguine Moon because of its bright color.

#FullMoonEngageMe Social Media Event N°6 Schedule

The event will start on Tuesday 7th of October at 18:00 UTC and will last until Monday the 13th in HERE.

What is this about?

A great opportunity for you to super charge your social networking, to meet Empire Avenue Leaders, to connect with top social media engagers and more… May 2014 initial SoMe event was followed by the strawberry, the buck, the sturgeon and the harvest moons.  In the Empire Avenue EAv Gangstas community, you can still access May‘s, June‘s, July‘s, August‘s and September‘s conversation threads.

Questions?
  • Please read our FAQs and use the comment section to ask any question about the event.
  • You can join – for FREE – Empire Avenue at anytime – before and after any FullMoon EngageMe Social Media Event.
    You can use this link – with no strings attached – to get some extra “eaves” at start !
    See you soon 😉

Does the Perjeta Drug extend Breast Cancer Patients’ Lives for nearly 16 Months?

Does Pertuzumab add 16 months survival benefit to Trastuzumab and chemotherapy treatment for HER2-Positive metastatic breast cancer?

ESMO logo image
Long-term follow-up from CLEOPATRA study presented at ESMO 2014 demonstrates ‘unprecedented’ benefit.

A drug used to treat advanced breast cancer has had what appears to be unprecedented success in prolonging lives in a clinical trial, researchers reported on Sunday.

Patients who received the drug — Perjeta, from the Swiss drug maker Roche — had a median survival time nearly 16 months longer than those in the control group.

The Swiss drugmaker also has another related drug called Kadcyla, which is also being tested in combination with Perjeta.

Aim
In CLEOPATRA, 808 pts with HER2-positive MBC were randomized to receive 1L placebo (Pla) + T + D or Ptz + T + D. At primary analysis, pertuzumab was shown to increase progression-free survival significantly, with a strong trend to OS benefit. At a second interim analysis (May 2012), OS was improved to a degree which was both statistically significant and clinically meaningful (HR = 0.66, 95% CI 0.52–0.84; P = 0.0008) but the median OS in pts who received Ptz was not reached. Here we report results of a subsequent prespecified OS analysis.

Methods
This OS analysis was planned when ≥385 deaths were reported. The log-rank test, stratified by prior treatment status and geographic region, was used to compare OS between arms, applying the Lan-DeMets α-spending function with an O’Brien-Fleming threshold of p ≤ 0.0456. The Kaplan–Meier approach was used to estimate median OS in both arms; a stratified Cox proportional hazard model was used to estimate HR and 95% CIs. Subgroup analyses of OS were performed for stratification factors and other key baseline characteristics.

Results
Median follow-up time was 50 months (mos) and the statistically significant improvement in OS in favor of Ptz + T + D was maintained (HR = 0.68, 95% CI 0.56–0.84; p = 0.0002). Median OS was 40.8 mos in the Pla arm and 56.5 mos in the Ptz arm, the difference at the medians being 15.7 mos. The OS benefit in predefined subgroups was consistent with previous observations. It is to be noted that following the previous report of OS benefit, cross-over therapy was allowed and 48 pts in the Pla arm crossed over to the Ptz arm. The safety profile of Ptz + T + D in the overall population and in pts who crossed over to the Ptz arm was consistent with the known safety profile of Ptz and the long-term cardiac safety profile was maintained.

Conclusions
1L treatment with Ptz + T + D significantly improved OS for pts with HER2-positive MBC compared with Pla + T + D, providing a 15.7 mo increase in the median values. The 56.5 mo median OS is unprecedented in 1L MBC and this substantial improvement confirms the Ptz regimen as 1L standard of care for pts with HER2-positive MBC.

Sources and Press Releases:

  • Pertuzumab Adds 16 Months Survival Benefit to Trastuzumab and Chemotherapy Treatment for HER2-Positive Metastatic Breast Cancer, ESMO 2014 Press Release, 28 Sep 2014.
  • Final overall survival (OS) analysis from the CLEOPATRA study of first-line (1L) pertuzumab (Ptz), trastuzumab (T), and docetaxel (D) in patients (pts) with HER2-positive metastatic breast cancer (MBC), ESMO 2014, 28.09.2014.
  • Roche Breast Cancer Drug Appears to Greatly Extend Patients’ Lives, NYTimes, SEPT. 28, 2014.
  • Roche breast cancer drug shows ‘unprecedented’ survival benefit, Reuters, 28.09.2014.

Prenatal exposure to sodium valproate associated with neurodevelopmental impairments

Anti-epileptic drugs during pregnancy affects babies’ brain

A new research suggests that children whose mothers took anti-epileptic drugs during pregnancy might suffer from brain impairments.

Abstract:

WileyLibINFO logo image
The study, conducted by researchers at the University of Birmingham and partners in Australia, found that brain development problems were higher in children born to mothers who use sodium valproate (VPA) during pregnancy.

Prenatal exposure to sodium valproate (VPA) is associated with neurodevelopmental impairments. Cortical thickness was measured in 16 children exposed prenatally to VPA and 16 controls. We found increased left inferior frontal gyrus (IFG; BA45) and left pericalcarine sulcus (BA18) thickness, an association between VPA dose and right IFG thickness, and a close relationship between verbal skills and left IFG thickness. A significant interaction between group and hemispheric IFG thickness showed absence of the normal asymmetry in the IFG region of VPA-exposed children. These data provide preliminary insights into the putative neural basis of difficulties experienced by some VPA-exposed children.

Sources and more information:
  • Altered cortical thickness following prenatal sodium valproate exposure, wileyonlinelibrary, DOI: 10.1002/acn3.74, 3 JUL 2014.
  • Anti-epileptic Drugs During Pregnancy Affects Babies’ Brain, natureworldnews, articles/8010, 2014.07.11.

Sandrine et le Distilbène: mon parcours, mon procès, ma victoire

On ne “s’improvise pas” victime du distilbène si on n’a pas au moins un élément prouvant un lien avec celui ci

Ci-dessous un “guest-post” reprenant le parcours médical de Sandrine Jean et ce qui a été retenu au délibéré du jugement. Bravo à Sandrine pour son courage et sa persévérance.
Une exclusivité DES Daughter Network.

Mon procès a débuté en avril 2011, le délibéré à été rendu en juillet 2014. Quant à l’expertise médicale elle a eu lieu en mars 2012.

Il a été retenu :

image de Sandrine Jean
On ne “s’improvise pas” victime du distilbène si on n’a pas au moins un élément prouvant un lien avec celui ci
dit Sandrine

La chose qui a joué un rôle très important au cours du procès c’est que j’avais les ordonnances de ma mère stipulant la prescription du DES (Stilboestrol = nom de la molécule fabriquée par le laboratoire Novartis, Distilbène = nom de la molécule fabriquée par UCB Pharma).

Sur les ordonnances apparaît que ma mère a pris du Stilboestrol depuis avril 1969 à début février 1970 (un comprimé quatre fois par jour) et ensuite du 7 février 1970 jusqu’à avril 1970 (lorsque je suis née – à deux comprimés par jour).

Il faut noter que dans mon malheur j’ai eu l’avantage que le laboratoire concerné était Novartis qui sont plus “arrangeants” que UCB Pharma. UCB fait systématiquement appel, Novartis pas forcément. Dans mon cas il n’y a effectivement eu aucun appel.

L’avocat de Novartis a reconnu lui même qu’il ne pouvait rien face à mon dossier et que c’était la deuxième fois en quinze ans de plaidoirie qu’une victime du Distilbène allait jusqu’au procès. Autrement dit, les autres victimes ont soit laisser tombé avant la fin, soit accepté un arrangement à l’amiable.

Au cours des six mois précédents le procès, Novartis m’a par trois fois proposé un arrangement à l’amiable. Ce qui prouve que le laboratoire était donc en faute. On ne propose pas de l’argent à quelqu’un comme ça, quand on n’a rien à se reprocher. C’est pour cela que je suis allée sereinement jusqu’à la fin du procès, refusant catégoriquement leur arrangement à l’amiable. Sachant que la somme proposée était bien inférieure à ce que je devais attendre.

En définitive j’ai obtenu 104.873€, Novartis m’avait proposé une moindre somme à l’amiable. J’ai eu pour 20.000€ de frais environ.
Sur ces 104.873€, mon père a obtenu 6.000€. Ma mère aurait eu droit au double mais elle est décédée deux mois avant l’issue de mon procès. L’avocate a fait valoir cela lors du procès également. Car c’est une affection supplémentaire qui m’empêche de “savourer” pleinement ma victoire. Si j’ai gagné c’est grâce à ma mère qui a gardé les ordonnances et elle est décédée sans savoir si j’avais réellement gagné.

Le Stilboestrol lui avait été prescrit car elle faisait des fausses couches a répétition. Comme elle a eu beaucoup de mal pour avoir des enfants et que c’était son désir le plus cher elle a gardé tout ce qui était en lien avec ses grossesses, voilà pourquoi elle avait gardé les ordonnances.
Il faut donc noter essentiellement pour celles qui voudraient s’engager dans une procédure que l’ordonnance est évidemment un élément des plus important mais également le lien direct avec le Distilbène.
J’avais en ma possession une radio où l’on voit nettement mon utérus typique distilbène.

Je recommande au cours de l’expertise d’être assisté par le professeur Blanc de la Timone à Marseille, qui s’est spécialisé dans le Distilbène. Son intervention a été aussi un facteur très important pour le procès. Il a un coût bien sûr (1.000€) mais ça en vaut vraiment la peine.

Il est évident qu’on ne “s’improvise pas” victime du distilbène si on n’a pas au moins un élément prouvant un lien avec celui ci. Ca serait trop facile, la partie adverse faisant valoir que l’infertilité peut être dû à bien d’autres choses que le Distilbène.

Je recommande également à celles qui souhaiteraient engager une procédure de demander conseil au Réseau DES France, une association de très bon conseil et d’une aide très précieuse. De mon côté si certaines souhaitent des renseignements complémentaires je me tiens à leur disposition (gratuitement bien entendu).

Sandrine JEAN

Le Distilbène DES, en savoir plus

HealthApps: do they do More Harm than Good?

By 2015, 500 million smartphone users worldwide will be using a health app

apple health image
Apple’s HealthKit brings all your health data together in one place and allows you to share it with health care providers.

” Amost 20% of smartphone users have one or more applications on their device that helps them track or manage their health. It is estimated that by next year, 500 million smartphone users worldwide will be using a health app. There is no doubt that these apps are growing in popularity.
But are they actually beneficial to our health?
Or could they do more harm than good? “

  • Do calorie-counting and fitness apps pull their weight?
  • Could health apps be detrimental to health?
  • No need for medical input when developing health app
  • Sharing data with doctors
  • Apple HealthKit – not necessarily ‘the beginning of a health revolution’
  • The use of HealthKit in clinical trials

Read Health apps: do they do more harm than good?, MNT articles/283117, by Honor Whiteman, 26 September 2014.

Perturbateurs Endocriniens: des documents exclusifs éclairent la guerre de lobbying à Bruxelles

Petits arrangements bruxellois entre amis du bisphénol A

Exclusif – Qui veut la peau des perturbateurs endocriniens ? Certainement pas le lobby de la chimie, qui tente par tous les moyens de ralentir les travaux de la Commission européenne, chargée de régler leur sort. Plongée dans les coulisses d’un thriller belge, où les héros portent un costume-cravate et une mallette en cuir. ” …

Terra eco logo image
Perturbateurs endocriniens : comment les empoisonneurs ont pris le pouvoir à Bruxelles .
  • Portrait-robot des suspects
  • Un vieux goût de tabac
  • Pressions et mauvais coups
  • Déluge d’e-mails
  • Festival de conflits d’intérêt
  • La Suède met la commission sous pression
  • DOCUMENTS EXCLUSIFS

Lisez Petits arrangements bruxellois entre amis du bisphénol A, EterraEco.net, 25-09-2014.