Posted on: July 22, 2009

'Meta' Warning Signs

A new study uses a well-known condition to predict who might be at risk for postmenopausal breast cancer

By Perry Gattegno
CTW Features

A new study uses a well-known condition to predict who might be at risk for postmenopausal breast cancer

Forty-seven million Americans suffer from metabolic syndrome, a condition related to insulin resistance marked by abdominal obesity, high blood sugar and high blood pressure.

Doctors already know that metabolic syndrome can heighten risks for heart disease and diabetes. Now a team of researchers across America has found it may also be related to postmenopausal breast cancer.

Because the metabolic syndrome results in increased insulin levels, researchers believe that associated effects on interrelated hormones such as estrogen may occur. Ultimately, says researcher Dr. Geoffrey C. Kabat of the Albert Einstein College of Medicine, New York City, more progress can be made.

"This study suggests that having the metabolic syndrome itself or some of its components may increase a woman's risk of postmenopausal breast cancer," says Dr. Kabat, an epidemiologist.

"However, much more work is needed to understand the role of these metabolic factors and their interplay with better established breast cancer risk factors, such as reproductive and hormonal factors."

Previous studies, according to Dr. Kabat, had inconsistently attempted to identify individual components of breast cancer and metabolic syndrome, and his study was the first to assess whether women with markers for metabolic syndrome were also at risk for breast cancer.

The study followed almost 5,000 women, ages 50-79, who had displayed symptoms of metabolic syndrome. Of those women, 165 were diagnosed with breast without diabetes, and the researchers found that those with metabolic syndrome in the three to five years prior to their diagnosis had a doubling of risk for breast cancer. Elevated blood sugar, triglyceride and diastolic blood pressure levels also were markers of breast cancer risk.

Dr. Tim Byers, associate the Colorado School of Public Health, Denver, says this study suggests a concrete link between breast cancer and increased weight.

"We have assumed that the relationship between weight and breast cancer risk is due to increased circulating estrogens among postmenopausal women who are overweight or obese," he says. "An alternative explanation is explored here: that some other aspect of the metabolic syndrome might be involved, such as growth stimulating effects of insulin, or insulin-like growth factors."

Safe and Sound

Teenage girls can use ultrasound exams rather than invasive biopsies to determine if breast lumps are cancerous

CTW Features

A surefire way to ascertain whether a breast lump is malignant is to perform a biopsy. But for teenage girls, breast cancer is rare and the biopsy process can leave permanent damages. That's why a new study's discovery that ultrasound exams on teenage girls can accurately show if a lump is benign is such welcome news.

Radiologists in the study, published in the American Journal of Roentgenology, Leesburg, Va., by the Loyola University Health System, Chicago, performed ultrasound exams on 20 girls ages 13-19 with breast lumps, including one girl with a lump in each breast. The ultrasounds revealed that 15 of the 21 appeared to be benign, while six were suspicious. Doctors followed up with excisional biopsies, the currently accepted method of treatment, or other clinical exams to test the lumps. They were all benign.

Dr. Aruna Vade, lead author of the study and a professor of radiology at Loyola, said that the study suggests an excisional biopsy is not needed if the ultrasound produces unsuspicious results. Excisional biopsies can leave scars or change the shape of the breast. For girls younger than 19, fewer than 25 per 100,000 cases of breast cancer occur each year.

Many benign breast lumps are products of hormonal activity or other normal body functions. While they tend to wax and wane in teenage girls, many are removed in biopsy due to parents' or doctors' concerns.

Dr. Vade said lumps that require surgical attention are those that show progressive growth, are found in patients who have malignant tumor elsewhere in the body or appear in patients with family history of cancer.