XRAYS - Making Sense of Cancer Headlines

FORCE’s eXamining the Relevance of Articles for Young Survivors (XRAYS) program is a reliable resource for breast cancer research-related news and information. XRAYS reviews new breast cancer research, provides plain-language summaries, and rates how the media covered the topic. XRAYS is funded by the CDC.

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STUDY: A new method for determining whether genetic variants in BRCA1 increase cancer risk

Ever since BRCA1 was discovered, researchers have been trying to understand which of the thousands of possible DNA changes in this gene increase cancer risk and which are harmless changes.  A new study in Nature reports how a cutting-edge technology called “genome editing” may be used to classify changes—known as variants of uncertain significance-in BRCA1 as harmful or harmless. Once validated, this same technology may be used to classify variants in other genes. (9/29/18)

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ARTICLE: Cancer experience in families affects decision making

Women with inherited mutations in genes that increase breast and ovarian cancer risk have an additional challenge: coping with how those mutations impact their families and how a family member’s cancer experience can shape their own perception. In a recent U.S. News and World Report article, Elaine Howley explores how a woman's decisions about healthcare, cancer prevention and treatment are affected by experience with cancer in the family. (9/25/18)

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STUDY: Hormone therapy and breast cancer risk after ovary removal in women with a BRCA1 mutation

Does hormone therapy (HT) alter the risk of breast cancer for woman carrying a BRCA1 mutation who have never been diagnosed with cancer? In this JAMA Oncology study, researchers showed that among women with BRCA1 mutations, HT use did not increase breast cancer rates for 10 years after ovary removal. More women taking combined estrogen plus progesterone developed breast cancer compared to those taking estrogen only, though this difference was not statistically significant. (9/7/18)

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STUDY: Study identifies genes associated with risk of triple-negative breast cancer

Panel testing can identify women who are at increased risk for breast cancer.  However, those at risk for triple-negative breast cancer cannot easily be identified because other than BRCA1, genes that increase the risk for triple-negative breast cancer are unknown.  A new study uses panel testing to identify which genes increase the risk for triple-negative breast cancer. (8/23/18)

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STUDY: Evaluation of some direct-to-consumer genetic testing reveals inaccuracies and misinterpretations

A clinical genetic testing laboratory examined results from direct-to-consumer genetic testing ordered directly by patients. They found many instances of false positives—reported mutations that were not actually present—and in some cases, reports of variants that "increased risk," but were actually benign. This study emphasized the importance of involving genetics experts in the interpretation of genetic test results. (6/28/18)

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STUDY: Disparities in research impact breast screening guidelines

For women at average risk of breast cancer, the United States Preventive Services Task Force (USPSTF) currently recommends beginning annual breast cancer screening at age 50. However, because these guidelines are largely based on data from white women, they may not be sensitive to racial differences.  A new study assesses the age distribution of breast cancer cases across race/ethnicity in the U.S. (6/21/18)

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STUDY: Mutations in Lynch syndrome genes MSH6 and PMS2 are associated with breast cancer

A research study published in Genetics in Medicine earlier this year shows that women with mutations in MSH6 and PMS2, two Lynch syndrome genes, have a modest (2 to 3-fold) but significantly increased risk for breast cancer. Lynch syndrome mutations have a known risk of colorectal, ovarian and uterine/endometrial cancer, as well as many other cancers. This is the first study to evaluate breast cancer risk in women with mutations in specific Lynch syndrome genes. (6/14/18)

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STUDY: XRAYS Follow Up: Does expanded genetic testing benefit Jewish women with breast cancer?

In this follow-up, we update a recent XRAYS on expanded genetic testing in Jewish women with breast cancer.  An expert in the field suggests a different interpretation of the original study than the authors. We examine the key differences in interpretation of the data. (6/7/18)

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ARTICLE: The right not to know when not knowing is dangerous

Healthcare providers are bound by the guiding principle of doing no harm. But how does this concept apply to their patients who have not consented to genetic testing or who do not want to know their results? In that case, is providing test results more harmful or not? Anna Clausen explores these issues in the context of breast cancer gene testing in her Global Health Now article “The Right Not to Know: When Ignorance is Bliss but Deadly.” (4/20/18)

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STUDY: FDA approves breast cancer test kits: how useful are they?

Interest in personalized genetic testing is growing. Genetic testing about health conditions typically requires a prescription from a health care provider. Until recently, the direct-to-consumer (DTC) testing market has focused on ancestry and discovery of unknown branches of family trees. A laboratory called 23andMe that provides direct-to-consumer genetic testing has been given FDA approval to report results for 3 mutations found in the BRCA1 and BRCA2 genes. The FDA statement provides details about this approval and cautions consumers about the limitations of the 23andMe test. (03/19/18)

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ARTICLE: Insurance companies are more than curious about your genetic test results

A recent article on CBSNews.com addressed why insurance companies, particularly long-term insurance companies, might want to know which of their policy holders and potential policy holders have a gene that raises their risk for cancer. The article discusses genetic discrimination by insurance companies that provide long term care policies. Federal laws protect people with gene mutations from discrimination in health insurance. No such federal laws exist for life insurance, disability insurance or long term care. (3/13/18)

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STUDY: Should biannual MRIs replace annual mammograms in high-risk women?

The risk of breast cancer is exceptionally high in women who have a personal or family history of breast cancer or who carry a mutation in BRCA or certain other genes. More frequent screening is one strategy for early detection of breast cancer for these women. Study results presented at the 2017 San Antonio Breast Cancer Symposium suggest that MRI screening every 6 months may be more effective than the currently recommended annual breast MRI and annual mammogram in detecting early stage breast cancers-which are more treatable-in high-risk women. (2/1/18)

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STUDY: What is the risk of breast cancer recurrence after nipple-sparing mastectomy?

Nipple-sparing mastectomy (NSM) offers better cosmetic results for women who have immediate breast reconstruction (at the same time as their mastectomy). Over the past decade, NSM has gained popularity among surgeons and patients. Studies show that women who keep their own nipples have higher rates of satisfaction and psychological well-being after mastectomy and reconstruction compared to women who lose their nipples. However, little data exists on the long-term risk of recurrence following NSM. New research adds to a growing body of evidence suggesting that risk of recurrence is low after NSM in carefully selected patients with breast cancer. (1/25/18)

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STUDY: No new high-risk breast cancer genes here

While some of the inherited causes of breast cancer are known (for example, inherited mutations in genes like BRCA, ATM and PALB2), others remain unidentified. Two recent reports identified 72 DNA changes (also known as “variants” or “SNPs”) that are associated with increased breast cancer risk.  However, unlike mutations in a gene that dramatically increase risk, the majority of these new variants are not located within the portion of DNA that codes for proteins, and they confer only a small increase in risk. Further research is needed on these new variants before they can be used by doctors to assess and manage cancer risk in patients. (1/12/18)

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STUDY: Does extended hormonal treatment impact risk of recurrence?

Hormonal therapy significantly reduces the risk of recurrence for women with early-stage estrogen receptor-positive breast cancer. Standard hormonal therapy is given for 5 years; extending that therapy for a longer period offers additional protection but has added side effects.  A new study looked at women who stopped hormonal therapy after 5 years and identified factors that may guide the decision to extend treatment.  (12/21/17)

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STUDY: Birth control and breast cancer risk among younger women

On December 7, 2017 the New England Journal of Medicine published results from a study by Lina Mørrch of the University of Copenhagen and colleagues showing that hormonal contraceptives (birth control) increase the risk of breast cancer. The study is unique because it is one of the first to specifically assess the breast cancer risk associated with newer, low-dosage methods of contraception. The large and significant effort analyzed medical data of nearly 1.8 million young women in Denmark on average for over 10.9 years. Results were covered widely in the U.S. by many major media outlets, including the New York Times, USA Today, Forbes and Time.  (12/14/17)

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ARTICLE: Dense breasts and mammograms: Jill Goodacre’s story

Korin Miller’s piece for SELF magazine focuses on why women with dense breasts may need more than a screening mammogram. Miller highlights the recent story in People magazine of Jill Goodacre, a former Victoria’s Secret model and the wife of recording artist and talk show host Harry Connick Jr. Goodacre told of her breast cancer diagnosis 5 years ago after having additional screening of her dense breast tissue following a normal mammogram.  (12/8/17)

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STUDY: Alcohol and breast cancer risk in African American women

The link between alcohol intake and breast cancer is well known, but most studies have involved only White women. Recently, a large study of more than 22,000 African American (AA) women found that similar to White women, increased alcohol consumption is associated with a greater risk of breast cancer. (10/27/17)

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ARTICLE: Mixed reviews of at-home genetic testing

National guidelines recommend that patients meet with a genetics expert before undergoing genetic testing for cancer risk. Genetic counseling can help patients decide whether genetic testing is right for them and order the most appropriate test. Once test results are available, genetics experts also help patients understand their results. Over the last decade, the popularity of direct-to-consumer (DTC) genetic testing, such as 23andMe has grown. Some genetic tests are marketed to consumers on television, in print advertisements, and on the Internet. These “at-home” genetic tests give people direct access to their genetic information without first involving a healthcare provider in the process. A recent report outlines the benefits and limitations of DTC genetic testing. (10/20/17)

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STUDY: Beauty and the breast: hair product use and breast cancer risk

Past studies using mostly animal models showed a link between use of hair products (dyes, straighteners and relaxers) and increased risk of certain cancers. In this study, researchers looked at data on hair product use among African-American (AA) and White women to see if certain types of hair products increased breast cancer risk, and how that risk might differ between race and breast cancer hormone status. (9/27/2017)

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ARTICLE: Can lifestyle changes impact breast cancer risk?

A recent New York Times article shared how “adopting protective living habits”  could help keep breast cancer “at bay”.  While many of these lifestyle changes and strategies like not smoking, avoiding weight gain, reducing alcohol consumption, eating a heart-healthy diet, and increasing physical activity have been shown to reduce breast cancer risk, there are other risk factors that one cannot control such as having a BRCA or other mutation that significantly increases breast cancer risk. Importantly, no one strategy has been proven to totally eliminate breast cancer risk. However many of these approaches have overall health benefits. (9/21/2017)

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STUDY: Does expanded genetic testing benefit Jewish women diagnosed with breast cancer?

Carrying a BRCA gene mutation increases the risk of cancer in both women and men. Such information is valuable for people diagnosed with cancer and can affect medical decisions for both the patient and his or her family members. Approximately 2% of people of Ashkenazi Jewish (Eastern European) descent carry one of three common BRCA gene mutations. For Ashkenazi Jewish women diagnosed with breast cancer who do not carry one of the three common BRCA mutations, little is known about their chance of carrying another hereditary mutation that may increase risk. This study looked at how often Ashkenazi Jewish women diagnosed with breast cancer were found to carry mutations other than the three common BRCA gene mutations found among individuals of Ashkenazi Jewish descent. (09/13/17)

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STUDY: Does aspirin lower a woman’s breast cancer risk?

Women who take aspirin regularly may have a reduced risk of breast cancer. However, previous studies have reported mixed results—some suggest risk is lowered with aspirin while others do not see a protective effect. Few of these studies have looked at whether this potential benefit of aspirin is linked to specific types of breast cancer. This study found a modest reduction in breast cancer risk for women who took a low-dose aspirin at least three times per week, but only for one subtype of breast cancer. Women who took aspirin were less likely to develop ER/PR-positive/Her2- negative breast cancer, the most common type of breast cancer. This study found no breast cancer risk reduction for women who used regular-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDS). (8/29/17)

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STUDY: Breast cancer rates are rapidly increasing among Asian women in California

The majority of racial groups in the United States have seen declines in breast cancer rates. However, this study provides new insights into the patterns of breast cancer rates in Asian American subgroups in California. Using 26 years of data, this research found that breast cancer is rapidly increasing among this population, contrasting to a decline in rates among non-Hispanic white women in California and nationwide. (8/15/17)

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STUDY: New cancer risk estimates for BRCA1/2 mutation carriers

Cancer risk estimates for BRCA1 and BRCA2 mutation carriers are important because they impact patient decision-making. Until now, almost all risk estimates for mutation carriers were based on results of retrospective studies that looked back on mutation carriers who had cancer. This new study is prospective—it followed almost 10,000 BRCA mutation carriers without cancer to see if or when they developed breast or ovarian cancer. The cancer risk estimates of this study may be more accurate because it followed mutation carriers who did not have cancer over time. (7/28/17)

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STUDY: Diet during teen years and early adulthood is linked to breast cancer risk

During teen years, breast tissue grows rapidly in young girls and is more likely to be harmed by substances that are known to cause cancer. Few studies have looked at the relationship between diet during puberty and breast cancer risk. This study looks at how a woman’s diet during their teenage years and early adulthood is associated with breast cancer development later in life. (6/30/17)

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STUDY: Routine breast cancer screening leads to overdiagnosis

Routine breast cancer screening for women of average risk has been controversial for many years because some believe that the benefits do not outweigh the risks. Recent headlines covering a study in Denmark suggests that routine breast cancer screening leads to “overdiagnosis” of breast cancer. (4/4/17)

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STUDY: Does working night shifts increase breast cancer risk?

The World Health Organization’s International Agency for Research on Cancer (IARC) classified night shift work as a possible risk factor for breast cancer in 2007, although the majority of the evidence for this claim came from studies of animals after their normal sleep-wake cycle was disrupted. The authors of this study surveyed women from three different cohorts to examine whether night shift work can increase a woman’s breast cancer risk. (3/24/17)

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STUDY: Patient experiences with genetic testing

Patients can now find out if they have a mutation in more than 20 different genes that are associated with cancer risk, thanks to research advances and the decreasing cost of genetic testing. However, patients’ experiences and use of genetic counseling and testing with these changes are unknown. Do patients want genetic testing? Are they getting tested? (3/7/17)

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STUDY: A step in the development of a new breast cancer risk assessment tool for Hispanic women

Current tools used to calculate breast cancer risk make their estimations based on data from non-Hispanic white women and may not accurately predict breast cancer risk in women of other races and ethnicities. With further testing, a new risk assessment tool developed specifically for Hispanic women could more accurately predict breast cancer risk in women who do not have mutations in BRCA or other genes associated with hereditary breast cancer. (02/07/17)

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STUDY: Women with breast cancer symptoms but no lump may wait longer to seek medical care

Some patients take longer than others before getting a potential breast cancer checked by their health care provider. Believing that women who have breast cancer symptoms but have no lump may wait longer, researchers in this study used data from women who were diagnosed with breast cancer in 2009 and 2010 to identify possible explanations. (1/18/17)

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ARTICLE: Male transgender breast cancer patient shares his experience in NYT piece

Denise Grady’s New York Times piece presents the struggles faced by Eli Oberman, a male transgender patient who was diagnosed with breast cancer, including the difficulty of being the only male patient in gynecologist waiting rooms that are full of women. (12/21/16)

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ARTICLE: Men get breast cancer too

Cathy Free's piece for People, “Men Have Breasts Too: New York Man Who Survived Stage 2 Breast Cancer Spreads Message,” tells the stories of two men whose experiences with breast cancer inspired them to speak openly about breast cancer awareness for men. (11/29/16)

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ARTICLE: Genetic testing has become more affordable and available. Should you get it?

What are reasons to get or not get genetic testing? Cynthia Graber gives her thoughts on the matter in her Wired opinion piece, "Why I Won't Get the Genetic Test for Breast Cancer." (11/15/16)

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STUDY: Breast cancer mortality among Hispanic women in the United States varies by country of origin

"Hispanic" is a broad ethnic category that includes people from numerous countries. When discussing breast cancer statistics, Mexicans, Cubans, Puerto Ricans and people whose families originated in Central and South America are typically grouped into one Hispanic category. A new study looked at whether the country of origin affected breast cancer prevalence and mortality rates in Hispanic women in the U.S. (10/25/16)

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STUDY: Breast cancer screening should be tailored to a woman’s risk factors and breast density

The United States Preventative Services Task Force (USPSTF) recommends a screening mammogram every other year for women ages 50-74 who are at average risk for breast cancer. But do all patients in this category benefit from this screening regimen?

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STUDY: Rare mutations in PALB2, CHEK2, and ATM: how much do they increase cancer risk?

As multi-gene panel tests become more common, people are discovering they have mutations in genes that are not understood as well as BRCA. This can make it difficult to give patients accurate assessments of their cancer risk. For example, mutations in PALB2, CHEK2, and ATM are rare, but some specific changes in these genes are even less common. How can researchers study the cancer risks for people who carry rare mutations in these genes? This study's an international collaboration aiming to better understand the cancer risks of some PALB2, CHEK2, and ATM mutationsshows how difficult it can be to obtain enough data to provide accurate risk information. The findings are relevant only to the specific mutations in this paper and do not apply to all people with mutations in PALB2, CHEK2, or ATM. (9/27/16)

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STUDY: Does IVF increase a woman’s risk for breast cancer?

In vitro fertilization (IVF) wasn't commonly used until the 1980s, so its long-term effects are mostly unknown. A new study suggests that the treatment does not increase a woman's risk for developing breast cancer. (8/23/16)

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STUDY: NIH awards $12 million grant to better understand breast cancer genetics in black women

Black women are more likely to develop aggressive breast cancers, and are more likely to die from their breast cancers. The reason for this is unclear. The National Cancer Institute has awarded a grant of approximately $12 million so that the biology of breast cancer in black breast cancer patients can be better understood. The results of this study will not be available to the public for several years, but the announcement brings much needed attention to this disparity. (8/15/16)

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STUDY: Early research on a drug to prevent breast cancer

Many researchers are interested in non-surgical options to reduce the higher-than-average risk of developing breast cancer in BRCA mutation carriers. This research study identified a type of drug, called a “RANK ligand inhibitor,” that may prevent breast cancer. Among mice that were genetically engineered to have no BRCA1 genes, those that were given the drug developed tumors less frequently than those that did not. While this is an exciting early study for BRCA mutation carriers, more work and human clinical trials need to be done before this can be used as a prevention therapy in humans. (7/12/16)

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STUDY: Breast cancer risk model updated for average risk women with genetic, lifestyle and environmental information

A number of factors are known to increase breast cancer risk, but some newly discovered factors have not been incorporated into breast cancer risk prediction models. This study incorporates some of these risk factors, such as genetics, smoking, and drinking, to give white women in the U.S. a more individualized breast cancer risk assessment. (6/29/16)

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STUDY: Does light alcohol consumption affect your breast cancer risk?

Alcohol is known to increase breast cancer risk, but does that include light consumption? This study indicates that some breast cancer occurrences and mortality is due to light alcohol consumption. (06/21/16)

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STUDY: Genetic testing for cancer risk: How many genes to sequence?

The past four years has seen a revolution in genetic testing for increased cancer risk. As the cost of genetic testing falls, patients can choose to have a single gene or a dozen or more sequenced. But many questions remain: Which genes should you search? How many should be sequenced? What tests are appropriate for which patients? A recent study that looked at sequencing 180 different genes found that increasing the number of genes sequenced beyond those known to elevate breast and ovarian cancer risk increases the number of uncertain results and does little to change clinical management. (06/14/16)

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STUDY: Dense breast notifications are informative but hard to read and understand

Some states offer women dense breast notifications that are meant to explain that dense breasts are risk factors for breast cancer and can hide cancer on mammograms, and to identify appropriate supplemental screening options. But recent research found that this information is often not easy to read or understand, which questions the usefulness of the documents. (6/7/16)

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STUDY: Is breast cancer risk increased in BRCA-mutation negative women?

Some women who do not carry a BRCA mutation, but come from a BRCA-positive family, still develop breast cancer. This research examines whether these women are at higher risk for breast cancer, or whether their risk is similar to women in the general population. (4/19/16)

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STUDY: Do women who eat a high fiber diet have a lower risk of breast cancer?

Some researchers believe that dietary fiber may decrease breast cancer risk by lowering estrogen levels in the blood. However, many previous studies have failed to find a link between fiber consumption and lower breast cancer risk. The current study suggests that consuming high dietary fiber during adolescence and young adulthood may lower breast cancer risk, but more work needs to be done to confirm this finding. In the meantime, everyone is encouraged to eat a variety of high fiber foods for the many well-documented health benefits. (March 8, 2016)

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STUDY: What are the genetics underlying 12 different cancer types?

As gene sequencing has become more affordable, researchers and health care providers are now looking for mutations in many genes beyond BRCA1, BRCA2 and others that are associated with known hereditary cancer syndromes. By sequencing thousands of genes rather than just one or two, researchers can better understand which inherited mutations affect cancer risk. In this study, researchers sequenced thousands of genes in patients with one of 12 cancers, including breast, and catalogued which gene mutations are most commonly found in each cancer.

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STUDY: How do ultrasound and mammography compare in breast cancer screening?

Mammography has been shown to reduce breast cancer deaths; however, women in developing countries don’t have easy access to mammography. Ultrasound screening, on the other hand, is portable and less expensive, and could be an alternative to mammography. This study compared mammography to ultrasound in women with dense breasts and found the two techniques have similar cancer detection rates, although the false positive rate is higher with ultrasound.

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STUDY: Do parabens in personal care products increase cancer risk?

Parabens are chemicals that can mimic the hormone estrogen in the body. As estrogen has been shown to increase breast cancer risk, some people have asked if parabens found in some cosmetics and shampoos will also increase breast cancer risk. Many studies have shown that parabens in the quantities found in personal care products are safe. A recent study of human breast cancer cells suggests that in certain conditions, parabens could help some breast cancer cells grow. It is important to remember that this is early research; this single laboratory-based study does not conclusively prove that parabens are dangerous. More work, including human studies, needs to be done to understand if parabens increase cancer risk.

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STUDY: Breastfeeding may reduce hormone receptor negative breast cancer risk

Previous studies have shown that women who breastfeed have a reduced breast cancer risk. This study examines this association in the different breast cancer subtypes (ER, PR, HER2 negative/positive) and finds that breastfeeding is associated with a reduced risk of ER-/PR- breast cancer.

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ARTICLE: What “The Truth About Cancer” got wrong about BRCA mutations and cancer

A recent web series and related articles contain dangerous misinformation about BRCA mutations and cancer. Everyone is born with two copies of both the BRCA1 and BRCA2 genes, which play essential roles in preventing cancer. Individuals born with a change or mutation in one of these genes have a higher lifetime risk of breast, ovarian, and other cancers than those without a mutation. Some claim that cancer in people with BRCA mutations can be controlled by 'turning the gene on and off.' This is false and misleading. BRCA mutation carriers are at risk of cancer because they lack a working copy of one of the genes involved in preventing cancer development. Turning a mutated BRCA gene on or off has no effect because once a mutation develops, the gene no longer works.

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STUDY: Impact of familial breast cancer risk on young girls

Does growing up in a family that is at high risk for breast cancer affect young girls? Recent research found girls from families with BRCA mutations and/or a strong family history of cancer to be as well adjusted as peers of the same age. The one difference was that girls from families facing breast cancer risk had more stress related to breast cancer than their peers. While these findings are reassuring, parents know their children best, and they should ask for help if they believe their daughters are not coping well.

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STUDY: Prenatal exposure to the pesticide DDT and breast cancer risk

This study found an association between prenatal exposure to the pesticide DDT, and an increased risk of women developing breast cancer. While this study does not prove that DDT exposure directly causes breast cancer, it serves as a reminder that pregnant women's exposure to toxic environmental agents can affect their children's risk for disease later in life.

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