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: FDA asks Allergan to recall certain textured breast implants

On July 25, 2019, the Food and Drug Administration requested that breast implant manufacturer Allergan recall its BIOCELL textured implants and expanders due to an association with a rare type of lymphoma called Breast Implant Associated Anaplastic Large Cell Lymphoma or BIA-ALCL. The FDA does not recommend removing implants for people who do not have disease symptoms. This XRAYS review updates information about this FDA recall. (7/29/19)

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STUDY: Prevalence of BRCA founder mutations in Bahamian women


Population-based testing for BRCA mutations can detect mutation carriers who do not have a family history of cancer. This study reviewed whether population-based testing is an effective approach in the Bahamas which has the highest known frequency of BRCA mutations among breast cancer patients. (3/4/19)

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ARTICLE: Pamela Munster's story: Cancer in the family

In the Saturday essay of The Washington Post, Dr. Pamela Munster recounts her family's history with cancer associated with a mutation in the BRCA2 gene. She details her father's extraordinary journey with pancreatic cancer, one of the most aggressive and deadly cancers. (11/27/18)

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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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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: 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 updates report on risk of lymphoma from breast implants

In March 2017, the Food and Drug Administration reported that patients with breast implants may be at increased risk for a rare type of lymphoma. This was covered in a previous XRAYS review. The FDA has continued to collect data since the first reported association in 2011. Recently, the agency released an update on the number of reported cases of breast implant-associated lymphoma and lifetime risk estimates for women with textured breast implants. (04/02/18)

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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: 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: 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: 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: Gaps in genetic testing and decision-making for women with early-stage breast cancer

Genetic testing for cancer risk is now more affordable and easier to obtain. As a result, many breast cancer patients are tested without ever seeing a genetic counselor. Genetic testing results affect treatment decision making, but they can be confusing, especially if patients do not receive genetic counseling. This study looks at breast cancer patients’ experiences following genetic testing and how testing results affect surgical decision making. (7/14/17)

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STUDY: FDA report claims women with breast implants may be at risk for rare cancer

Recent headlines highlighted an FDA report stating that patients with breast implants may be at increased risk for a rare type of non-Hodgkin lymphoma. What is the scientific evidence behind this claim? (4/21/17)

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STUDY: Removing ovaries before age 50 may increase the risk of chronic conditions for some women

Removal of ovaries and fallopian tubes prevents ovarian cancer, but it may come with other health risks. Experts recommend removal of ovaries and fallopian tubes in women at high risk for ovarian cancer due to inherited mutations in BRCA, and also suggest it for women with mutations in some other genes, because for these high-risk women the benefit of ovarian cancer prevention outweighs the risk of long-term complications. Based on a recent study, some researchers feel that for women who are not at increased risk for cancer, the risk for some chronic conditions is too high to consider removal of both ovaries. (11/1/16)

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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: 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: Institute of Medicine report on state of ovarian cancer research and patient care underscores the need to know if you are at high risk for ovarian cancer

Young women with breast cancer meet national guidelines for genetic counseling and/or testing to determine if they have a mutation in BRCA and other genes that puts them at high risk for ovarian cancer. Recently, the Institute of Medicine brought together a committee of experts to evaluate the state of ovarian cancer research and care, because many things are still unknown about this disease. The committee published 11 recommendations to improve ovarian cancer risk prediction, prevention, early detection and care. (5/10/16)

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STUDY: BRCA testing in young women with breast cancer

National guidelines recommend genetic testing for BRCA mutations in young women who are diagnosed with breast cancer. However, little is known about how women decide to get testing, or how they use genetic information to decide on treatment options. This study found that genetic testing is increasing among young breast cancer survivors, and it explores some of the factors that play into patients’ decision making about genetic testing. (3/22/16)

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STUDY: Researchers study the potential association between thyroid and breast cancers

Researchers and health care providers have observed that thyroid and breast cancers occur in the same patients more often than would be expected by chance. This has prompted them to attempt to better understand whether or not an association exists between the two cancers. This study found that compared to the average person, women diagnosed with breast cancer appear have a slightly higher risk for a diagnosis of thyroid cancer, and that women with thyroid cancer are at a slightly higher risk for breast cancer. More research needs to be done to better understand the basis of this association. (3/15/16)

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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. (03/01/16)

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STUDY: Are mutations in BRIP1, BARD1, PALB2, and NBN associated with an increased risk for ovarian cancer?

Many women who meet national guidelines for genetic testing for BRCA mutations find that they do not carry a mutation in BRCA1 or BRCA2 despite their personal and family history of breast and/or ovarian cancer. Expanded panel tests now look for mutations in other genes associated with increased cancer risk. However, the extent of cancer risk for people with mutations in some of these other genes is not yet known. This study examines whether mutations in four genes found on many commercially available panels, BRIP1, BARD1, PALB2, and NBN, are associated with an increased risk for ovarian cancer. The researchers estimate that BRIP1 mutation carriers have about a 6% risk of developing ovarian cancer by age 80. (02/09/16)

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STUDY: Potential genetic basis for breast cancer survivors who develop therapy-related leukemia

The population of breast cancer survivors in the United States is increasing. One rare but dangerous long-term effect of breast cancer treatment is an increased risk of leukemia, a type of bone marrow cancer. A recent study uncovered a potential genetic basis for this condition. (01/26/2015)

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STUDY: How many children with cancer have mutations in genes that increase cancer risk?

Many genes are associated with increased cancer risk in adults, but it is unclear how common these mutations are in children with cancer. This study found that about 9% of children with cancer carry mutations in a gene that is known to increase cancer risk. Over half of the mutations were in the TP53 gene, which is associated with increased cancer risk at a young age and increased risk of breast cancer in adults. (12/15/2015)

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

A website called thetruthaboutcancer.com, created a 9-part docu-series titled “The Truth About Cancer: A Global Quest” (TACGQ). The video states that Angelina Jolie’s decision to remove her breasts was one made out of fear; one commentator states that her decision was “barbaric." This video  contains a lot of dangerous misinformation about BRCA mutations and inherited cancer. FORCE XRAYS provides the following point-by-point analysis on "The Truth About Cancer." (11/10/2015)

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STUDY: Mutations found through multigene panel testing for cancer risk can change patient care

Multigene panel testing can look for mutations in many genes associated with increased cancer risk all in the same test. Some panels include genes associated with increased risk of multiple cancers, including breast, ovarian, colon, and gastric cancers. This study showed that results from multigene panel testing may change medical options for patients who test positive for a mutation linked to increased cancer risk. (9/22/15)

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STUDY: All DCIS is not the same: Young women and African American women at higher risk after DCIS diagnosis

Diagnoses of ductal carcinoma in situ (DCIS), sometimes called stage 0 breast cancer, have increased in recent decades. Many people with DCIS wonder if they need aggressive treatment. A recent study looking at the survival of over 100,000 women found that breast cancer mortality after DCIS is low (3%), and identified groups of women who are at higher risk after DCIS. (9/8/15)

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