Key Statistics presented at the Press Conference 7 October 2013
A new mutation signature which may impact the efficacy of treatment for breast cancer patients has been discovered and researched! This finding will be published within the next few days in the prestigious Cancer Research Journal.
There has been stability in the incidence rates vis-à-vis the number of women diagnosed with breast cancer. 79% of patients are over the age of 50. An additional improvement has been noted in survival rates which have seen an 87% increase and mortality rates have dropped among Jewish and Arab women.
Pancreatic cancer is the third most common cause of cancer death among men. Israel ranks high in incidence rates (fourth place) and mortality (in second place among men and fourth place among women).
According to the National Screening Program report, 73% of women are diagnosed with breast cancer at an early stage.
A survey of patient needs and subsequent intervention showed enhanced coping skills among cancer survivors (with symptoms such as - physical fatigue, pain, sleep disorders, emotional distress, and other such phenomena).
In a new Israel Cancer Association survey, among other things it emerged that more ultra-Orthodox women reported a family history of breast cancer, but were less likely to seek genetic consultation.
A new research study examining the disparities in different aspects of breast cancer, between Jewish women in Israel according to their religious affiliation, showed that breast cancer incidence rates were significantly lower among the ultra-Orthodox Jewish population, compared to the incidence rates among the secular Jewish population. Upon comparing the two populations, a more aggressive disease process was observed among ultra-Orthodox patients, apparently due to features of the tumor, stage of detection and lifestyle (more obesity, less physical activity, etc.).
The Israeli government has decided to establish a new National Knowledge Center on electro-magnetic radiation, to be headed by Prof. Sigal Sedetzky, and in collaboration with the Gertner Institute at Sheba Medical Center and the Holon Institute of Technology (HIT).
Abstract of the National Cancer Registry statistics presented by Dr. Lital Keinan-Boker, Deputy Director of the National Disease Control Center of the Ministry of Health:
The age-standardized incidence rates of invasive breast cancer have been stable both among Jewish and Arab women.
Over the past decade, breast cancer mortality rates have revealed a downward trend among Jewish and Arab women alike.
A comparison to the rates reported from OECD countries for 2009 shows that in terms of incidence, Israel ranks fourth among countries with the highest rates of breast cancer in the world - after Belgium, France and Holland.
In terms of mortality rates, Israel ranks fifth, after Denmark, Belgium, Ireland and Hungary.
79% of breast cancer patients are women over the age of 50.
The incidence rates for breast cancer among Arab women are similar to those of Jewish women in very young age groups (up to 34), but are lower than those of Jewish women in all other age groups.
Pancreatic cancer is one of the most common malignant tumors in Israel in terms of incidence; however it ranks high on the list of the leading causes of cancer death.
The disease incidence is stable in Israel and it is prevalent mainly at an older age, however the number of patients is steadily on the rise, due to population growth and ageing.
Pancreatic cancer is more prevalent among men than among women, and it is the third most common cause of cancer death among men.
A comparison of the pancreatic cancer incidence and mortality rates in Israel to those of 20 countries with the highest rates of pancreatic cancer in the world, according to the statistics of the International Agency for Research on Cancer (IARC) for 2008, shows that the incidence rate in Israel is high and that Israel ranks fourth in the world, among men and women alike. The mortality rate is also among the highest in the world, respectively, both among men (second place, after Uruguay) and women (fourth place).
Findings of a new Israel Cancer Association survey among 600 secular and ultra-Orthodox Jewish women and Arab females:
Heightened breast cancer awareness and nearly full compliance among all sectors with early detection screening tests can potentially save lives. In practice, nearly three quarters of ultra-Orthodox Jewish women and Arab women over the age of 50, and 81% of secular Jewish women, reported having undergone a routine mammography screening.
In the ultra-Orthodox sector, more women reported having a first-degree relative who had breast cancer in their family (17% compared to 13% among Arab and secular Jewish women). Nevertheless, these women sought genetic counseling less frequently than women belonging to other sectors.
The survey further revealed that a higher percentage of the ultra-Orthodox Jewish women had excessive weight gain, and secular Jewish women smoked more frequently and consumed a greater amount of alcohol, compared to women of other sectors (however the smoking and drinking rates per se were low). The Arab women engaged in less physical activity compared to women of other sectors.
Arab and ultra-Orthodox Jewish women cited the family physician as the most important source of information, while secular and traditional Jewish women cited the media, including TV, radio, written press, internet and Facebook, as the main source of information.
The survey participants indicated a healthy lifestyle, mainly proper nutrition and avoiding smoking, as an important factor which may reduce the risk of developing breast cancer. Ultra-Orthodox Jewish women also indicated prayer as an important factor.
Statistics in Detail
There are some 19,493 breast cancer patients and survivors, or those who are still coping with the disease in Israel, today.
Invasive breast cancer incidence
In 2010, 4,036 patients were diagnosed with invasive breast cancer, of whom 3,540 were Jewish (88%), 307 Arab (8%), and 189 Christians who are not Arabs or those who are unaffiliated with any particular religion ("others").
From 2006-2010, the incidence rates were stable both among Jewish women and Arab women.
The seasonal trends over a 30-year period, 1980-2010, indicate an increase in incidence rates among Jewish women, which was more discernible in the early 90s, upon the launch of the National Breast Cancer Early Detection Program, initiated by the ICA and the Ministry of Health. Since the early 2000s, there has been a decline in incidence and stability in rates. Among Arab women, there has been a slow increase in incidence rates over the years, showing a stabilizing trend over the past three years.
In-situ breast cancer incidence
In 2010, 451 patients were diagnosed with in-situ breast cancer, of whom 406 were Jewish, 26 Arab, and 19 Christian, who are not Arab or unaffiliated ("Other").
From 2006-2010, the in-situ breast cancer rates showed an upward trend, both among Jewish and Arab women.
The seasonal trends over the past 30 years 1980-2009 show an increase in rates among Jewish women, which was more discernible in the early 90s, upon the launch of the National Breast Cancer Early Detection Program, initiated by the ICA and the Ministry of Health. Among Arab women, there has also been an increase in incidence rates over the years, which have gained momentum since the mid-90s, and have reached stability in recent years.
Disease stage at diagnosis
Among patients with access to information (from the call center, or at the initial stage of the invasive disease), in recent years the percentage of women diagnosed at an early stage has risen to 62% of all those recently diagnosed with breast cancer.
Birthplace and Age-specific invasive breast cancer morbidity rates
In 2010 as well, invasive breast cancer morbidity was mainly observed among women over the age of 50, among Jewish and Arab women (79% and 55% respectively).
As compared to Jewish women, Arab women had incidence rates similar to those of Jewish women in the very young age groups (up to 34), but showed lower rates than Jewish women in all other age groups.
The highest rate was observed in native-born Israelis (94.6 per 100,000), and the lowest rate was observed among those of African descent (69.8 per 100,000).
Breast cancer survival rates
There is a seasonal upward trend in relative breast cancer survival rates, and today, the 5-year relative survival rate exceeds 87% among Jewish women and nearly 79% among Arab women.
Breast cancer mortality rates
In 2010, 963 women died of invasive breast cancer in Israel, of whom 867 (90%) were Jewish, 63 (6.5%) were Arab and 33 (3.5%) were "others".
Over the previous decade, from 2001-2010, breast cancer mortality rates have been on a downward trend, both among Jewish and Arab women.
In terms of incidence, Israel ranks above the average for OECD countries, in fourth place and higher, after Belgium, France and Holland (which present higher rates). Respectively, in terms of mortality rates, Israel exceeds the average of OECD countries, but it is in fifth place and higher, after Denmark, Belgium, Ireland and Hungary (which present higher rates).
It is important to keep in mind that when a disease is more prevalent in a particular population, its mortality rates are also higher. However, it is worth noting that in Israel, just as in other OECD countries, when breast cancer mortality rates, from 2000-2009, are compared, a significant decline may be discerned.
Click here for more detailed information (in Hebrew)
Annual Summary of Israel's 2013 National Breast Cancer Early Detection Program
Prof. Gad Rennert heads the National Breast Cancer and Colorectal Cancer Early Detection Programs
Since the inception of the program and to this very day, over 5.8 million breast imaging tests have been conducted (!) on over one million different women. 493,301 tests were conducted in 2012. 73% of women who were screened in 2010 were already tested in the past, meaning these are women who have undergone repeated tests as required.
Gaps in screening compliance rates that emerged in the past between sub-populations in Israel have significantly narrowed. The compliance rate currently measured in the Jewish population is about 69%, and it is slightly lower in the new-immigrant population (those who arrived in Israel after 1989) - 67% and in ultra-Orthodox Jewish population - 61%. In the Arab population, higher compliance rates were observed than in the past, and were even slightly higher than those observed in the Jewish population - 70%.
In 2011, 4,612 cases of breast cancer were recorded by the National Program statistics (including breast cancer recurrence in women who contracted the disease in the past), this number is similar to the number in previous years and indicates stability in morbidity rates. 73% of the women were diagnosed at the initial stage of the disease.
This year saw a notable decrease in the number of women who are recommended additional testing following a routine mammography screening (9.4% as opposed to 12.9% in 2010). At the same time, it should be noted that the early detection rates exceeded the anticipated target.
To view the complete article please click here (in Hebrew)
Cultural Influences in Cancer Morbidity: Religiosity and Breast Cancer in Israel
Professor Sigal Sedetzky - the Cancer Epidemiology Unit, the Gertner Institute, Sheba Medical Center, Tel Hashomer
Dr. Dorit Izak's doctoral thesis, moderated by Prof. Sigal Sedetzky, aims to examine the possible differences in breast cancer prevalence and the consequences of the disease among disparate population groups who differ in their religious way of life.
This research examine the differences in various aspects of breast cancer among Jewish women in Israel according to their religious affiliation (secular, traditional, national-religious and ultra-Orthodox). The research group was based on the national morbidity statistics as well as on a sample of some 1,500 cancer patients who were diagnosed from 2006-7.
The main study findings showed that:
About 88% of the general female population in the sample had undergone a mammography screening between the ages of 50 and 74, respective of the Ministry of Health recommendations. The gap that was observed in the past in screening compliance, between ultra-Orthodox Jewish women and secular Jewish women, was significantly narrowed.
Significant differences were observed in breast cancer rates by classification according to religious affiliation. The incidence rates among the ultra-Orthodox Jewish population were significantly lower as compared to the incidence rates among the secular Jewish population. These results support the current knowledge that delivery-hormonal factors, including multiple births and a young age at first delivery, protect against breast cancer.
Upon comparing the disease process between secular Jewish patients and ultra-Orthodox patients, a more aggressive pattern was observed among ultra-Orthodox Jewish patients, which was manifest in higher recurrence rates and lower survival rates. An in-depth analysis of the statistics showed a significant difference between the two populations in the stage of disease at diagnosis, in certain features of the tumor as well as in lifestyle parameters (physical activity and weight). These factors impact the chances of breast cancer survival and may explain the disparities that were observed between the two populations.
Findings of a new survey conducted by the ICA among 600 Jewish women*, ultra-Orthodox Jewish women and Arab women marking Breast Cancer Awareness Month
The telephone survey was conducted by Yifat Gat Ltd. Mutagim Institute, August 2013 (three targeted surveys were conducted among women aged 40 and older, 200 interviewees from each sector: general Jewish female population - refers to secular, traditional and religious Jewish females)
Obesity - ultra-Orthodox Jewish women are more obese. 58% reported excessive weight gain exceeding desired healthy weight compared to 41% of the Arab sector and 50% of the general Jewish female population. Obesity was more significant among ultra-Orthodox women aged 50 or older (60%).
Smoking - Jewish women in the general sector smoke more frequently (mainly among those aged 50 or older) (16% compared to 1% in the Ultra-Orthodox sector and 7% in the Arab sector). 8% of Jewish women in the general sector indicated that they smoke more than 10 cigarettes a day.
Alcohol consumption - Jewish women in the general sector tend to drink more alcoholic beverages (19%) compared to other sectors (4% in the ultra-Orthodox sector, 7% in the Arab sector). The consumption of alcoholic beverages is more common among young Jewish females in the sample (7% reported weekly drinking).
Physical activity - a small number of women in the Arab sector engage in physical activity in general and regular physical activity in particular (21% engage in regular physical activity, compared to 50% in the ultra-Orthodox Jewish sector, and 52% in the general Jewish sector). Jewish females aged 50 or older engage in more physical activity compared to women between the ages of 40-50 (75% compared to 52%). Among ultra-Orthodox Jewish women, no differences were found in the engagement in physical activity by age, and among Arab women, young women engage more in physical activity (65% compared to 49%).
Early Detection Awareness
There is heightened awareness and nearly complete knowledge in all sectors of the fact that early detection has the potential to save lives. Among younger Arabs, awareness is particularly high (92% of young women agreed with the statement that attributes importance to early detection, compared to 81% of older women).
Sources of Information
Arab women (57%), as well as ultra-Orthodox Jewish women, although at lower rate (25%) cite the family physician as the most important influence and a central source of knowledge. Ultra-Orthodox women also cited the written press as a source of information.
Jewish women in the general population cite the media as the main source of information (radio and TV, 47% and written press 30%), and the family physician is also cited as an important source of information (30%). Young Jewish women cite media as the main source of information (radio, and TV 59%, internet and Facebook 30%).
Mammography Screening Implementation
Of the women who are age 50 or older who participated in the survey, 94% of the Jewish women, and nearly 90% of the women from the ultra-Orthodox and Arab sectors, reported have undergone a mammography screening during their lifetime.
Nearly three quarters of the ultra-Orthodox Jewish women and Arab women; (73% and 74% respectively) and 81.3% of the Jewish women reported having undergone a routine mammography screening, according to the recommended guidelines.
Reasons for not having undergone a screening
Among the relatively few women who had not undergone a mammography screening, the main obstacles were: fear of the outcomes of the test and the pain involved in the test itself. Among Arab women, the main obstacle was the fear of the results.
More women from the ultra-Orthodox sector reported having a first-degree relative who had breast cancer (17% compared to 13% among Arab and Jewish women).
Nevertheless, of the women who had a first-degree relative who had breast cancer, the percentage of ultra-Orthodox women who sought genetic counseling was low compared to women of other sectors (53% sought counseling, compared to 58% Jewish women in the general population and 69.5% in the Arab sector).
In the general Jewish sector and the Arab sector, the highest percentage of women who sought genetic counseling was the group over the age of 50 (58% and 76% respectively). No differences were observed in the ultra-Orthodox sector in terms of seeking genetic counseling by age. Those who did not seek genetic counseling cited reasons such as fear, or repression "it's not important", "I don't want to know" (general), and 19% of the ultra-Orthodox claimed that there is "no need".
Factors that may reduce the risk of cancer
One of the factors that stood out among factors that may reduce the risk of breast cancer was a healthy lifestyle (mainly in terms of nutrition and prevention of smoking) (56% of the Jewish women, 41% of the ultra-Orthodox Jewish women and about 26% of the Arab women). Ultra-Orthodox Jewish women cited prayer (17%) as a factor that may help reduce the risk of cancer. Some of the Arab women who were interviewed saw the disease as "divine punishment" and believed that there is nothing that can be done to reduce the risk (11%).
In age-related distribution, Jewish women aged 40-50, referred less to physical activity, obesity and alcohol as risk factors for breast cancer, compared to women aged 50 and older. Among ultra-Orthodox Jewish women, prayer is perceived as an important factor that may reduce the risk of cancer, regardless of age, and cited nutrition and [prevention of] smoking after prayer. The perception that this constitutes a "divine punishment" emerged among Arab women over the age of 50. However, as mentioned, the findings indicate that in practice, in all sectors, recommended screening compliance rates are high.
New Survey: Can High Quality Cancer Survivorship Care Be Achieved?
Prof. Eliezer Robinson and researcher scientists of the Rambam Medical Center
The number of patients cured of their cancer has been steadily increasing in recent years. According to the National Cancer Registry of the Ministry of Health, there are some 200,000 cancer survivors in Israel today.
According to statistics published by the WHO International Agency for Research on Cancer (IARC), there are 30 million cancer survivors in the world today, and their numbers are increasing dramatically; according to estimates, this number expected to reach 70 million by 2050.
A previous survey conducted from 2009-2010 among breast and colorectal cancer survivors, indicated that 80% of survivors, reported that most of the medical needs directly linked to cancer were met. This as opposed to 67% of their needs related to physical functioning as a result of the disease, 54% of their emotional needs, and only 44% of their practical needs having been met (such as - work, financial situation, etc.).
In 2012, it was decided to redo the survey, and examine whether cancer survivors' referral to professional entities for support may enhance their coping strategies.
Some 198 survivors were interviewed in the survey; they were diagnosed with breast or colorectal tumors, subsequent to the completion of radiotherapy, brachytherapy and chemotherapy treatments, as well as radiotherapy treatment combined with hormonal treatment. They were asked 27 questions. And the responses were rated according to the intensity of the complaint, on a scale of 1-5, with 1 indicating not at all, and 5 indicating regularly.
Subsequent to the interview, the survivors were given an explanation and training by an oncology nurse, and as required were referred to various individuals who could assist them (such as: dietician, social worker, psychologist, and other professionals).
About a year and a half later, the nurse returned and interviewed the same survivors with a similar questionnaire.
Findings: It emerged that survivors who implemented the recommendation and contacted various professionals for assistance, had enhanced coping strategies to deal with resulting symptoms such as: fatigue, pain, sleep disorders and reliance on sleep medication, emotional distress and other factors.
To view the presentation, please click here (in Hebrew)
A new mutation signature which may impact the efficacy of treatment for breast cancer patients has been discovered and researched: from the clinic to genetics and back (Dr. Ido Wolf, Director of the Oncology Institute, Ichilov Medical center *)
* This article will be published in the next coming days in the prestigious Cancer Research Journal
Breast cancer is the most prevalent malignancy among women. It is common practice to divide breast cancer into three main groups: tumors which consist of cells that express receptors for certain hormones, tumors which consist of cells that express the Her2 protein, and tumors whose cells do not express either of the above.
When it comes to metastatic breast cancer, the entire body must be treated. The type of treatment will be determined by the dimensions of the tumor. When this involves a tumor that consists of cells that express receptors for certain hormones, the preferred treatment is of course hormonal treatment with drugs such as tamoxifen.
This treatment has many advantages - it is very effective and is usually also much less toxic than chemotherapy. The difficult problem is that after a while (months to years), the tumor develops resistance to hormonal treatment. At this stage, there is no choice but to begin chemotherapy. The mechanisms of resistance to hormonal treatment are not very clear.
Recently, using innovative genetic methods, a mutation was detected in the receptor for estrogen. The mutation causes a very small change in the protein (the replacement of one amino acid). The mutant protein (the protein that underwent a mutation process), has been under investigation in Dr. Wolf's lab, in a research study that has led to several important conclusions:
The change in protein causes it to be active all the time, even in the absence of estrogen.
The mutation causes the protein to be resistant to all existing hormonal treatments.
In the presence of the mutation, the tumor cells become more aggressive (they grow faster, have the tendency to develop liver metastases).
The mutation is not present in the primary tumor, but rather develops over time - the tumor changes and undergoes an "evolutionary" process.
Similar findings have been recently reported among other research groups around the globe. The future significance is revolutionary! The presence of the mutation (and several other mutations that have been discovered by other groups concurrently) may be investigated in the very near future, whereby we may know if there is any point in continuing hormonal treatment, or whether to switch to chemotherapy.
In the future, we will be able to try to develop innovative drugs to counter the mutant protein. Such drugs are anticipated to be more effective and less toxic than chemotherapy.
Please click here for information contained in a Word file (in Hebrew)
New! The National Knowledge Center on Electro-Magnetic Radiation and Public Health (Prof. Sigal Sedetzky - Cancer Epidemiology Unit, Gertner Institute, Sheba Medical Center, Tel Hashomer)
Over the past three decades there has been a significant development in technologies which use electro-magnetic radiation, and the number of users of devices that emit EMF (electric and magnetic fields) has dramatically increased. Consequently, there has been a significant increase in the duration and amount of radiation encountered by the public at a wide range of frequencies.
Contemporaneously, the discussion as to risks to health that might exist from exposure to non-ionizing radiation has been expanded, and fears have been raised that this type of exposure is possibly carcinogenic. In 2001, the International Agency for Research on Cancer (IARC) defined radiation emitted from power lines (for example, high voltage transmission lines) as a possible carcinogen. In 2011, microwave and radio frequency radiation (emitted from cellular phones and other sources) was also classified under this category.
Respectively, the official authorities in Israel (as well as in many other countries) are exercising preventive caution, a principle according to which in order to protect human lives and their health, one must take precautions, even if the cause-effect relationship has not yet been scientifically proven.
With the aim of formulating a comprehensive perspective on electro-magnetic radiation and public health, the Israeli government has decided to establish a National Knowledge Center. This Center was set up in January 2013, headed by Prof. Sigal Sedetzky, in collaboration with the Gertner Institute at the Haim Sheba Medical Center and the Holon Institute of Technology (HIT).
The launch of the Knowledge Center website is currently underway, and the public may learn more about this subject very soon, and may also contact the Knowledge Center to receive additional information and ask any questions they may have.
To view the complete article, please click here (in Hebrew)
ICA Information Center introduces new research studies
Is the quality of life of breast cancer survivors similar to that of women with no history of the disease?*
Research scientists from the University of Toronto in Canada studied changes in quality of life from time of breast cancer diagnosis to long-term survivorship and compared quality of life in long-term survivors to that of age-matched women with no history of breast cancer.
535 women with localized breast cancer were recruited from 1989 to 1996 and followed, completing quality of life questionnaires at diagnosis and 1 year post diagnosis. The questionnaire dealt with subjects such as physical functioning, pain, vitality, social functioning, emotional health and other factors.
Between 2005 and 2007, 285 survivors without distant recurrence were recontacted to participate in a long-term follow-up study. A control group consisting of 167 healthy women completed quality of life questionnaires similar to those completed by the survivor group.
During the course of the follow up period, on average 12.5 years post diagnosis, clinically significant improvements were observed in the quality of life indicators of the survivors. The questionnaire that was conducted 1 year post diagnosis, saw an improvement in many parameters, and additional improvement indicators were reported during the long-term follow-up.
The quality of life of survivors was similar to that of the control group. Slight deficits were observed in self-reported cognitive functioning (5.3% difference) and financial impact (6.3% difference) in breast cancer survivors compared with healthy control group members.
Examples of improvement: breast cancer survivors showed significant improvements in social functioning a year post diagnosis, statistics that go hand in hand with statistics from additional research studies, which indicate that 79%-82% of survivors go back to work during the first year post diagnosis. In terms of fatigue, despite the fact that over the course of the first year no significant improvement was observed, in a long-term follow up, the disparity that existed between survivors and healthy subjects was completely effaced.
To sum up, the investigators conclude that breast cancer survivors have similar quality of life over time to that of age-matched non-cancer controls, although small deficits in cognition and finances were identified. Additional studies are required to assess the sub-group consisting of survivors among whom these deficiencies are significantly more apparent.
This research study was published in the October 2013 issue of the Journal of Clinical Oncology
Courtesy of the ICA Information Center
Can risk of developing breast cancer be affected by blood pressure medication among menopausal women?*
Up until now, reports regarding the link between various groups of blood pressure medications and the risk of developing breast cancer, were inconsistent and few and far between, and failed to provide sufficient data regarding the estimated impact of long-term use of these medications.
A group of investigators from Seattle, Washington, U.S., conducted a study in which they sought to assess the link between taking different types of blood pressure medications and the risk of developing breast cancer. Two types of prevalent breast cancers were investigated, Invasive ductal carcinoma (IDC) and Invasive Lobular Carcinoma (ILC). This research study bears great significance, considering the fact that these drugs are taken for many years and incessantly, and in view of the fact that there are many treatment options to manage hypertension.
In this study, researchers studied 2500 women between the ages of 55 and 74, who were divided into three groups: one group of 880 women who were diagnosed with invasive ductal carcinoma, a second group of 1,027 women diagnosed with invasive lobular carcinoma, and 856 women without cancer, who comprised a control group.
The information was collected through personal interviews conducted in the homes of the subjects, which included detailed questions about heart diseases and hypertension, and about the use of various drugs. Details were collected about ACE blockers, beta blockers, calcium channel blockers, varying drugs and different combinations of these drugs.
All the women were asked about known or suspected risk factors for breast cancer, including family history, lifestyle, and body mass index.
The research results indicated a significant positive link between the use of anti-hypertensive drugs of the calcium channel blocker group, that are administered for ten years or longer, and the risk of developing one of the two prevalent types of breast cancer, IDC and ILC, while taking drugs for less than 10 years does not significantly increase the risk of developing breast cancer. Use of other groups of antihypertensive drugs did not increase risk for breast cancer.
This research study joins other existing reports that demonstrated that most anti-hypertensive drugs that are administered in the short-term, up to five years, are not associated with a risk for IDC or ILC breast cancer. This information may help in the decision making process regarding treatments for hypertensive patients, however additional research is necessary in order to establish these findings.
This study was published on 23 September 2013 in the JAMA Internal Medicine Journal.
Courtesy of ICA Information Center
Decision-Making Factors Among Breast Cancer Patients Undergoing Radical Mastectomy*
Women diagnosed with unilateral breast cancer are electing to undergo contralateral prophylactic mastectomy (CPM)-or removal of the healthy breast-at rapidly increasing rates in the United States. At the end of the 90s, 5% of women who underwent a mastectomy, also decided to remove the contralateral breast, whereas, in recent years, the percentage of women electing to do so stands at 11%-25%.
Against the backdrop of these data, researchers from the Dana Farber Cancer Institute at Boston University School of Public, U.S., conducted a survey among young women with breast cancer considering a bi-lateral mastectomy. This survey examined the women's priorities and knowledge of this subject, as well as their decision-making process, understanding of the dangers involved, and fear of recurrence.
The study conducted in 8 medical centers, assessed 550 women diagnosed with breast cancer from 2006-2010, and who hesitated, upon diagnosis, regarding radical mastectomy including the contralateral healthy breast. These women were in their 40s or younger. 123 of the subjects elected to remove the contralateral healthy breast as well.
In the questionnaire, the women reported their age, socio-economic status, family history, BRCA1/2 gene mutation carriership, tumor characteristics, and other factors. About a fourth of the women participating in the survey reported to be gene mutation carriers.
The researchers analyzed the survey findings and found that the main decision-making factors that were indicated by most of the women were the desire to reduce the risk of developing cancer in the contralateral breast (98%), prolonging their lives (94%), achieving peace of mind (95%), and preventing the spreading of the disease to other parts of the body (85%).
The investigators indicate that women who developed breast cancer who elect to undergo contralateral mastectomy, do so thinking they will gain survival benefit, despite the knowledge that it does not significantly improve their chances of survival. The perception of BRCA 1/2 gene mutation carriers was more accurate regarding the risks involved in developing cancer in the contralateral breast, compared to women who were non-carriers, who overestimated the risk.
The researchers recommend improving ways of delivering information to women with respect to the risks they face, in order to promote evidence-based decision-making.
This research study was published in the September 2013 issue of the Annals of Internal Medicine Journal.
ICA Marks Breast Cancer Awareness Month with a Plethora of Additional Activities
The Estée Lauder Companies, in collaboration with the Israel Cancer Association, initiated an innovative and unique concept in Israel - a Breast Cancer Awareness Pink Dish Program. Top chefs of twenty of Israel's most popular restaurants will be preparing a "Pink Dish" that will be featured on menus during the month of October, and NIS 15 of the cost of the meal shall go to the Israel Cancer Association to promote its fight against cancer.
Marking Breast Cancer Awareness Month, the ICA has published a new book called "Hope and a Tear through the [Camera] Lens". This book was written in the form of a comic book, by Revital and Chen Leopold, depicting a mother's struggle with breast cancer, communicated through the lens of her daughter's camera. This story is told with great sensitivity and with a dash of humor and optimism. This book, published courtesy of Roche Pharmaceuticals, will be distributed for free, like any other ICA publication.
On Sunday, 13 October, 2013, ICA will launch a new initiative called "the Pink Postcard". This initiative has developed a special application in which surfers can send a potentially life-saving e-card to a woman they care about who is 50 years old or older, to remind her to go get herself checked with a mammography screening. What makes this postcard special is that every surfer can include a personal message, by clicking and dragging on a selection of words that will appear on the card, to compose a personal letter of encouragement addressed to a woman who holds a special place in their hearts. This initiative has been made possible by Novartis.
ICA will be holding its annual "Celebrating Life" seminar on 28 October, at Kfar Hamaccabiya, to be attended by hundreds of female patients, survivors and their families, featuring top experts who will present the most up-to-date information on this subject.
In keeping with global survivorship trends, the ICA has been initiating programs and endeavoring to streamline processes and update professionals in order to assist attending medical staff and further open lines of communication with patients and survivors. The ICA initiated two new projects as part of this initiative:
Forum for Professionals - oncologists offer consultation for family physicians with respect to cancer patients and survivors.
A standard form for a medical summary letter has been prepared for attending oncologists, upon the completion of treatment of breast cancer and colorectal cancer patients - the most common cancers in Israel. This letter will be integrated in oncologists' computers at the respective oncology institutes, with the aim of providing an update for family physicians regarding treatment that their patient received, follow up techniques, and long-term side effects that may emerge.