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Breast cancer risk: It's not all in the family

WOMEN DO NOT automatically have a higher risk of getting breast cancer just because someone else in the family has tested positive for breast cancer genes, scientists noted recently. The findings may bring comfort to

women from high-risk families after a 2007 study suggested that simply having a relative with a BRCA1 or BRCA2 mutation raised their risk of developing breast cancer, even if they had tested negative for the genes. “The results are encouraging and

reassuring,” said Dr. Allison Kurian of Stanford University School of Medicine, whose study appears in the Journal of Clinical Oncology. The average woman in the U.S.

has about a 12% to 13% chance of developing breast cancer in her lifetime. Some 5% to 10% of breast cancers are genetic, and most of these cases are caused by abnormalities in the BRCA1 or BRCA2 genes. Women with these

Journal of Medical Genetics challenged that notion, suggesting that even though women did not carry the family breast cancer mutation, they still had a two to five times higher risk of developing breast cancer.That created a considerable amount of anxiety among doctors and patients. To study this, her team analyzed

mutations have a five- to 20-fold higher risk of developing breast or ovarian cancer, and must undergo intensive cancer screenings and take other precautions to reduce their cancer risk. Many of these women elect to have

their breasts or ovaries removed to keep from developing cancer.Once these mutations turn up in a family, other family members are screened as well. Women from these families who test negative have traditionally been told they have about the same risk as women in the general population. But a 2007 study published in the

data on more than 3,000 families with BRCA1 or BRCA2 mutations from three countries: the U.S., Canada, and Australia. They compared breast cancer rates among carriers and non-carriers of family mutations of the BRCA1 and BRCA2 genes. They found no evidence of an

increased breast cancer risk among women who were non-carriers. “It’s reassuring that we don’t see a

signal for elevated breast cancer risk from women who test negative for a familial mutation,” Kurian said. ■ Source: Reuters Health

ID Increased safety using simultaneous techniques for cardiac testing

THE CANADIAN JOURNAL OF CARDIOLOGY has published a paper on the safety of cardiac imaging methods. This study is important for patients worried about radiation exposure during x-ray based studies of the heart. X-ray based methods have greatly improved the diagnosis of heart disease, but they

can produce significant levels of radiation exposure. New imaging methods offer the possibility of much safer external investigations for conditions that in the past required potentially dangerous probes within the body (like wires or tubes within blood vessels).One example is high-definition CT scans to look at the arteries of the heart and diagnose coronary artery disease. However, such procedures have required radiation levels that could themselves be potentially dangerous. Dr. Heydari et al. provide the first report of high-definition CT scans with the simultaneous application of several techniques to reduce the level of radiation to much safer values. In an accompanying editorial in the

same issue of Canadian Journal of Cardiology 06

titled, ‘Cardiac ComputedTomography and Risks of Radiation Exposure: How Low Can We Go?’, Paul Galiwango,MD, commented that although the study has limitations, the results demonstrate that reduction techniques are feasible and should be adopted whenever possible. They offer the challenge - 'Do we need to go even lower?' “Previous studies have shown that radiation exposure during cardiac diagnostic tests can increase cancer risk.This paper reports how various new methods can be applied to reduce radiation exposure during cardiac diagnostic tests by about 75-85%.The procedures they describe can greatly reduce patient risk,” comments Stanley Nattel,MD, Editor-in-Chief of Canadian Journal of Cardiology. ■

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