Posted by: Chris Maloney | October 21, 2011

Breast Cancer: Lumpectomies and Binge Diets.

Early signs of breast cancer.

Image via Wikipedia

It’s breast cancer awareness month.

Big news which isn’t really news.  Lumpectomies work as well as mastectomies as long as there are clear margins.  It flies in the face of simple logic:  a mastectomy means no more breast, so no more breast tissue to be affected.  But evidently, it’s completely unnecessary, and we have a huge number of women undergoing even double mastectomy rather than “have to deal with it later.”  What they don’t realize is that there really isn’t likely to be any later to deal with and that removing the entire breast leads to longer recovery times.

Here’s the link to the most recent news.  Here’s an older link to the Cochrane analysis from 2008 saying pretty much the same thing.

On to other breast cancer topics.  It’s pretty well established that excess weight leads to increased risk of breast cancer.  I’ve already talked about obesogens, environmentally contaminants that act as external hormones on the body.  The same process that generates excess fat also generates excess cancer risk.

So we should all starve ourselves thin, right?  Not necessarily.  The human studies aren’t in, but the rat studies show than intermittent dieting may actually help overall cancer risk.  It works better than consistent starvation.  WARNING:  these are rats, not people.  Rats don’t necessarily mean we get a free pass to binge diet.   I’ll put the study below.

Finally, why aren’t we using ultrasound to check for breast cancer?  The new ultrasounds are good enough to check for clear boundaries during breast cancer removal, but we’re continuing to squish and irradiated breasts despite some evidence that this might be making things worse.  Boundary study below.

J Carcinog. 2011;10:21. Epub 2011 Sep 21.

The manner in which calories are restricted impacts mammary
tumor cancer prevention.

Cleary MP, Grossmann ME.


University of Minnesota Hormel Institute, 801 16th Ave. NE
Austin, MN 55912-3679, USA.


Although treatments for breast cancer have improved and
long-term survival after diagnosis is now common, prevention of the disease is
the ultimate goal. Weight loss or weight maintenance is one approach that has
been recommended to reduce the risk of breast cancer, particularly for
peri/postmenopausal women. This approach is supported by decades of data
indicating that calorie restriction prevents spontaneous and chemically induced
mammary tumor development in rodents. In most cases, calorie restriction was
implemented by a consistent daily reduction of calories, i.e. chronic calorie
restriction (CCR). There have also been several studies where periods of
reduced caloric intake were followed by periods of refeeding, i.e. intermittent
calorie restriction (ICR), resulting in the prevention of spontaneous mammary
tumorigenesis. In most of the early studies, there were no direct comparisons
of CCR to ICR. One study using moderate calorie restriction in a chemically
induced breast cancer rat model found a slight increase in mammary tumor
incidence compared with ad libitum fed and CCR rats. However, recently, it has
been demonstrated in several transgenic mouse models of breast cancer that ICR
consistently provided a greater degree of protection than CCR. This review will
provide a detailed comparison of ICR and CCR for breast cancer prevention. It
will also examine potential mechanisms of action that may include periods of
reduced IGF-I and leptin as well as an increase in the adiponectin:leptin
ratio. Application of this approach to at-risk women may provide an approach to
lower the risk of breast cancer in overweight/obese women.

PMID: 22013391

J Acoust Soc Am. 2011 Oct;130(4):2428.

Ultrasonic analysis of breast tissue for pathology

Sorensen KM, Doyle TE.


Dept. of Phys., Utah State Univ., 4415 Old Main Hill, Logan,
UT 84322-4415,


The effectiveness of breast conservation surgery (BCS) or
lumpectomy relies heavily upon pathology to assure negative or cancer free
margins. In a study to develop an intraoperative pathology method, surgical
specimens from 17 breast cancer patients were tested with high-frequency (HF) ultrasound
(20-80 MHz) to search for pathology sensitive features for the detection of
cancer in margins during BCS. Pulse-echo and pitch-catch waveforms were
obtained using two single-element 50-MHz transducers. Analysis of time-domain
waveforms yielded ultrasonic attenuation and sound speed, whereas fast Fourier
transforms of the waveforms produced ultrasonic spectra and cepstra for the
evaluation of spectral peak density and cepstrum slope. Spectral peak density
indicated significantly higher values for carcinomas and precancerous
pathologies than for normal tissue. Cepstrum slope exhibited a substantial
distinction between benign and adipose tissues when compared with normal and
malignant pathologies. The attenuation coefficients were sensitive to fat necrosis,
fibroadenoma, and invasive lobular carcinoma. A multivariate analysis of these
parameters was used to further distinguish pathologic classification.
Evaluation of ultrasonic attenuation, spectra, and cepstra permits
differentiation between normal, adipose, benign, and malignant breast
pathologies. These results indicate that HF ultrasound may assist in
eliminating invasive re-excision for lumpectomy patients. [Work supported by
NIH R21CA131798.].

PMID: 21973906



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