It’s Time For A New Tool In The Battle Against Breast Cancer
For many women, for many reasons, early breast cancer detection through existing screening protocols is reduced.
About half of all women have dense or very dense breasts.
Mammography sensitivity decreases with higher breast density because both cancer and dense breast tissue appear white on mammograms, creating a camouflage effect.²
In Canada, women under 50-years arent typically referred for mammography screening. Breast cancer among younger women is less common but still significant. In fact, 18 percent of breast cancer diagnoses are women under age 50.³
How Does Blood Test Determine Cancer
Cancer blood tests work by screening for DNA released by dying tumor cells. These tests are showing promise for detecting traces of tumor DNA in the blood of cancer patients. However, the results dont indicate where the tumor resides.
What is the best blood test for breast cancer?
One type of blood test for breast cancer is referred to as the BRCA gene test. This test is used to evaluate two genes, called BRCA1 and BRCA2, that indicate a persons susceptibility to breast cancer. Mutations of these genes may mean that a woman is more likely to develop breast cancer.
How does cancer affect blood work?
Blood cancers can affect blood cell counts in a number of ways, either lowering or increasing measurements. If youre currently receiving cancer treatment such as chemotherapy, drug therapy or radiation, your blood counts will be affected. Blood counts usually return to normal after treatment is complete.
Is Breast Cancer Hereditary And What Are My Risks For Developing The Disease
A womans risk of breast cancer begins to increase close to age 50 as menopause approaches. But its important to note that cancer in general increases as a person ages. There is also evidence that genetics play a role in whether or not you will develop breast cancer.
However, there are some factors inherent in just being a female that put women at risk for breast cancer:
Things that dont increase your risk, despite some common myths and misconceptions: having large breasts, breast implants, drinking coffee, deodorants and wearing underwire bras.
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Why Do Doctors Want To Discuss Blood Results
assess your general state of health. check if you have an infection. see how well certain organs, such as the liver and kidneys, are working. screen for certain genetic conditions.
New research suggests that a routine blood test could help find cancers early. Researchers have previously shown that high levels of platelets cells in the blood that help stop bleeding can be a sign of cancer. But now they have found that even slightly raised levels of platelets may be an indication of cancer.
Normal May Differ Between Men And Women
If you compare your blood test results with those of someone of the opposite sex, you may be surprised to find differences. For example, the normal reference range for the number of red blood cells in a complete blood count is between 5 million and 6 million cells per microliter for a man, but for women, its between 4 million and 5 million, according to the NHLBI.
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However There Is Currently No Accurate Cancer Blood Test Available
One of the biggest causes of mortality is cancer. According to the American Cancer Society, cancer will be responsible for more than 600,000 deaths in the United States by 2022. Doctors who detect and treat cancer cells early usually have the greatest results.
Regular self-examinations and blood tests are critical for early cancer diagnosis. Anyone who sees any irregularities, such as lumps or dimpling on their skin, should see a doctor right once.
Instead of doing a single test, the doctor will employ a combination of diagnostic lab tests to screen for cancer, including:
- Genetic testing
- Specific blood tests
In this article, well look at how physicians identify cancer using normal blood tests. We also look at whether individuals can test for cancer at home and provide some questions for physicians to ask if they have cancer concerns.
Blood Test Can Detect Cancers In Previously Undiagnosed Women
Researchers have shown for the first time that a blood test can be used safely to detect multiple types of cancer in women with no previous signs of the disease.
In a clinical trial of 9,911 women with no evidence or history of cancer, the blood test or “liquid biopsy” detected 26 of the 96 cancer cases identified during the trial. Scientists uncovered an additional 24 cancers among the group using traditional screening methods like mammography, according to the study published April 28 in Science.
Among the 26 women who had their cancers first detected by the blood test, 65% were diagnosed at an early stage of their cancer. Twelve of the women are now in remission after treatment, and eight remain in treatment or have their cancer stabilized nine months after their diagnosis.
“This study suggests that a multi-cancer blood test can be complementary and additive to standard of care screening and may be a good strategy for increasing early detection of cancer,” said Anne Marie Lennon of Johns Hopkins University School of Medicine, the study’s lead author.
Breast, lung, thyroid and colorectal cancers were among the 10 types of cancers detected by the blood test screening. In all, 16 types of cancers were identified in the study participants. The researchers enrolled only women because they wanted to be sure ovarian and uterine cancers were sufficiently represented the study.
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What Are The Treatments Available For Breast Cancer
Surgery remains the standard choice of treatment for diagnosed breast cancer say most physicians. There are two broad types of surgery, depending upon diagnosis, medical recommendations, family history and personal preference: breast-conserving which typically removes just the tumor but saves the breast, and mastectomy in which the entire breast is removed.
Within those two broad surgical choices are different types of surgical procedures that include:
- Lumpectomy removes only the breast lump and a margin of surrounding tissue.
- Partial mastectomy tumor, breast tissue and chest muscle lining are removed some lymph nodes may also be removed.
- Total mastectomy the entire breast is removed but not the underarm lymph nodes or underlying muscle.
- Radical mastectomy extensive surgery that removes the entire breast, lymph nodes and chest wall muscles.
- Double mastectomy sometimes used as a preventive measure for high-risk women.
In nearly all cases, reconstructive plastic surgery is available and performed. Radiation, chemo and other follow-up therapy may also be prescribed, depending upon the progression of the cancer and recommendations made by healthcare providers.
Personal choice is also involved: in one study half of women whom experts said were eligible for lumpectomy chose a mastectomy instead. In addition, some younger women are choosing double mastectomies as a preventive measure if they are at high risk of developing breast cancer. .
Study Examines Whether Blood Test Can Identify Early Cancers
In a new study, an experimental blood test identified cancers for which there are recommended screening tests and other cancer types for which no screening tests exist.
In the first study of its kind, a blood test combined with imaging tests detected tumorssome at an early stagein women without a history of cancer or any symptoms.
The blood test identified breast, lung, and colorectal cancers, for which there are recommended screening tests. But it also identified seven other cancer types for which no screening tests exist.
Researchers led by Nickolas Papadopoulos, Ph.D., of Johns Hopkins University School of Medicine, designed the study to see whether it was possible to use such a blood test to detect cancers before symptoms developed. They also wanted to make sure the testing process did not cause participants distress or lead to many unnecessary diagnostic procedures.
The study was not designed to determine whether finding and treating the cancers identified by the test reduced the number of deaths from cancer among participants.
The findings were presented at the American Association for Cancer Research annual meeting and published in Science on April 28.
Although its counterintuitive, detecting a cancer early does not necessarily reduce the likelihood of dying from cancer, explained David Ransohoff, M.D., of UNC Lineberger Comprehensive Cancer Center, who was not involved with the study. Some screening may actually cause more harm than good, Dr. Ransohoff said.
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What Are The Symptoms Of Prostate Cancer
Difficulty with urination frequency, weak stream, trouble getting started, etc. is usually the first sign of prostate cancer. But these and other early symptoms of prostatic cancer can also come from benign prostate conditions, so diagnostic testing is important, including PSA tests and digital rectal exam.
Test Values Can Be Different From Lab To Lab
Lab technicians reports compare your blood test results with a range that is considered normal for that laboratory. The labs reference range is based on test results from many people previously tested in that lab. This normal range may not be the same as another labs, notes the Food and Drug Administration, so dont be surprised if you find that a prior blood test report varies from newer reports the difference could be in the lab.
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Hdl Cholesterol Blood Testing And Lower Cancer Risk
New research provides another reason to monitor your cholesterol through blood testing and increase your High density lipoproteins cholesterol, also known as good cholesterol, through diet and exercise. The study suggests that increasing your HDL by 10 points can reduce your risk of cancer by one third over the following years. HDL has long been known to decrease your risk of heart disease.
Blood tests that can detect the signs of various forms of cancer are important diagnostic tools, often providing the first indication that a person may have cancer. However, it is important to note that, in most cases, further testing is necessary for a definitive diagnosis. Generally, that will include biopsy, which is a procedure to obtain a sample of potential cancerous cells for testing. Additionally, false positives and false negatives are possible with some cancer blood tests, so it is important that other symptoms and health factors are taken.
Table : Sample Blood Chemistry Panel With Results And Reference Interval
Albumin is the most prevalent protein in the blood. It is synthesized in the liver and removed from circulation by the kidney, which causes it to be excreted in the urine. Albumin is often measured in order to detect liver damage or kidney damage, either of which may be a side effect of cancer or cancer treatment.
Alanine aminotransferase is an enzyme in the liver that rearranges the building blocks of proteins. It is released from damaged liver cells. Cancer patients may experience liver damage as a side effect of some cancer treatments or due to spread of cancer to their liver. ALT may also be referred to as SGPT
Aspartate aminotransferase is an enzyme in the liver that rearranges the building blocks of proteins. It is released from damaged liver cells. Cancer patients may experience liver damage as a side effect of some cancer treatments or due to spread of cancer to their liver. AST may also be referred to as SGOT
Alkaline phosphatase is an enzyme is that involved in bone growth. It is processed in the liver and excreted into the digestive tract in the bile. A higher than normal amount of alkaline phosphatase indicates bone or liver problems. In cancer patients, elevated alkaline phosphatase may indicate that cancer has spread to the bones or that liver damage, possibly due to some chemotherapy drugs, has caused problems with bile excretion.
Chloride is a chemical that helps maintain fluid balance in the body. Low chloride levels may be caused by vomiting or diarrhea.
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Who Needs Hormone Receptor Testing
Hormone receptor testing is generally recommended for all breast cancers, including DCIS. If your doctor orders this test, you may be asked to discontinue taking any prescribed hormones for a period of time before the breast tissue sample is obtained. Usually, the sample comes from a biopsy, but the test may also be performed on tissue removed during a lumpectomy or mastectomy. It is standard of care however to obtain these types of pathology results on biopsy tissue.
What Will The Her2/neu Results Tell Me
There are four tests for HER2, and results of these may appear on your pathology report, which may take several weeks to come back.
The first one is the IHC test, which is short for ImmunoHistoChemistry. It looks at whether there is excess HER2 protein in the cancerous cells. A result of 0 or 1+ indicates there is no excess, 2+ is borderline, and 3+ means the cells test positive for HER2 protein overexpression.
The remaining three tests all examine if the cells contain too many copies of the HER2 gene. These tests include:
- The SPoT-Light HER2 CISH test
- The Inform HER2 Dual ISH test
There are only two possible results for these three tests: positive, meaning HER2 gene amplification, or negative, indicating the number of HER2 genes is not excessive.
In the pathology report, breast cancers with HER2 protein overexpression and HER2 gene amplification are called HER2-positive. This type of cancer often grows faster, spreads to other areas more readily, and has a higher likelihood of recurring versus HER2-negative breast cancer.
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Genomic Tests To Predict Recurrence Risk
Doctors use genomic tests, also called multigene panels, to test a tumor to look for specific genes or proteins that are found in or on cancer cells. These tests help doctors better understand the unique features of a person’s breast cancer. Genomic tests can also help estimate the risk of the cancer coming back after treatment. Knowing this information helps doctors and patients make decisions about specific treatments and can help some patients avoid unwanted side effects from a treatment they may not need.
Genomic tests are different from genetic tests. Genetic tests are performed on blood or saliva and are used to determine what gene changes a person may have inherited from a parent that may increase their risk of developing breast cancer. The results of a few genetic tests can also be used to make decisions about specific treatments.
The genomic tests listed below can be done on a sample of the tumor that was already removed during biopsy or surgery. Most patients will not need an extra biopsy or more surgery for these tests.
For patients age 50 or younger who have cancer in 1 to 3 lymph nodes
Recurrence score less than 26: Chemotherapy is often recommended before hormonal therapy is given
Recurrence score of 26 or higher: Chemotherapy is usually recommended before hormonal therapy is given
For patients older than 50 who do not have cancer in any lymph nodes or who have cancer in 1 to 3 lymph nodes
The Benefits Of Early Detection
To determine how effective a blood test would be at catching breast cancer in its earliest stages, the researchers compared blood test results of 90 breast cancer patients when they first received their diagnosis with 90 study participants who had not been diagnosed with the disease.
The blood test was effective in differentiating between the participants who had breast cancer and those who didnt. The researchers found that their diagnoses were the most accurate when more TAAs were incorporated into the tests.
While a test that included five TAAs accurately detected breast cancer 29 percent of the time, increasing that figure to nine TAAs led to nearly 40 percent accuracy in detecting breast cancer. Using those same TAAs, the tests were accurate in identifying patients without cancer 84 percent and 79 percent of the time, respectively.
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What Are Some Of The Signs And Symptoms Of Breast Cancer
While finding a lump in your breast or having one appear on a mammogram doesnt automatically mean you have cancer, it does indicate there is a need for further evaluation. Other conditions can cause lumps in the breast includes cysts, benign tumors and certain noncancerous disorders.
According to the Mayo Clinic, the most common sign of breast cancer is a lump or thickening in one breast that can be felt. It may be painless, or it may be tender with some associated pain. Many cancerous lumps are firm, with irregular borders and develop in the upper portion of the breast near the armpit. In the early stages of cancer, there may not be other signs or symptoms.
Since even an experienced healthcare provider cant always tell if a lump is benign or malignant, all lumps and changes to the breast should be examined and evaluated, with a full medical history, physical exam and imaging tests. If further studies are needed, a biopsy may be necessary. Diagnosing breast cancer is generally a step-by-step procedure that can take several days. Many women say the worst part is the waiting and the uncertainty of knowing whether or not they have cancer.
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Do Doctors Call Right Away With Bad Test Results
If a normal or negative test result comes back, the physician can telephone the patient with the good news, and patients have the option of canceling the follow-up appointment. Although it is preferable to give bad news face-to-face, there may be times when giving bad news over the phone is unavoidable.
What Are The Hardest Cancers To Detect
Kidney cancer Like pancreatic cancer — kidney, or renal cell cancer — is hard to detect because there are few symptoms in the early stages of the disease, which affects 54,000 people in the U.S. per year. One of the earliest warning signs is discolored urine, or urine that has a high blood cell count.