Cancer Research UK has reported that its scientists have developed a very comprehensive method of predicting a women’s risk of developing breast cancer.

This work was recently published in Genetics in Medicine where it was explained that by combining information on family history, genetics and other factors like weight, age at menopause, alcohol consumption and use of hormone replacement therapy, scientists are able to determine a woman’s breast cancer risk.

What makes their prediction more precise than previous methods is that researchers, for the first time, included 300 genetic indicators for breast cancer in their risk calculation.

This piece of work has led to the development of an online calculator that General Practitioners (GPs) in the UK can use in their surgeries. Currently this online  calculator is being tested by GPs, nurses and genetic counsellors before it is released nation-wide. The hope is that this tool will enable healthcare professionals to explore early detection and prevention strategies for women based on their risk and therefore improve survival rates for breast cancer.

Although this work is very exciting more work is needed, as expressed by lead author, Professor Antonis Antoniou, who said:

“It could be a game changer for breast cancer because now we can identify large numbers of women with different levels of risk – not just women who are at high risk.

 

This should help doctors to tailor the care they provide depending on their patients’ level of risk. For example, some women may need additional appointments with their doctor to discuss screening or prevention options and others may just need advice on their lifestyle and diet.

 

“We hope this means more people can be diagnosed early and survive their disease for longer, but more research and trials are needed before we will fully understand how this could be used.”

Additionally, Dr Richard Rope, Cancer Research UK’s GP expert warned that:

“Research like this is hugely exciting because in the future it will enable us to offer much more tailored care which will benefit patients and make best use of the services that we have available.

 

“Although having an increased risk of breast cancer means a woman is more likely to develop the disease – it’s by no means a certainty. A woman at high risk may never get breast cancer just as a woman at low risk still could. But any woman with concerns should speak to her GP to discuss the options.”

For more information on this work, you can read Cancer Research UK’s research paper here

Smashed Screen Films are to produce and direct a touching new short drama exploring love, identity and faith from a black woman’s point of view.  The story will be brought to life through three women of colour, Maia Waktins (writer), Chloe Tai (director) and Dominique Toussaint (producer), alongside co-producer and executive producer Nathan Adabadze.

Alpha and Omega will be set amongst the thriving multicultural epicentre of South London and will follow the story of Imani, a budding Rastafarian artist and health-stall owner, who upon learning of her diagnosis of breast cancer begins to question her faith, her relationship with her partner and what it really means to be a Rasta.

The film explores the conflict Imani has when she is forced to consider man-made treatments which goes against her faith and she has to evaluate her holistic lifestyle. This is a universal story about doubting your strength, facing your fears and the importance of relationships.

Maia Watkins, producer and lead actress

The film is inspired by writer Maia Watkin’s loss of her Godfather to cancer last year and coming from a Rastafarian family herself, the script is based on a world she knows very well, giving her great insight to not only bring this story to life but play the lead role with authenticity. Ms Watkin’s credits include starring in BBC’s East Enders and Channel 4’s The Educatoror as well as being a 3-time winner of the Monologue Slam UK.

Through this film Ms Watkins hopes to raise awareness of cancer and its devastating consequences, open up dialogue about how people cope with cancer and promote a better representation and understanding of Rastafari culture.

“I wrote this film first and foremost because I wanted to see untold stories on screen.      Having never seen Rastafari culture explored or represented in a positive light before, and coming from a Rastafari background myself, I wanted to portray a journey of consciousness and understanding of self through film, that is so rooted in the culture.”  Maia Watkins

The Lake Foundation is delighted to see this much-needed film produced. We believe it will provide an  engaging and effective way to raise awareness of cancer within the black community, addressing not only the myths but enabling discussion around some of the challenges that black women face when diagnosed with this serious condition.

You can help bring this story to life by supporting their IndieGogo fundraising campaign. You can also support them with in-kind donations or help promote the great work they’re doing. You can find out more about their work on Facebook and Instagram

“Alpha & Omega is a refreshing new perspective on the universal experience of fear, doubt and acceptance. Told through the eyes of a strong independent black woman, so rarely seen in film, but also entrenched in the Rasta culture barely explored in media, we have to make this film!”

Today, Cancer Research UK and Public Health England announced that a recent analysis of cancer data revealed that black women are twice as likely to be diagnosed with late stage breast cancer as their white counterparts. They found that 25% of black African breast cancer patients and 22% of black Caribbean patients had late stage disease compared to 13% of white patients.

The fact that black women are more likely to be diagnosed at a late stage has been known for some time and has also been observed in not just the UK but in the USA too. The Lake Foundation has conducted work in this area to explore the possible reasons behind this. In 2011, we carried out some qualitative research to explore black women’s beliefs about breast cancer and their help-seeking behaviour to determine whether these two factors may lead to delays in diagnosis. Overall our study suggested that, when it comes to seeking help, black women are quite proactive and there would be no delay in visiting their GP (doctor) if they noticed a breast lump; delays in visiting a GP could occur if black women experience other symptoms as they were less aware of these.

We also found that the following factors could delay help seeking in black women: other priorities such as family or work commitments; language barriers; lack of access to information; age (older people are more likely to delay visiting their GP); difficulty getting appointments; cultural insensitivy of the healthcare system, inaction by GPs; and a lengthy referral process. You can read more about this work on our research page (scroll to the bottom of the page).

National data suggests that black women are less likely to take part in the NHS Breast Screening Programme and this could be another reason for the late stage diagnosis. In 2011, our founder Abi Begho worked with Betterdays Cancer Care, the NHS and Cancer Black Care to determine why black women are less likely to attend breast screening and whether patient navigation could be an effective way of improving screening uptake in black women in Peckham and Lewisham. We found that, at the time, black women living in Lewisham and Peckham who were of screening (over the age of 50) were very mobile with many women being unreachable, on an extended trip abroad; having moved from their GP registered address or had relocated and lived abroad,  hence they missed their breast screening appointments. We found that patient navigation was effective at reaching women as numerous and extensive attempts were made to contact women and then support them to attend their screening appointments. You can read more about this work here

Finally, scientific research has also suggested that black women are more likely to develop a more aggressive form of breast cancer which grows rapidly, so this could explain some of the late stage cases. Studies also suggest that black women are more likely to develop breast cancer at a younger age.

This recent analysis by Cancer Research UK has reminded the nation that there is an issue around black women and breast cancer that needs to be addressed. We need to ensure that black women are aware of all the signs and symptoms of breast cancer and that they seek help quickly if they notice any of the symptoms. We also need to understand the biology of the disease and the best ways of detecting and treating the more aggressive forms of breast cancer.

So, the message to black women is:

• Be aware of all the signs and symptoms of breast cancer
• If you’re worried about any symptoms that you have, please visit your doctor as soon as possible
• Eat a healthy diet, keep active and maintain a healthy weight to reduce your risk of developing breast cancer
• If you’re aged 50 or over, consider accepting your invitation from the NHS to take part in breast screening
• Know your family history. If you have a strong family history of breast cancer you may be at an increased risk so visit your GP for some advice and information

A study published in the British Journal of Cancer has found that the effect of combined hormone replacement therapy (HRT) in increasing a women’s risk of developing breast cancer is likely to have been underestimated in previous studies.

HRT is used to treat the symptoms of menopause (hot flushes, mood changes etc) by replacing the oestrogen that is lost during a woman’s menopause. There are two type of HRT, oestrogen only HRT and combined HRT which is mixture of oestrogen and progestogen.

Over the years studies have identified that women using HRT have an increased risk of developing breast cancer but this was only felt to be a slight increase with many stating that the benefits of taking HRT outweigh the risks.  This new study has found that combined HRT actually has a bigger effect on breast cancer risk than was previously thought.

This New Study

This new  piece of work was part of the Breast Cancer Now Generations Study which was set up in 2004 to understand the causes of breast cancer. The full Generations Study is following 113,000 women in the UK for 40 years.

 For this research into the effect of HRT, 39183 women from the Generations Study were selected who were at menopausal age. These women had  been monitored for 6 years through questionnaires which asked a number of questions including questions about their HRT use.

After the six years of monitoring it was found that 775 of the 39,183 women had developed breast cancer. Statistical analysis revealed that women using combined HRT were 2.7 times more likely to develop breast cancer than those who had not used HRT. This applied to use of HRT for a median length of time of 5.4 years and when they explored longer use of HRT, so 15+ years of use, this increased to women being 3.27 times more likely to develop breast cancer. No overall increase in breast cancer risk was observed in women who used oestrogen only HRT.

They also found that the increase in risk returns to almost normal once combined HRT use is stopped. Researchers noted that after a year and also two years of ceasing to take combined HRT there was no significant increase in breast cancer risk.

How Did Other Studies  Result in an Underestimation of Risk?

The underestimation by previous studies occurred because of the way the studies were carried out. Previous studies didn’t comprehensively follow-up with women and document their use of HRT  (e.g. did some women  stop using HRT over the course of the research) nor did they determine the age at which women went through the menopause.  These oversights caused inaccuracies.

What Does this Mean for Women Considering Taking Combined HRT?

Baroness Delyth Morgan, the Chief Executive of Breast Cancer Now said:

“Whether to use HRT is an entirely personal choice, which is why it’s so important that women fully understand the risks and benefits and discuss them with their GP. We hope these findings will help anyone considering the treatment to make an even more informed decision.

 

“On balance, some women will feel HRT to be a necessity. But in order to minimise the risk of breast cancer during treatment, it is recommended that the lowest effective dose is used for the shortest possible time.

 

“The good news is that the increased risk of breast cancer begins to fall once you stop using HRT. “If anyone is at all worried about either HRT or breast cancer, we’d highly encourage you to speak to your GP.”

The Lake Foundation believes that women considering using the combined HRT should have a discussion with their doctor about the pros and cons and make an informed decision about whether to proceed with treatment. If you can avoid combined HRT we would recommend that you do so.

You can download the full research paper below.

We were recently asked about breast implants and mammograms and in today’s blog we thought we’d address this.

A mammogram is an X-ray that is used during the breast screening process to detect breast cancer at a very early stage and hence aims to give women with breast cancer the best chance of survival.  During a mammogram X-rays are passed through the breast in order to generate images (radiographs) of each breast. If a tumour, cyst or calcium deposits are present this will be detected as bright spots on the radiographs.

Image credit: Prague Beauty

When a woman has a breast implant (breast augmentation/ enlargement), the implant is inserted between her breast tissue and chest muscle or behind her chest muscle.  The implant may make a mammogram less effective at detecting breast cancer as it prevents the X-rays from penetrating the tissue properly and hence distorts the image. This can be overcome by a slight modification in the way in which the mammogram is performed which will allow as much of the breast tissue as possible to be visualised by the x-ray.