Young women with breast cancer in their family background who need treatment for the disease themselves need not worry that it will be any less successful for them as for women without a family history, suggests a study comparing sporadic versus hereditary breast cancer.
The authors say younger women have a greater fear of breast cancer recurrence than older women, and that those with a strong family history may have a high level of anxiety.

The large study published in the British Journal of Surgery offers a hopeful conclusion - that young patients "presenting to breast surgical clinics with a positive family history can be reassured that this is not a significant independent risk factor for breast cancer outcome."

The findings are from a large prospective cohort study - so had a strong scientific design for finding links between disease factors and outcomes - and involved 2,850 women under age 41 years who were diagnosed with breast cancer and treated in the UK.

Ramsey Cutress, an associate professor in breast surgery at the University of Southampton and University Hospital Southampton Foundation Trust in the UK, did the analysis with colleagues on data from the so-called POSH study (prospective outcomes in sporadic vs. hereditary breast cancer).

The team followed the women for 15 years to record personal characteristics, tumor characteristics, breast cancer treatment, disease-free periods and family history of breast and/or ovarian cancer.

No significant differences in rates of cancer returning after treatment were seen for women with a family history of breast cancer compared with those without.

Cutress sums up how this study means young women with experience of breast cancer in their family now have cause to be less worried:

"Successful treatment for breast cancer is just as likely in young patients with a family history of breast cancer, as in those without a family history.

Patients with a family history of breast cancer can therefore be reassured that their family history alone does not mean that their outcome will be worse."

The 2,850 women analyzed were those from 3,095 recruited to the POSH study who could yield data on whether or not there was a history in their family of breast cancer.

Two thirds of the patients reported no history, while a third reported breast/ovarian cancer in at least one first- or second-degree relative.

Such family relationships include parent or sibling for first-degree relatives, and uncle, aunt, grandparent and so on for second-degree.

Different cancer characteristics but similar chances of staying disease-free

The results for cancer characteristics showed that women with a family history were more likely than those without to have higher-grade tumors (to have grade 3 tumors - 63.3% versus 58.9%), and their tumors were more likely (28.8% versus 24.7%) to be negative for HER2 (human epidermal growth factor receptor 2) than in the women without heredity.

Women with breast cancer in their family background are more likely to have the disease - but no more likely to relapse after treatment, study finds.

The hereditary element of breast cancer cause in women with a family history is complex - background genetic etiology is "likely to be accounted for by a wide spectrum of genes and modes of inheritance," say the authors. However, they cite a simpler fact in reviewing previous evidence:

"Approximately 25% of breast cancers in developed countries are thought to be related to hereditary factors and these usually present at a younger age than sporadic breast tumors."

The study findings add some clarity for these younger women with family history thinking about the potential outcomes of their disease.

The similar outlook for them as for those without close relatives being diagnosed comes from the following percentage results.

The estimated distant disease-free intervals (DDFI) - measured as the time from the date of diagnosis of invasive breast cancer to distant relapse or death from breast cancer - were, for a 5-year period:

74.9% for the group without family history77.4% for women positive for family history.

The respective 8-year DDFI rates were 68.7% and 72%.

These comparable rates meant "no significant differences in distant disease-free intervals for patients with versus those without a family history," the authors report.

These results for the whole cohort of women remained true when they were stratified to different groups by estrogen receptor (ER) status.

In other breast cancer news last week, a report in the journal Radiology finds a potential role for magnetic resonance imaging (MRI) in breast cancer prediction.

Written by Markus MacGill

Breastfeeding is associated with a 30% overall decreased risk of breast cancer recurrence among women who have previously had one subtype of the disease, according to a new study published in the Journal of the National Cancer Institute.
Breastfeeding may make the breasts less susceptible to carcinogens, leading to slower growing tumors.

The team behind the new study, from the Kaiser Permanente Division of Research in Oakland, CA, claims that this is the first study to examine the role of breastfeeding history in cancer recurrence.

The new study is part of ongoing research in breast cancer from the Kaiser Permanente team. Last year, the team discovered that patients with specific HER2+ breast cancer tumors have a low risk of cancer recurrence within 5 years of diagnosis. In 2013, they found that consuming high-fat dairy products following diagnosis of breast cancer increases likelihood of dying from the disease.

In the new study, the team found that breastfeeding appeared to improve outcomes of women diagnosed with the luminal A subtype of breast cancer.

Women with these cancers had a 30% decreased risk of breast cancer recurrence if they had a history of breastfeeding. Breastfeeding mothers were also found to be 28% less likely to die from luminal A breast cancer. The protection was found to be strongest for women who had a history of breastfeeding for 6 months or more.

However, no significant improved outcomes for women with other subtypes of breast cancer were associated with breastfeeding.

Why does breastfeeding have a protective effect for women with luminal A cancers?

Luminal A tumors are the most commonly diagnosed of breast cancers. These tumors generally have better outcomes than other tumor subtypes as they are less likely to metastasize and can be treated with hormonal therapy, such as tamoxifen or aromatase inhibitors.

Marilyn L. Kwan, PhD, research scientist with the Kaiser Permanente Division of Research and lead author of the study, explains a potential mechanism behind the protective effects of breastfeeding for women with these cancers:

"Women who breastfeed are more likely to get the luminal A subtype of breast cancer, which is less aggressive, and breastfeeding may set up a molecular environment that makes the tumor more responsive to anti-estrogen therapy."

"Breastfeeding may increase the maturation of ductal cells in the breast," hypothesizes senior author Bette J. Caan, "making them less susceptible to carcinogens or facilitate the excretion of carcinogens, and lead to slower growing tumors."

In 2014, Medical News Today reported on another study published in the Journal of the National Cancer Institute, which observed that African-American women who had four or more births and who never breastfed had a 68% higher chance of developing breast cancer compared with women who had only one birth but who breastfed their child.

A 2013 study published in the Journal of Clinical Nursing also found that women who breastfed for over 6 months were less likely to develop early breast cancer than women who did not breastfeed.

In that study, by researchers at the University of Granada in Spain, women who did not breastfeed were found to get breast cancer 10 years earlier on average than breastfeeding mothers.

However, that study also found that smoking appeared to counter the protective effects of breastfeeding. Female smokers were diagnosed with breast cancer at a younger age and had no significant benefit from breastfeeding.

The University of Granada team suggested that hormonal changes taking place during pregnancy and lactation could be responsible for the protective benefits of breastfeeding.

Written by David McNamee

Founding members of Our Bodies Ourselves in the late 1960s / Photo: Ann PopkinBy Guest Contributor | March 6, 2015
“She’s Beautiful When She’s Angry” filmmaker Mary Dore and Our Bodies Ourselves founders discussed the critically acclaimed documentary and OBOS’s place in the women’s movement following a recent screening in Boston (video is available). OBOS founder Norma Swenson later wrote this reflection; read more reactions in the comments.
The founders are hosting an event May 3 in the Boston area to continue the conversation the film sparked about the women’s health movement, both then and now.
by Norma Swenson
As we approach International Women’s Day, viewing “She’s Beautiful When She’s Angry,” Mary Dore’s remarkable, unique film on the women’s movement, feels perfectly timely. We are encouraged to remember our roots on IWD, and this film opens it all up, especially little-known parts from the recent past.
I was thrilled to see “She’s Beautiful When She’s Angry” at the Coolidge Theatre with the filmmaker and founders of Our Bodies Ourselves. I’ve always had a special interest in documentaries and use them to teach students and to inspire audiences to action. Because so much of the footage was scarcely ever seen before, “She’s Beautiful When She’s Angry” stands as a work of scholarship about the beginnings of second-wave feminism and social history. The scenes and interviews are exhilarating; there is simply nothing else like it.
Women and Their Bodies cover (1970); later renamed “Our Bodies, Ourselves”
This is the first film about second-wave feminism to illustrate clearly the distinctions between what became the global women’s health movement and how, as a movement, we were somewhat distinct from what most would call mainstream feminism — closer to roots in women’s liberation. No other documentary thus far has done that.
It explains the place of “Our Bodies, Ourselves” in providing a feminist guide to women’s health and medical care, while providing a bibliography and lexicon for who was organizing and how to organize for local and national change.
Just as it is almost impossible to explain what life was like before television, it is also difficult to realize now that the most important work done in the early, radical days of the women’s movement was done before computers or the internet. There were no websites, no Skype. We paid a lot for long-distance phone calls, and overseas we could only trust crude, thermal-paper faxes.
All the organizing and labor was given freely, with few paid expenses — though being paid, and paid equally, was on the list of Second Wave demands.
The connectivity of modern communication and social media was still a ways off. All we saw at the time was what commercial media chose to show the American public. This film reveals what we did not clearly see while it was happening: a vast landscape of historic change in human consciousness. Most who lived it are still among the living.
My mother was 8 years old when women won the right to vote and electricity came to the immigrant farming community where she was born. By the time I was a mother, she was president of a women’s rights organization. One of the high points of “She’s Beautiful When She’s Angry” is the tribute paid and the link made to that first wave, which started with such a sweeping agenda and ended after not quite a century with the single, narrow goal of giving women the right to vote.Learn more about Our Bodies Ourselves founders and history >
First-wave feminists also smiled when they marched, as we see in Mary Dore’s film, but we know they were also very angry and endured extreme violence. Whenever I see the White House fence on TV, I imagine Alice Paul’s ghost still chained to it, as I learned from the film “Iron-Jawed Angels.” My mother had been dead for more than a decade before I realized she had been quoting Paul when she said during a speech, “Deeds, not Words!”
On the back of an early edition of “Our Bodies, Ourselves” is a picture of a smiling Florence Luscomb, suffragist and MIT grad, standing next to a “Feminism Lives” banner. It was taken a few years before her death. Many of us feel linked to those activists, in one way or another.
I remember marching down Huntington Avenue going west, starting from the Boston Public Library, holding one side of the Our Bodies Ourselves banner, realizing I was not warmly enough dressed for the stiff breeze. I cannot say now when, or what for, we were marching. I carried the OBOS banner again for the 2004 March for Women’s Lives in Washington, D.C., with my new partner holding the other side.
In Brazil’s São Luís do Maranhão, I marched with local women past a police station, because a woman had been raped by one of the officers who then accused her of lying. We carried defiant, hand-made signs tied to sticks. I will never forget the heart-stopping drums of the tribal groups that greeted us marching into the opening ceremonies at the Nairobi Conference at the close of the UN Decade of Women in 1985, or the Indigenous People’s Aztec drummers welcoming attendees in 1983, at the first UN Human Rights Conference since 1948.
“She’s Beautiful When She’s Angry” shows us the new generation of emerging young women protesters, with different styles and voices. They have figured out that upcoming generations have to keep fighting if they want the rights and gains won in the past to be alive and robust for them when they need them.
It’s all in the film. Let’s hope it will be seen, everywhere.
Norma Swenson, a founding member of Our Bodies Ourselves, has worked with colleagues throughout the United States and globally to help define and create the field known as women and health. Read her full bio.
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“She’s Beautiful When She’s Angry” Articles & Reviews
As Dore shows us protests, street theater and consciousness-raising meetings, the effect is to be thoroughly transported back to a heady time when “the personal is political” was a revelatory statement rather than a bumper-sticker slogan. This is another success of the film: It makes clear how new and tenuous this all was. – Rebecca Jacobson, Willamette Week
The timing couldn’t be better for “She’s Beautiful When She’s Angry,” a celebratory but clear-eyed documentary history of the 1970s women’s movement. - Ty Burr, Boston Globe
There was an energy to the activism. It’s that era’s passion and sense of purpose that [Mary Dore] has sought to reclaim in her new film … – Loren King, Boston Globe
While there have been dozens, if not hundreds of books that cover similar terrain, few films have been so encompassing or ambitious. – Erin Trahan, WBUR