Intakes of alcohol and folate during adolescence and risk of proliferative benign breast disease.

OBJECTIVES: To examine the combined effect of alcohol and folate intake during adolescence on the risk of proliferative benign breast disease (BBD). METHODS: We used data from 29 117 women in the Nurses' Health Study II who completed both adolescent alcohol consumption questions in 1989 and an adolescent diet questionnaire in 1998. A total of 659 women with proliferative BBD diagnosed between 1991 and 2001 were confirmed by central pathology review. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CIs), adjusted for established risk factors of breast cancer. RESULTS: Adolescent alcohol consumption was dose-dependently associated with an increased risk of proliferative BBD (hazard ratio = 1.15 per 10 g/day consumption; 95% CI, 1.03-1.28). There was no significant association between adolescent folate intake and the risk of proliferative BBD. Stratified analyses showed that each 10-g/day alcohol intake during adolescence was associated with a 21% (95% CI, 1.01-1.45) increase in the risk of proliferative BBD among women with low folate intake during adolescence, which was not significantly different from the alcohol-associated risk among women with moderate and high folate intake during adolescence (P for interaction = 0.18). CONCLUSIONS: Adolescent alcohol consumption is associated with increased risk of proliferative BBD, which may not be reduced by increased folate intake during adolescence.

Enfoque comunitario y preventivo de las mastopatías / Community and preventive approach of the mastopathies

Las mujeres por el interés que prestan a su integridad física y espiritual, hacen especial cuidado de su salud y brindan atención a diferentes partes de su cuerpo. Constituyen motivo frecuente de consulta, procesos patológicos tanto benignos como malignos (mastopatías), que afectan el tejido mamario y son un problema de salud. Teniendo en cuenta la importancia del enfoque preventivo y comunitario de esta problemática, se realizó una revisión documental sobre el tema, con el objetivo de describir las acciones de salud dirigidas a la disminución de los indicadores de morbilidad y mortalidad por mastopatías. Se utilizaron para esto los métodos teóricos de análisis-síntesis e inducción-deducción(AU)

Women due to interest related to its physical and spiritual integrity, pay attention to its health and also t o different parts of its body. However, this is the frequent reason for consultation of the pathologic, benign and malignant (mastopathies) involving the breast tissue and are a serious health problem. Taking into account the significance of preventive and community approach to describe the health actions directed to decrease of indicators of morbility and mortality from mastopathies. Theoretical methods of analysis-synthesis and induction-deduction were used(AU)

Enfoque comunitario y preventivo de las mastopatías / Community and preventive approach of the mastopathies

Las mujeres por el interés que prestan a su integridad física y espiritual, hacen especial cuidado de su salud y brindan atención a diferentes partes de su cuerpo. Constituyen motivo frecuente de consulta, procesos patológicos tanto benignos como malignos (mastopatías), que afectan el tejido mamario y son un problema de salud. Teniendo en cuenta la importancia del enfoque preventivo y comunitario de esta problemática, se realizó una revisión documental sobre el tema, con el objetivo de describir las acciones de salud dirigidas a la disminución de los indicadores de morbilidad y mortalidad por mastopatías. Se utilizaron para esto los métodos teóricos de análisis-síntesis e inducción-deducción

Women due to interest related to its physical and spiritual integrity, pay attention to its health and also t o different parts of its body. However, this is the frequent reason for consultation of the pathologic, benign and malignant (mastopathies) involving the breast tissue and are a serious health problem. Taking into account the significance of preventive and community approach to describe the health actions directed to decrease of indicators of morbility and mortality from mastopathies. Theoretical methods of analysis-synthesis and induction-deduction were used

What effect, if any, does soy protein have on breast tissue?

Differences in breast tissue can be determined using breast-enhanced scintigraphy test (BEST) imaging. Minimal work in vivo has been done previously to determine the effects of soy protein on breast tissue. The authors' earlier work demonstrated reduction in inflammatory changes in breast tissue. This work was conducted to examine the effect of daily soy protein consumption on a larger group of women over the course of 1 year. Sixty-four premenopausal women were studied after initial BEST imaging evaluation revealed fibrocystic changes of the breast. Women were asked to consume a medical-grade soy protein on a daily basis, making no other dietary or lifestyle changes during that time. Each woman underwent BEST imaging 1 year later with the results compared to the initial findings. Women and their physicians reported a subjective reduction in both breast tenderness and fibrocystic disease (FCD). There was a nonstatistical reduction in both the average and maximal count breast activity following 1 year of daily soy consumption. There was a statistically significant reduction ( P < .01) in variability of tissue activity following 1 year of soy protein treatment. This is the first in vivo study looking at the effect of soy protein on breast tissue health. The findings are promising and showed both objective and subjective findings consistent with a reduction in fibrocystic disease of the breast. Further research is needed to confirm these findings in a greater number of women and to determine if soy protein has the same beneficial effect in atypia and breast cancer.

Noncontraceptive benefits and therapeutic uses of the oral contraceptive pill.

The oral contraceptive pill is one of the most extensively studied medications ever prescribed. The health benefits are numerous and outweigh the risks of their use. Definitive evidence exists for protection against ovarian and endometrial cancers, benign breast disease, pelvic inflammatory disease requiring hospitalization, ectopic pregnancy, and iron-deficiency anemia. It has also been suggested that oral contraceptives may provide a benefit on bone mineral density, uterine fibroids, toxic shock syndrome, and colorectal cancer. Minimal supportive evidence exists for oral contraceptives protecting against the development of functional ovarian cysts and rheumatoid arthritis. Treatment of medical disorders with oral contraceptives is an "off-label" practice. Dysmenorrhea, irregular or excessive bleeding, acne, hirsutism, and endometriosis-associated pain are common targets for oral contraceptive therapy. Most patients are unaware of these health benefits and therapeutic uses of oral contraceptives, and they tend to overestimate their risk. Counseling and education are necessary to help women make well-informed health-care decisions and improve compliance.

Risk factors for benign proliferative breast disease.

BACKGROUND: As part of a nested case-control study of benign proliferative breast disease (BPBD) conducted within the cohort of women participating in the Alberta breast screening programme, an analysis of all women who had a benign breast biopsy between 1990 and 1995 was undertaken to identify the epidemiological risk factors for BPBD. METHODS: The breast biopsies of all eligible women were re-reviewed by a panel of four pathologists using Page's classification for benign breast disease. Cases were 165 women whose biopsies, upon review, showed benign breast tissue changes ranging from sclerosing adenosis to atypical ductal hyperplasia. Controls were 217 women whose biopsies showed no evidence of any proliferative or neoplastic changes. In-person interviews were conducted with all study subjects. RESULTS: Women with >/=25% fibroglandular breast tissue density, as compared to women with <25% density, experienced nearly a doubling in risk of BPBD (OR = 1.91, 95% CI : 1.24-2.94). All other possible risk factors examined were not associated with BPBD. CONCLUSION: This study suggests that fibroglandular tissue density may be a risk factor, or marker, for increased risk of BPBD.

[Preliminary results of a screening programme by mobile units in the province of Liege]. / Résultats préliminaires d'une expérience de dépistage du cancer du sein par unités mobiles en Province de Liège.

The goal of the mass screening of breast cancer undertaken under the authority of the Province of Liège is to focus the action on rural communities. For this reason, mobile vans equipped with X-Ray dedicated units are used. The main difficulty of this programme is to reach a massive participation of the population. It varies up to now from 45% to 20% in the different visited villages. During the 42 first months of functioning, 16,207 mammographies were carried out in women aged from 40 to 69; 69 cancers were discovered in apparently healthy women plus 10 cases of epithelial hyperplasia with atypias. These first results are quite encouraging. The main task of this continuing programme will be to reach a better participation of the population.

[When are recommended breast biopsies carried out, and what information does the physician responsible for mammography receive? Experiences with 317 breast biopsy in a regional quality assurance project for screening mammography]. / Wann werden empfohlene Mammabiopsien durchgeführt, und was erfährt der mammographierende Arzt darüber? Erfahrungen mit 317 Mammabiopsien aus einem flächendeckenden Qualitätssicherungsvorhaben zur Früherkennungsmammographie.

In a regional quality assurance project for screening mammography (German Mammography Study), 27,335 women were screened in 40 participating, office-based mammography units from 1990-1992. Screening led to 317 biopsies with a positive predictive value of 0.33. All biopsy documentation available to the mammography physicians was analysed with a view towards biopsy interval and completeness of information fed back to the Mx physicians. Biopsy recommendations were acted upon in 29% of cases within 2 weeks. With the exception of the dignity Mx physicians were incompletely informed about biopsy results. The surgical procedure was known in the doctors' offices in 62% of the cases. Specimen radiographies were not done regularly. A pathology report was available overall in 42 of 106 malignant cases, respectively. With the exception of the histological diagnosis itself, no variable mentioned in the reports was documented completely. Only one third of the physicians received such reports routinely. Fail-safe information are requested by Mx physicians and can help them to better target biopsy recommendations. A (regional) quality assurance center should be made responsible to analyse the flow of information in mammography screening, to fill in gaps and to speed up professional cooperation.

The role of tamoxifen in the prevention and treatment of benign and malignant breast lesions: a chemopreventive.

Tamoxifen (Nolvadex) has been in use for over 20 years and currently is probably the most prescribed anti-cancer medication in the world. It is an orally effective, synthetic, non-steroidal, estrogen antagonist and agonist agent. In studies and trials it has been shown to have only limited side effects. It has produced regressions in women with fibrocystic changes, including precancerous ones, and in those with metastatic breast cancer, where its benefits were first observed. It has increased disease free survival (DFS) and overall survival (OS) rates when given as an adjuvant systemic type of therapy in women with early breast cancers, and it has reduced the incidence of contralateral breast cancers. In addition there are reports indicating its long term use, especially in postmenopausal women, may produce overall health benefits. Over the years an increasing body of data has emerged allowing for viable hypotheses about the possible use of tamoxifen in the prophylaxis of breast cancer, namely that when administered in long-term therapy it may reduce the incidence of breast cancer in women so treated, that it may provide overall health benefits, particularly in postmenopausal women, and that its benefits should far outweigh any risks from its relatively limited side effects. However, carefully designed and conducted clinical trials are needed to test the safety of tamoxifen and its ability to prevent breast cancer before it is advocated for the prophylactic treatment of healthy women to prevent breast cancer, even realizing the increasing magnitude of the breast cancer problem.

Noncontraceptive benefits of oral contraceptive agents. Patients should know the positive effects.

Physicians' role as teachers and counselors includes the responsibility to provide detailed and accurate information on the risks and benefits of therapy whenever a prescription is written. Inaccurate or overly negative communication, particularly from the mass media, may confuse patients trying to make an informed decision regarding use of oral contraceptives. Patients have the right to be informed of possible prevention of life-threatening disease and improvement of quality of life as a result of oral contraceptive therapy.

Caffeine inhibits development of benign mammary gland tumors in carcinogen-treated female Sprague-Dawley rats.

The purpose of this study was to assess the influence of caffeine on the incidence of benign mammary tumors in carcinogen (DMBA) treated female Sprague-Dawley rats. Four different animal models were used in these studies, i.e., the administration of DMBA to: [1] 55 day old virgin rats; [2] 53 day old ovariectomized, estrogen treated virgin rats; [3] 135 day old virgin rats and [4] 135 day old parous rats. A high incidence of benign mammary fibroadenomas was observed in each of the four animal models. In addition, in the estrogen treated ovariectomized animals, a high incidence of secretory mammary gland cysts was observed. Caffeine (500 mg/L drinking water) was administered daily throughout the study commencing 3-31 days after carcinogen treatment. Caffeine treatment significantly (P less than 0.05 to P less than 0.001) reduced the incidence of benign mammary fibroadenomas in the 55 day old virgin rat model (P less than 0.01), in the 53 day old estrogen treated ovariectomized virgin rat model (P less than 0.05 to P less than 0.001) and in the 135 day old virgin rat model (P less than 0.05). The number of benign mammary fibroadenomas was reduced by caffeine in the 135 day old parous rat model but this reduction was not significant (P less than 0.10). In addition, in the estrogen treated ovariectomized virgin rat model, caffeine significantly (P less than 0.05 to P less than 0.001) reduced the incidence of mammary gland cysts. Caffeine treatment either increased or had no significant effect on body weight gains, depending upon the animal model.(ABSTRACT TRUNCATED AT 250 WORDS)

Recommendations for the prevention of chronic disease: the application for breast disease.

Experimental and epidemiological evidence suggest that a diet with dietary fat as low as 20% of kcal may be necessary to reduce the risk of breast cancer. Two groups of women, postmenopausal women treated for breast cancer and premenopausal women with cystic breast disease accompanied by cyclical mastaligia, participated in an intervention program to determine the feasibility of such a low-fat diet. After 3 mo of intervention both groups were consuming a low-fat diet; in the premenopausal groups serum estrogen levels decreased in response to the fat reduction. Other nutrition-education programs in research institutions, restaurants, and schools are attempting to influence the public's knowledge and behavior regarding the importance of dietary fat reduction.

Oral contraceptive use and the risk of breast cancer in women with a "prior" history of benign breast disease.

PIP: This article suggests that an improper definition of prior history of benign breast disease may be responsible for research results that show an increased risk of breast cancer among oral contraceptive (OC) users with such a history. It is maintained that women who developed fibrocystic breast disease in the 1960s-late 1970s despite longterm use of OCs were intrinsically at greater risk of breast cancer than nonusers who developed fibrocystic disease. Thus, it is improper in epidemiologic studies of OC use and the risk of breast cancer to define a prior history of fibrocystic disease as prior to the development of breast cancer or to corresponding reference ages of women without breast cancer. Rather, prior history should be defined as prior to the use of OCs. The article further analyzes the 3 major case-control studies of breast cancer that developed before 1978 that have suggested OC use increases the risk of breast cancer in women with a prior history of benign breast disease. In the 1st study, by Paffenbarger et al, the operational definition of prior history of benign breast disease appears to be prior to hospitalization for breast cancer. In the 2nd study, by Lees et al, a prior history was defined as prior to presentation at the clinic. In the 3rd study, by Brinton et al, a prior history of benign breast disease was defined as prior to the 1st screening. When stratification or adjustment for prior history of benign breast disease is restricted to disease that develops prior to any OC use, the epidemiologic studies fail to show that women with existing benign breast disease who initiate OC use alter their risk of developing breast cancer.^ieng