BreastNextTM is a next gen sequencing panel that offers a comprehensive testing panel for hereditary breast cancer and or ovarian cancer. BRCA, BRCA testing and genetic testing for breast cancer.
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My BRCA2 mutation isn’t a death sentence, but it has changed my life. Meet the group that’s helping me handle a reality that Angelina Jolie and millions more also face. By Abby Haglage.
Susan Zager's insight:
This has top be the WORST TITLE for an article. Calling a BRCA mutation an Angie gene? OMG. It's too bad the article has such an awful start because inside is an intersting look at FORCE a great organization about women facing what their risk is for breast and ovarian cancer. Delete the scoop?
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Quebec will review three quarters of their mammography machines for their effectiveness in detecting cancer
Susan Zager's insight:
This article talks about how in Quebec they are having to check 3/4 of thier mammoogram machines to see if they are working properly. Delete the scoop?
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Angelina Jolie had a mastectomy after being told there was an 87% chance she would develop breast cancer. How high is the risk for other women?
Susan Zager's insight:
This article is well worth reading to look at figures for the risk of getting breast cancer in England and other countries. I also attended a recent talk from a famous British doctor about how we treat much more breast cancer in an earlier state in developed countries because of the technology that detects things earlier. This along with age, is a factor in the statistic for certain countries. Delete the scoop?
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"Much has been written about the relationship between high medical expenses and the likelihood of filing for bankruptcy, but the relationship between receiving a cancer diagnosis and filing for bankruptcy is less well understood. We estimated the incidence and relative risk of bankruptcy for people age twenty-one or older diagnosed with cancer compared to people the same age without cancer by conducting a retrospective cohort analysis that used a variety of medical, personal, legal, and bankruptcy sources covering the Western District of Washington State in US Bankruptcy Court for the period 1995–2009. We found that cancer patients were 2.65 times more likely to go bankrupt than people without cancer. Younger cancer patients had 2–5 times higher rates of bankruptcy than cancer patients age sixty-five or older, which indicates that Medicare and Social Security may mitigate bankruptcy risk for the older group. The findings suggest that employers and governments may have a policy role to play in creating programs and incentives that could help people cover expenses in the first year following a cancer diagnosis. The financial burden of cancer can be substantial for patients and their families. Data from the Medical Expenditure Panel Survey suggest that $1.3 billion (6.5 percent) of the $20.1 billion spent on cancer care in the nonelderly population each year comes directly from the patients themselves.1 Deductibles and copayments for cancer treatments, supportive care, and related services, along with nonmedical costs such as child care and lost income, may be financially devastating, even for cancer patients with medical insurance.2"
Susan Zager's insight:
"Conclusion: This study found strong evidence of a link between cancer diagnosis and increased risk of bankruptcy. Although the risk of bankruptcy for cancer patients is relatively low in absolute terms, bankruptcy represents an extreme manifestation of what is probably a larger picture of economic hardship for cancer patients. Our study thus raises important questions about the factors underlying the relationship between cancer and financial hardship. Future studies that include information on patients’ financial and insurance status at the time of diagnosis and throughout their treatment will be needed to fully understand the relationship among cancer, financial difficulties, and bankruptcy. Also important is the impact of cancer on the patient’s ability to remain employed, since most health insurance is obtained through the workplace.24 These factors are particularly important in younger working-age populations, in which employment, income, insurance status, and personal assets vary greatly. We believe that cancer care facilities and oncology practitioners should assess the financial health of their patients as a matter of course. Because temporary inability to work is often unavoidable during therapy, patients and their families should be encouraged to make financial preparations to the greatest extent possible. More generally, this study underlines the importance for cancer care providers of carefully considering the use of services that have limited evidence of substantial benefit and potential high out-of-pocket costs. As a policy issue, there may be a role for employers and governments in creating programs or incentives to reduce the likelihood of financial insolvency, given that bankruptcies are “lose-lose” events for debtors and creditors alike. An example would be tax incentives to encourage employers to provide supplemental insurance policies with fixed sums to cover household and out-of-pocket expenses in the first year following a cancer diagnosis. Finally, future studies of cancer patients who declare bankruptcy should examine the impact of this event on their cancer-related outcomes and later ability to obtain health insurance and access to health care. Delete the scoop?
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"Jolie's announcement was an important reminder, however, for women and their doctors to look carefully at patients' family histories, Peshkin says. Women with BRCA mutations don't have to have surgery to reduce their breast cancer risk, she notes. Some opt for intensive screening instead. Jolie's revelation would have been important no matter what choice she made, Peshkin says. "There are a lot of women with suggestive family histories and doctors are not taking their history," Peshkin says. "The fact that she took this step is really, really important." Genetic counseling and testing are out of reach for many low-income or uninsured women, notes Karuna Jaggar, executive director of Breast Cancer Action, an advocacy group. Medicaid doesn't pay for BRCA testing, which can cost more than $4,000. Medicare limits coverage of genetic testing to people who have had cancer, Schlager says. And Peshkin says she hopes women won't think these surgeries, which pose risks such as pain and infection, are easy. And implants don't last forever. Four of 10 women who have a mastectomy need surgery within three years of getting implants, Jaggar says. And even women with insurance may not be able to take six weeks off to recover, Peshkin says."
Susan Zager's insight:
I think Angelina Jolie was very brave in her difficult decision and I am also glad she told her story herself before the press made a mess of it. It is also good that she is bringing to light the important issue of Myriad charging so much money for the BRCA gene test. The case is currently before the Supreme Court and I have scooped many articles about it because Myriad is trying to patent our genes and thanks to Breast Cancer Action and other plaintiffs in the case they are trying to stop Myriad from doing this. The test is so expensive and many people can't afford it on top of the fact that Myriad is preventing other companies from doing vital research about these genes known to cause high risk of breast and ovarian cancer. When I questioned the statistics about the risk involved I was in no way saying anything against Angelina Jolie personally and I was just noting that statistics are only as good as how the scientist sets up the equation and they are not an exact science. This is an awful genetic mutation and even though there are different numbers each case is different. For example if one carries a p53 genetic mutation and more family members have had the disease ones risk is higher. I met a wonderful new friend who had the preventive double mastectomy and still ended up with metastatic breast cancer. That is why I was questioning the numbers because I think it is so unfair that she did all she could and still got this awful disease. Also no matter what the statistics are they are still at very high risk and I would never go after someone personally for making such a difficult decision. I also had to face a similar decision when I had my recurrence after a lumpactomy, chemo and radiation so I am the last person to question anyones difficult choices when it comes to this disease. Delete the scoop?
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Even wealthy celebrity Angelina Jolie took note that the $3,000 cost to test for gene mutations that can increase the risk of breast cancer remains an obstacle for many women. Delete the scoop?
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Angelina Jolie was up and working with “bountiful energy” on her next film project just four days after having her double mastectomy, her surgeon said on Tuesday. Delete the scoop?
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"The American Society of Plastic Surgeons (ASPS) today announced its strong support of the "Breast Cancer Patient Education Act" (S. 931). This bipartisan legislation is being introduced today, coinciding with National Women's Health Week, in the U.S. House of Representatives by Reps. Leonard Lance (R-NJ) and Donna Christensen, M.D. (D-VI) and in the United States Senate by Sens. Roy Blunt (R-MO), Sherrod Brown (D-OH) and David Vitter (R-LA). Since 1998, health plans that offer breast cancer coverage have been required to provide coverage for breast reconstruction and prostheses. Yet published research shows that many women eligible for breast reconstruction following breast cancer, minorities in particular, are not informed of the variety of care options. Approximately 232,340 women will be diagnosed with breast cancer in 2013, according to the American Cancer Society's most recent estimates for breast cancer in the United States."
Susan Zager's insight:
This article talks about a wonderful bipartisan legislation that will help women especially minorities be informed of all of the options available when it comes to breast cancer surgery and reconstruction. Introduced by the ASPS (American Society of Plastic Surgeons) the "Breast Education Act" S.931 will be so helpful to women facing breast cancer and being informed of what choices are available to them. Delete the scoop?
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"Background: Phosphatidylinositol 3-kinase (PI3K) pathway activation has been suggested to negatively influence response to anti-HER2 therapy in breast cancer patients. The present study focused on mutations of the PIK3CA gene, encoding one of the two PI3K subunits.
Susan Zager's insight:
"Conclusion of the trial: These results confirm that the outcome of HER2-positive patients treated with trastuzumab is significantly worse in patients with PIK3CA-mutated compared with wild-type tumours." Delete the scoop?
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"Fears raised that waiting times will increase with expansion in number of women eligible and following Angelina Jolie revelation Women at high risk of breast cancer could be forced to endure long waits for genetic testing and extra screening for the disease because NHS services for such patients receive too little money, cancer experts have warned. Some experts in Britain's most common cancer are expecting the NHS to face increasing demand from women anxious about developing breast cancer and keen to be tested after actor Angelina Jolie revealed on Tuesday that she had undergone a double mastectomy that had reduced her risk of getting breast cancer from 87% to 5%. But fears have been raised that the NHS's 35 genetic testing centres, which test about 8,000 women for the BRCA genes – which can increase the risk of breast cancer by up to 80% – will not be able to cope with a planned expansion in the number of women eligible to go there."
Susan Zager's insight:
It is interesting to note how much fear has a great impact on women facing the terrible risk of getting breast cancer. This does not take away from Angelina Jolie's decision nor other women facing their risk. In light of Peggy Orensein's article, "Our Feel Good War on Breast Cancer" at: http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0 this just brings to light the points raised by Peggy in her article. Delete the scoop?
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Could blocking an androgen ( testosterone) receptor lead to a new way to treat an aggressive form of breast cancer?
Susan Zager's insight:
This is an intersting study looking at the relationship of adrogen (testosterone) recepters and triple negative breast cancer. Since TNBC can only be treated with chemotherapy unlike other pathologies in breast cancer this study is an interesting approach to looking for other ways to attack TNBC. This study showed the need for more studies in this area. Delete the scoop?
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"Rates of women who are opting for preventive mastectomies have increased by an estimated 50 percent in recent years, experts say. And surveys show they are happy with the decision. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring. Women can take tamoxifen or one of several newer drugs called aromatase inhibitors and reduce their risk by as much as 50 percent." Delete the scoop?
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"For women who already have the disease, the choice used to be whether to have the lump or the whole breast removed. Now there are more options that allow faster treatment, smaller scars, fewer long-term side effects and better cosmetic results. It has led to a new specialty — “oncoplastic” surgery — combining oncology, which focuses on cancer treatment, and plastic surgery to restore appearance.
Susan Zager's insight:
This article talks about new options for breast cancer surgery and the specialty called "oncoplastic surgery" which combines oncology and plastic surgery. It quotes Dr. Deanna Attai who is our #BCSM (breast cancer social media) community moderator (every Monday night on Twitter at 9PM EST) as well as a breast surgeon on the board of the American Society of Breast Surgeons talking about cosmetics. and some of the new approaches dicussed at their meeting earlier this month in Chicago. Delete the scoop?
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When is BRCA Genetic Testing for Breast and Ovarian Cancer Appropriate? Genetic testing for breast and ovarian cancer is not recommended, unless your family history suggests an increased risk for harmful >BRCA mutations.
Susan Zager's insight:
Here is great information from the CDC about who should consider genetic testing for breast and ovarian cancer. Delete the scoop?
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In India, mastectomy is a big stigma. So much so, even patients who are diagnosed with cancer don’t want to opt for it. They accept it with great difficulty, say doctors.
Susan Zager's insight:
Things are very different in India. This article is really interesting from the perspective of women in India. Delete the scoop?
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Gil Welch says women shouldn't worry after hearing about Angelina Jolie's double mastectomy -- 99% of women don't carry the gene that raises their cancer risk 
Natalie Palmer's curator insight,
May 18, 10:22 AM
This article is definitely worth reading as it helps to explain BRCA 1 and the risk... 
Susan Zager's comment,
May 18, 1:01 PM
This article is really good because it lets women know that this genetic mutation is not the norm. As the author so beautifully states: "Then I realized something was missing in her piece; something that should have been printed in big black letters:
NOTE: This story is not relevant to more than 99% of American women. Why? Because more than 99% of women do not have the BRCA1 mutation -- or the BRCA2 mutation, for that matter. Let's be clear, the BRCA1 mutation is a bad thing. Although I might quibble with the exact numbers in the piece, the big picture is this: the mutation increases the risk of developing breast cancer about five fold and increases the risk of ovarian cancer more than 10 fold. Delete the scoop?
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Many women facing similar risk as Hollywood actress may not know it unless they can pay more than $3,000, or family members were diagnosed with breast cancer at young age. Montefiore and Columbia researchers' lawsuit could help.
Susan Zager's insight:
This is so important that people know that truth about this test and how Myriad is trying to patent our genes involved with this test. Hopefully this will help with the case before the Supreme Court against Myriad and they will be ruled against so that this test can be affordable and more research in to known gene mutations can be done without Myriad trying to have a monopoly on the test. Delete the scoop?
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HOLLYWOOD star Angelina Jolie's decision to make public her very personal breast cancer surgery is attracting universal admiration and acclaim. Delete the scoop?
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"This blog describes the main stages of her treatment. It is important to emphasize that each woman’s case is different. Surgery will not necessarily be the right choice for everyone, and there are alternatives available. As Angelina says in her article, the important thing is to be aware of your options." Delete the scoop?
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"Campaign Center Inc. and Morgan are charged with deceiving thousands of donors into making charitable contributions to the breast cancer "charity" on false pretenses that the organization helped women fight and survive breast cancer. Donors were mislead into believing that their money would used to fund breast cancer research, mammogram screenings through a mobile van, and seminars and forums for survivors and their families, Schneiderman's office said.
Susan Zager's insight:
How horrible of this organization to take advantage of people by collecting for a false charity misleading donors that it would help women fight and survive breast cancer. What's even worse is that when these people were caught they continued to try to take advantage of New Yorker's to collect money for hurricaine Sandy. It reminds us to always investigate where our charitable dollars are really going. Delete the scoop?
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"Background: We demonstrated how to comprehensively translate the existing and updated scientific evidence on genomic discovery, tumour phenotype, clinical features, and conventional risk factors in association with breast cancer to facilitate individually tailored screening for breast cancer.
Susan Zager's insight:
"Altogether, these data suggest that only PIK3CA wild-type cancers clearly benefit from neoadjuvant trastuzumab therapy added to chemotherapy. On the other hand, the subgroup of patients bearing PIK3CA mutations could further benefit from treatment targeting PI3K pathway signalling (PI3K or its downstream major effectors; Kataoka et al, 2010; Tanaka et al, 2011; Jensen et al, 2012). Such treatment may be able to overcome the activation effect of PIK3CA mutations and block the PI3K pathway signalling. Our results support the importance of PIK3CA mutational status assessment in the management of future gene-based therapies (HER2, mTOR or PI3K inhibitors used alone or in combination) for HER2-positive breast cancer. In conclusion, these results confirm that PIK3CA mutations are a pejorative factor in HER2-positive breast cancer patients receiving trastuzumab. PIK3CA mutations should be assessed in clinical trials testing anti-HER2 therapies and, in the future, in clinical practice. Delete the scoop?
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"Studies have shown nearly 70 percent of patients with breast cancer do not discuss all surgical options with their surgeon before their initial surgery and that such a discussion significantly affects a woman's treatment decision1. To address this knowledge gap, the Search, Share, Spare campaign launched today to raise awareness about surgery options that spare a woman's breast while effectively removing cancer. The campaign encourages women facing breast cancer surgery to visit breastcancersurgeryoptions.com to search for information, share what they learn and spare their breast."
Susan Zager's insight:
This is a great article because it informs woman where to find information that will help them understand all of the factors involved when making decisions about surgical options for breast cancer surgery. Delete the scoop?
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Actress Angelina Jolie's medical revelation Tuesday brought the issue of breast cancer surgery into world headlines. The decision to get a preventive double mastectomy as Jolie did may seem extreme, but for women who are faced with a definitive risk of breast cancer, the decision has to do more with logic than emotion. Allison Dalton learned nearly every female relative in her mother's generation was dealing with breast or ovarian cancer. "All of the women who had breast cancer, except for my mother, ended up dying from breast cancer," Dalton said. Genetic testing at the age of 24 revealed Dalton also carried a genetic predisposition to these cancers. Three years ago, the now 41-year-old Dalton decided she didn't need to wait to be diagnosed. Like Jolie, Dalton wanted to be around to see her daughter grow up, so she had both her breasts surgically removed.
Susan Zager's insight:
As I mentioned yesterday in the articles about Angelina Jolie's personal choice based on her risk for being diagnosed with breast and/or ovarian cancer, the percentages can be different for women facing this choice when they carry the BRCA mutation.There is even another gene mutation known as p53 that can even raise a women's % of risk higher for getting breast cancer and other cancers. This is why genetic counseling with the genetic test is so important because every case is different and there are different factors that can have an effect on the numbers that are presented to the patient. According to this article: Breast surgeon Dr. Deanna Attai says every woman's risk will be different. "A woman who tests positive for BRCA gene mutation can have as high as a 60 to 80 percent chance of eventually developing a breast cancer. (For) those patients, prophylactic mastectomy is certainly indicated," Attai said. Women who test positive for one or two genes that predisposed them to cancer have other options besides prophylactic mastectomy, they can take Tamoxifen, which studies show can prevent some cancers, but not all. Women can also choose to watch and wait, which involves screening two to four times a year. "Surveillance, obviously, is not preventative, it's aimed at early detection," Attai said. "By close surveillance, we would usually include mammogram, ultrasound and MRI." Delete the scoop?
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Treating breast cancer almost always involves surgery, and for years the choice was just having the lump or the whole breast removed. Now, new approaches are dramatically changing the way these...
Susan Zager's insight:
We have great new approaches to surgery for breast cancer today. We now talk about "oncoplastics" offereing even newer options that combine oncology with plastic surgery to restore the appearance of the breast. Dr Deanna Attai, one of the great moderators of the #BCSM (Breast Cancer Social Media) Community meetings on Twitter every Monday night at 9PM EST and also on the board of directors for the American Society of Breast Surgeons which held its annual meeting in Chicago earlier this month said, "Cosmetics is very important" and can help a woman recover psychologically as well as physically. " The article continues with more options including making new choices of where to make the inscisions to avoid unsightly scars. Delete the scoop?
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Although I have put this article in before, in light of everyone talking about BRCA1 and BRCA2 genetic mutations, I think people may have missed this one talking about a comprehensive panel of tests for hereditary breast and ovarian cancer, and it would be interesting to take another look at this test.