Guest Blog Post: What Causes Breast Cancer?

Dr. James Holland is the Distinguished Professor of Neoplastic Diseases at the Icahn School of Medicine at Mount Sinai and his leadership is instrumental in the development of the T.J. Martell Memorial Laboratories in the Icahn School of Medicine at Mount Sinai.

Although there has been wonderful progress in diagnosing breast cancer in the last 35 years using physical exam, sonography, mammography and magnetic resonance imaging, and in surgery, substituting lumpectomy for radical mastectomy, and sentinel node biopsy for wide dissection, and in radiation therapy, hormone therapy, chemotherapy and immunotherapy, so that the majority of women are now cured of this common disease,  little research has been done on finding one or more causes that makes this disease so common.

Recognized inherited genetic factors account for less than 10% of cases. The T.J. Martell Memorial Laboratories in the Icahn School of Medicine at Mount Sinai has a deep program exploring a viral cause for human breast cancer. Breast cancer in mice is known to be caused by a mammary tumor virus (MMTV).  We have found a virus 90 to 95% identical to MMTV which we have named HMTV, in 40% of the breast cancers in American women.  We can infect other cells with it, indicating HMTV is alive and active.  It is not in the normal tissues of the patient, thus excluding genetic inheritance, but rather is acquired after birth.  The distribution of the virus in breast cancers around the world (high in the USA, low in China for example) parallels the content of MMTV in the different species of mice which varies widely.

The work will continue until we provide rock solid proof that HMTV causes human breast cancer, which then opens up new means of prevention and therapy.  And none of this would have happened without Martell Foundation support.

Guest Blog Post: Mammography – A Limited Tool for Early Detection of Breast Cancer

Dr. Margaret Cuomo is the author of “A World Without Cancer: The Making of a New Cure and the Real Promise of Prevention.”

Margaret I. Cuomo, M.D. is a Board-certified radiologist; Board member, Lesscancer; Author, ‘A World Without Cancer;’ and T.J. Martell Foundation Women of Influence honoree. She wrote the following post on this week’s mammography report for HuffingtonPost.com, which we excerpt below:

Mammography has been the gold standard for early detection of breast cancer since the 1970s but has been surrounded by controversy more recently. In 2009, the United States Preventive Services Task Force (USPSTF) recommended that routine screening mammography begin at age 50, and that screening should be optional for younger women. Mammograms performed every two years, rather than annually, was advised for women of average risk of breast cancer.

The American Cancer Society, American College of Radiology, and others opposed the USPTF recommendations and supported annual mammograms and also advised annual mammography for women younger than 50.

This week, a study in Cancer by Blake Cady, M.D., of Massachusetts General Hospital in Boston, and co-authors reported that annual mammography has a definite survival benefit for young and older women:

Regular screening increases the likelihood of detecting nonpalpable cancers (cancers that cannot be detected by physical examination), and annual screening further increases the likelihood relative to biennial screening.

These authors also analyzed breast cancer and non-breast cancer deaths by age and discovered that half of all breast cancer deaths occurred in women younger than age 50, and 69 percent before age 60.

What Dr. Cady and his colleagues are not examining is the effect on cancer risk due to the radiation exposure of annual mammograms beginning at a young age.

Other scientific studies have reported on the radiation risk from screening mammography in women younger than age 50, especially among women with a family history of breast cancer, or a genetic predisposition. [1] While these studies have admitted a risk of cancer due to annual mammograms, the public’s perception is that the risk is small compared with the benefit in saving women’s lives. [2] [3]

We can all agree that mammography is a limited screening tool at best. It is time to engage in an intensive, focused research effort to discover the specific biomarkers that will assess a women’s breast cancer risk and identify those patients most likely to benefit from a specific molecularly-targeted therapy. A non-invasive test that is sensitive and specific for the early detection of breast cancer is a goal worthy of our investment and dedication.

Mammography will remain a controversial issue because it is an imperfect tool involving ionizing radiation. Let’s move beyond this method that is decades old and move forward with an early detection method for breast cancer that will not increase a women’s cancer risk at all. The National Cancer Institute, American Cancer Society and research institutions across the U.S. could join in a collaborative effort to achieve this goal so that our daughters and granddaughters will have a safer, more intelligent approach to breast cancer screening.

For the full article, please click here.