Inside Prevention

Five Things You Should Know About Environmental Links to Breast Cancer (Forbes, 12/7/2011)

Amy Westervelt's article on Forbes.com does a great job of parsing through the intricacies of the Institute of Medicine's new report, Breast Cancer and the Environment: A Life Course Approach. Here's an excerpt, including a quote from our president and CEO, Jeanne Rizzo:

In the absence of clear advice from the IOM, consumers might want to consider reducing their exposure to these chemicals. “The failure to take a precautionary approach may leave the public confused and even misinformed, as is evidenced by some of the initial media headlines about the report that say that chemicals are unproven to raise breast cancer risk, when the report itself indicated there are plausible reasons for concern,” Rizzo says.

Read the full article and share it with your networks or submit a comment.

Flight risk and radiation

Two days before Thanksgiving, and odds are you're traveling somewhere this week. If an airport is in your immediate future, you may have a new choice to make: full-body radiation scan or the dreaded pat-down.

Particularly if you've been exposed to a lot of radiation in your life (cancer survivors who've had radiation treatment, anyone who's had a lot of X-rays or CT scans, those whose jobs expose them to radiation), you might consider the pat-down.

Ionizing radiation is the best-established environmental cause of breast cancer. What's more, radiation's carcinogenic effects are cumulative over your lifetime. That cumulative concern led a pilots' union earlier this month to advise its members to skip the scan and go for the pat-down.

And while scanners may be considered "safe" by the federal government and FDA if correctly set up, monitored and used, the reality is that even X-ray equipment in health care settings, run by medical professionals, may be miscalibrated, malfunctioning or otherwise deliver an excessive dose of radiation accidentally.

Like the screening process itself, the choice to get a scan or a pat-down is a very personal decision. Whatever you decide is best for you this week, we wish you a happy, healthy Thanksgiving! May you and yours be well.

It's Time for Breast Cancer Prevention Month (Huffington Post, 10/12/2010)

Read Breast Cancer Fund President Jeanne Rizzo's opinion piece on the Huffington Post about why it’s time to move beyond breast cancer awareness to prevention—very timely as we’re all awash in pink this month. Here's an excerpt:

It's that pink time of year again, Breast Cancer Awareness Month. But when virtually every American has been touched by the disease, who among us is not aware of breast cancer? What we need is Breast Cancer PREVENTION Month, and a focus on identifying and eliminating the preventable causes of the disease so fewer people ever have to receive that life-changing diagnosis. What we need is a national breast cancer prevention plan.

We know that 1 in 8 women will be diagnosed with breast cancer, and that no more than 1 in 10 of them has a genetic history of the disease. We know that breast cancer rates have increased dramatically since the 1930s, when the first reliable cancer incidence data were established, and that, strikingly, the increase parallels the proliferation of synthetic chemicals. Today, approximately 85,000 synthetic chemicals are registered for use in the United States, more than 90 percent of which have never been tested for their effects on human health.

(Read the full article.)

New report catalogues chemical and radiation links to breast cancer

On the first day of what we at the Breast Cancer Fund consider Breast Cancer Prevention Month, we released the 2010 edition of our landmark report, State of the Evidence: The Connection Between Breast Cancer and the Environment.

What emerges from the latest scientific research is a clearer picture than ever of how exposures to chemicals and radiation affect breast cancer risk. From this evidence, we create a roadmap for a national breast cancer prevention plan.

Read the full report and explore online content at www.breastcancerfund.org/evidence.

Read an excerpt from our press release:

New Report Catalogues Chemical and Radiation Links to Breast Cancer
Scientists, health advocates call for national breast cancer prevention plan

San Francisco – A report released today by the Breast Cancer Fund presents a comprehensive summary of the scientific data on the environmental causes of breast cancer. The report catalogues the growing evidence linking breast cancer to, among other factors, synthetic hormones in pharmaceuticals, cosmetics and meat; pesticides in food; solvents in household cleaning products; BPA in food containers; flame retardants in furniture; and radiation from medical treatments. The report also highlights impacts on the most vulnerable populations (including infants, pregnant women, African-American women and workers), and outlines the policy initiatives required to develop a national breast cancer prevention plan.

The report, entitled State of the Evidence: The Connection Between Breast Cancer and the Environment, is the sixth edition published by the Breast Cancer Fund. “With each new edition of the report, the growing scientific evidence compels us to act to prevent breast cancer,” said Jeanne Rizzo, R.N., president of the Breast Cancer Fund. “This Breast Cancer Awareness Month, our message is clear: we must move beyond awareness to prevention.”

(Read full press release)

Toxins causing 'grievous harm,' cancer panel says (USA Today, 5/6/2010)

USA Today is also reporting this morning on the just-released President's Cancer Panel report, which highlights the cancer risk of environmental exposures:

Widespread exposure to environmental toxins poses a serious threat to Americans, causing "grievous harm" that government agencies have not adequately addressed, according to a strongly worded report released today by the President's Cancer Panel, a body of experts that reports directly to President Obama. ...

...Jeanne Rizzo, president of the Breast Cancer Fund, an environmental advocacy group, said the report was "a watershed that could transform federal policy not just on cancer, but on chemicals." (Read complete article.)

Lowering medical radiation risk

Amid growing concern about the cancer risk of improperly administered medical radiation, last month the Food and Drug Administration proposed new guidelines designed to prevent accidental radiation overdoses from the machines used for CT scans, nuclear medicine and fluoroscopy. But at a recent House subcommittee hearing, testimony made it clear the problem is bigger than can be solved by better technology – and that the focus on radiation safety must also include the risks of radiation from routine X-rays.

The New York Times – which in January ran a blockbuster series on radiation overdoses, reported:

Much of the hearing focused on CT scans, which are largely responsible for a sevenfold increase since 1980 in the average lifetime dose of diagnostic radiation. As evidence of their power, an abdominal CT scan “delivers approximately the same radiation as getting 1,500 dental X-rays,” said one witness, Rebecca Smith-Bindman, a professor of radiology, epidemiology and biostatics at the University of California, San Francisco.

Given the dangers of too much radiation, Dr. Smith-Bindman said, it is important that the lowest possible dose be given.

Higher-than-needed doses of radiation are all too common in medical imaging and are often due to inadequate training of personnel and inadequate regulation. Experts estimate that in many procedures the radiation dose could be cut as much as 50 percent without sacrificing image quality. The radiation dose for a mammogram has been reduced from 2 rads in the 1970s to 0.2 rads today, for example. The current law regulating radiology dates from 1981 and made the adoption of professional standards for radiology voluntary.

The Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy (CARE) Act currently in front of Congress would require states to meet minimum standards for quality assurance through licensing and training of radiology professionals. This act, sponsored by the American Society of Radiologic Technologists, would also ensure that patients undergoing all types of radiological procedures would have the same assurance of quality as patients who get mammograms currently do under the provisions of the Mammography Quality Standards Act. Requiring minimum training standards would reduce the need for repeated tests and improve the safety of radiologic procedures, thus reducing the risks of medical radiation.

FDA steps up radiation safety efforts

The terrible irony of medical radiation, be it mammography, X-rays, CT scans or radiation treatment, is that it not only diagnoses and treats cancer, it also causes cancer.

As individuals we weigh the risks vs. benefits. But we have no control over errors in treatment, which it turns out may be more common that anyone really knows. A gripping new series by the New York Times chronicles software flaws, improper training of radiation technicians, miscalibration of equipment and other errors that lead to overradiation, sometimes resulting in the patient's death.

Today the FDA stepped in to tackle CT scans, nuclear medicine and fluoroscopy, which deliver far higher doses of radiation than X-rays or mammograms. The agency's new proposal would require manufacturers to incorporate safeguards in the design of these machines to prevent overradiation.

According to the Times, no single agency oversees medical radiation, accidents are chronically underreported, many workers who have made mistakes during a patient's radiation therapy are still practicing, and, through a rather strict New York law, hospitals that report medical mistakes can have their identity shielded.

While today's news and the Times article focus on acute reactions to excess radiation, the long-term lifetime risk of cancer is also a serious concern -- a concern that we hope the FDA will address in the near future.

Some strides have been made, including the Breast Cancer Fund's successful passage of a California radiation standards law in 2005. Today's FDA announcement is good news, but we have far to go to ensure patients receive the lowest possible dose of radiation.

Mammography Screening: Are we asking the wrong question?

This week, the U.S. Preventive Services Task Force announced new mammography guidelines, moving the recommended age for women to receive their annual screenings from 40 to 50. Because mammography is one of the few tools available for breast cancer detection, the response from women across the country has been one of overwhelming frustration and anxiety.

With a mission to identify and eliminate the environmental causes of breast cancer, the Breast Cancer Fund has long been concerned about women’s exposures to ionizing radiation, the longest and best-established link to the disease.

The Breast Cancer Fund calls for a change in the national conversation about breast cancer detection, moving away from blanket guidelines and toward an investment in safer and more effective alternatives and in better understanding the causes of the disease.

This is a moment of opportunity to recognize the weaknesses in our current tools and fully invest in breast cancer prevention.

Read the Breast Cancer Fund’s complete position on the new mammography guidelines.

Final weekly roundup: Tips for breast cancer prevention

October has come to an end and so has our tip series for Breast Cancer Awareness Month. But, please remember that these helpful, everyday tips can still be found on the Breast Cancer Fund’s blog. We definitely encourage you to revisit these suggestions, written by Dr. Janet Gray, editor of the Breast Cancer Fund’s 2008 and upcoming 2010 State of the Evidence reports, and to look to the Breast Cancer Fund’s Web site and Facebook page for upcoming healthy living ideas.

Here’s a recap of this week’s tips for prevention:

• Avoid exposures to PAHs, whenever possible –- buy low-emission vehicles, maintain your car and avoid unnecessary exposure to tobacco smoke.
• Include soy and other vegetables in your regular diet, but avoid high-dose supplements of soy derivatives.
• Consult with your medical team to minimize your exposures to radiation –- the longest- and best-established environmental cause of breast cancer.
• Keep toys made with phthalates out of your children’s mouths and hands.
• Avoid use of synthetic hormone replacement therapies (HRT), especially progestin-estrogen combinations.

Taking individual actions toward reducing your everyday exposures to toxic chemicals and radiation is a step in the direction of breast cancer prevention, but stopping this disease before it starts also requires greater accountability by corporations and policymakers to protect our health and the health of our environment. Please continue to join us in important legislative initiatives, such as banning BPA from food and beverage containers, expanding the FDA’s authority to make sure cosmetics are safe, and creating a national health-tracking system to connect disease rates and pollution.

Thank you for taking time throughout October to share these tips with your family and friends. Your help has been a crucial piece in expanding the conversation about breast cancer to include prevention.

Your next mammogram may not be necessary

For forty-somethings: 120,000 doctors want you to stop and think about your next mammogram.

As reported last week in the Washington Post, the American College of Physicians (ACP), the largest medical specialty group in the country representing 120,000 internists, issued new guidelines urging women in their 40’s to consult with their doctors about whether or not to have mammograms.

The ACP believes the risks of mammograms including exposure to radiation, a known breast carcinogen, unnecessary biopsies, surgery and chemotherapy – may outweigh the benefits.

"All we're saying is that women should be informed about the risks and benefits so they can make a decision based on all the facts," said Douglas K. Owens of Stanford University, who chaired the committee that wrote the guidelines.

This flies in the face of the recommendations from the American Cancer Society and the National Cancer Institute. Both recommend mammograms starting at age 40.

BCF was thrilled to see the ACP encouraging women to take an active role in deciding if, when and how often they should schedule their mammograms.

Read the Breast Cancer Fund’s mammography position statement to get more info on radiation, risks, etc.