3-D Doppler May Reveal Malignant Breast Lesions

According to an article in MedPage Today, in a group of women with suspicious breast lesions, 3-D power Doppler assessment of lesion vascularity had a 100% sensitivity and 86% specificity, Gerald L. LeCarpentier, Ph.D., of the University of Michigan, and colleagues reported in the November issue of Radiology.

If the results are borne out in larger studies, the imaging technique has the potential to spare some women from biopsies.

"Using speed-weighted 3-D power Doppler ultrasound, higher flow velocities in the malignant tumor-feeding vessels may be detected, whereas vessels with slower flow velocities in surrounding benign masses may be excluded," said Dr. LeCarpentier.

While additional study is required to confirm the potential, the small study using the hand-held 3-D Dopper device showed promise for the elimination of some surgical biopsies.

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Liver Cancer Survival Rates Predicted by Genes

In a study supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Cancer Institute, the Samuel Waxman Cancer Research Foundation, among others, it was found that in hepatocellular carcinoma, genetic analysis of the non-cancerous part of the liver can predict survival after surgery.

Gene-expression profiling of such tissue yielded gene signatures that were highly associated with both survival and late recurrence of the cancer, according to Todd Golub, M.D., of the Broad Institute, and colleagues.

On the other hand, the same approach applied to tumor tissue found no significant associations with survival, the researchers reported online in the New England Journal of Medicine.

The findings support the notion that late recurrence of liver cancer is not caused by proliferation of cancer cells left behind after surgery, but to a "field effect" in a liver damaged by environmental factors, Dr. Golub and colleagues said.

The research needs further validation before it's ready for the clinic, they said, but it may allow doctors to identify patients at the highest risk for recurrence and intervene earlier.

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Primary Care Relationship Impacts Cancer Screenings

According to MedPage Today, only about half of older Medicaid patients receive recommended screening for colorectal, breast, and cervical cancers, largely because their physicians don't recommend the tests, researchers here reported.

About half of eligible Medicaid patients had evidence of screening when medical record and claims data were analyzed together.

Previous studies have shown that Medicaid recipients are more likely to have an advanced stage of cancer at the time of diagnosis than patients with other sources of health insurance, the researchers said.

And other studies have found that patients with lower socioeconomic status have lower rates of cancer screening.

All patients in this study, however, had "access to primary care and full coverage of cancer screening services under Medicaid," the researchers said.

Read the rest of this article at MedPage Today.

Platinum Standard for Treatment of Small Cell Lung Cancer is Being Questioned

As reported by MedPage Today, platinum regimens caused significantly more nausea, vomiting, anemia, and thrombocytopenia, the investigators found.

"These data suggest nonplatinum chemotherapy regimens have a more advantageous risk-benefit profile," the authors concluded.

"This systematic review highlights the lack of quality-of-life data in trials involving chemotherapy treatment for [small-cell lung cancer]. With poor long-term survival associated with both treatment groups, the issue of the quality of the survival period takes on even more significance," they said.

Only three of more than two dozen studies included in the analysis reported data on quality of life, they added.

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Excess Weight and Insulin Increase Prostate Cancer Mortality

Multiple studies have indicated that obesity before or at the time of prostate cancer diagnosis increases the mortality risk. However, they have not attempted to explain the association, the authors said.

Among obesity-driven metabolic changes that could influence prostate cancer mortality, hyperinsulinemia stands out as a prime suspect, they continued.

Laboratory studies demonstrated that mice fed a high-energy diet gained weight, became hyperinsulinemic, had accelerated growth of prostate cancer xenografts, and had increased downstream signaling of the insulin receptor in neoplastic prostate tissue.

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Double Reading of Mammograms More Effective

The interpretation of screening mammograms by two readers (double reading) rather than by one reader increased the rate of cancer detection by 4 to 14% in several studies, and by 10% according to a meta-analysis. Double reading is standard practice in at least 12 European countries, but has not been widely adopted in the United States.

The use of computer-aided detection systems has the potential to increase cancer-detection rates. Thus, a single reader using computer-aided detection might be able to match the performance of two readers. Single reading with computer-aided detection could be an alternative to double reading and improve results of single reading.

Computer-aided detection systems use computer algorithms to analyze digital mammographic images. They identify and mark potentially suspicious regions to attract the reader's attention to features that might have been overlooked or dismissed as normal. In the United States, where single reading is standard practice, commercial computer-aided detection systems have been widely adopted to improve reader performance and are used in 25 to 30% of all mammogram readings. However, the benefit of computer-aided detection in screening mammography was recently questioned in an observational study by Fenton, et al, and remains controversial.

Read more about double reading and computer-aided detection at the New England Journal of Medicine

Hepatitis B Linked to Pancreatic Cancer

As reported by MedPage Today, a history of hepatitis B infection may be associated with the development of pancreatic cancer, researchers here said.

In a case-control study, patients with pathologically confirmed adenocarcinoma of the pancreas were more likely to have evidence of past hepatitis B than were matched controls, according to Manal Hassan, M.D., Ph.D., and colleagues at M.D. Anderson Cancer Center.

On the other hand, there was no association between pancreatic cancer and hepatitis C, Dr. Hassan and colleagues said in the Oct. 1 issue of the Journal of Clinical Oncology.

Dr. Hassan cautioned that the study shows only an association between the two diseases. "More research is needed to determine whether this relationship is one of cause and effect," she said in a statement.

To read the rest of this article, visit MedPage Today.