Stanford’s New Computer-Based Decision Tool for Women with BRCA Mutations

The following is taken directly from the above-referenced link:

Purpose and Intended Use:   This decision support tool is designed for joint use by women with BRCA mutations and their health care providers, to guide management of cancer risks. This tool is not intended to replace any aspect of medical care. Testing for BRCA gene mutations, and managing hereditary cancer risk, is a complex process which should be supervised by expert medical professionals. The goal of this tool is to inform discussion between providers and patients about options for reducing cancer risk.

Intended Population:   The decision tool calculates the probability of health outcomes for women ages 25-69 who carry a BRCA1 or BRCA2 mutation, and who have never had the following: 1) cancer; 2) screening mammograms or magnetic resonance imaging; 3) preventive surgery to remove breasts, ovaries or fallopian tubes; 4) preventive medications such as tamoxifen or raloxifene.

Assumptions Made:   The tool’s calculations result from a computer simulation model, not a clinical trial. The decision tool uses data from clinical studies of BRCA mutation carriers on cancer incidence and the efficacy of screening, preventive surgeries, and treatment, and data from the general United States population on survival according to breast cancer stage, hormone receptor expression, and grade. Long-term validation of the tool’s model-based estimates is warranted. Articles describing methods are available on the publications page. Medical terms (in red font) are defined by clicking on each term, and in the glossary.

Please click on the above link to find out more and to use the decision tool.

No pain, No Gain

Dag-blamitt! :-)  I’m still having significant pain issues.  Why does it take so long to heal?   I’m ready to start implementing changes and getting into a good fitness routine.  That’s hard to do when your body doesn’t yet want to cooperate.  Some things I can start implementing.  Now that I found my wallet, it’s time to revisit Trader Joe’s and get transitioned to a more macrobiotic/raw foods based diet.  I feel I’m just going to have to work through the pain, grin and bear it so to speak, as that may be the only way to heal.  I have to move the upper part of my body.  I think if I’d chosen a full mastectomy vs. skin-sparing, I wouldn’t have such pain issues.  I think the majority of the pain comes from the remaining skin bunching and adhering to the chest wall, basically scar tissue type pain.   Hopefully, I’ll get into the Star Program at Seton Hospital that my oncologist’s office has referred me to and start physical therapy to get me into better shape to start a good fitness program.

New Pre-Surgery Treatment Combination More Effective For Women With Triple-Negative Breast Cancer

Adding the chemotherapy drug carboplatin and/or the antibody therapy bevacizumab to standard presurgery chemotherapy increased the number of women with triple-negative breast cancer who had no residual cancer detected at surgery, according to results of a randomized, phase II clinical trial presented at the 2013 San Antonio Breast Cancer Symposium.

An increasing number of patients with triple-negative breast cancer are receiving chemotherapy before surgery, a treatment approach called neoadjuvant chemotherapy. In about one-third of these patients, no identifiable cancer cells are found in breast tissue and lymph nodes removed at surgery performed after the neoadjuvant chemotherapy. These patients are said to have had a pathologic complete response and have a much lower risk of cancer recurrence compared with patients whose cancers do not respond this well to the neoadjuvant chemotherapy.

“Our study was designed to find out if adding either carboplatin or bevacizumab to standard preoperative chemotherapy would increase the percentage of patients in whom cancer is eliminated before surgery,” said William M. Sikov, M.D., F.A.C.P., associate professor of medicine at the Warren Alpert Medical School of Brown University in Providence, R.I. “We are excited to report that adding either therapy significantly increased the percentage of patients in whom cancer was eliminated from the breast, and that adding both was even more effective.

“While our results show increases in pathologic complete response rates with both carboplatin and bevacizumab, we do not yet know how large an impact, if any, these differences will have on cancer recurrences or deaths. Although the study is not large enough to detect significant differences in these endpoints, we plan to follow patients for 10 years after their surgery to see if patient outcomes suggest long-term benefits from the investigational treatments.”  Click here ( to read the rest.

The above was taken from an e-mailed article sent through the Pink Ribbon Cowgirls.