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Posted on: November 26, 2008

Cancer 'Older' than Sheryl & Christina

By Carley Ribet
CTW Features

Image courtesy A&M Records/Sheryl Crow

Celebrity breast-cancer survivors Christina Applegate and Sheryl Crow are the age of woman that most people associate with breast cancer. A new study reveals, however, that the disease is ageless.

According to a recent study conducted at the University of Michigan, more than half of breast cancer instances happen in women over age 65, though some have the perception that breast cancer is a "middle-aged disease."

As a result, experts at the University of Michigan Comprehensive Cancer Center, Ann Arbor, recommend women continue to receive yearly breast screenings through their 70s. "Women don't seem to take the risk of breast cancer as they get older seriously," says Kathleen Diehl, M.D., assistant professor of surgery at the University of Michigan Medical School. "A lot of women seem to think of it as a middle-aged disease, and as they get older, they anticipate that if they were going to get breast cancer, they would have already had it. Therefore, they aren't as careful about getting screened."

Contrary to what many believe, the risk of breast cancer increases with age, without drop-off until after age 84. Statistics show that more than half of breast cancer cases are diagnosed in women age 65 or older, and as many as 45 percent are diagnosed after age 70.

In addition, women who do not follow screening guidelines are often diagnosed when the cancer has progressed, and is thus more difficult to treat. Women who previously have been treated for breast cancer have not been diligent about getting regular breast exams. Recent studies have shown that survivors who continue to have their annual mammograms after age 65 significantly cut their risk of dying from the disease.

Specialists, including Diehl, are currently working on guidelines for screening older women. Until new guidelines come out, Diehl recommends all women continue to get screened for breast cancer past the age of 70 and at least up to age 85.

"The message I want every woman over age 65 to really understand is that they need to continue to take care of their health. They need to continue to be diligent about seeing their physician for health maintenance, including a breast, and about getting that mammogram done every year," Diehl says.

Urine Tests Prove Promising in Breast Cancer Detection

"Less invasive" and "earlier detection" are welcome phrases for any woman when it comes to breast cancer screenings. Recent findings may change the way the disease is detected, according to recent research conducted at Children's Hospital Boston by Marsha Moses, PhD., of the vascular biology program.

The presence of elevated levels of certain biomarkers, which indicate increased the growth of new blood vessels from pre-existing vessels, known as MMP-9 and ADAM-12, can be an early warning sign of breast cancer, and in some cases may show up before cancer is detected in a mammogram. These findings suggest that the way cancer is treated could be altered for people who show elevated levels of these biomarkers.

Essentially, Moses hopes that cancer will one day be treated like other chronic illnesses such as diabetes and cardiovascular diseases. With these new advances in technology, it might be possible to begin treating cancer before it starts to spread.

"The idea would be to catch cancer before it's a disease. Here's my fantasy: A doctor saying to a patient, 'You've got things in your urine that suggest you may have some cancer activity; we'd better check it out further,'" Moses says.

If the urine test is put into practice as an early indicator of cancer, it would accompany a mammogram. Currently, the problem with mammograms is the possibility of a false positive. In many instances there is a benign tumor and a biopsy is done when it is not necessary. By adding the urine test, physicians believe that they can determine whether or not a tumor is cancerous by looking at the levels of MMP-9 and ADAM-12 (biological enzymes believed to play a role in tumor-associated tissue remodeling) in the urine.

In Moses' small pilot study, 71 breast cancer patients were tested. Of those in the sample, 67 of them, or 94 percent contained ADAM-12. On the contrary, only 15 percent of the healthy urine samples had detectable ADAM-12, and they were at very low levels. ADAM-12 testing is not commercially available yet, because it needs further validation before it can be used clinically.

If these urine tests are proven effective, it could change the way cancer is dealt with as an illness. "We're going to discover as many key biomarkers as we can, then look to see how they can best be combined," Moses says. "We're not necessarily trying to replace existing tests, but to give clinicians more data so they can make informed decisions."