Cancer Risk Increased by Excess Body Fat, Red and Processed Meats, and Alcohol

October 31, 2007 — There is convincing evidence that excess weight and obesity can increase the risk for 6 different cancers, including those of the colon, kidney, and pancreas, according to a report issued by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund. The second expert report, Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, considered to be the most comprehensive scientific analysis of cancer prevention and causation ever undertaken, also reported that there is convincing evidence that the consumption of alcohol, red meat, and processed meat elevates cancer risk.

"The most striking finding in the report is that excess body fat increases risk for numerous cancers. That is why body weight is the focus of our first recommendation," expert panel member W. Phillip T. James, MD, DSc, from the International Obesity Task Force, in London, United Kingdom, told journalists.

The document, which was written by an international expert panel, reviewed 7000 research studies over a 5-year period and classified the accumulated evidence for specific diet-cancer links. It is the second one to be published in the past 10 years and provides the most inclusive evidence to date linking cancer risk to diet, physical activity, and weight.

Although cancer is considered to be a disease of genes that are vulnerable to mutation, evidence indicates that only a small number of cancers are inherited, write the experts. Instead, it appears that environmental factors are the most important, and these can often be modified with a resultant reduction in risk. These factors include tobacco use, infectious agents, radiation, industrial chemicals, pollution, medications, nutrition, physical activity, and body composition.

One of the strongest findings in the report was that excess body fat is associated with an increased cancer risk and can increase the risk for 6 different types of the disease: colon, kidney, pancreas, adenocarcinoma of the esophagus and endometrium, and postmenopausal breast cancer. They also reported that alcohol is convincingly linked to a number of cancers, including those of the colon, breast, esophagus, and mouth, larynx and pharynx.

To combat excess weight and maintain a healthy body-mass index, the experts recommend limiting the intake of energy-dense foods, particularly those that are highly processed. These products tend to be high in sugar and fat and low in fiber. They also advise increasing physical activity and getting some exercise for at least 30 minutes a day. Physical activity not only helps individuals keep excess weight off, but it helps reduce the risk for cancer in its own right.

Evidence has also increased since the first report, issued in 1997, which links the consumption of red meat (beef, pork, and lamb) to colorectal cancer. The panel's recommendation is to limit the consumption of red meat to 18 ounces per week because, beyond this amount, evidence shows that for every additional 1.7 ounces of red meat consumed per day, the risk for cancer rises by 15%.

Their recommendation concerning the consumption of processed meats is even more stringent. Processed meats, such as bacon, ham, sausage, and lunch meat, should be avoided entirely; the panel was unable to find a level at which the consumption of these products can be reliably considered completely safe. For every 1.7 ounces of processed meat consumed per day, the risk for colorectal cancer rises by 21%.

Evidence also indicates that the majority of diets that are protective against cancer are made up primarily of foods of plant origin. Higher consumption of several plant foods might offer protection against cancers of various sites.

"We are recommending 5 servings or more of vegetables and fruit daily because, like physical activity, they pack a double whammy against cancer. Probable evidence indicates that they help reduce cancer risk on their own and, as low energy-dense foods, they help maintain a healthy weight, which the evidence shows has a big influence on cancer risk," Dr. James said during a press conference.

The panel also looked at factors that included birth weight, childbearing, breast-feeding, and adult height and found that they all can influence the risk for cancer. High birth weight is associated with an increased risk for premenopausal breast cancer, which is likely linked to excess body fat and the resultant hormonal changes.

Exclusive breast-feeding appears to offer protection for both mother and child. It can help lower the risk for breast cancer in women and also lower the risk of becoming overweight and obese in children.

"The evidence is uniformly strong on breast-feeding, and the fact that it offers cancer protection to both mothers and their children is why we made breast-feeding 1 of our 10 recommendations to prevent cancer," said expert panel member Walter J. Willett, MD, PhD, from the Harvard School of Public Health, in Boston, Massachusetts, at a press conference.

The panel also found an association between adult height and cancer risk. Tall adults appear to have a higher risk of colorectal and postmenopausal breast cancer, and there is some evidence linking tallness to an increased risk for ovarian, pancreatic, and premenopausal cancer.

The recommendations made in this report are applicable to cancer survivors when appropriate and unless otherwise advised by their healthcare practitioner. Because increasing numbers of cancer patients survive their disease and live long enough to develop new primary cancers or other chronic diseases, the expert panel believes that these recommendations can help reduce the risk.

Recommendations for Cancer Prevention

1. Be as lean as possible within the normal range of body weight.

2. Be physically active as part of everyday life.

3. Limit consumption of energy-dense foods; avoid sugary drinks.

4. Eat mostly foods of plant origin.

5. Limit intake of red meat; avoid processed meat.

6. Limit alcoholic drinks.

7. Limit consumption of salt; avoid moldy cereals (grains) or pulses (legumes).

8. Aim to meet nutritional needs through diet alone.

9. Mothers should breast-feed; children should be breast-fed.

10. Cancer survivors should follow the recommendations for cancer prevention.

World Cancer Research Fund/American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. Washington, DC: AICR; 2007

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WEIGHT GAIN INCREASES RISK

Oct 23, 2007

CHICAGO - Women who put on a lot of weight at any stage of adulthood increase their risk of   breast cancer likely because the hormone estrogen accumulates in the acquired fat and promotes tumors, researchers said on Monday.

Women who became overweight or obese had 1.4 times the risk of breast cancer compared to women whose weight remained stable or declined, their study found.

"The present findings indicate that the relations of adult weight gain to breast cancer is evident throughout the entire adulthood life span rather than being limited to a specific time in life," Jiyoung Ahn of the U.S. National Cancer Institute wrote in the Archives of Internal Medicine.

"These findings may reinforce public health recommendations for the maintenance of a healthy weight throughout adulthood as a means of breast cancer prevention," Ahn wrote.

The nearly 100,000 women in the study reported their weights at age 18, 35, 50 and now. Of them, 2,111 developed breast cancer.

On average, women in the study gained more than 34 pounds during their adult lives, roughly evenly divided in the ages between 18 and 35, 35 and 50, and 50 and their current age, while 8 percent maintained their weight.

"Women who gained weight or were overweight or obese were more likely to develop advanced disease or hormone receptor-positive tumors," Ahn wrote.

The relationship between weight gain and breast cancer is complicated, researchers say, because the timing of estrogen exposure and levels of the hormone can be hard to pinpoint.

In this study, for instance, weight gain was less of a risk factor among women who began menstruating relatively early in life or who took hormone-replacement therapy during or after menopause — both of which acclimated their bodies to more estrogen.

Women in the study who lost weight during their adult lives did not have a lower risk of breast cancer, unlike indications of such an association reported in some earlier studies.

But the study did conclude that weight gain at any stage of adulthood increased breast cancer risk. Some earlier studies have suggested the riskiest time to put on weight was after menopause, when a woman's ovaries stop producing estrogen and fat cells become the primary source of the hormone.

It was unclear from the study whether modest weight gains increased the risk of breast cancer.

In the United States, there will be an estimated 178,000 new cases of breast cancer this year, with 40,000 deaths.

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MORE WOMEN CHOOSING 'PREVENTATIVE DOUBLE MASTECTOMY'

 
Oct. 23 (HealthDay News) -- Women diagnosed with breast cancer who have a mastectomy are increasingly choosing to have their other, healthy breast removed as a preventive measure.

The rate of the procedure, called a contralateral prophylactic mastectomy, more than doubled from 1998 to 2003, according to a new study.

The increase concerns study lead author Dr. Todd Tuttle, chief of surgical oncology and associate professor of surgery at the University of Minnesota Medical School. He believes many women may be making the choice for inappropriate reasons, and removing the other breast may be unnecessary.

"We don't know why women are choosing this," he said. "If they are choosing it because they think it will improve their breast cancer survival, I am very concerned. It won't improve their overall survival."

Research has failed to show a survival benefit with the second mastectomy, Tuttle said in his report, published online Oct. 22 in the Journal of Clinical Oncology. The reason: The risk of cancer spread from the original breast to other body sites often exceeds the risk of getting cancer in the second breast, he said.

Tuttle and his colleagues evaluated 4,969 women who chose contralateral prophylactic mastectomy, looking at the Surveillance, Epidemiology and End Results (SEER) database. From 1998 to 2003, the rate of preventive mastectomy for the second, healthy breast increased from 4.2 percent to 11 percent. Those most likely to choose the preventive operation were younger women and non-Hispanic whites.

Tuttle said there are times when a second mastectomy is appropriate. "I will tell patients to consider it strongly if they have a known genetic mutation -- BRCA1 or 2 [the so-called breast cancer genes] -- or a very strong family history, such as first-degree relatives who develop breast cancer before age 50," he said.

"Sometimes, we will recommend it in those who need mastectomy on one side and because of body symmetry issues, the other breast would be too big" once the cancerous breast is removed, he added.

Tuttle's advice is in line with advice from the Society of Surgical Oncology and the American Cancer Society. Many women overestimate their risk of getting cancer in the second breast, according to the Society of Surgical Oncology.

In March, a study led by researchers at Wake Forest University found that most women diagnosed with breast cancer who also chose to have their unaffected breast removed said they didn't regret their decision. And they said their quality of life equaled that of women who chose not to have a preventive mastectomy, according to the study in the Journal of Clinical Oncology.

Dr. S. Eva Singletary, professor of surgical oncology at the University of Texas M.D. Anderson Cancer Center in Houston, said the increase in requests for the preventive mastectomies found in the new study "rings true clinically" for her patient population.

Singletary credits the increase in second mastectomies to "an improvement in breast reconstruction techniques," among other factors. Women who opt for immediate reconstruction after a mastectomy may be more likely to choose contralateral mastectomy and get the second breast reconstructed at the same time, sometimes to achieve better symmetry, particularly if they are heavy, she said.

In another study, published last week in the American Journal of Epidemiology, researchers reported that increased exposure to sunlight, which boosts vitamin D levels, may reduce the risk of advanced breast cancer in light-skinned women.

The study compared 1,788 breast cancer patients in San Francisco with a control group of 2,129 women who did not have breast cancer. The study participants had a wide range of natural skin colors. Vitamin D may help slow breast cancer cell growth, the researchers speculated. But the results aren't an endorsement to sunbathe. Instead, they said, vitamin D from diet and supplements may someday be recommended to help reduce breast cancer risk.

SOURCES: Todd Tuttle, M.D., chief of surgical oncology and associate professor of surgery, University of Minnesota Medical School, Minneapolis; S. Eva Singletary, M.D., professor of surgical oncology, University of Texas M.D. Anderson Cancer Center, Houston; Oct. 22 2007, Journal of Clinical Oncology, online; The Society of Surgical Oncology, Arlington Heights, Ill.; American Cancer Society, Atlanta
Publish Date: October 23, 2007

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 NEW CHEMOTHERAPY DRUG GETS APPROVAL FOR BREAST CANCER

Oct. 18 (HealthDay News) -- A new chemotherapy drug called Ixempra has received U.S. Food and Drug Administration approval to treat women with advanced breast cancer who haven't responded to three other types of chemotherapy.

The drug, made by Bristol-Myers Squibb Co., was also approved for use with the chemotherapy drug capecitabine (brand name Xeloda) for treatment of women with breast cancer that's spread to other parts of the body, the Wall Street Journal reported.

Ixempra was granted priority review status by the FDA. This status, which cuts four months off the standard 10-month drug review time, is given to products that are considered to be an advance over existing therapies on the market.Ixempra, which belongs to a new class of drugs called epothilones, is designed to stop the growth of cancer cells. It does this by targeting a protein called tubulin that helps cells proliferate, the Wall Street Journal reported.

Bristol-Myers also is studying the use of Ixempra to treat earlier-stage breast cancer, as well as ovarian, prostate, renal, pancreatic and non small cell lung cancers.

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Oct. 9 (HealthDay News) -- The size and shape of a woman's hips may affect her daughter's breast cancer risk, an international group of researchers report.

The study of 6,370 Finnish women found that breast cancer rates were nearly three times higher among those born to mothers with relatively wide hips, and nearly seven times higher among women born to mothers with wide hips who’d already given birth to one or more children.

A woman was more likely to develop breast cancer if her mother’s intercristal diameter (the widest distance between the wing-like structures at the top of the hip bone) was more than 30 centimeters (11.8 inches). The risk of breast cancer was also higher if these wing-like structures were rounded, the team said.Breast cancer risk was 2.5 times higher for daughters of women in whom the widest distance was more than three centimeters greater than the distance at the front, said the American, British and Finnish researchers.

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DOCTORS DEBATE WHETHER TOXIC CHEMO IS BETTER THAN ALTERNATIVE

Oct 8, 2007

WASHINGTON – Breast cancer survivors may face increased risk of heart disease — and doctors are debating whether it is time largely to abandon a chemotherapy mainstay that is one reason.

Drugs called anthracyclines are a breast chemo staple despite a well-known risk: They weaken some women’s hearts. What is new is research that suggests the drugs work no better than safer alternatives for most women.It is a controversy born of success: Treatment advances are allowing more women than ever to beat breast cancer, and some 2.4 million survivors are alive in the United States today. Now a move is under way to determine just how many are vulnerable to heart disease because of their cancer battle and how to help those who are.

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NEW BREAST CANCER TREATMENT CLOSER TO CLINICAL TRIAL

10/01/07

Science Daily — University of Manchester researchers have developed new ways of controlling and treating breast cancer.

Dr Robert Clarke and his team at the University's Cancer Studies research group have been investigating human breast cancers for the presence of stem cells - cells that generate new tumours and can cause the cancer to recur - in a series of studies funded by the charity Breast Cancer Campaign.

One third of women who are successfully treated for breast cancer find that the disease recurs some years later because some of these cancer cells survive the treatment and begin to grow again.The team's research into these 'breast cancer stem cells' revealed that the cells are stimulated by the Notch gene. The team, who published the study in Journal of the National Cancer Institute, is now hoping to develop new drug therapies to target this gene and thus stop the growth of any surviving breast cancer stem cells.

One drug that is known to attack Notch is already used for the treatment of Alzheimer's Disease so, having undergone health and safety checks, its clinical trial for use on breast cancer patients could be sped up and lead to a treatment in hospital clinics within a few years. Herceptin, by contrast, took more than 15 years to go from the discovery of its gene target to treatment.The team is also aiming to identify other new pathways of controlling breast cancer stem cells by using a genetic library to shut down other genes at random to see how it affects them, in a study with Rene Bernards at the Netherlands Cancer Institute.

The team, along with Professor Tony Whetton, are using a state-of-the-art mass-spectrometry based proteomics facility at the Paterson Institute of Cancer Research to identify proteins that control breast cancer stem cells. The facility - one of only a few in the UK - enables them to break up breast cancer stem cell proteins and analyse the sequence of amino acids to identify novel proteins that control the cells' growth.

Dr Clarke says: "Our work has revealed the importance of several pathways not previously known to regulate stem cell survival and self-renewal, which is tremendously exciting. Inhibitors of signalling pathways that regulate cancer stem cells could represent a new therapeutic modality in breast cancer, to be used in combination with current treatments in the near future."

This research is being presented at the National Cancer Research Institute conference in Birmingham October 1, 2007.

The University of Manchester team includes Professor Robert Clarke, Dr Gillian Farnie and Professor Nigel Bundred  and Dr Keith Brennan.

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WINE, BEER, SPIRITS BOOST BREAST CANCER RISK EQUALLY

Sept. 27 (HealthDay News) – Three or more drinks a day boosts a woman’s risk for breast cancer by 30 percent. And it doesn’t seem to matter which form of alcohol – wine, beer, or spirits – is consumed, researchers report.

“The majority of previous studies have found an association between alcohol and elevated breast cancer risk,” said lead researcher Dr. Yan Li, an oncologist at Kaiser Permanente in Oakland, Calif. What hasn’t been as clear, she said, is how much alcohol raises the risk and whether one type of alcohol boosts that risk more than another.

Li tackled those questions with Dr. Arthur Klatsky, an investigator at the Kaiser Permanente Division of Research in Oakland and a long-time researcher on the health benefits and risks of alcoholic beverages. Klatsky is due to present the team’s findings Sept. 27 at the European Cancer Conference in Barcelona, Spain.The researchers first evaluated the drinking habits of more than 70,000 women, all members of the Kaiser Permanente HMO. The women had undergone health exams during the years 1978 to 1985. By 2004, more than 2,800 women had experienced a breast cancer diagnosis.

Comparing the women’s drinking habits to the incidence of breast cancer, the team found that women who drank between one and two alcoholic drinks a day increased their risk of breast cancer by 10 percent compared to light drinkers – defined as those who drank less than one drink a day.

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EDUCATION LINKED TO CANCER DEATHS

Sept. 13 (HealthDay News) -- If you have a college degree, you have up to a 76 percent reduced risk of dying from cancer, a new study found.

Higher education lowers the risk for black and white women and men, according to the report in the Sept. 11 online edition of the Journal of the National Cancer Institute.

"Cancer mortality varies a great deal for all cancers by individual level of education," said study co-author Elizabeth Ward, the American Cancer Society’s director of cancer surveillance. "If we could get everyone's cancer mortality to the level we see among the best educated, it would make a huge impact on cancer in the United States."

Education is tied to socioeconomic status and access to medical care, Ward noted. The new study finding makes it clear that many of the factors that influence cancer mortality are preventable, she said.

"They are preventable by social policies -- things we can change, such as smoking prevention, access to cancer screening and opportunities to good nutrition and physical activity," Ward said.In the study, Ward and her colleagues used data from death certificates and the U.S. Census Bureau to look at the associations between education level and death rates from lung, breast, prostate and colorectal cancer. The researchers collected data on 137,708 cancer deaths from 2001 involving black and white men and women between the ages of 25 and 64.

The researchers found that more education was associated with lower death rates from cancer among all race and gender groups. The greatest difference was found between people with 12 or fewer years of education and those with more than 12 years of schooling, Ward's team found.Compared with those with the lowest levels of education, those with the highest levels of education cut their risk of dying from cancer. For the highest educated white men, the risk was cut by 48 percent, for white women it was cut by 76 percent as it was for black men, and the most educated black women had a 43 percent lower risk of dying from cancer, the researchers reported.This difference in cancer deaths is most likely due to a relationship between education and other factors directly associated with risks of developing and dying from cancer, such as smoking, cancer screening, and access to health care, the researchers speculated.

Although cancer death rates were higher among blacks than whites with the same level of education, they were almost the same for black and white men with zero to eight years of education, the researchers said."The difference between blacks and whites is most certainly due to socioeconomic conditions and access to care," Ward said.

Sholom Wacholder, an epidemiologist with the National Cancer Institute and author of an accompanying editorial in the journal, thinks the study findings account for some -- but not all -- cancer disparity rates between blacks and whites.

"I asked myself if I could use this data to figure out the difference between blacks and whites in cancer mortality," said Wacholder. "And the answer is that it is probably not possible."

The problem is that there are too many unanswered questions, Wacholder said. "We can't answer the question whether additional education by itself is the explanation or whether people with access to education have lower cancer mortality beyond the effect of education," he said.

SOURCES: Elizabeth Ward, Ph.D., director, cancer surveillance, American Cancer Society, Atlanta; Sholom Wacholder, Ph.D., National Cancer Institute, Bethesda, Md.; Sept. 11, 2007, Journal of the National Cancer Institute, online
Publish Date: September 13, 2007

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Study: MRI scans might prevent breast cancer progression

WASHINGTON (Reuters) -- MRI scans may offer a new way to detect breast cancer at its earliest stages, European researchers said Thursday.Details of a German study show that magnetic resonance imaging was better than standard mammograms, a type of X-ray, at detecting a nonmalignant tumor called ductal carcinoma in-situ, or DCIS. This could give surgeons time to remove the lesion before it can turn cancerous.

The findings, published in the Lancet medical journal, suggest that MRI should be tested in more women to see whether it should become a standard screening tool, said Dr. Carla Boetes and Dr. Ritse Mann of the Radboud University Nijmegen Medical Centre in the Netherlands. "Although these results were unexpected, the pathophysiology of breast cancer provides ample justification for the findings," they wrote in a commentary in Lancet.

Boetes and Mann noted that autopsy results show that about 9 percent of women have undetected DCIS, and that almost all malignant breast cancer is believed to start out as DCIS.

"MRI should thus no longer be regarded as an adjunct to mammography but as a distinct method to detect breast cancer at its earliest stage," they wrote.

Dr. Christiane Kuhl, a radiologist at the University of Bonn and colleagues studied 7,319 women over five years for their study, which was also presented in June to a meeting of the American Society of Clinical Oncology.

MRI found DCIS in more than 90 percent of the 167 women with the condition, while mammograms only found 56 percent of DCIS cases.

"MRI could help improve the ability to diagnose DCIS, especially DCIS with high nuclear grade," Kuhl's team wrote.

Too soon to recommend

But Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society, said it is far too soon to use MRI routinely for breast cancer screening.

"The American Cancer Society recommends that MRI screening be done annually in addition to mammography starting at age 30 for women at high risk," Saslow said in a telephone interview.

"For the most part, these are women who have had either a genetic test or found a mutation (that puts them at high risk of developing breast cancer), there is a mutation in the family, or there is a strong enough family history that would lead you to think that the risk of having a mutation is pretty high," she added.

Women who already have had breast cancer have only a moderate risk of a recurrence and are not necessarily candidates for MRI, Saslow said. The reason is that MRI is expensive -- $1,000 to $1,500 per scan -- and has a high rate of false positives, meaning it detects lesions that are harmless.

"Sometimes doctors will think they see something. With MRI it is not clear-cut," Saslow said. "Some of those women are choosing to have mastectomies."

And having an MRI does not save women from undergoing the uncomfortable mammogram process, as MRIs are always done alongside mammograms, Saslow noted. "Mammography still finds things that an MRI doesn't," she said.

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SHORTER COURSE OF RADIATION ACCEPTABLE FOR SOME BREAST CANCERS

Jun 3

By MARILYNN MARCHIONE, AP Medical WriterSun

Women with early-stage breast tumors can undergo a shorter course of radiation without a greater risk that their cancer will come back years later, the largest study to test this suggests.

The results are good news for women who must quit work or travel far to receive the five-week, daily treatments usually given."This is very disruptive to your life. If we could achieve the same outcome with less frequent visits to the radiation center ... this would be a tremendous benefit," said Dr. Julie Gralow of the Fred Hutchinson Cancer Center in Seattle.

Gralow was not involved in the study, but reviewed and discussed it at a meeting Sunday of the American Society of Clinical Oncology.

Most of the 180,000 breast cancers diagnosed each year in the United States are the type this study addressed — still confined to the breast. The usual treatment is surgery plus chemotherapy or hormone therapy, followed by radiation to prevent a recurrence.

Dr. John Dewar of the University of Dundee in Scotland led a two-part study of nearly 4,500 women in the United Kingdom to test shorter courses of radiation.

Women received either the standard 50 Grays, the unit used in measuring radiation, in 25 treatments spread over five weeks, or roughly 40 Grays given in 13 treatments every other day for five weeks or in 15 treatments over three weeks.

Five years later, cancer recurrence rates were low for all groups, ranging from 2 to 5 percent. So few recurrences occurred — 158 — that doctors believe the treatments are equivalent but cannot say so with certainty.

Many will want to see what happens to these women with longer follow up, said Dr. Gary Freedman of Fox Chase Cancer Center in Philadelphia. He is testing a shorter course, too, and noted that in the United States, most doctors give a total of 60 to 64 Grays — the standard 50 plus a boost dose directly to the tumor area.

Lisa Warren is a patient who received the shorter course in Freedman's study. Warren, 46, lives nearly an hour's drive from the cancer center and was eager when the short course was offered.

"I was all for that," she said. "Seven weeks is a long time to be running back and forth. Mentally and physically, it's very draining."Gralow, whose Seattle clinic sees many Alaskan women who must travel great distances for treatment, said she would consider the shorter treatment in such situations.

"This is very exciting news for our patients," because many women around the country live in rural areas or are elderly and must have someone drive them to get care, she said.

Shorter treatment had another benefit: less swelling or shrinkage of breast tissue and less enlargement of blood vessels as a side effect of radiation.

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HERCEPTIN REDUCES NEED FOR MASTECTOMY

June 4, 2007 BBC NEWS

Using the cancer drug Herceptin before surgery could reduce the number of mastectomies needed in women with breast cancer, scientists say.

A study showed using the drug with chemotherapy before surgery completely eradicated tumours in 43% of patients with HER-2 positive breast cancer.

This was almost twice as many as for patients treated only with chemotherapy - 23% of these showed the same effect.

The findings were reported to the American Society for Clinical Oncology.

Herceptin is currently used after surgery in women with HER-2 positive breast cancer to prevent tumours returning.

About a quarter of the 44,000 breast cancer patients in the UK each year have HER-2 positive tumours, which are particularly aggressive and likely to return.

Normally women with large tumours are treated with chemotherapy to shrink the tumours so that operations can be performed with less risk of having to remove the whole breast.

In the new research scientists studied 228 patients with HER-2 positive breast cancer.

115 patients received chemotherapy plus Herceptin for one year, and 113 patients received chemotherapy alone, before surgery.

Taking Herceptin made the shrinking more likely, as well as eradicating the tumours completely in many cases.In 38% pf patients tumours which had spread to other parts of the body were also removed.

Professor Alex Markham, Cancer Research UK's senior medical advisor, said it was encouraging that the cancer was eradicated from the lymph nodes of some patients.

He said the results of the study were exciting, but he added that it had only included a relatively small number of patients.

Long-term survivalDr Andrew Wardley, consultant medical oncologist at Christie Hospital, Manchester, said the results added to the already substantial evidence supporting the use of Herceptin.He said: "This is very welcome news for patients with a particularly aggressive form of breast cancer, some of whom will no longer face the prospect of losing their breasts."

He added that treating cancer early with Herceptin to eradicate it could have important implications for long-term survival.

The research was carried out by cancer organisation Group SOLTI, and drug manufacturer Roche.

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