FRIDAY, May 16 (HealthDay News) -- A simple blood test to check levels of circulating tumor cells can help doctors more accurately assess how well treatments are working in women with metastatic breast cancer, according to a Georgetown University Medical Center study.

"It can take several weeks, and sometimes months, to determine if a particular cancer treatment is working, because it can take that long to observe any significant radiographic changes in tumor size or appearance," principal investigator Dr. Minetta Liu, of Georgetown's Lombardi Comprehensive Cancer Center, said in a prepared statement.

"Right now, we have to rely on radiology studies such as CT scans, ultrasound, and the like to determine whether or not there is disease progression. With this new blood test, we have another reliable tool that may allow us to determine much sooner if a therapy is ineffective, so that we can change therapy earlier and potentially make more significant improvements in survival," Liu explained.

In this study, Liu and colleagues measured the number of circulating tumor cells (CTC) in blood samples collected from metastatic breast cancer patients every three to four weeks. The women were receiving various treatments, including chemotherapy, endocrine therapy, and combination therapy with a biologic agent.

The researchers found that 71 percent of patients with a CTC count of five or greater had disease progression, compared with 66 percent of patients with a CTC count of less than five.

"A CTC count of five or greater at the time of restaging was associated with a 5.32-fold increase in a patient's chances of having disease progression compared to CTC counts of less than five," Liu said. "CTC assessments should be used as a surrogate marker for treatment efficacy and disease responsiveness. Changes in CTC results from less than five to greater than or equal to five over time may herald disease progression."

The findings were released online May 15 in advance of the annual meeting of the American Society of Clinical Oncology, in Chicago.

The study was funded by Veridex, LLC, which makes the technology used in this study to measure CTC levels. Liu has received payments from Veridex for speaking engagements.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

FRIDAY, May 16 (HealthDay News) -- After years of declining rates, the number of mastectomies performed on women with breast cancer is on the rise again, the Mayo Clinic now reports.

The increase coincided with heavier usage of magnetic resonance imaging (MRI) before surgery, according to the authors, who were expected to present their findings May 31 at the American Society of Clinical Oncology (ASCO) annual meeting, in Chicago.

Guidelines introduced in 1990 pronouncing that lumpectomy was equally effective as mastectomy for overall survival in women with early-stage breast cancer resulted in a rise in lumpectomies, also known as breast-conserving surgery, along with a decline in the number of mastectomies performed.

"But in the last 10 years, more changes have occurred in the preoperative work-up of breast cancer, and some of the changes have included the introduction of new imaging modalities such as MRI," senior study author Dr. Matthew Goetz, an assistant professor of oncology at the Mayo Clinic in Rochester, Minn., said during a May 15 teleconference. "There are also improved breast reconstruction options, as well as the introduction of genetic testing."

Previously published trials have shown that mastectomy rates may be increasing in general in the United States, Dr. Julie Gralow, an associate professor of medical oncology at the University of Washington, Seattle, added at the same news conference.

Dr. Richard J. Bleicher, co-director of the Breast Fellowship Program at Fox Chase Cancer Center in Philadelphia, confirmed this. "This is a real finding. This is not something that is isolated to Mayo. We see the same thing," he said.

Breast MRIs may detect cancer in more than one part of the breast, which, in turn, may prompt surgeons and patients to choose mastectomy over lumpectomy. MRIs also pick up noncancerous masses, which leads women to choose a mastectomy, even though the lesion doesn't need to be removed immediately.

The new research involved more than 5,000 patients with early-stage breast cancer who underwent surgery between 1997 and 2006. Information on whether an MRI was performed before surgery became available in Mayo Clinic records, starting in 2003.

In 1997, the mastectomy rate was 44 percent. That number declined to 30 percent in 2003, then rose again from 2004 to 2006, to 43 percent.

"That's similar to the rate seen in the late 1990s," Goetz said.

In 2003, 11 percent of women underwent MRI before their surgery; by 2006, that number had risen to 23 percent.

Fifty-two percent of all patients receiving MRI had a mastectomy, versus 38 percent of women who did not have an MRI.

Mastectomy rates in women who did not have an MRI also increased, from 28 percent in 2003 to 41 percent in 2006.

Nevertheless, Goetz said, "patients who had preoperative MRI were significantly more likely to undergo mastectomy."

But the greater sensitivity of MRI may, in fact, be a double-edged sword.

"Although there has been a lot of excitement about the sensitivity of MRI, there is a significant downside. We don't have evidence that MRI improves our outcome. What we do know is that it finds a lot of things that we don't know the significance of, and many aren't significant," Bleicher.

He added, "I would say this data is phenomenally important, because we're starting to take a step back about the excitement of MRI and look at it through more realistic non-rose-colored glasses."

"Future studies are needed to determine those factors most likely to influence changes in surgical management and whether the changes influence breast cancer outcomes or quality of life," Goetz said.

More information

The National Cancer Institute has more on surgery options for breast cancer patients.

MONDAY, May 12 (HealthDay News) -- A gene called COMT, already known for its role in schizophrenia, also plays a significant part in the dangerous obstetric complication known as preeclampsia, a new study finds.

Although the current study was done in mice, the researchers envision a time when the findings could be used as a test to identify women at risk of preeclampsia -- and even as a means of preventing the condition.

"This gene regulates the oxygenation of the placenta," explained lead researcher Raghu Kalluri, a professor of medicine at Harvard Medical School. "Preeclampsia is a pregnancy disorder where the placenta is hypoxic (isn't receiving enough oxygen)," he added.

Preeclampsia, which affects about 5 percent of all pregnancies, is a leading cause of sickness for pregnant women and their infants. Symptoms of preeclampsia include high blood pressure, protein in the urine and swelling.

The COMPT (catechol-O-methyltransferase) gene is involved in breaking out estrogen into a metabolite called 2ME (2-methoxyestradiol), which prevents a shortage of oxygen in the placenta. When the gene does not function properly, levels of 2-ME are reduced, setting in motion a series of events that lead to preeclampsia, Kalluri explained.

The report was published online in the May 12 issue of Nature.

In their current experiments, the researchers worked with mice that did not have the COMT gene, and therefore do not produce 2-ME. After 14 weeks of gestation -- equivalent to the third trimester of human pregnancy -- the mice developed high blood pressure and other symptoms of preeclampsia, the researchers found.

The mice also delivered their pups earlier than normal, with a high incidence of stillborn offspring. Once the pups were delivered, the mother's health return to normal, the researchers found.

However, when the mice were given supplemental 2-ME, symptoms of preeclampsia disappeared, Kalluri said.

Kalluri's team found that COMT levels were deficient, and 2-ME levels were also lower, in women diagnosed with preeclampsia.

Because 2-ME is found in the blood and urine, the researchers hope to use their finding to develop a urine test that would identify women at risk from preeclampsia, Kalluri said. "This can be designed as a urine strip test, like pregnancy tests are," he said.

In addition, giving 2-ME to women who have low levels of this protein may prevent them from developing preeclampsia, Kalluri said. "We can give back the missing amount to bring levels back to where they should be," he said.

One expert believes the results are promising, but said more work is needed before 2-ME could become either a screening test or treatment.

"This is an interesting and novel study, which gives insight into the pathophysiology of preeclampsia," said Dr. Arun Jeyabalan, an assistant professor in the division of maternal fetal medicine in the department of Obstetrics, Gynecology and Reproductive Sciences at Magee Women's Hospital, University of Pittsburgh.

Jeyabalan said that it will be sometime before these findings can be extended to patients. Using these findings to develop a screening test is something worth looking into, she added.

"Most of this work is of animals, and I think we have to be cautious before we extend these findings to humans," Jeyabalan said. "But it is something that is definitely worth testing in the future."

More information

For more about preeclampsia, visit the U.S. National Library of Medicine.

TUESDAY, April 29 (HealthDay News) -- Increasing levels of thyrotropin within the normal range may increase the risk of fatal coronary heart disease in women, a Norwegian study finds.

Thyrotropin, a hormone produced by the pituitary gland, is released into the blood and acts on the thyroid gland to stimulate its growth and function.

"Emerging evidence indicates that levels of thyrotropin within the reference [normal] range are positively and linearly associated with systolic [top number] and diastolic [bottom number] blood pressure, body-mass index and serum lipid concentrations with adverse effects on cardiovascular health," according to background information in the study led by Dr. Bjorn O. Asvold, of the Norwegian University of Science and Technology in Trondheim, and colleagues.

They examined the association between thryotropin levels and fatal heart disease in 17,311 women and 8,002 men without known thyroid disease, cardiovascular disease or diabetes at the start of the study.

During follow-up, 228 women (1.3 percent) and 182 men (2.3 percent) died of coronary heart disease.

"Of these, 192 women and 164 men had thyrotropin levels within the clinical reference range of 0.5 milli-international units per liter to 3.5 milli-international units per liter," the researchers wrote. "Overall, thyrotropin levels within the reference range were positively associated with coronary heart disease mortality; the trend was statistically significant in women but not in men."

"This study shows that coronary heart disease mortality increases in women with increasing levels of thyrotropin within the reference range," the researchers concluded. "These results indicate that relatively low but clinically normal thyroid function may increase the risk of fatal coronary heart disease."

The study was published in the April 28 issue of the Archives of Internal Medicine.

More information

The U.S. Food and Drug Administration has more about heart disease in women.