MONDAY, Oct. 22 (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.

More information

To learn more about contralteral prophylactic mastectomy, visit The Society of Surgical Oncology  .

MONDAY, Oct. 22 (HealthDay News) -- About 60 percent of the protection provided to women by exercise against heart disease and stroke comes from its effect on a few specific risk factors, says a U.S. study in the journal Circulation.

Researchers assessed cardiovascular risk factors and exercise levels in more than 27,000 women, ages 45-90 (average age 55) enrolled in the Women's Health Study who were followed for more than 11 years for new diagnosis of heart attack and stroke.

Women who exercised the most were 40 percent less likely to have a heart attack or stroke than those who did the least amount of exercise.

"Regular physical activity is enormously beneficial in preventing heart attack and stroke," lead author Dr. Samia Mora, instructor of medicine at Harvard Medical School in the divisions of preventive and cardiovascular medicine at Brigham and Women's Hospital in Boston, said in a prepared statement.

"We found that even modest changes in risk factors for heart disease and stroke, especially those related to inflammation/hemostasis and blood pressure, can have a profound impact on preventing clinical events. This study is the first to examine the importance of a variety of known risk factors in explaining how physical activity prevents heart disease and stroke," Mora said.

The Harvard team found that exercise-related changes in inflammatory and hemostatic biomarkers -- fibrinogen, C-reactive protein and intracellular adhesion molecule-1 -- had the largest impact, lowering heart attack and stroke risk by 33 percent.

"Inflammatory and hemostatic factors as a group have overlapping functions and roles and, in our study, had the biggest effect in mediating exercise-related cardioprotection, more so than blood pressure or body weight," Mora said.

Exercise-related improvement in blood pressure was the second most important (a 27 percent reduced risk), followed by lipids (blood fats), body mass index, glucose abnormalities, kidney function, and homocysteine.

Due to a lack of clinical evidence, the inclusion of inflammatory and hemostatic biomarkers as risk factors in assessing cardiovascular disease isn't yet recognized by the American Heart Association.

More information

The American Academy of Family Physicians has more about exercise  .

MONDAY, Oct. 22 (HealthDay News) -- Diets rich in whole grains, fruits, vegetables and even a little alcohol may help ward off heart woes, new studies show.

In one study, regular consumption of whole-grain breakfast cereal cut the risk of heart failure for male American physicians.

Another study, this time from Sweden, touted the benefits of fruits, veggies and the occasional drink in helping women beat heart attack.

The American study analyzed the association between breakfast cereal intake and new cases of heart failure, in which the heart progressively loses its ability to pump blood.

The study included data on more than 21,000 participants in the Physicians' Health Study who were followed for almost 20 years.

Compared to those who ate no whole-grain cereal, men who consumed 2 to 6 servings per week saw their risk of heart failure fall by 21 percent, while those who ate 7 or more servings per week reaped a 29 percent reduction in risk, the researchers reported in the Oct. 22 issue of the Archives of Internal Medicine.

That effect is due, in part, to the high levels of magnesium, potassium and fiber in those breakfast cereals, said study co-author Dr. Luc Djousse, an associate in epidemiology at Brigham and Women's Hospital in Boston.

"Our recommendation is that a lay person consuming breakfast cereal should look at fiber," Djousse said. "At least four grams of fiber [per serving], that should be sufficient."

Fiber increases cells' sensitivity to insulin, thus reducing the risk of diabetes, while potassium and magnesium lower blood pressure, he explained.

Breakfast cereal is best taken with skim milk, Djousse said, "and if you want to add to it, a piece or half-piece of fruit would be good."

While the study included only men, there is "no reason at all" why the results shouldn't apply to women, he said.

The Swedish study, done at the Karolinska Institute, Stockholm, took a much broader approach to the food intake of more than 24,000 postmenopausal women who supplied information on how often they ate 96 common foods.

The study, published in the same issue of the journal, identified four major dietary patterns: healthy (vegetables, fruits and legumes); Western/Swedish (red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes, fish); alcohol (wine, liquor, beer and some snacks); and sweets (sweet baked goods, candy, chocolate, jam and ice cream).

In an average 6.2-year follow-up period, 308 of the women had heart attacks. However, two dietary patterns, healthy and alcohol, were associated with a reduced risk of heart attack, the researchers said.

A low-risk diet is characterized by a high intake of whole grains, fish, vegetables, fruit and legumes, moderate alcohol consumption, along with not smoking and being physically active and relatively thin, the researchers concluded. "This combination of healthy behaviors -- present in 5 percent [of those studied] -- may prevent 77 percent of myocardial infarctions [heart attacks] in the study population," the team wrote.

The study was called "empowering" by Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York, because "it demonstrates that people have control over their health and can take control, eat properly and exercise and prevent onset of disease."

"This study clearly demonstrates that it is within an individual's control to change destiny and the ability to control his or her health," Steinbaum said.

"What's amazing is that a study of 24,000 women shows that a reduction of 77 percent is possible," she said. "What could be more empowering than that?"

The issue is muddied by a plethora of books urging different diets, she acknowledged. But the real road to long-term health "is not so much going on a diet as adopting a healthy lifestyle," Steinbaum said.

More information

There's more on heart-healthy lifestyles at the American Heart Association  .

THURSDAY, Oct. 4 (HealthDay News) -- Compared to conventional tests, human papillomavirus (HPV) DNA testing enables earlier detection of lesions that lead to cervical cancer, Dutch researchers say.

That means women could go longer between screenings, say researchers at the VU University Medical Center in Amsterdam.

The study included more than 17,000 women ages 29 to 56. Of those, close to 8,600 were assigned to receive HPV DNA testing to detect the high-risk types of HPV that can cause cervical cancer. The other half underwent conventional cytological testing. Five years later, both groups of women received both cytological and HPV DNA testing.

At the start of the study, more CIN3+ lesions (cervical cancer and its most serious precursor lesions) were detected in women who had HPV DNA testing (68 of 8,575) than in those who had conventional cytological testing (40 of 8,580). Five years later, fewer CIN3+ lesions were detected in the women who'd had HPV DNA testing (24 of 8,413) than in those who'd had conventional cytological testing (56 of 8,456).

While the number of lesions detected over the two rounds of testing didn't differ between the groups, the lesions were detected earlier in the HPV DNA testing group, the researchers said.

"Our results show that implementation of HPV DNA testing in cervical screening leads to earlier detection of clinically relevant cervical lesions. On the basis of this data, we suggest that the current screening interval of five years could be extended by at least one year. The extension will be advantageous to women because of a reduction in the lifetime number of screening tests and referrals," the study authors wrote.

"A full cost-effectiveness analysis will help to determine whether primary HPV testing alone is the preferred strategy for primary cervical screening," they concluded.

The study was published in The Lancet medical journal.

More information

The U.S. National Women's Health Information Center has more about cervical cancer.