WEDNESDAY, Jan. 30 (HealthDay News) -- High levels of a protein called Ki-67 are associated with poor prognosis in women with early-stage breast cancer, but this protein may not be useful in identifying patients who would benefit from additional chemotherapy, an Italian study suggests.

Some studies have suggested that breast tumors with a high percentage of tumors cells expressing Ki-67 are more responsive to chemotherapy. This study looked at whether Ki-67 levels predicted responsiveness to chemotherapy in women who'd had surgery for breast cancer.

Researchers at the University of Milan in Italy assessed Ki-67 expression in tumor samples from women in two randomized clinical trials comparing the use of endocrine therapy alone to endocrine therapy after chemotherapy.

They found that Ki-67 expression didn't predict which women would benefit from chemotherapy prior to endocrine therapy, but they did find that having a high percentage of tumor cells expressing Ki-67 was associated with poorer disease-free survival.

"In this study, Ki-67 [expression] was a prognostic factor, not a predictive factor," the study authors wrote.

The findings were published in the Jan. 29 issue of the Journal of the National Cancer Institute.

These results support the position of the American Society of Clinical Oncology Tumor Markers Expert Panel that Ki-67 shouldn't be used to make decisions about chemotherapy, Matthew Ellis, of Washington University in St. Louis, wrote in an accompanying editorial.

"Biomarker studies with negative results can be just as important to publish as those with positive results, because clinging to a long-favored but incorrect hypothesis in the face of negative evidence impedes scientific and clinical progress," Ellis wrote.

More information

Breastcancer.org has more about breast cancer treatment  .

FRIDAY, Jan. 25 (HealthDay News) -- Woman who take oral contraceptives greatly reduce their risk of developing ovarian cancer, and the longer they take them the greater the protection, a new study confirms.

The use of oral contraceptives has long been connected with reductions in the incidence of ovarian cancer. The authors of the new study say their findings show that the Pill has already prevented 200,000 ovarian cancers and 100,000 deaths worldwide. Over the coming decades, use of the Pill will prevent some 30,000 cases of ovarian cancer each year, they contend.

"What's new here is that we have brought together all the people who have done epidemiological studies on ovarian cancer," said study co-author Dr. Valerie Beral, of Oxford University's Cancer Research UK Epidemiology Unit, in England. "This is pretty much what we know today."

"If women take the Pill, [ovarian] cancer is not their worry," Beral added.

For the study, Beral's team -- the Collaborative Group on Epidemiological Studies of Ovarian Cancer -- analyzed the results of 45 studies of ovarian cancer. These studies included 23,257 women with the disease and 87,303 women who did not have the disease. Thirty-one percent of those with ovarian cancer had used oral contraceptives, compared with 37 percent of the women who did not have cancer.

The researchers found that women who took oral contraceptives for 10 years reduced their risk of ovarian cancer from 12 per 1,000 women to eight per 1,000, and death from the disease from seven per 1,000 women to five per 1,000. They also found that this protective effect can last for decades after a woman stops using the Pill.

The findings are published in the Jan. 26 issue of The Lancet.

The protection from ovarian cancer is greater than the risk of other cancers associated with use of the Pill, such as breast and cervical malignancies, Beral said.

"There is a slight transient risk of breast cancer and cervical cancer, but that goes away when you stop taking the Pill," she said. "But the decrease in ovarian cancer is persistent and long-lasting. The magnitude of this outweighs the other risk."

Beral doesn't think women should decide whether to take the Pill based on its ability to reduce ovarian cancer risk. "The decision to take the Pill is about contraception, but there is a bonus at the end of all that," she said.

Dr. Eduardo Franco, a professor of epidemiology and oncology at McGill University in Montreal, and co-author of an accompanying editorial in the journal, said this study answers a lot of lingering questions about the extent of the protection the Pill offers against ovarian cancer.

"Oral contraceptives are beneficial to women worldwide," Franco said. "In fact, a lot of ovarian cancers have been averted."

Franco noted that estrogen in oral contraceptives has a protective effect, yet after menopause hormone-replacement therapy is associated with an increased cancer risk. "What is protective before menopause gets to be harmful after menopause," he said. "It's an exercise in risk and benefit."

Another editorial in the same journal issue argues for making oral contraceptives available over-the-counter. "We believe that the case is now convincing. Women deserve the choice to obtain oral contraceptives over-the-counter, removing a huge and unnecessary barrier to a potentially powerful cancer-preventing agent," the journal editorial states.

"A strong message about the overall cancer-preventing benefits of oral contraceptives would be a positive public health message, empowering women to decide for themselves about the evidence," the editorial concludes.

However, Franco strongly disagrees with this proposal. "Because of the complexity of use and the potential for misuse, it should always be a prescription medication," he said.

According to the American Cancer Society, ovarian cancer is the eighth most common cancer in women, skin cancer excluded. It's the fifth-leading cause of cancer death in women. An estimated 22,430 new cases of ovarian cancer are diagnosed in the United States each year, and about 15,280 women die from the disease. Two-thirds of women with ovarian cancer are 55 or older.

More information

To learn more about ovarian cancer, visit the U.S. National Cancer Institute.

MONDAY, Jan. 21 (HealthDay News) -- Caffeine consumption by pregnant women can increase the risk of miscarriage, a new study reports.

And, it doesn't matter if the caffeine comes from coffee, tea, soda or hot chocolate. What does matter is the amount -- the study found that when women drink more than 200 milligrams of caffeine daily, the risk of miscarriage increases twofold.

"What we found was that if women have heavy caffeine intake -- greater than 200 milligrams a day -- they have double the risk of miscarriage than women that don't have any caffeine," said one of the study's authors, Dr. De-Kun Li, a reproductive and perinatal epidemiologist in the division of research at Kaiser Permanente in Oakland, Calif.

Results of the study were published online in the January issue of the American Journal of Obstetrics and Gynecology.

Caffeine, the most frequently consumed drug in the world, crosses the placental barrier and reaches the developing fetus, according to the study. While previous studies have found an association between caffeine intake and miscarriage, it hadn't been clear whether the problem was due to the caffeine or another substance in coffee, or if it had something to do with non-coffee drinkers' lifestyles -- perhaps people who didn't drink coffee ate more fruits and vegetables, for example.

For the new study, the researchers looked at 1,063 women from the Kaiser Permanente Medical Care Program in San Francisco; they were interviewed at an average of 10 weeks' gestation. During the study period, 16 percent of the women -- 172 -- had miscarriages.

The researchers found that 25 percent of the women who miscarried reported consuming no caffeine during their pregnancy. Another 60 percent said they had up to 200 milligrams of caffeine daily, and 15 percent regularly consumed more than 200 milligrams of caffeine each day.

In addition to asking about caffeine intake, the researchers also assessed the other known risk factors for miscarriage, such as smoking, a history of previous miscarriage, alcohol use and more. The researchers also compensated for nausea and vomiting during pregnancy.

"If you have a low risk of miscarriage, the effect of caffeine tends to show more," said Li.

Li said that even among women who drank less than 200 milligrams of caffeine a day, the study found a 40 percent increased risk of miscarriage, but this finding didn't reach the level of statistical significance.

"Women shouldn't drink more than two regular cups of coffee a day, and hopefully they stop drinking totally for at least the first three months. It's not a permanent stop. If they really have to drink, limit the amount to one or two cups -- a regular cup is about seven and half ounces," Li said.

But, not every doctor is convinced that there's a direct cause-and-effect relationship between caffeine and miscarriage.

"The problem with this study is that when people miscarry, a large percentage of those miscarriages are due to genetic abnormalities, and the researchers didn't say whether these were normal or abnormal fetuses," said Dr. Laura Corio, an obstetrician and gynecologist at Mount Sinai Medical Center in New York City.

"Women are always worrying and wondering, 'What did I do?' Before we say a woman drank too much caffeine and that's why she had a miscarriage, let's see if it was an abnormal or normal pregnancy, said Corio.

"I think about 60 to 80 percent of miscarriages are due to genetic abnormalities," she added.

That said, however, Corio does advise her pregnant patients to limit caffeine consumption. "Women have a responsibility to the fetus -- no cigarettes, no alcohol and just one cup of coffee a day," she said, noting that many store-bought cups of coffee contain far too much caffeine, so a woman has to be aware of how much caffeine is in her favorite coffee.

"Have less than 200 milligrams a day," no matter what the source -- coffee, tea, cola, chocolate, etcetera, Corio advised. She said caffeine has also been linked to low birth weights and smaller head circumferences.

Li also advised limiting caffeine to less than 200 milligrams a day, especially in the early months of pregnancy and in the preconception period.

More information

To learn more about caffeine and pregnancy, visit the American Pregnancy Association  .

(HealthDay News) - It's important to take care of yourself while you're pregnant. But you should begin caring for your body long before you confirm that you're expecting a baby.

Here are suggestions on how to prepare your body for pregnancy, courtesy of the U.S. Department of Health and Human Services:

• Eat a healthy, balanced diet, rich in fruits and vegetables and low in fat.
• Start a regular exercise routine. You should get at least 30 minutes of exercise on most days of the week.
• Stick to a regular sleep schedule, to make sure you get plenty of rest every night.
• Take a daily multivitamin that includes 400 milligramns of folic acid.
• See your doctor for a physical exam, and make sure you're up-to-date on all vaccinations. Also talk to your doctor about whether any of your current medications may not be safe during pregnancy.
• Don't use illicit drugs, cigarettes or alcohol.