How much do women understand about breast density? And other current research

According to a national cross-sectional survey, women’s awareness of breast density (BD) varies by race/ethnicity, education, and income, despite laws in 21 states mandating disclosure of the information.

Researchers at the Mayo Clinic administered the survey in English and Spanish to 2311 women, using a probability-based sample of individuals who were of age for breast cancer screening. Connecticut was oversampled because it was the only state with legislation on the books for more than a year before the survey started that mandated disclosure of BD information.

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Of the 1502 women (65%) who responded, 58% had heard of BD, 53% knew that BD affects the risk of cancer, and 49% knew that BD can impact the detection of breast cancer. After adjusting for multiple variables, increased BD awareness was associated with white non-Hispanic race/ethnicity (Hispanic v white non-Hispanic: odds ratio [OR], 0.23; P < .001), education (OR, 1.19 per category increase; P < .001), diagnostic evaluation after a mammogram (OR, 2.64; P < .001), postmenopausal hormone therapy (OR, 1.69; P = .002), and household income (OR, 1.07 per category increase; P < .001).

Women who knew about the masking effect of BD were more likely to have a prior breast biopsy (OR, 2.16; P < .001), to be educated (OR, 1.22; P = .01), to have a higher household income (OR, 1.10; P < .001), and to reside in Connecticut (Connecticut v other states: OR, 3.82; P = .003). Residents of Connecticut were also more likely to have previously discussed their BD with their healthcare provider than were residents of other states (67% v 43% for residents of other US states; P = .001).

The researchers concluded that awareness and knowledge of BD vary according to a woman’s income, education, and race/ethnicity. Mandatory disclosure laws, they believe, will help increase knowledge about BD and its impact on breast cancer detection. 

NICHD dedicates $41.5 million to placenta research

Understanding and monitoring development of the human placenta during pregnancy is the goal of new research to which $41.5 million in funding is being dedicated by the National Institutes of Health (NIH). The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) will lead the effort, dubbed The Human Placenta Project (HPP).

The funding-which corresponds to eight to nine awards for fiscal year 2015-is intended to drive development and application of tools for safe assessment of structure and function of the human placenta at a micro and macro level throughout gestation in real time. Use of such tools and technologies should ultimately lead to new ways to treat, cure, and even prevent placental dysfunction disorders such as preeclampsia, fetal growth restriction, spontaneous preterm birth, and stillbirth. Because the methods developed may be applicable to assessment of other internal organs, the impact of the HPP may reach beyond pregnancy.

The HPP has five overarching goals:

·       Improvement in current methods and development of new technologies for real-time assessment of human placental structure and function across gestation;

·       Application of these technologies to understand and monitor, in real time, placental development and function in normal and abnormal human pregnancies;

·       Development and evaluation of noninvasive markers of placental dysfunction for prediction of adverse human pregnancy outcomes;

·       Understanding of how placental development contributes to long-term human health and disease; and

·       Development of interventions to prevent abnormal placental development and hence improve pregnancy outcome.

Researchers requesting grants from the HPP can receive up to $3 million in direct costs for the entire project of up to 4 years; applications are due by June 1, 2015. All proposed teams must include at least one obstetric clinician to provide insights into current or potential clinical functional or safety limitations of the chosen technology. Studies performed must apply technology to assess the impact of environmental factors on placental structure and/or function across pregnancy in real time. Factors can include discrete physical entities such as cigarette smoke, alcohol, medications, infection, and pollution, or general conditions such as exercise, maternal diet and nutritional status, body mass index, or level of stress.

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To date, most studies of the placenta have provided foundational information about the organ through use of ultrasound, blood tests, and examination of placental tissue after delivery. The HPP is designed to address the paucity of information on earlier gestation, the time when many pregnancy pathologies originate, and the limited data gleaned throughout gestation from normal pregnancies.

In an announcement to its members about the HPP, the Society for Maternal-Fetal Medicine said, “Funding opportunities of this magnitude in our discipline are few and far between and this is a real opportunity for SMFM members to lead the development of new approaches that can provide significant and sustained improvements in pregnancy outcomes for our patients and their families.”

Can lycopene cut risk of kidney cancer in some women?

Postmenopausal women who consume a diet high in lycopene may be at lower risk of developing renal cell carcinoma (RCC), according to a recent analysis in Cancer. The results, based on data from the Women’s Health Initiative (WHI), suggest a need for further study of the compound, found in tomatoes, papaya, and watermelon.

Included in the analysis were 96,196 postmenopausal women enrolled in the WHI between 1993 and 1998, who were then followed through July 2013. Micronutrient intake was estimated from the baseline WHI food frequency questionnaire. Supplement use data were collected via an interview-based inventory procedure.  Follow-up surveys were used to ascertain RCC cases and were centrally adjudicated. Cox proportional hazards regression, adjusted for confounders, was used to analyze risks of RCC associated with intake of α-carotene, β-carotene, β-cryptoxanthin, lutein plus zeaxanthin, lycopene, and vitamins C and E.

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During the course of follow-up, 240 women were identified as having RCC. Lycopene was inversely associated with RCC risk (P = .015). Compared with the lowest quartile of lycopene intake, the highest quartile was associated with a 39% lower risk of RCC (hazard ratio, 0.61; 95% confidence interval, 0.39-0.97). None of the other micronutrients studied were found to be significantly associated with RCC risk.

Investigators concluded that a higher intake of lycopene could reduce the risk of RCC. They urged further study to determine if the lycopene intake and the RCC risk reduction were correlated.