Study Findings: Testosterone and Triple Negative Breast Cancer – Mayo Clinic

Could blocking an androgen ( testosterone) receptor lead to a new way to treat an aggressive form of breast cancer?

That’s a question researchers at the Mayo Clinic in Arizona and the Translational Genomics Research Institute (TGen) in Phoenix, Ariz are exploring. Preliminary results of a Mayo Clinic — TGen collaborative study show the androgen receptor may be a potential target to attack in treating triple negative breast cancer (TNBC).

Barbara Pockaj, M.D., a surgical oncologist at the Mayo Clinic in Arizona, discusses the study findings and the next steps in research.

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Immunotherapy and Triple Negative Breast Cancer – Mayo Clinic

A promising new study from Mayo Clinic, in conjunction with Caris Life Sciences, points to immunotherapy as a possible treatment option for patients with the difficult-to-treat triple negative breast cancer mutation. The study was presented this week at the 50th annual meeting of the American Society of Clinical Oncology in Chicago.

“This study may change our ability to treat triple negative breast cancer patients,” says Barbara Pockaj, M.D., lead investigator of the study and Mayo Clinic surgeon. “We may have signs that these patients can be treated with immunotherapy. We don’t have a lot of options for these patients and this would really expand our options.”

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The Basics: Vitamin D

Vitamin D is sometimes called a “wonder vitamin.” Find out why we need it and where to get it.

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The Benefits of Breastfeeding for Both Mother and Baby | WebMD


In honor of Breastfeeding Awareness Month, we will be sharing a series of articles promoting breastfeeding.  This next one is about the “ABC’s” of breastfeeding – a brief overview of the basics you should know, republished in full from WebMD.


Breastfeeding Overview

Making the decision to breastfeed is a personal matter. It’s also one that’s likely to draw strong opinions from friends and family.

Many medical experts, including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists, strongly recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. And breastfeeding for a year at least with other foods which should be started at 6 months of age, such as vegetables, grains, fruits, proteins.

But you and your baby are unique, and the decision is up to you. This overview of breastfeeding can help you decide.

What Are the Benefits of Breastfeeding for Your Baby?

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat — everything your baby needs to grow. And it’s all provided in a form more easily digested than infant formula. Breast milk contains antibodies that help your baby fight off viruses and bacteria. Breastfeeding lowers your baby’s risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first 6 months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.

Breastfeeding has been linked to higher IQ scores in later childhood in some studies. What’s more, the physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight children. The AAP says breastfeeding also plays a role in the prevention of SIDS (sudden infant death syndrome). It’s been thought to lower the risk of diabetes, obesity, and certain cancers as well, but more research is needed.

Are There Breastfeeding Benefits for the Mother?

Breastfeeding burns extra calories, so it can help you lose pregnancy weight faster. It releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth. Breastfeeding also lowers your risk of breast and ovarian cancer. It may lower your risk of osteoporosis, too.

Since you don’t have to buy and measure formula, sterilize nipples, or warm bottles, it saves you time and money. It also gives you regular time to relax quietly with your newborn as you bond.

Will I Make Enough Milk to Breastfeed?

The first few days after birth, your breasts make an ideal “first milk.” It’s called colostrum. Colostrum is thick, yellowish, and scant, but there’s plenty to meet your baby’s nutritional needs. Colostrum helps a newborn’s digestive tract develop and prepare itself to digest breast milk.

Most babies lose a small amount of weight in the first 3 to 5 days after birth. This is unrelated to breastfeeding.

As your baby needs more milk and nurses more, your breasts respond by making more milk. Experts recommend breastfeeding exclusively (no formula, juice, or water) for 6 months. If you supplement with formula, your breasts might make less milk.

Even if you breastfeed less than the recommended 6 months, it’s better to breastfeed for a short time than no time at all. You can add solid food at 6 months but also continue to breastfeed if you want to keep producing milk.

What’s the Best Position for Breastfeeding?

The best position for you is the one where you and your baby are both comfortable and relaxed, and you don’t have to strain to hold the position or keep nursing. Here are some common positions for breastfeeding your baby:

  • Cradle position. Rest the side of your baby’s head in the crook of your elbow with his whole body facing you. Position your baby’s belly against your body so he feels fully supported. Your other, “free” arm can wrap around to support your baby’s head and neck — or reach through your baby’s legs to support the lower back.
  • Football position. Line your baby’s back along your forearm to hold your baby like a football, supporting his head and neck in your palm. This works best with newborns and small babies. It’s also a good position if you’re recovering from a cesarean birth and need to protect your belly from the pressure or weight of your baby.
  • Side-lying position. This position is great for night feedings in bed. Side-lying also works well if you’re recovering from an episiotomy, an incision to widen the vaginal opening during delivery. Use pillows under your head to get comfortable. Then snuggle close to your baby and use your free hand to lift your breast and nipple into your baby’s mouth. Once your baby is correctly “latched on,” support your baby’s head and neck with your free hand so there’s no twisting or straining to keep nursing.

How Do I Get My Baby to ‘Latch on’ During Breastfeeding?

Position your baby facing you, so your baby is comfortable and doesn’t have to twist his neck to feed. With one hand, cup your breast and gently stroke your baby’s lower lip with your nipple. Your baby’s instinctive reflex will be to open the mouth wide. With your hand supporting your baby’s neck, bring your baby’s mouth closer around your nipple, trying to center your nipple in the baby’s mouth above the tongue.

You’ll know your baby is “latched on” correctly when both lips are pursed outward around your nipple. Your infant should have all of your nipple and most of the areola, which is the darker skin around your nipple, in his mouth. While you may feel a slight tingling or tugging, breastfeeding should not be painful. If your baby isn’t latched on correctly and nursing with a smooth, comfortable rhythm, gently nudge your pinky between your baby’s gums to break the suction, remove your nipple, and try again. Good “latching on” helps prevent sore nipples.

What Are the ABCs of Breastfeeding?

  • A = Awareness. Watch for your baby’s signs of hunger, and breastfeed whenever your baby is hungry. This is called “on demand” feeding. The first few weeks, you may be nursing eight to 12 times every 24 hours. Hungry infants move their hands toward their mouths, make sucking noises or mouth movements, or move toward your breast. Don’t wait for your baby to cry. That’s a sign he’s too hungry.
  • B = Be patient. Breastfeed as long as your baby wants to nurse each time. Don’t hurry your infant through feedings. Infants typically breastfeed for 10 to 20 minutes on each breast.
  • C = Comfort. This is key. Relax while breastfeeding, and your milk is more likely to “let down” and flow. Get yourself comfortable with pillows as needed to support your arms, head, and neck, and a footrest to support your feet and legs before you begin to breastfeed.

Are There Medical Considerations With Breastfeeding?

In a few situations, breastfeeding could cause a baby harm. You should not breastfeed if:

  • You are HIV positive. You can pass the HIV virus to your infant through breast milk.
  • You have active, untreated tuberculosis.
  • You’re receiving chemotherapy for cancer.
  • You’re using an illegal drug, such as cocaine or marijuana.
  • Your baby has a rare condition called galactosemia and cannot tolerate the natural sugar, called galactose, in breast milk.
  • You’re taking certain prescription medications, such as some drugs for migraine headaches, Parkinson’s disease, or arthritis.

Talk with your doctor before starting to breastfeed if you’re taking prescription drugsof any kind. Your doctor can help you make an informed decision based on your particular medication.

Having a cold or flu should not prevent you from breastfeeding. Breast milk won’t give your baby the illness and may even give antibodies to your baby to help fight off the illness.

Also, the AAP suggests that — starting at 4 months of age — exclusively breastfed infants, and infants who are partially breastfed and receive more than one-half of their daily feedings as human milk, should be supplemented with oral iron. This should continue until foods with iron, such as iron-fortified cereals, are introduced in the diet. The AAP recommends checking iron levels in all children at age 1.

Discuss supplementation of both iron and vitamin D with your pediatrician Your doctor can guide you on recommendations about the proper amounts for both your baby and you, when to start, and how often the supplements should be taken.

Why Do Some Women Choose Not to Breastfeed?

  • Some women don’t want to breastfeed in public.
  • Some prefer the flexibility of knowing that a father or any caregiver can bottle-feed the baby any time.
  • Babies tend to digest formula more slowly than breast milk, so bottle feedings may not be as frequent as breastfeeding sessions.

The time commitment, and being “on-call” for feedings every few hours of a newborn’s life, isn’t feasible for every woman. Some women fear that breastfeeding will ruin the appearance of their breasts. But most breast surgeons would argue that age, gravity, genetics, and lifestyle factors like smoking all change the shape of a woman’s breasts more than breastfeeding does.

What Are Some Common Challenges With Breastfeeding?

  • Sore nipples. You can expect some soreness in the first weeks of breastfeeding. Make sure your baby latches on correctly, and use one finger to break the suction of your baby’s mouth after each feeding. That will help prevent sore nipples. If you still get sore, be sure you nurse with each breast fully enough to empty the milk ducts. If you don’t, your breasts can become engorged, swollen, and painful. Holding ice or a bag of frozen peas against sore nipples can temporarily ease discomfort. Keeping your nipples dry and letting them “air dry” between feedings helps, too. Your baby tends to suck more actively at the start. So begin feedings with the less-sore nipple.
  • Dry, cracked nipples. Avoid soaps, perfumed creams, or lotions with alcohol in them, which can make nipples even more dry and cracked. You can gently apply pure lanolin to your nipples after a feeding, but be sure you gently wash the lanolin off before breastfeeding again. Changing your bra pads often will help your nipples stay dry. And you should use only cotton bra pads.
  • Worries about producing enough milk.A general rule of thumb is that a baby who’s wetting six to eight diapers a day is most likely getting enough milk. Avoid supplementing your breast milk with formula, and never give your infant plain water. Your body needs the frequent, regular demand of your baby’s nursing to keep producing milk. Some women mistakenly think they can’t breastfeed if they have small breasts. But small-breasted women can make milk just as well as large-breasted women. Good nutrition, plenty of rest, and staying well hydrated all help, too.
  • Pumping and storing milk. You can get breast milk by hand or pump it with a breast pump. It may take a few days or weeks for your baby to get used to breast milk in a bottle. So begin practicing early if you’re going back to work. Breast milk can be safely used within 2 days if it’s stored in a refrigerator. You can freeze breast milk for up to 6 months. Don’t warm up or thaw frozen breast milk in a microwave. That will destroy some of its immune-boosting qualities, and

it can cause fatty portions of the breast milk to become super hot. Thaw breast milk in the refrigerator or in a bowl of warm water instead.

  • Inverted nipples. An inverted nipple doesn’t poke forward when you pinch the areola, the dark skin around the nipple. A lactation consultant — a specialist in breastfeeding education — can give simple tips that have allowed women with inverted nipples to breastfeed successfully.
  • Breast engorgement. Breast fullness is natural and healthy. It happens as your breasts become full of milk, staying soft and pliable. But breast engorgement means the blood vessels in your breast have become congested. This traps fluid in your breasts and makes them feel hard, painful, and swollen. Alternate heat and cold, for instance using ice packs and hot showers, to relieve mild symptoms. It can also help to release your milk by hand or use a breast pump.
  • Blocked ducts. A single sore spot on your breast, which may be red and hot, can signal a plugged milk duct. This can often be relieved by warm compresses and gentle massage over the area to release the blockage. More frequent nursing can also help.
  • Breast infection (mastitis). This occasionally results when bacteria enter the breast, often through a cracked nipple after breastfeeding. If you have a sore area on your breast along with flu-like symptoms, fever, and fatigue, call your doctor. Antibiotics are usually needed to clear up a breast infection, but you can most likely continue to breastfeed while you have the infection and take antibiotics. To relieve breast tenderness, apply moist heat to the sore area four times a day for 15 to 20 minutes each time.
  • Stress. Being overly anxious or stressed can interfere with your let-down reflex. That’s your body’s natural release of milk into the milk ducts. It’s triggered by hormones released when your baby nurses. It can also be triggered just by hearing your baby cry or thinking about your baby. Stay as relaxed and calm as possible before and during nursing — it can help your milk let down and flow more easily. That, in turn, can help calm and relax your infant.
  • Premature babies may not be able to breastfeed right away. In some cases, mothers can release breast milk and feed it through a bottle or feeding tube.
  • Warning signs. Breastfeeding is a natural, healthy process. But call your doctor if:
  • Your breasts become unusually red, swollen, hard, or sore.
  • You have unusual discharge or bleeding from your nipples.
  • You’re concerned your baby isn’t gaining weight or getting enough milk.

Where Can I Get Help With Breastfeeding?

Images of mothers breastfeeding their babies make it look simple — but most women need some help and coaching. It can come from a nurse, doctor, family member, or friend, and it helps mothers get over possible bumps in the road.

Reach out to friends, family, and your doctor with any questions you may have. Most likely, the women in your life have had those same questions.

SOURCE: WebMD Medical Reference Reviewed by Dan Brennan, MD on December 5, 2017

Sources

 

SOURCES:

News release, American Academy of Pediatrics.

Baker, R. Pediatrics, November 2010.

American Academy of Pediatrics: “Policy Statement: Breastfeeding and the Use of Human Milk.”

American College of Obstetricians and Gynecologists: “Breastfeeding Your Baby.”

CDC: “Proper Handling and Storage of Human Milk.”

National Women’s Health Information Center: “Benefits of Breastfeeding.”

National Women’s Health Information Center: “Questions and Answers About Breastfeeding.”

National Women’s Health Information Center: “How Lifestyle Affects Breast Milk.”

La Leche League International: “How Do I Position My Baby to Breastfeed?”

American Academy of Family Physicians: “Breastfeeding: Hints To Help You Get Off to a Good Start.”

National Library of Medicine: “Overcoming Breastfeeding Problems.”

KidsHealth.org: “Feeding Your Newborn.”

American College of Nurse-Midwives, GotMom.org: “Breastfeeding with Confidence.”

© 2017 WebMD, LLC. All rights reserved.

Breastfeeding saves lives, boosts economies in rich and poor countries


In honor of Breastfeeding Awareness Month, we will be sharing a series of articles promoting breastfeeding.  This one focuses on breastfeeding as the most exquisite form of personalized medicine.


SOURCE:  By Catharine Paddock PhD, Published

The decision not to breastfeed harms the long-term health, nutrition and development of children – and the health of women – around the world, conclude leading experts in a new series of papers on breastfeeding published in The Lancet. They also detail how this loss of opportunity damages the global economy.

The authors say countries should see promoting breastfeeding as an investment that benefits not only their public health, but also their economies. The two-part series is the most detailed analysis of levels, trends and benefits of breastfeeding around the world.

By not being exclusively breastfed for the first 6 months of their lives, and not continuing to receive their mother’s milk for another 6 months, millions of children are being denied the important health benefits of breastfeeding, note the authors.

Figures estimated for the series suggest if all countries were to increase breastfeeding for infants and young children to near-universal levels, over 800,000 child deaths (13% of all deaths in the under-2s), 20,000 breast cancer deaths and $302 billion in costs to the global economy could be prevented every year.

The authors say that by not doing enough to promote and encourage breastfeeding, the world’s nations – both rich and poor – are overlooking one of the most effective ways of improving health of children and mothers.

Cesar Victora, a professor from the Federal University of Pelotas in Brazil and a leading author in the series, says the need to tackle this global issue is greater than ever. She notes:

“There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth. Our work for this Series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike.”

Breast milk is a ‘very exquisite personalized medicine’

The experts say their analyses – comprising 28 systematic reviews of available evidence, 22 of which were prepared for the series – show, for example, that breastfeeding has a significant benefit to life expectancy.

In wealthy countries, breastfeeding reduces sudden infant deaths by over a third, and in low and middle-income countries, breastfeeding halves cases of diarrhea and reduces respiratory infections by a third.
In a podcast interview for the series, Prof. Victora says while we are only “beginning to scratch the surface,” a lot of evidence is emerging about the biology of breastfeeding and the components and properties of breast milk.

He quotes a colleague who likens breast milk to “very exquisite personalized medicine” because it reflects the biological interaction between the mother and her child, “something that formula will never be able to imitate,” he notes.

Prof. Victora cites as an example the effect that receiving breast milk has on the development of the microbiome – the trillions of friendly bacteria that live in and on our bodies and play a key role in our health.
He says we are also beginning to understand that breast milk has epigenetic effects – that is, it influences the expression of genes that control cell activity and development. And, another recent discovery is that breast milk contains stem cells.

There is evidence, the authors note, that breastfeeding increases intelligence and may protect against obesity and diabetesin later life. And for mothers, breastfeeding for longer reduces their risk of breast cancer and ovarian cancer.

Promoting breastfeeding makes economic sense

The authors say countries should see promoting breastfeeding as an investment that benefits not only their public health, but also their economies.  They estimate that loss to economies due to impact of not breastfeeding on intelligence amounted to $302 billion in 2012, or 0.49% of world gross national income.

Prof. Victora and colleagues also calculate that if rates of breastfeeding in babies under 6 months were to increase to 90% in the US, China and Brazil, and to 45% in the UK, they would save these countries $2.45 billion, $223.6 million, $6.0 million and $29.5 million, respectively, due to reductions in treating common childhood illnesses like pneumonia, diarrhea and asthma.

This loss of opportunity to boost public and economic health is further highlighted by the fact that worldwide rates of breastfeeding are low, particularly in wealthy countries – for example the UK, Ireland and Denmark have some of the lowest rates of breastfeeding at 12 months in the world (under 1%, 2% and 3%, respectively).

Prof. Victora remarks that breastfeeding is one of the few “positive health behaviors” that is more prevalent in poor countries than in wealthy countries. Also, in poor countries, it is the poorer mothers that practice it more. He notes:

“The stark reality is that in the absence of breastfeeding, the rich-poor gap in child survival would be even wider.”

He urges policymakers to take note of this and be reassured that promoting breastfeeding provides a rapid return on investment that takes less than a generation to come to fruition.

Aggressive formula marketing undermines breastfeeding promotion

One of the papers also touches on the effects that aggressive marketing of “formula” or breast milk substitutes is having, despite countries attending the World Health Assembly in 1981 adopting the World Health Organization (WHO) International Code of Marketing of Breast-Milk Substitutes, which the authors note has not been enforced effectively.

The multi-billion dollar breast milk substitute industry must be reined in, they urge, or it will continue to undermine breastfeeding as the best feeding practice in early life.

The WHO recommend babies start breastfeeding within 1 hour of life, are exclusively breastfed for 6 months. After this, there should be gradual introduction of adequate, safe and properly fed complementary foods with babies continuing to breastfeed for up to 2 years of age or more.

The authors note that global sales of breast milk substitutes are expected to reach $70.6 billion by 2019, as co-author Dr. Nigel Rollins, from the Department of Maternal, Newborn, Child and Adolescent Health at the WHO in Geneva, explains:

Saturation of markets in high-income countries has caused the industries to rapidly penetrate emerging global markets. Almost all growth in the foreseeable future in sales of standard milk formula (infants <6 months) will be in low-income and middle-income countries, where consumption is currently low,…”

He cites the example of the Middle East and Africa, where estimates show per-child consumption of breast milk substitutes will likely grow by over 7% in the period 2014-2019.  And in wealthy nations, growth in breast milk substitutes will be largely driven by sales of follow-on and toddlers milk, which are set to increase by 15% by 2019, he notes.

Breastfeeding must become a key public health issue

The authors say governments and international organizations have to show powerful political commitment and provide the financial backing needed to protect, promote and support breastfeeding at all levels – national, community, family and workplace.

In an accompanying comment paper, leading experts in the field – including Frances Mason from Save the Children UK and Dr. Alison McFadden from the School of Nursing and Health Sciences at the University of Dundee, UK – say world leaders must not repeat the mistake of leaving out breastfeeding from the Millennium Development Goals when it sets the Sustainable Development Goals later this year.

They plead for breastfeeding not be tagged onto the child nutrition agenda but to be treated as a key public health priority that reduces disease, infant deaths and inequity, and also urge leaders at all levels to “end promotion of products that compete with breastfeeding.”

Prof. Victora concludes:  “There is a widespread misconception that breast milk can be replaced with artificial products without detrimental consequences.”
In October 2015, Medical News Todaylearned of a report from the Centers for Disease Control and Prevention (CDC) that shows while breastfeeding support at US hospitals has improved since 2007, there are still many ways it could be better. Improved hospital care could increase breastfeeding rates nationwide, it concludes.


If you are looking for a physician to care for you along your birthing journey or to support you in your efforts to breastfeed, you might connect with them in HealthLynked.  WE are the first of its kind social ecosystem designed specifically for physicians and patients to collaborate in the efficient exchanges of health information.

Ready to get Lynked for free?  Go to HealthLynked.com right not to Improve HealthCare!

Radiation Therapy of the Breast or Chest-wall: Acute side effects and self-care recommendations

This video discusses the common acute side effects that occur during Radiation therapy to the breast or chest-wall. Recommendations on how to best care for your skin during radiation therapy as well as post radiation therapy skin changes are reviewed.

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Inflammatory Breast Cancer – Suzy’s Story

Suzy Underhill, a patient at Mayo Clinic in Arizona, shares her story battling inflammatory breast cancer. She explains the diagnosis, treatment and how she managed to keep a positive outlook during the process. Learn more about breast cancer treatment at Mayo Clinic: http://mayocl.in/2lulFoe

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Genetic Testing for Breast Cancer – Mayo Clinic

It could be your mom, sister, aunt or best friend. One out of 8 women will get breast cancer in her lifetime. A small subset of the women who get diagnosed have inherited an abnormal copy of a gene that runs in families and can greatly increase their risk of certain cancers. One question these women and their families face is, “Should I get tested to find out if I have a genetic risk?” The answer is always a very personal one.

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