Aspirin associated with decreased risk for breast cancer recurrence and death

Source: ACP Internish 2/23/10

Aspirin associated with decreased risk for breast cancer recurrence and death

Women with breast cancer who take aspirin after their diagnosis may be less likely to experience recurrence or die of the disease, a new study reports.

Researchers used data from the Nurses’ Health Study to perform a prospective observational study of aspirin use in 4,164 women diagnosed with stage I, II, or III breast cancer between 1976 and 2002. Patients were observed until June 2006 or until death. The study’s main outcome measure was risk for death from breast cancer, according to number of days that aspirin was taken per week. Aspirin use was first assessed 12 months after cancer diagnosis because it is contraindicated during chemotherapy. The study results were published online Feb. 16 by the Journal of Clinical Oncology.
 
During follow-up, 341 women died of breast cancer. The adjusted relative risks (RRs) for breast cancer death with one, two to five, and six to seven days of aspirin use per week versus no use were 1.07 (95% CI, 0.70 to 1.63), 0.29 (CI, 0.16 to 0.52) and 0.36 (CI, 0.24 to 0.54), respectively. The association was not affected by adjustment for stage, menopausal status, body mass index, or estrogen-receptor status. The adjusted RRs for recurrence were 0.91 (CI, 0.62 to 1.33), 0.40 (CI, 0.24 to 0.65), and 0.57 (CI, 0.39 to 0.82) for the same aspirin use categories compared with no use.

The study was limited because some data were obtained by self-report and because the authors did not have information on aspirin dose, among other factors. However, the authors concluded that aspirin may have a beneficial effect on survival after a breast cancer diagnosis. They called for additional studies on aspirin’s mechanism of action in this population, including a possible randomized trial.

Obesity may delay onset of puberty in boys.

Source: AMA Morning Rounds 2/2/10

Obesity may delay onset of puberty in boys.

The Los Angeles Times (2/1, Healy) "Booster Shots" blog reported, "While obesity has been shown to bring on puberty earlier in girls," a paper appearing in the Archives of Pediatrics and Adolescent Medicine reveals something quite different: "Male children whose body-mass index (BMI) is consistently highest through early and mid-childhood are significantly more likely than thinner boys to have delayed puberty."

        In fact, after "analyzing the records of 401 boys from diverse socioeconomic backgrounds in ten regions of the US," University of Michigan researchers discovered that "at 11.5 years, boys with the highest body mass index (mean BMI z score=1.84) were 165% more likely to be prepubertal than the thinnest boys," MedPage Today (2/1, Emery) reported. Notably, "rates of obesity among American girls and boys have nearly tripled since the 1960s."

        Surgeon General's obesity plan said to be "sensible." In "The Checkup" blog of the Washington Post (2/1), Jennifer LaRue Huget writes that the Surgeon General's plan to combat obesity "got surprisingly little press coverage." Huget attributes this to it being a "sensible, seemingly heart-felt document" that doesn't call for governmental intervention. "Instead, it talks about personal responsibility, about communities working together, about grassroots efforts," and "places the onus for weight loss squarely on the shoulders of individuals." Huget asserts that "is not what many people want to hear -- or expect to hear in these paternalistic days."

Medical community turning to new obstructive sleep apnea treatments.

Moral of the story: Less traditional methods are being examined to help with sleep apnea- a common comorbidity of obesity.

Source: AMA Morning Rounds 2/2/10

Medical community turning to new obstructive sleep apnea treatments.

The Wall Street Journal (2/2, Mahrer) reported that as manufacturers work on streamlining the often bulky and expensive breathing masks used during CPAP treatments to help patients with obstructive sleep apnea, some dentists are turning to appliances that reposition the jaw. Meanwhile, physicians are either practicing various surgical techniques or encouraging their patients to make certain lifestyle changes, such as losing weight or changing one's sleep position. As a last resort, an Australian paper appearing in the BMJ indicates that learning to play the didgeridoo may actually help too.