Dear Editor:

Breast cancer affects one in eight women in the western world and is currently the second leading cause of cancer-related deaths in American women. It is not a single disease buta spectrum of diseases with very different behaviors ranging from spreading slowly to being very aggressive. While one-third of patients will be cured by primary local therapy, the remaining two-thirds' tumors will spread to other organs and they will eventually succumb to their disease after a variable length of time ranging from a few months to decades.

Despite major advances in treatment, the best hope for decreasing breast cancer mortality is prevention. At Penn State Hershey Cancer Institute at Penn State Milton S. Hershey Medical Center, scientists are collaborating to research ways to prevent breast cancer, as well as better ways to treat it.

A major breakthrough in breast cancer prevention has been provided by the observation that the antiestrogens Tamoxifen and Raloxifene reduce breast cancer incidence by 50 percent in high-risk women. Antiestrogens are drugs that block the female hormone estrogen, which some breast cancers require for growth.

However, the side effects of these drugs, particularly clotting complications which, although rare, are significant since these drugs are given to normal women, prevents their general use. Furthermore, both antiestrogens are unable to prevent hormone-independent tumors which are the most aggressive. Therefore, there is a need for more effective interventions associated with reduced toxicity.

Considerable attention has been placed on dietary interventions, such as low-fat diets or diets rich in omega-3 fatty acids (fish oil). These approaches are attractive because of their lack of toxicity and added health benefits such as reduction in cardiovascular risk. However, despite encouraging evidence in laboratory animals, the benefit of dietary manipulations in reducing breast cancer in humans remains controversial and yet unproven.

Well-designed studies rigorously testing the effects of dietary manipulations possibly in conjunction with other non-toxic treatments in reducing breast cancer risk need to be conducted. For more information on studies available at Penn State Hershey Cancer Institute that healthy women can participate in to help future women with cancer, call Cindy DuBrock at 717-531-4300. Post-menopausal women can be very helpful in current research.

Susan G. Komen for the Cure is a foundation that supports breast cancer research, including a large study at Penn State Hershey. It has helped train more than 400 breast cancer researchers and funded more than 1,800 research projects in its 26-year history.

Susan G. Komen for the Cure recommends the following breast cancer screening guidelines:

· Talk to your family to learn about your family health history

· Talk to your doctor about your personal risk of breast cancer

· Ask your doctor which screening tests are right for you if you are at higher risk

· Have a mammogram every year starting at age 40 if you are at average risk

· Have a clinical breast exam at least every 3 years starting at age 20 and every year starting at age 40

· Know how your breasts look and feel and report changes to your health care provider right away

· Make healthy lifestyle choices that may reduce your risk of breast cancer

This month, think about how you can protect yourself from breast cancer, but also, think about how you can help others, including through research.

Andrea Manni, M.D.

Penn State Hershey Cancer Institute/Penn State Milton S. Hershey Medical Center