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June 2, 2017
Digest

Study Estimates Number of U.S. Women Living with Metastatic Breast Cancer

A new study shows that the number of women in the United States living with distant metastatic breast cancer (MBC), the most severe form of the disease, is growing. This is likely due to the aging of the U.S. population and improvements in treatment.

group of women holding hands

Researchers came to this finding by estimating the number of U.S. women living with MBC, or breast cancer that has spread to distant sites in the body, including women who were initially diagnosed with metastatic disease and those who developed MBC after an initial diagnosis at an earlier stage.

The researchers also found that median and 5-year relative survival for women initially diagnosed with MBC is improving, especially among younger women.

The findings appeared online on May 18 in Cancer Epidemiology, Biomarkers & Prevention.

In documenting the prevalence of MBC, the findings point to the need for more research into how to address the health care needs of women who live with this condition.

“Even though this group of patients with MBC is increasing in size, our findings are favorable,” said Dr. Angela Mariotto, chief of NCI’s Data Analytics Branch. “This is because, over time, these women are living longer with MBC. Longer survival with MBC means increased needs for services and research. Our study helps to document this need.”

Although researchers have been able to estimate the number of women initially diagnosed with MBC, data on the number of women whose cancers spread to a distant organ site, either as a progression or a recurrence after being first diagnosed with an earlier stage of breast cancer, has been lacking because U.S. registries do not routinely collect or report data on recurrence.

To develop a more accurate estimate of the total number of women living with MBC, researchers used data from NCI’s Surveillance, Epidemiology, and End Results Program to include women who developed MBC after diagnosis. The researchers estimated that, as of Jan. 1, 2017, more than 150,000 women in this country were living with MBC, and that 3 in 4 of them had initially been diagnosed with an earlier stage of breast cancer.

“These findings make clear that the majority of MBC patients, those who are diagnosed with non-metastatic cancer but progress to distant disease, have never been properly documented,” said Mariotto. “This study emphasizes the importance of collecting data on recurrence at the individual level in order to foster more research into the prevention of recurrence and the specific needs of this growing population.”

Study Finds Tens of Millions Of Americans Drink Alcohol at Dangerously High Levels

Nearly 32 million adults in the United States (13 percent of the U.S. population age 18 and older) consumed more than twice the number of drinks considered binge drinking on at least one occasion, according to a 2013 survey that asked about past-year drinking. This higher level of drinking is associated with increased health and safety risks. A report of the findings is online in the American Journal of Preventive Medicine. The study was conducted by researchers at NIAAA.

a depressed man seating at a bar drinking alcohol

“This important study reveals that a large number of people in the United States drink at very high levels and underscores the dangers associated with such ‘extreme’ binge drinking,” said NIAAA director Dr. George Koob. “Of the nearly 90,000 people who die from alcohol each year, more than half, or 50,000, die from injuries and overdoses associated with high blood alcohol levels.”

Binge drinking, defined as having four or more drinks on an occasion for women, or five or more drinks on an occasion for men, can produce blood alcohol levels greater than 0.08 percent, which is the legal limit for driving in the United States. Reaching this level is well known to increase the risk of harms to the drinker and others. However, evidence suggests that many people drink far beyond four or five drinks per occasion, defined as extreme binge drinking.

Extreme binge drinking was particularly common among study participants who used other drugs. This is a concern because combining alcohol with other drugs can increase the risk of injuries and overdose deaths.

“Drinking at such high levels can suppress areas of the brain that control basic life-support functions such as breathing and heart rate, thereby increasing one’s risk of death,” said senior author Dr. Aaron White, senior scientific advisor to the NIAAA director. “The risk increases further if other sedative drugs, particularly opioids or benzodiazepines, are added to the mix.”

The researchers noted that their findings highlight the need to identify interventions to reduce extreme binge drinking and its negative consequences. Additional research is needed to determine how questions about peak alcohol consumption levels can be valuable in screening for alcohol misuse, as well as in assessing gender- specific risk factors and harms for drinking at extreme levels.

Researchers Connect Brain Blood Vessel Lesions to Intestinal Bacteria

A study in mice and humans suggests that bacteria in the gut can influence the structure of the brain’s blood vessels and may be responsible for producing malformations that can lead to stroke or epilepsy. The research, published in Nature, adds to an emerging picture that connects intestinal microbes and disorders of the nervous system. The study was funded by NINDS.

Cerebral cavernous malformations (CCMs) are clusters of dilated, thin-walled blood vessels that can lead to seizures or stroke when blood leaks into the surrounding brain tissue. A team of scientists at the University of Pennsylvania investigated the mechanisms that cause CCM lesions to form in genetically engineered mice and discovered an unexpected link to bacteria in the gut. When bacteria were eliminated, the number of lesions was greatly diminished.

“This study is exciting because it shows that changes within the body can affect the progression of a disorder caused by a genetic mutation,” said Dr. Jim Koenig, program director at NINDS.

The researchers were studying a well-established mouse model that forms a significant number of CCMs following the injection of a drug to induce gene deletion. However, when the animals were relocated to a new facility, the frequency of lesion formation decreased to almost zero.

“It was a complete mystery. Suddenly, our normally reliable mouse model was no longer forming the lesions that we expected,” said Dr. Mark L. Kahn, professor of medicine at Penn and senior author of the study. “What’s interesting is that this variability in lesion formation is also seen in humans, where patients with the same genetic mutation often have dramatically different disease courses.”

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