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Breast-feeding may reduce risk of certain cancer

By Chelsea Conaboy
Globe Staff / August 29, 2011

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Having multiple children is generally thought to reduce the risk of breast cancer in women. But African-American women who give birth to two or more children have about a 50 percent greater chance than those who have no children at all of developing a kind of aggressive breast cancer, which is characterized by the absence of estrogen or progesterone receptors.

A study led by Julie Palmer, senior epidemiologist for Slone Epidemiology Center at Boston University, found that breast-feeding may mitigate that risk. African-American women who had two or more children and breast-fed had no more risk of the cancer than those who had no children. One theory is that breast-feeding allows the breast to return more slowly to its normal structure after childbirth.

The researchers used data from the Black Women’s Health Study to look at the childbirth and breast-feeding patterns of 318 women who developed this type of cancer. The authors suggest that increasing breast-feeding among African-American woman could help curb the cancer rate. Palmer is leading a large new study to further investigate breast cancer in African-American women.

BOTTOM LINE: The risk of developing a certain aggressive breast cancer is higher among African-American women who give birth two or more times, but only for those who do not breast-feed.

CAUTIONS: Though this is the first prospective study large enough to assess reproduction in relation to this kind of cancer, the study group was somewhat small.

WHERE TO FIND IT: Journal of Cancer Epidemiology, Biomarkers & Prevention, online Aug. 16.

Drug may avert strokes in some heart patients

Doctors have long prescribed the anticoagulant warfarin to people with an abnormal heart rhythm, called atrial fibrillation, who are at risk of stroke. But it comes with side effects, including drug interactions and bleeding.

In a study of 18,201 patients, a newer drug was more effective at preventing stroke and other complications. Participants were randomly selected to receive either the experimental drug, apixaban, or warfarin.

Among the apixaban group, 1.27 percent of patients per year experienced a stroke or systemic embolism, compared with 1.6 percent of the warfarin group. Rates of major bleeding and death from any cause were lower in the apixaban group, too.

BOTTOM LINE: In a large study of patients with an abnormal heart rhythm and risk of stroke, apixaban was more effective at preventing stroke and systemic embolism than warfarin.

CAUTIONS: This study was paid for by Bristol-Myers Squibb and Pfizer, pharmaceutical companies that are jointly developing apixaban. The drug is likely to be more expensive than warfarin, which is now available in generic form. A different trial of the drug was halted last year because of excessive bleeding in heart disease patients.

WHERE TO FIND IT: New England Journal of Medicine, online Aug. 28.

Chelsea Conaboy can be reached at cconaboy@boston.com.

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