Biphosphonate drugs are widely taken to prevent bone density deterioration in women and men. Now a team led by an Israeli researcher has concluded from an epidemiological analysis that taking them for more than a year may reduce the risk of breast cancer by 29 percent in postmenopausal women.
Prof. Gad Rennert, chairman of the department of community medicine and epidemiology at Haifa's Carmel Medical Center and a faculty member at the Technion-Israel Institute of Technology, presented the team's findings at a recent breast cancer symposium in San Antonio, Texas.
He said the data help shed light on a possible new pathway for breast cancer prevention. If proven in randomized trials, he said, "we may be able to recommend it to postmenopausal women." Clinical trials of healthy women are needed because retrospective studies can't prove that taking the drugs actually prevents some women from getting cancer. In definitive clinical trials, half the women are given bisphosphonates and half are not; researchers then follow them up for years to see how many in each group contract breast cancer.
Rennert and colleagues extracted data from the Breast Cancer in Northern Israel Study, which is a population-based, case-control study. They evaluated the use of bisphosphonates for at least five years in 4,575 postmenopausal study participants using a structured interview. The researchers took into account the effects of a large variety of risk factors for breast cancer such as age, fruit and vegetable consumption, sports activity, family history of breast cancer, ethnic group, body mass index, calcium supplement and hormone replacement therapy use, number of pregnancies, months of breastfeeding and age at first pregnancy.
Moreover, the breast tumors identified among patients who used bisphosphonates were more often estrogen receptor positive and less often poorly differentiated. "These tumors," the Haifa epidemiologist said, "are the type associated with a better prognosis."
If efficacy is confirmed, it would be a very
exciting development, because large numbers of elderly women already take biphosphonates on a regular basis.
APPETITE LOSS FROM BATTERY
A two-and-a-half-year-old Gedera girl who lost
her appetite and suffered a fever was recently saved at Rehovot's Kaplan Medical Center after she was found to have swallowed a button-sized battery that got lodged in her esophagus and was life threatening. The girl, named Sally, underwent surgery in which doctors removed the slightly rusty battery. Dr. Moshe Yehuda of the ear-nose-and-throat department said the child had agreed only to drink a little before her parents took her to the hospital. Fortunately, none of the chemicals inside leaked into her internal organs, and she has recovered.
Yehuda said a child who refuses to eat for more than a day - and certainly if he or she has a fever - must be examined by a doctor. If the refusal to eat continues, the child must be taken to a hospital emergency room. Batteries contain heavy metals that can cause an inflammation, with the tissues swelling and making it impossible to eat. If they are small enough and reach the stomach, they usually pass through the digestive system and out of the body, but if they are stuck in the esophagus or trachea, they have to be removed immediately, he said.
BOTTLED WATER WON'T PROTECT AGAINST CAVITIES
Young children who drink only bottled - rather than fluoridated tap - water are at higher risk of cavities, according to a retrospective study recently presented at the American Public Health Association's annual meeting in Philadelphia. Dr. Rosalia Mendoza of the University of California at San Francisco initiated the study after noticing that 62% of children referred to an oral health clinic in the area had caries by the age of two. More than half of them drank bottled water, from which fluoride is usually removed by reverse osmosis.
In Israel, more than three-quarters of the population get fluoridated water through their faucets, but drinking mineral and other bottled water and even giving it to babies has become fashionable due to the mistaken belief that tap water is not clean enough.
Mendoza said immigrants to the US use bottled water for their children more frequently than veteran residents because they think tap water is not healthful. "In our local community, we are going to be looking at ways that we can do successful public health promotion around these identified areas," she said. The researcher recommended that family physicians tell parents that fluoridated water helps protect teeth from cavities.