Radiation may increase breast cancer risk for some

  by MARIA CHENGLONDON -- Mammograms aimed at finding breast cancer might actually raise the chances of developing it in young women whose genes put them at higher risk for the disease, a study by leading European cancer agencies suggests.

The added radiation from mammograms and other types of tests with chest radiation might be especially harmful to them and an MRI is probably a safer method of screening women under 30 who are at high risk because of gene mutations, the authors conclude.

The study can't prove a link between the radiation and breast cancer, but is one of the biggest ever to look at the issue. The research was published Thursday in the journal BMJ.

"This will raise questions and caution flags about how we treat women with (gene) mutations," said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society. He and the society had no role in the research.

Mammograms are most often used in women over 40, unless they are at high risk, like carrying a mutation of the BRCA1 or BRCA2 gene. Having such a mutation increases the risk of developing cancer five-fold. About one in 400 women has the gene abnormalities, which are more common in Eastern European Jewish populations. Unlike mammograms, an MRI, or magnetic resonance imaging scan, does not involve radiation.

The breast cancer screening tests have been proven to save lives and are clearly beneficial for women aged 50 and over who have an average risk of breast cancer. Experts are divided about their value in women younger than 50.

Some studies have suggested women with the genetic mutations could be more sensitive to radiation because the genes are involved in fixing DNA problems. If those genes are damaged by radiation, they may not be able to repair DNA properly, raising the cancer risk.

In several European countries including Britain, the Netherlands and Spain, doctors already advise women with BRCA mutations to get MRIs instead of mammograms before age 30. In the U.S., there is no specific advice from a leading task force of government advisers, but the American Cancer Society recommends yearly mammograms and MRIs from age 30 for women with BRCA gene mutations.

In the BMJ study, European researchers followed nearly 2,000 women over 18 with one of the gene mutations in Britain, France and the Netherlands. Participants reported their previous chest X-rays and mammograms, including the age of their first screening and the number of procedures. About 850 women were later diagnosed with breast cancer. Roughly half of them had X-rays while one third had at least one mammogram, at an average age of 29.

The researchers did not have a breakdown of how many women were exposed to chest radiation before age 30 but estimated that for every 100 women aged 30 with a gene mutation, nine will develop breast cancer by age 40. They projected the number of cases would increase by five if all of them had one mammogram before age 30. But they cautioned their results should be interpreted with caution because most women didn't have a mammogram before 30.

Researchers found women with a history of chest radiation in their 20s had a 43 percent increased relative risk of breast cancer compared to women who had no chest radiation at that age. Any exposure before age 20 seemed to raise the risk by 62 percent. Radiation after age 30 did not seem to affect breast cancer risk.

"We believe countries who use mammograms in women under 30 should reconsider their guidelines," said Anouk Pijpe of the Netherlands Cancer Institute, one of the study authors. "It may be possible to reduce the risk of breast cancer in (high-risk) women by using MRIs, so we believe physicians and patients should consider that."

The study was paid for by European cancer groups.

Lichtenfeld said the study wouldn't immediately change advice from the American Cancer Society but said concerned women should talk to their doctor about their options. "It's not possible today to make a blanket statement about what women (with the gene mutations) should do, but physicians and patients need to weigh the risks and benefits carefully," he said.

He also warned that women who need scans involving radiation shouldn't avoid them because of breast cancer fears.

"No one should think that they should never get an X-ray because they have the BRCA1 or 2 gene mutations," he said. "Just be careful that the X-rays you get are really the ones that you need."

Online:

www.bmj.com

BRCA fact sheet: http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA

American Cancer Society: www.cancer.org

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Coffee prices increase across the country

By Scott Curkin; Eyewitness NewsTARRYTOWN, New York (WABC) -- We all know that folks are paying a lot more to fuel up these days, not just for gas but for coffee too.

In fact coffee price increases have outpaced gas prices in the past year.

While fuel prices are expected to stabilize, coffee could continue to rise.

A batch of espresso blend coffee beans fresh out of the roaster piping hot and $2 more per pound than last year. At coffee labs in Tarrytown, they've had no choice but to pass along rising costs to their customers.

The jump in price of unroasted coffee beans known as green coffee isn't limited to specialty shops or exotic blends. Smucker the company that distributes Folgers and Dunkin Donuts brand coffee in supermarkets is raising what it charges retailers 11percent.

Reasons vary from speculators driving up costs to harsh winters limiting supply.

Experts say it's unlikely prices will drop anytime soon. But for many, coffee is as much a necessity as milk or bread.

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Air traffic controller errors said a real increase

The FAA control tower at Reagan National Airport is seen in Arlington, Wednesday, March 23, 2011. Federal safety officials are investigating a report that two planes landed at the airport without control tower clearance because the air traffic controller was asleep. (AP Photo/Cliff Owen)

  By JOAN LOWYWASHINGTON -- A surge in errors by air traffic controllers appears to be at least partly a real increase and not just the result of better error reporting as Federal Aviation Administration officials claim, a government watchdog said Tuesday.

Also, FAA Administrator Randy Babbitt disclosed that the agency is investigating two additional cases of controllers falling asleep on the job, both in January at radar centers that handle high altitude air traffic.

One controller found sleeping at his work station in Los Angeles has been suspended pending the outcome disciplinary proceedings, the FAA said later in a statement. The other controller, in Fort Worth, Texas, was observed with his eyes closed while he was supposed to be working. He was reprimanded. In all, the FAA has disclosed seven instances of controllers sleeping on the job this year.

Transportation Department Inspector General Calvin Scovel said there has been a 39 percent increase in errors at air traffic control facilities that handle aircraft at high altitudes even though there's been no change in recent years in automated error counting equipment at those facilities.

"That would indicate an absolute increase," Scovel told the Senate Commerce, Science and Transportation aviation subcommittee.

Overall, errors in which planes come too close together in the air increased 53 percent from 2009 to 2010. It's the job of controllers to keep aircraft separated at safe distances.

The increase in errors, as well as a series of inIt would be "cold comfort" to the family of a victim of an air crash caused by a controller error that the controller wasn't allowed to sleep on the job, Scovel said.

Greg Belenky, a sleep expert at Washington State University, said all night shift workers suffer from fatigue no matter how employers try to manipulate shift schedules. The only solution that really works, he said, is allowing brief naps during night shifts.

The head of the air traffic controllers' union said a large increase in new controllers who need on-the-job training is partly responsible for the increase in errors. The FAA plans to hire 11,000 new controllers through 2019.

All those new controllers have to receive on-the-job training from current controllers, placing a serious strain on air traffic operations, Paul Rinaldi, president of the National Air Traffic Controllers Association, testified.

Babbitt disagreed. About 25 percent of controllers are currently in training, a share that is down significantly compared with the last few years and is more in line with the norm, he said.

"We're very comfortable with that," he said.

In response to questioning by Sen. Jay Rockefeller, D-W.Va., Rinaldi acknowledged that some air traffic controllers moonlight.

He said it was more common for less experienced controllers earning lower salaries to hold second and third jobs prior to 2009, when the union and the Obama administration reached a contract agreement that increased controller salaries.

"That's stunning to me," Rockefeller said. "That's like asking for trouble. How do you make the case that this doesn't cause sleeplessness and bad judgment?"

There is no prohibition on outside jobs in the union's contract with the FAA, Rinaldi said.

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