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WEDNESDAY, July 11 (HealthDay News) -- Women with breast cancer who carry BRCA gene mutations have the same death rates from their malignancies as women without this DNA variant do, a new study finds.

These findings, published in the July 12 issue of the New England Journal of Medicine, run counter to much current medical thought.

"Our main finding of similar -- or even better -- survival of the carriers is in contrast to some, but not all, of the former publications on the subject," noted study author Dr. Gad Rennert, of the Clalit National Cancer Control Center and Carmel Medical Center in Haifa, Israel. "However, we employed a 'clean' design which was not possible for other research groups and therefore our study results come closer to 'truth' than any other study on the subject."

Practically speaking, the findings could impact the treatment decisions of women who have one of the two genetic mutations, called BRCA1 or BRCA2.

Many previous studies on the issue had suggested that cancer resulting from these mutations had a worse outcome than other types of breast tumors.

The BRCA mutations are more common among women of Ashkenazi Jewish descent, which may help account for why breast cancer is the leading cause of all deaths from cancer among Israeli women. Some 60 percent of Israeli Jews are Ashkenazi. About 2 percent of all Ashkenazi women and 12 percent of Ashkenazi women with breast cancer carry a mutation in one of these two genes.

BRCA1-associated breast cancers, especially, tend to occur in younger women, are high-grade and are not estrogen-receptor positive, all factors which are associated with a poorer outcome.

But information on how a woman's BRCA status might affect her prognosis has been "inconsistent," the authors stated.

To clarify the picture, the authors looked at all cases of invasive breast cancer diagnosed between Jan. 1, 1987 and Dec. 31, 1988, and recorded in the Israeli National Cancer Registry. This represented the majority of all women who had been diagnosed with breast cancer in Israel during this time period. The researchers examined patient tumor samples and analyzed DNA, and they also catalogued deaths occurring within 10 years of diagnosis.

The authors were able to look at tumor samples from 1,794 of 2,514 participants and obtained medical records for 1,545 of the women. Ten percent of participants who were of Ashkenazi Jewish ancestry had either a BRCA1 or BRCA2 mutation.

The risk of dying from breast cancer was not significantly different among carriers and non-carriers, the researchers found. Furthermore, both groups responded similarly well to chemotherapy.

"The main importance of the study is in demonstrating that in spite of the bad prognostic factors profile, [BRCA] carriers do well, which is of importance both to doctors as well as to the carrier women," Rennert said. "It also demonstrates that chemotherapy is very efficacious in the carriers and that oncologists should not spare carrier women, even with small tumors, the potential benefits of treatment."

The next step will be to individualize treatments, "as it seems that certain treatments probably work better for carriers, while they might be resistant to others," Rennert added.

More information

There's an overview of the genetics of breast cancer at the U.S. National Cancer Institute.

FRIDAY, July 5 (HealthDay News) -- Would-be moms often want to know how to trim their bellies after having children. But how actively do they seek tips for getting their bodies in great shape before getting pregnant?

Until recently, that part of the baby-making equation had been largely absent from the discussion. Increasingly, though, maternal health and prenatal-care experts are urging women to improve their health before conceiving.

The hope is that measures taken to bolster a woman's health prior to conception -- whether it's reaching an optimal weight, controlling a chronic disease or boosting overall nutritional health -- will improve the odds of having an uncomplicated pregnancy and a healthy baby.

Dr. Lorey H. Pollack, director of obstetrics and gynecology at Mercy Medical Center in Rockville Centre, N.Y., has some patients who are very informed and motivated to take better care of themselves before contemplating pregnancy. Others, though, come in pregnant and say, "By the way, I have diabetes; by the way, I have Lupus; by the way, I have high blood pressure, and they're kind of shocked to find out that's an issue when they're pregnant," he said.

Pollack blames the medical profession and the media for failing to get the word out.

But recommendations compiled by experts at the U.S. Centers for Disease Control and Prevention as well as more than 35 government, public and private partners may help to draw attention to the importance of preconception care.

Dr. Hani K. Atrash, associate director for program development at the CDC's National Center on Birth Defects and Developmental Disabilities and co-author of the government report, said, "If a woman or couple has decided to conceive, then at least one pre-pregnancy visit is recommended, and the five most important things to do are":

• Take 400 micrograms of folic acid a day for at least three months before pregnancy to reduce the risk of birth defects.
• Stop smoking and drinking alcohol.
• Consult with a health-care provider to manage any and all medical conditions, including, but not limited to, asthma, diabetes, oral health, obesity, or epilepsy, and maintain up-to-date vaccinations.
• Talk to your doctor and pharmacist about any over-the-counter and prescription medicines you are taking, including vitamins and dietary or herbal supplements.
• Avoid exposure to toxic substances or potentially infectious materials at work or at home, such as chemicals, or cat and rodent feces.

Atrash was also co-editor of a special supplement of the Maternal and Child Health Journal, published last September, devoted entirely to the topic of preconception care.

The movement to intervene prior to conception is based on evidence linking certain factors, such as lack of folic acid, smoking, alcohol misuse and obesity, to unwanted pregnancy outcomes.

"Some of these risk factors have stronger associations with particular adverse outcomes than others," Atrash explained. "For instance, daily consumption of 400 micrograms of folic acid before or early in pregnancy can reduce the occurrence of neural tube defects," such as spina bifida.

And while single interventions, such as taking folic acid or quitting smoking, are effective in modifying behaviors in pregnancy, "we do not yet know the effectiveness of multiple interventions packaged together in the form of a preconception care model," Atrash said, "mostly because this is a new approach that has not been widely practiced, and we have very little or no data to analyze."

"It's a hard thing to measure," Pollack agreed. Still, he always tells patients contemplating pregnancy to make an appointment to talk about some of these issues and begin taking steps to address health issues.

"It's always easier to try to prevent a problem than to catch up with it later on," he reasoned.

More information

For more on preconception health, visit the American Pregnancy Association  .

THURSDAY, July 5 (HealthDay News) -- Overweight or obese white American women are more likely than their black peers to ask for dieting assistance, such as counseling from a medical professional, a doctor's prescription, membership in a weight-loss group, or advice from a trainer, a new study finds.

The study authors, who surveyed 120 women in Philadelphia, also found that body image was an important motivator for white women in seeking dieting help but not as important to black women.

The findings are published in the current issue of the journal Ethnicity & Disease.

"We found that African-American women did not differ from Caucasians in terms of concerns about body shape and weight," but those concerns were more likely to motivate white women to seek dieting assistance, said lead author Rachel Annunziato, assistant professor in the department of psychiatry, Mount Sinai School of Medicine, New York City.

Obesity-related health concerns were not cited by either black or white women in the study as a primary motivation for losing weight.

Annunziato said cultural factors likely play an important role in influencing whether, when, and where women seek help with dieting and the type of assistance they prefer.

"Community-based approaches appear to be promising vehicles for promoting weight loss in ethnic minorities; however, there is much work to be done in terms of developing programs that improve both weight loss and successful maintenance of weight loss," Annunziato said in a prepared statement.

Modifying weight-loss programs to better address the needs of black women and other minorities may be an important step.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases offers advice on choosing a safe and effective weight-loss program.

THURSDAY, July 5 (HealthDay News) -- New research finding men and women speak roughly the same number of words each day is likely to get both sexes talking, experts say.

Researchers recorded the daily conversations of 400 university students in the United States and Mexico over a period of several days. They found that females spoke about 16,215 words each day, and males uttered an average of 15,669 words, which was considered a statistical dead heat.

"So, counter to stereotypes, there doesn't seem to be evidence that males and females talk at different rates, at least among college students," said study author James Pennebaker, the psychology department chairman at the University of Texas at Austin.

His team published the findings in the July 6 issue of Science.

Well-worn clichés about women being chatterboxes all stem from the same cultural notion -- that they love talking much more than men, experts said..

But there has never been any scientific proof to back up that stereotype, said Marianne LaFrance, a professor of psychology and women's gender and sexuality studies at Yale University.

In her own and others' work, LaFrance noted, "the research is consistently showing either no sex differences in the amount that men and women talk, or if there is a difference, then it depends on the context. For example, in a professional context, men actually outspeak women by a long shot."

That's why behavioral psychologists won't be overly surprised by the Science findings, added LaFrance, who was not involved in this research. "What's novel here isn't the findings but rather the methodology," she said..

Because of recent advances in technology, Pennebaker's group was able to design a cell phone-sized recording device that the study participants could carry in a pocket while their everyday conversations were taped by a mike clipped to their lapel. The participants quickly forgot they were wearing the recorder, Pennebaker said, and "after the first couple of hours, people rarely made mention of the device."

And unlike prior studies, where participants had some control over when and where the recorder was switched on, the device used in the new study automatically clicked on every 12 minutes to record whatever was being said -- or not said -- for the next 30 seconds.

The 19- to 25-year-olds in the study wore the voice recorders for several days each.

The result: Pennebaker's team found no gender difference whatsoever in the amount of talking done each day by these young men and women.

According to Pennebaker, it's still possible that differences in verbalization between the sexes emerge as people age. And he said the study's focus on college students might also ignore behavioral differences between men and women based on social class.

But LaFrance believes that prevailing notions of the "female chatterbox" have cultural and political roots based in sexism.

"There's this prevailing idea that women are engaged in trivia, in minutia, silly patter," she said. On the other hand, stereotypical men are thought to hang back, silent, until they have something really important to say.

But study after study refutes these pat assumptions, the Yale expert said. For example, there's ample evidence that gossip is just as popular a topic of conversation (if not more so) among men as it is among women, LaFrance said.

However, it is true that women and men tend to favor distinct subject matter when they talk, she said.

"The data shows that women do tend to talk about relationships more," LaFrance said. And it's possible that this desire by women to better understand other people, most notably their partners, has given rise to certain stereotypes.

"If I were going to guess why people think women talk more, it would be that it probably comes from what happens during [romantic] conflict," Pennebaker said. "There have been some studies to suggest that during emotional conflict, guys get quiet and women talk more."

Even though the tendency of males to "clam up" in these private disputes doesn't carry over to other social contexts, people may generalize that men are withdrawn by nature, Pennebaker said.

LaFrance agreed. "One of the biggest complaints in heterosexual relationships that women have is the 'unforthcomingness' of their male partners," she said. "That may be where part of these stereotypes come from."

But the experts agreed that men can quickly become much more verbal when the mood strikes them.

In marital conflict situations, "the data shows that it depends what they're talking about," LaFrance said.

"If she wants to talk about something that he cares about, then he will respond," she added.

And subject matter is also key, she noted: "Just get guys talking about sports or finance or lawnmowers -- then you've got another category of chatterboxes."

More information

Find about gender and the brain at the Society for Neuroscience.