BREAST CANCER: AN OVERVIEW

 

 

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About Authors:
Amardeep Sharma
Rathi Orthopaedic & research centre,
Ahmedabad, India
amardeep.sharma54@gmail.com

ABSTRACT:-
The knowledge of breast cancer development and progression has grown in recent years and relatively development of novel therapeutic strategies, but for cancer mortalities in women breast cancer stands at 2nd position as cause.

In U.S. Approximately 39970 women & 450 men in the U.S. will be diagnosed from the disease in 2011.[1] Breast cancer is a hormone dependent disease.[3] Breast cancer occurs when breast epithelial cells grows in abnormal way. HER2/neu, ER, PR, BRCA1, BRCA2 are the well known influencing factors responsible for breast cancer initiation. The major issues that limit the currently available breast cancer treatment are high cost, poor availability and resistance to chemotherapeutic agents. To overcome this problem researchers are working on several novel approaches i.e. “Novel drug targets & Novel target therapies”.

Since from past few years, mammogram is playing a huge role for decreasing incidence rate in developed countries. Breast cancer is adversely affecting the “quality of life” of patients and its impact has been increasing on the Social capital, population structure and economic growth. Need for novel anti breast cancer agent and novel early diagnosis technique is necessary to combat one of the most serious crises facing Human development.

Reference Id: PHARMATUTOR-ART-1495

PharmaTutor (ISSN: 2347 - 7881)

Volume 1, Issue 1

Received On: 08/10/2013; Accepted On: 02/11/2013; Published On: 25/11/2013

How to cite this article: Sharma A, Breast Cancer: An Overview, PharmaTutor, 2013, 1(1), 29-38

INTRODUCTION:
Breast cancer is a heterogeneous disease & since past 2 decades it has been estimated that breast cancer is a common malignancy in women of world. The data suggests that higher numbers of incidences are estimated in developed countries such as U.K., U.S., and CANADA but nowadays developing counties also suffers with the high numbers of breast cancer incidences. But past few years the incidences of breast cancer is continuously fallen in developed countries such as U.S., U.K. because of recent advancement in treatment & diagnosis approaches.

“The cells of breast become abnormally multiply without any control or order to form a cancerous tumor that is called Breast cancer”. Breast cancer starts from epithelial cell linings of the ducts (that work as a carrier of milk to the nipple) that called Ductal type of cancer. Similarly the other forms of breast cancer that starts in glands (that produce milk) that is called lobular cancer or in other parts of the breast. In case of later stage of breast cancer the cancerous tumor moves to other tissue or distance parts of the body.

If in case of breast cancer cells spreads (metastasize), cancerous cells most often appear in site of bones, liver, lungs, or brain. Tumors that starts at site and then spread to other areas of the body are called metastasize cancer and this type of breast cancer is incurable.

INCIDENCES:-
“Breast cancer is a hormone-dependent disease. The age during menarche, 1st pregnancy, & fulltime menopause is the major factor responsible for the incidence of breast cancer in women.” [2].

BY AGE: The breast cancer age standardized incidences of the worldin 2008(figure-1[3]) estimated by the ICD (International classification of disease) coding system set by the W.H.O. the data suggests that the incidences of breast cancer was high in Europe & U.S. countries than African & Asian counties. But from past few years the incidence rate are continuously coming dawn in developed countries [U.K. & U.S.].  It is estimated by American cancer society that the major factor behind reduced incidence rate is the regular mammograms.

Mammograms impact on incidence
In developed countries routine mammogram is playing a key role for decreasing incidence rate. Figure:2 shows the data of women who taken  mammogram in between 1975-2009.

PATHOLOGY: -
Breast cancer initiation and development has different types of pathways that depends on the various factors or receptor those responsible for the breast cancer initiation and progression.

Mutation in epithelial cell, HER-2, ER, PR, BRCA1 and BRCA2 are the main target or receptor for development of the breast cancer.

Pathology of hereditary breast cancer:
Various risk factors are responsible for breast cancer have been identified such as positive family history, early minarch,and a positive family history, late menopause, and nulliparity. The cause of breast cancer may include any one of this genetic, hormonal, lifestyle, dietary and environmental cause. A number of genes conferring high risk of breast cancer includes BRCA1 and BRCA2[4][5]  P53 “Li-fraumeni syndrome” [6] & PTEN “Cowden syndrome”[7] have been identified where P53 and PTEN are associated with rare cancer syndrome. Almost it is clear that variants of many genes mediate the overall susceptibility of breast cancer. These genes are evidenced in literature such as RAD51, ATM, CHEK2, BRIP1, PALB2, and NBS1[8-12]conferring small to moderate risk of breast cancer.

It has been well known that BRCA1 and BRCA2 germline mutation resulting in breast cancer differ in different cases and the difference lies in morphology, molecular, and immunophenotype vary in age matched sporadic & familial breast cancer in non BRCA1 or 2 patient cases.[13-16]BRCA1 and BRCA2 perform regulation of cell cycle, DNA repair, transcriptional regulation & chromatin remodeling, regulation of RAD51 activities and DNA recombination respectively.

BRCA1 and BRCA2 functions loss leads to following activities such as non-conservative/error prone, potentially mutagenic and ultimately result into genomic instability contributing to the cancer predisposition.[17]

Clinical symptoms
v  The general symptoms of breast cancer at early stage such as…
*  Presence of lump or swelling as a mass.
*  Arm pit (lymph node) swelling.
*  Bloody or clear discharge from nipple.
*  Nipple pain and retracted inverted nipple.
*  Unusual breast pain

v  Advanced stage of disease also some symptoms are mainly occurs such as…
*  Bone painfulness (metastases in bone)
*  Loss of appetite(Metastases in liver)
*  weight loss(Metastases in liver)

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