Brca1/2 Mutations In Breast Cancer
Approximately 10%â20% breast cancer patients have at least one first-degree relatives affected with breast cancer., Among them, up to 20% of women with a family history of breast cancer have a mutation in the breast cancer susceptibility genes 1 or 2 . Thus, the significance of BRCA1 and BRCA2 in breast cancer can be told from their names., The prevalence of germline BRCA mutations is relatively high in women of Ashkenazi Jewish ethnicity, where the risk is estimated to be 30%â35%., , In male breast cancer cases, up to 14% have a BRCA2 mutation although 4.5% of Ashkenazi Jewish men presenting with breast cancer have a BRCA1 mutation., Moreover, among women with ovarian cancer, regardless of family history, about 15% are attributable to BRCA mutations, while the proportion with a germline BRCA mutation may be as high as approximately 40% in Ashkenazi Jewish women with epithelial ovarian cancer.
The BRCA proteins share a similar, and cooperative, tumor suppressing mechanism by repairing DNA damage through homology-directed repair , which inhibits tumorigenesis., Thus, deletion mutations and/or loss of function in the BRCA genes lead to decreased DNA repair efficiency and possibly give rise to the expansion of cancerous cells, elevating the risk of developing breast cancer by five to six fold.,
Cosmetic Implants And Breast Cancer Survival
The general agreement, based on , is that silicone breast implants do not increase the risk of breast cancer. A 2015 meta-analysis of 17 studies that included participants who had undergone cosmetic breast augmentation discovered no increase in the risk of breast cancer associated with the procedure. In fact, the research showed that the incidence among these participants was lower than expected.
In 2021, another study found that women with cosmetic implants have significantly lower rates of breast cancer than those who do not have them.
Meanwhile, a 2013 meta-analysis found that women who received a diagnosis of breast cancer after getting cosmetic breast implants may have a higher risk of dying from the disease.
However, this research did not factor in other variables that may influence breast cancer mortality, such as body mass index, age at diagnosis, or cancer stage at diagnosis. And at least one of the studies in the analysis looked at overall mortality, instead of breast cancer-specific mortality, thereby potentially skewing the results. As such, a person should consider the finding with caution.
most common type is ductal carcinoma, which begins in a milk duct. Another type is lobular carcinoma, which begins in a lobule, one of the tiny glands that produce milk.
Invasive breast cancer involves cancerous cells spreading to nearby tissue. It is then more likely that the cancer will spread to other parts of the body.
Signs And Symptoms Of Breast Cancer
In its early stages, breast cancer may not cause any symptoms. In many cases, a tumor may be too small to be felt, but an abnormality can still be seen on a mammogram.
If a tumor can be felt, the first sign is usually a new lump in the breast that was not there before. However, not all lumps are cancer.
Each type of breast cancer can cause a variety of symptoms. Many of these symptoms are similar, but some can be different. Symptoms for the most common breast cancers include:
- a breast lump or tissue thickening that feels different than surrounding tissue and has developed recently
- breast pain
- changes to the appearance of the skin on your breasts
- a lump or swelling under your arm
If you have any of these symptoms, it doesnt necessarily mean you have breast cancer. For instance, pain in your breast or a breast lump can be caused by a benign cyst.
Still, if you find a lump in your breast or have other symptoms, you should see your doctor for further examination and testing.
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Kinds Of Breast Cancer
The most common kinds of breast cancer are
- Invasive ductal carcinoma. The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
- Invasive lobular carcinoma. Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.
How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
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Tips On How To Prepare For A Mammogram
Undergoing regular mammogram screenings can help detect breast cancer early. It is common knowledge that early detection of breast cancer increases rate of survival. There are different types of mammograms, the most common one is digital mammogram. Some feel nervous or anxious before a mammogram screening, especially if this is …
Does Breast Cancer Affect Women Of All Races Equally
All women, especially as they age, are at some risk for developing breast cancer. The risks for breast cancer in general arent evenly spread among ethnic groups, and the risk varies among ethnic groups for different types of breast cancer. Breast cancer mortality rates in the United States have declined by 40% since 1989, but disparities persist and are widening between non-Hispanic Black women and non-Hispanic white women.
Statistics show that, overall, non-Hispanic white women have a slightly higher chance of developing breast cancer than women of any other race/ethnicity. The incidence rate for non-Hispanic Black women is almost as high.
Non-Hispanic Black women in the U.S. have a 39% higher risk of dying from breast cancer at any age. They are twice as likely to get triple-negative breast cancer as white women. This type of cancer is especially aggressive and difficult to treat. However, it’s really among women with hormone positive disease where Black women have worse clinical outcomes despite comparable systemic therapy. Non-Hispanic Black women are less likely to receive standard treatments. Additionally, there is increasing data on discontinuation of adjuvant hormonal therapy by those who are poor and underinsured.
In women under the age of 45, breast cancer is found more often in non-Hispanic Black women than in non-Hispanic white women.
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How Does Tumor Size And Location Affect Treatment
Its important for your doctor and entire healthcare team to know the cancers stage in order to plan treatment. Treatment for breast cancer takes into account the tumors size, location, and spread, if there is any.
For advanced-stage cancers, a doctor may use systemic treatments. These include chemotherapy, hormone therapy, targeted therapy, and more. Radiation may also be used for advanced-stage cancer, but other treatments will likely be used in conjunction.
Age At First Menstrual Period First Pregnancy And Menopause
The earlier menstruation begins , the higher the risk of developing breast cancer.
The later the first pregnancy occurs and the later menopause occurs, the higher the risk. Never having had a baby increases the risk of developing breast cancer. However, women who have their first pregnancy after age 30 are at higher risk than those who never have a baby.
These factors probably increase risk because they involve longer exposure to estrogen, which stimulates the growth of certain cancers.
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Types Of Breast Cancer
There are many different types of breast cancer. The type is determined by the specific kind of cells in the breast that are affected. Most breast cancers are carcinomas. The most common breast cancers such as ductal carcinoma in situ and invasive carcinoma are adenocarcinomas, since the cancers start in the gland cells in the milk ducts or the lobules . Other kinds of cancers can grow in the breast, like angiosarcoma or sarcoma, but are not considered breast cancer since they start in different cells of the breast.
Breast cancers are also classified by certain types of proteins or genes each cancer might make. After a biopsy is done, breast cancer cells are tested for proteins called estrogen receptors and progesterone receptors, and the HER2 gene or protein. The tumor cells are also closely looked at in the lab to find out what grade it is. The specific proteins found and the tumor grade can help decide the stage of the cancer and treatment options.
To learn more about the specific tests done on breast cancer cells, see Understanding a Breast Cancer Diagnosis.
Screening For Breast Cancer
Women aged between 50 and 74 are invited to access free screening mammograms every two years via the BreastScreen Australia Program.
Women aged 40-49 and 75 and over are also eligible to receive free mammograms, however they do not receive an invitation to attend.
It is recommended that women with a strong family history of breast or ovarian cancer, aged between 40 and 49 or over 75 discuss options with their GP, or contact BreastScreen Australia on 13 20 50.
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Examples Using The Full Staging System
Because there are so many factors that go into stage grouping for breast cancer, it’s not possible to describe here every combination that might be included in each stage. The many different possible combinations mean that two women who have the same stage of breast cancer might have different factors that make up their stage.
Here are 3 examples of how all of the factors listed above are used to determine the pathologic breast cancer stage:
Symptoms Of Endometrial Cancer
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Conventional Stages Of Breast Cancer Progression: 0 Through Iv
As mentioned, there are five basic stages of breast cancer with a couple of sub-categories.
This is a bit of an unclear term which specialists use to describe the development of abnormal cells that are not yet invasive breast cancer. Indeed physicians consider Ductal Carcinoma in situ, or DCIS, stage 0 breast cancer.
Here the malignant cancer cells are present in the lining of the breast d uct but have not yet invaded the surrounding breast tissue or spread beyond the duct. Almost 100% of DCIS is curable, but it obviously, does need treatment.
Early-stage breast cancer Stage 1
Stage 1 breast cancer is an early stage breast cancer. There is a considerable difference in medical opinion as to what exactly constitutes early stag e breast cancer. Also, how aggressive the treatment for Stage I breast cancer is another area of debate.
The standard definition of a stage 1 breast tumor is that a certain amount of breast cancer cells invade tissues and structures beyond the duct lining. However, no cancer cells have spread beyond the breast.
Furthermore, the tumor size is less than 2 cm in diameter. If physicians can detect and treat breast cancer before it grows beyond 2cm, the prognosis is very very good.
The average age of diagnosis of a stage 1 breast tumor is about 52 years old. In over 90% of cases, treatment tends to involve breast conservation surgery, followed by radiation therapy.
Chance of stage 1 cancer recurrence or spreading.
How Much Do Tamoxifen And Raloxifene Lower The Risk Of Breast Cancer
Multiple studies have shown that both tamoxifen and raloxifene can reduce the risk of developing estrogen receptor-positive breast cancer in healthy postmenopausal women who are at high risk of developing the disease. Tamoxifen lowered the risk by 50 percent. Raloxifene lowered the risk by 38 percent. Overall, the combined results of these studies showed that taking tamoxifen or raloxifene daily for five years reduced the risk of developing breast cancer by at least one-third. In one trial directly comparing tamoxifen with raloxifene, raloxifene was found to be slightly less effective than tamoxifen for preventing breast cancer.
Both tamoxifen and raloxifene have been approved for use to reduce the risk of developing breast cancer in women at high risk of the disease. Tamoxifen is approved for use in both premenopausal women and postmenopausal women . Raloxifene is approved for use only in postmenopausal women.
Less common but more serious side effects of tamoxifen and raloxifene include blood clots to the lungs or legs. Other serious side effects of tamoxifen are an increased risk for cataracts and endometrial cancers. Other common, less serious shared side effects of tamoxifen and raloxifene include hot flashes, night sweats, and vaginal dryness.
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About Those Lymph Nodes
A surgeon will usually take a lymph node biopsy to determine if the breast cancer has spread to the axillary lymph nodes. This is not always necessary, however. A lymph node biopsy is not usually necessary for DCIS. However, for invasive breast cancer, yes, they do need to check the lymph nodes.
Sometimes, doctors will perform a sentinel node biopsy, rather than a full lymph node excisional biopsy if the concerns about cancer spread are minimal. Cancer cells tend to appear first in the sentinel node before spreading to the other nodes, or other areas of the body.
Are There Complications Of Breast Cancer
Possible complications from breast cancer treatment include:
- Lymphoedema in some cases, removing your lymph nodes may cause swelling, discomfort and pain in the arm, shoulder and upper body.
- Early menopause certain treatments, especially chemotherapy and hormone therapy, can cause menopause symptoms, such as hot flushes, joint pain, or a change in sex drive, to occur earlier than usual.
- Anxiety and depression research shows that anxiety and depression are common among women with breast cancer. One study found that up to 50 per cent of women with early breast cancer may experience anxiety and/or depression in the year after diagnosis.
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Expert Review And References
- American Cancer Society. Breast Cancer. 2015: .
- Foxson SB, Lattimer JG & Felder B. Breast cancer. Yarbro, CH, Wujcki D, & Holmes Gobel B. . Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett 2011: 48: pp. 1091-1145.
- Martini FH, Timmons MJ, Tallitsch RB. Human Anatomy. 7th ed. San Francisco: Pearson Benjamin Cummings 2012.
- Morrow M, Burstein HJ, and Harris JR. Malignant tumors of the breast. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2015: 79: 1117-1156.
What Is A Sentinel Lymph Node
A network of lymphatic vessels and lymph nodes drain fluid from the tissue in the breast. The lymph nodes are designed to trap foreign or abnormal cells that may be contained in this fluid. Sometimes cancer cells pass through the nodes into the lymphatic vessels and spread to other parts of the body.
Although fluid from breast tissue eventually drains to many lymph nodes, the fluid usually drains first through one or only a few nearby lymph nodes. Such lymph nodes are called sentinel lymph nodes because they are the first to warn that cancer has spread.
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How Cancer Spreads Into Surrounding Tissues
As a tumour gets bigger, it takes up more space in the body. The cancer can:
- press on surrounding structures
- grow into body structures nearby
This is called local invasion. Researchers don’t fully understand how cancer grows into the surrounding tissues
A cancer might grow out in a random direction from where it started. However, researchers know that tumours can spread into some tissues more easily than others. For example, large blood vessels that have strong walls and dense tissues such as cartilage are hard for tumours to grow into. So, tumours tend to grow along the ‘path of least resistance’. This means that they probably take the easiest route.
We know from research that there are 3 different ways that tumours may grow into surrounding tissues. A tumour probably uses all 3 of these ways of spreading. The way it uses most depends on:
- the type of tumour
- where the cancer is growing in the body
The 3 ways that tumours may grow into surrounding tissues are:
- pressure from the growing tumour
- cancer cells moving through the tissue
What Types Of Breast Cancer Are There
Most breast cancers are carcinomas, which start in the cells that line organs and tissue in the body. Breast cancer is usually a specific type of carcinoma called an adenocarcinoma, which starts in the milk ducts or glands in the breast that make milk.
Breast cancers can also be categorised by whether it has spread to other parts of the body or not. A pre-cancer that starts in a milk duct, but hasnt grown into other breast tissue, is called ductal carcinoma in situ .
If it has spread into nearby breast tissue, it is called an invasive or infiltrating breast cancer. Breast cancer that has spread further, to other parts of the body, is called metastatic breast cancer. Cancer found in another part of the body that has spread from the breast is a secondary breast cancer.
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