Nanotechnology In Breast Cancer
The field of nanotechnology has rapidly evolved as evidenced by the fact that there are more than 150 ongoing clinical trials investigating the efficacy of nanotechnology based drug delivery carriers targeting cancer. Various liposomal doxorubicin formulations were developed in an effort to improve the therapeutic index of the conventional doxorubicin chemotherapy while maintaining its anti-tumor activity. For example, the efficacy of three liposomal doxorubicins are currently being used: liposomal daunorubicin , liposomal doxorubicin , and pegylated liposomal doxorubicin . Generally, these agents exhibit efficacies comparable to those of conventional doxorubicin, except with better safety profiles and less cardio toxicity. In addition to liposomal doxorubicin, albumin-bound paclitaxel is another example of an E PR based nanovector application for breast cancer chemotherapy. Paclitaxel is highly hydrophobic and dissolved in cremophor to prevent paclitaxel precipitation. However, cremophor-associated toxicities are severe and challenge the application of paclitaxel. Albumin-bound paclitaxel was developed to improve the solubility of paclitaxel
Is It Possible To Prevent Breast Cancer
There is no guaranteed way to prevent breast cancer. Reviewing the risk factors and modifying the ones that can be altered can help in decreasing the risk.
Following the American Cancer Society’s guidelines for early detection can help early detection and treatment.
There are some subgroups of women that should consider additional preventive measures.
Women with a strong family history of breast cancer should be evaluated by genetic testing. This should be discussed with a health care provider and be preceded by a meeting with a genetic counselor who can explain what the testing can and cannot tell and then help interpret the results after testing.
Chemoprevention is the use of medications to reduce the risk of cancer. The two currently approved drugs for chemoprevention of breast cancer are tamoxifen and raloxifene , which also blocks the effect of estrogen on breast tissues. Their side effects and whether these medications are right for an individual need to be discussed with a health care provider.
Aromatase inhibitors are medications that block the production of small amounts of estrogen usually produced in postmenopausal women. They are being used to prevent reoccurrence of breast cancer but are not approved at this time for breast cancer chemoprevention.
For a small group of patients who have a very high risk of breast cancer, surgery to remove the breasts may be an option. Although this reduces the risk significantly, a small chance of developing cancer remains.
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.
Stage 0
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.
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How Is Metastatic Breast Cancer Diagnosed
Currently, there’s no one test that can diagnose metastatic breast cancer. How the cancer is diagnosed depends on where it has spread in the body, Alberto Montero, MD, director of the breast cancer program at University Hospitals Seidman Cancer Center in Cleveland, Ohio, tells Health.
In most cases, a diagnosis begins with someone with a history of breast cancer reporting a new, unusual symptom to their doctor, Dr. Montero says. This would prompt tests and imaging that would lead to a diagnosis of metastatic cancer. If a former breast cancer patient says they have worsening leg or knee pain, for example, their doctor might order an X-ray and bone scan to check for cancer lesions in those areas.;
“We really pay attention to people’s symptoms,” says Dr. Lin. “If somebody with a known prior history of early breast cancer calls with any suggestive symptoms, then we go on to do scans or tests focused on the areas that are having symptoms.” This is not to say that everyone with a history of breast cancer who reports headaches or abdominal pain has metastatic cancer. But doctors know to investigate further if they have a breast cancer patient with unusual symptoms, because they could indicate a cancer recurrence.;
This is different from how earlier-stage breast cancer is diagnosed, says Dr. Lin. In those cases, breast cancer is usually detected through a mammogram, and then confirmed with an ultrasound and then a biopsy to confirm the diagnosis.;
How Much Do Anastrozole And Exemestane Lower The Risk Of Breast Cancer
Studies have shown that both anastrozole and exemestane can lower the risk of breast cancer in postmenopausal women who are at increased risk of the disease.
In one large study, taking anastrozole for five years lowered the risk of developing estrogen receptor-positive breast cancer by 53 percent. In another study, taking exemestane for three years lowered the risk of developing estrogen receptor-positive breast cancer by 65 percent.
The most common side effects seen with anastrazole and exemestane are joint pains, decreased bone density, and symptoms of menopause .
Last reviewed by a Cleveland Clinic medical professional on 12/31/2018.
References
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Other Treatment For Breast Cancer
Depending on the cancer, other treatment options can include:
- Radiotherapy use x-rays to kill any remaining cancer cells. Women who have had breast-conserving surgery often have a course of radiotherapy. Side effects can include a short-term reddening of the skin, which looks like sunburn, or longer-term thickening of skin.
- Chemotherapy cancer-killing medication is given intravenously . Chemotherapy can be offered to women with early breast cancer as an extra treatment to surgery, radiotherapy or both. Chemotherapy has side effects that will depend on the type of medication you have, but can include nausea, vomiting and hair loss.
- Hormone treatments many breast cancers are influenced by the sex hormones oestrogen and progesterone. Hormone treatment can reduce the chances of breast cancer developing again.
- Biological therapies strengthen the immune system to fight cancer. Several types of biological therapies are now used to treat breast cancer. Research is continuing and various types of therapies are being tested in clinical trials.
- Complementary and alternative therapies when used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve quality of life. Others may not be so helpful and in some cases may be harmful. The Cancer Council Victoria booklet called Understanding complementary therapies can be a useful resource.
Who Gets Breast Cancer
Breast cancer is the most common cancer among women other than skin cancer. Increasing age is the most common risk factor for developing breast cancer, with 66% of breast cancer patients being diagnosed after the age of 55.
In the US, breast cancer is the second-leading cause of cancer death in women after lung cancer, and it’s the leading cause of cancer death among women ages 35 to 54. Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are “sporadic, meaning there is no definitive gene mutation.
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How Do Health Care Professionals Determine Breast Cancer Staging
Staging is the process of determining the extent of the cancer and its spread in the body. Together with the type of cancer, staging is used to determine the appropriate therapy and to predict chances for survival.
To determine if the cancer has spread, several different imaging techniques can be used.
- Chest X-ray: It looks for spread of the cancer to the lung.
- Mammograms: More detailed and additional mammograms provide more images of the breast and may locate other abnormalities.
- MRI: Health care professionals use an MRI to further evaluate the breast or examine other parts of the body.
- Computerized tomography : These specialized X-rays look at different parts of your body to determine if the breast cancer has spread. It could include a CT of the brain, lungs, or any other area of concern.
- Bone scan: A bonescan determines if the cancer has spread to the bones. Low-level radioactive material is injected into the bloodstream, and over a few hours, images are taken to determine if there is uptake in certain bone areas, indicating metastasis.
- Positron emission tomography : Medical professionals inject a radioactive material that rapidly growing cells absorb preferentially. The PET scanner then locates these areas in your body.
Staging system
A health care team uses this system to summarize in a standard way the extent and spread of the cancer. They use this staging to determine the treatment most appropriate for the type of cancer.
Can Exercise Help Reduce My Risk Of Developing Breast Cancer
Exercise is a big part of a healthy lifestyle. It can also be a useful way to reduce your risk of developing breast cancer in your postmenopausal years. Women often gain weight and body fat during menopause. People with higher amounts of body fat can be at a higher risk of breast cancer. However, by reducing your body fat through exercise, you may be able to lower your risk of developing breast cancer.
The general recommendation for regular exercise is about 150 minutes each week. This would mean that you work out for about 30 minutes, five days each week. However, doubling the amount of weekly exercise to 300 minutes can greatly benefit postmenopausal women. The longer duration of exercise allows for you to burn more fat and improve your heart and lung function.
The type of exercise you do can vary the main goal is get your heart rate up as you exercise. Its recommended that your heart rate is raised about 65 to 75% of your maximum heart rate during exercise. You can figure out your maximum heart rate by subtracting your current age from 220. If you are 65, for example, your maximum heart rate is 155.
Aerobic exercise is a great way to improve your heart and lung function, as well as burn fat. Some aerobic exercises you can try include:
- Walking.
- Dancing.
- Hiking.
Remember, there are many benefits to working more exercise into your weekly routine. Some benefits of aerobic exercise can include:
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How Is Breast Cancer Diagnosed
During your regular physical examination, your doctor will take a thorough personal and family medical history. He or she will also perform and/or order one or more of the following:
- Breast examination: During the breast exam, the doctor will carefully feel the lump and the tissue around it. Breast cancer usually feels different than benign lumps.
- Digital mammography: An X-ray test of the breast can give important information about a breast lump. This is an X-ray image of the breast and is digitally recorded into a computer rather than on a film. This is generally the standard of care .
- Ultrasonography: This test uses sound waves to detect the character of a breast lump whether it is a fluid-filled cyst or a solid mass . This may be performed along with the mammogram.
Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue. Biopsies are performed using surgery or needles.
After the sample is removed, it is sent to a lab for testing. A pathologist a doctor who specializes in diagnosing abnormal tissue changes views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is and whether it has spread beyond the ducts or lobules .
What Causes Breast Cancer
Breast cancer happens when there are changes in the genetic material . Often, the exact cause of these genetic changes is unknown.
But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.
There are also certain genetic changes that can raise your risk of breast cancer, including changes called BRCA1 and BRCA2. These two changes also raise your risk of ovarian and other cancers.
Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.
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What Are The Risk Factors For Breast Cancer
Like many conditions, risk factors for breast cancer fall into the categories of things you can control and things that you cannot control. Risk factors affect your chances of getting a disease, but having a risk factor does not mean that you are guaranteed to get a certain disease.
Controllable risk factors for breast cancer
- Alcohol consumption. The risk of breast cancer increases with the amount of alcohol consumed. For instance, women who consume two or three alcoholic beverages daily have an approximately 20% higher risk of getting breast cancer than women who do not drink at all.
- Body weight. Being obese is a risk factor for breast cancer. It is important to eat a healthy diet and exercise regularly.
- Breast implants. Having silicone breast implants and resulting scar tissue make it harder to distinguish problems on regular mammograms. It is best to have a few more images to improve the examination. There is also a rare cancer called anaplastic large cell lymphoma that is associated with the implants.
- Choosing not to breastfeed. Not breastfeeding can raise the risk.
- Using hormone-based prescriptions. This includes using hormone replacement therapy during menopause for more than five years and taking certain types of birth control pills.
Non-controllable risk factors for breast cancer
How Breast Cancer Spreads
Breast;cancer can spread when the cancer cells get into the blood or lymph system and are carried to other parts of the body.;
The lymph;system is a network of lymph vessels found throughout the body that connects lymph nodes . The clear fluid inside the lymph vessels, called lymph, contains;tissue by-products and waste material, as well as immune system cells. The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:
- Lymph nodes under the arm
- Lymph nodes around the collar bone
- Lymph nodes inside the chest near the breast bone
If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread to other parts of your body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Usually, you will need surgery to remove one or more lymph nodes to know whether the cancer has spread.
Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes develop metastases later.
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What I Wish People Knew About Metastatic Breast Cancer
Recurrent breast cancer is breast cancer that returns after initial treatment; it may occur months or years after your initial treatment.; The highest risk of recurrence is during the first two years after treatment, though the majority of patients won’t experience recurrence.
There’s currently no cure for metastatic breast cancer but with treatment to control it, many patients with the disease now live productive, fulfilling lives for years.
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If Your Breast Cancer Has Spread
Even if your breast cancer has spread to other parts of your body, it does not necessarily mean its not treatable. If the cancer cannot be removed, the goal of treatment is to improve symptoms, improve quality of life and extend survival.
Some women live with breast cancer for several years as they learn to adjust and accept that theyll be on treatment for an indefinite period of time, explains Dr. Roesch. Your cancer team will help you learn and cope with what you can expect on this journey.
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What Happens After The Local Breast Cancer Treatment
Following local breast cancer treatment, the treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with the surgeon, may advise the use of the drugs like tamoxifen or anastrozole or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.
After treatment for breast cancer, it is especially important for a woman to continue to do a monthly breast examination. Regular examinations will help you detect local recurrences. Early signs of recurrence can be noted in the incision area itself, the opposite breast, the axilla , or supraclavicular region .
Maintaining your follow-up schedule with your physician is also necessary so problems can be detected when treatment can be most effective. Your health care provider will also be able to answer any questions you may have about breast self-examination after the following procedures.