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
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
Standard Breast Cancer Care Today
We know that, in general, the three main typesof breast cancer identified based on proteinexpression of hormone receptors and HER2/neu protein can be effectively treatedby using medication to target specific drivers, or molecular-level factorsthat cause cancer to grow:
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What Is Estrogen Receptorpositive Breast Cancer And Progesterone Receptorpositive Breast Cancer
Cells from your breast cancer can be tested for receptors on two hormones that can fuel cancer growth: estrogen and progesterone. Receptors are special proteins on cells that attach to certain substances, such as estrogen and progesterone, much like a key entering a lock. Breast cancer can contain receptors for one of these hormones, both, or neither.
- Breast cancer with receptors for estrogen is called estrogen receptor positive, or ER positive.
- Breast cancer with no receptors for estrogen is called estrogen receptor negative, or ER negative.
- Breast cancer with receptors for progesterone is called progesterone receptor positive, or PR positive.
- Breast cancer with no receptors for progesterone is called progesterone receptor negative, or PR negative.
If your cancer is ER positive, PR positive, or positive for both estrogen and progesterone receptors, your treatment may include a hormone therapy a drug or drugs that keep these hormones from plugging into their receptors. The idea is to cut off the cancers access to the fuel that would otherwise power its growth, much like putting a child safety cap on an electrical outlet.
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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What Is Invasive Lobular Carcinoma
Invasive lobular carcinoma is a cancer that starts in the breasts lobules and invades surrounding tissue. ILC is the second most common form of invasive breast cancer, accounting for 10 to 15% of breast cancer cases. ILC doesnt always form a lump, but women who have it may notice a thick or full area that doesnt feel like the rest of the breast.
External Beam Radiation Therapy
The following three sections refer to treatment using x-rays.
Conventional external beam radiation therapy
Historically conventional external beam radiation therapy was delivered via two-dimensional beams using kilovoltage therapy x-ray units, medical linear accelerators that generate high-energy x-rays, or with machines that were similar to a linear accelerator in appearance, but used a sealed radioactive source like the one shown above. 2DXRT mainly consists of a single beam of radiation delivered to the patient from several directions: often front or back, and both sides.
Conventional refers to the way the treatment is planned or simulated on a specially calibrated diagnostic x-ray machine known as a simulator because it recreates the linear accelerator actions , and to the usually well-established arrangements of the radiation beams to achieve a desired plan. The aim of simulation is to accurately target or localize the volume which is to be treated. This technique is well established and is generally quick and reliable. The worry is that some high-dose treatments may be limited by the radiation toxicity capacity of healthy tissues which lie close to the target tumor volume.
Intensity-modulated radiation therapy
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Genetic Variation In Stromal Proteins Decorin And Lumican With Breast Cancer: Investigations In Two Case
The stroma is the supportive framework of biologic tissue in the breast, consisting of various proteins such as the proteoglycans, decorin and lumican. Altered expression of decorin and lumican is associated with breast tumors. We hypothesized that genetic variation in the decorin and lumican genes may contribute to breast cancer.
Types Of Invasive Breast Cancers
Invasive ductal breast cancer
About 8 out of 10 invasive breast cancers are this type. The cancer develops in the milk ducts of your breast, but breaks out of the duct tubes, and invades, or infiltrates the surrounding tissue of the breast and possibly other areas of the body.
It is usually treated with surgery, often followed by chemotherapy or radiotherapy. Read more about how breast cancer is treated.
The best treatment plan for you will also depend on if your cancer is helped to grow by hormones or particular proteins .
- Oestrogen receptor and progesterone receptor positive cancers are encouraged to grow by the female hormones oestrogen or progesterone. Read more about ER positive breast cancer.
- HER2 positive breast cancer means that the tumour produces too much of a protein called HER2, which helps breast cancer to grow. Read more about HER2+ breast cancer.
- Triple negative breast cancer doesnt have receptors for HER2, oestrogen or progesterone. More about triple negative breast cancer.
Other types of invasive breast cancer:
Rarer types of invasive breast cancer:
Medullary breast cancer, mucinous breast cancer, tubular breast cancer and malignant phyllodes tumours are rare types of breast cancer.
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Diagnosis Of Breast Cancer
To determine if your symptoms are caused by breast cancer or a benign breast condition, your doctor will do a thorough physical exam in addition to a breast exam. They may also request one or more diagnostic tests to help understand whats causing your symptoms.
Tests that can help diagnose breast cancer include:
- Mammogram. The most common way to see below the surface of your breast is with an imaging test called a mammogram. Many women ages 40 and older get annual mammograms to check for breast cancer. If your doctor suspects you may have a tumor or suspicious spot, they will also request a mammogram. If an abnormal area is seen on your mammogram, your doctor may request additional tests.
- Ultrasound. A breast ultrasound uses sound waves to create a picture of the tissues deep in your breast. An ultrasound can help your doctor distinguish between a solid mass, such as a tumor, and a benign cyst.
Your doctor may also suggest tests such as an MRI or a breast biopsy.
If you dont already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
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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Occupational Exposure And Safe Handling
In the 1970s, antineoplastic drugs were identified as hazardous, and the has since then introduced the concept of after publishing a recommendation in 1983 regarding handling hazardous drugs. The adaptation of federal regulations came when the U.S. first released its guidelines in 1986 and then updated them in 1996, 1999, and, most recently, 2006.
The has been conducting an assessment in the workplace since then regarding these drugs. Occupational exposure to antineoplastic drugs has been linked to multiple health effects, including infertility and possible carcinogenic effects. A few cases have been reported by the NIOSH alert report, such as one in which a female pharmacist was diagnosed with papillary transitional cell carcinoma. Twelve years before the pharmacist was diagnosed with the condition, she had worked for 20 months in a hospital where she was responsible for preparing multiple antineoplastic drugs. The pharmacist didn’t have any other risk factor for cancer, and therefore, her cancer was attributed to the exposure to the antineoplastic drugs, although a cause-and-effect relationship has not been established in the literature. Another case happened when a malfunction in biosafety cabinetry is believed to have exposed nursing personnel to antineoplastic drugs. Investigations revealed evidence of genotoxic biomarkers two and nine months after that exposure.
Molecular Receptor Status Of Cancer Cells
Receptors are molecules that cancer cells produce on their surface. These receptors can interact or bind with specific proteins and hormones in the patients body. This is called recognition.
Researchers have identified certain receptors that fuel the growth and spread of breast cancer when they recognize a specific molecule. By interrupting this recognition with cancer drugs, the diseases growth can be slowed or stopped.
Currently, three major receptor subtypes play important roles in the patients prognosis and treatment. As research into breast cancer continues, more receptor subtypes with different treatments may emerge. The three main subtypes follow.
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Lobular Carcinoma In Situ
Lobular carcinoma in situ is sometimes called lobular neoplasia. Though the name can be misleading, LCIS is not considered cancer or pre-cancer because it doesnt turn into invasive cancer if untreated. Instead, LCIS is an indication that a person is at an elevated risk of developing breast cancer later.
Life Style And Dietary Cause
Sedentary life style, high dietary intake of fat obesity particularly in postmenopausal women may cause breast cancer. The use of alcohol is also another one cause of breast cancer. The risk increases with the amount of alcohol consumed. Women who consume two to five alcoholic beverages per day have a risk about one and a half times that of nondrinkers for the development of breast cancer.
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How Breast Cancer Type Affects Treatment
Breast cancer is not a one-size-fits-all disease. Therefore, neither are breast cancer treatment options. It is crucial to determine which hormones, if any, are involved in the growth of your breast cancer. Typically, your treatment plan will be personalized, based on your specific type, biomarkers, and stage of breast cancer.
Your WVCI oncologist will run some tests that indicate the hormone receptor status and HER2/neu status of your breast cancer tumor. These results will play a significant role in the kind of breast cancer treatment we recommend.
What Is The Prognosis For Invasive Ductal Carcinoma
Your doctor will discuss what you can expect based on the characteristics of the invasive ductal carcinoma and the effectiveness of your treatment.
Specialty centers such as Johns Hopkins Medicines Breast Health Services can offer integrated teams of breast cancer specialists who have skill and experience in surgery, breast reconstruction, chemotherapy, biologic targeted therapy, radiation therapy and other hormonal therapies.
Medical science is making great strides forward in treating breast cancer, allowing our surgeries to be less invasive and improving surgical outcomes and overall quality of life, Wright says.
Breast Health Services
Johns Hopkins breast health services include preventive and noncancerous surgical treatment, risk assessment, diagnostic screenings and treatment for breast cancer.
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Frequently Occurring Breast Cancer
Lobular carcinoma in situ : The term, in situ, refers to cancer that has not spread past the area where it initially developed. LCIS is a sharp increase in the number of cells within the milk glands of the breast.
Ductal carcinoma in situ : DCIS, the most common type of non-invasive breast cancer, is confined to the ducts of the breast. For example, ductal comedocarcinoma.
Typical Structure associated with ductal carcinoma
How Is Inflammatory Breast Cancer Diagnosed And Treated
A diagnosis of inflammatory breast cancer is classified as Stage 3 breast cancer and is diagnosed through your physicians clinical judgment and a biopsy. A biopsy for inflammatory breast cancer is a biopsy of the skin of the breast.
If the pathology results show that the skin and dermal lymphatics of the breast skin contain breast cancer cells, this confirms it is inflammatory breast cancer.
Typically, IBC grows rapidly and requires aggressive treatment. This is the only type of breast cancer that requires urgent treatment, beginning with chemotherapy. Most oncologists recommend both local treatment of the affected breast and systemic treatment .
Surgery, radiation therapy, chemotherapy and hormone treatments may be included in the regimen. With aggressive treatment, the survival rate for inflammatory breast cancer patients has improved significantly in recent years.
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How Is Invasive Ductal Carcinoma Diagnosed
Several tests can help your doctor identify and diagnose IDC, including:
Physical exam. Manual examination of your breasts by your doctor can detect lumps and other changes. If your doctor feels a lump or thickening, he or she may recommend further tests to rule out IDC.
Digital mammography is an improved method for breast imaging that is performed much like a regular mammogram. However, it is better than conventional mammography in detecting cancer in younger patients and in those with dense breast tissue. Electronic images can be enhanced with computer-aided detection systems to spot masses, calcifications and abnormalities associated with cancer.
Breast ultrasound uses sound waves to examine the breast tissue and gauge blood flow. It is safe for examining pregnant patients, and does not use radiation.
Breast magnetic resonance imaging uses a large magnet, radio waves and a computer that can detect small breast lesions, and may be especially useful in examining patients with a high risk of breast cancer, such as those with BRCA1, BRCA2 or other gene mutations associated with cancer.
Schedule Your Mammogram
Biopsy. A breast biopsy involves taking a sample of breast tissue from a suspicious area and sending it to a laboratory for microscopic examination by a pathologist, a doctor who specializes in identifying signs of disease. A biopsy can confirm or rule out the presence of cancer and, if cancer is present, reveal its characteristics.
Stages Of Breast Cancer
Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, what part of the breast has cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome .
The most common staging system for breast cancer is the TNM system. For breast cancer there are 5 stages stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.
When describing the stage of breast cancer, sometimes doctors group them as follows:
In situ breast cancer The cancer cells are only in the duct or lobule where they started and have not grown into nearby breast tissue . It is stage 0.
Early stage breast cancer The tumour is smaller than 5 cm and the cancer has not spread to more than 3 lymph nodes. It includes stages 1A, 1B and 2A.
Locally advanced breast cancer The tumour is larger than 5 cm. The cancer may have spread to the skin, the muscles of the chest wall or more than 3 lymph nodes. It includes stages 2B, 3A, 3B and 3C. Inflammatory breast cancer is also considered locally advanced breast cancer.
Find out more about .
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