Breast Cancer

Breast cancer (click on a topic)

cause of breast cancer

chemoprevention

five-year survivals

future approaches with breast cancer

mammography

staging of breast cancer

symptoms of breast cancer

treatment of breast cancer

Introduction:

Breast cancer is a glandular cancer of breast tissue, the most common cancer among women. More women die of cancer of the lung because of its poor prognosis, but breast cancer is more frequent and accounts for about 27% of all cancers among women. Each year in the US alone 181,000 women will be diagnosed with breast cancer. In addition to that another 46,000 women are killed by this disease every year. Expressed in another way a woman in the US has a lifetime chance of 1 in 8 women (or about 12%) to get breast cancer (Ref. 1 and 3).

Fortunately, breast cancer is a slow growing cancer. Breast self examination every month has been shown in combination with mammography in women beyond the age of 50 years to lead to an early diagnosis of this disease and a high cure rate in a lot of women. A localized breast cancer has a 5-year survival rate of 92%. If women are conscientious about regular monthly self breast examinations, the breast cancer is usually caught at stage I where breast conserving surgery (=lumpectomy) rather than the more invasive, disfiguring modified mastectomy can be utilized. This fact has now been widely publicized in TV shows and magazines and acceptance of breast cancer screening among women is rising thus improving the cure rates for breast cancer.

What about mammography?

How successful is mammography in reducing breast cancer mortality? It has been proven in follow-up studies that there is a reduction in breast cancer mortality of 25% because of mammography screening. Furthermore it has been shown that the histologically proven cancer rate of lesions identified as suspicious by mammography and then removed, was between 15% and 30%. This is considered a very successful outcome, particularly as some of the benign lesions removed might in future also have turned cancerous.

Future approaches: "Telomerase inhibitors" is a buzz word that you will hear more often in future. This is an enzyme, which repairs the ends of the DNA in chromosomes as they divide in rapidly dividing cells. If cells are bathed in this enzyme telomerase, they would divide forever and ever: this is what happens with resistant cancer cells. They found a way by genetic mutation to have a constant supply of this enzyme and that's why cancer cells can multiply so well contrary to the normal cells. A new class of drugs has been developed and is further being refined that specifially targets this enzyme system. They are called telomerase inhibitors. This new knowledge will be used for diagnostic purposes on the one hand, but also for therapy on the other (Ref. 4). Finally, there might be a place for telomerase inhibitors as a preventative regimen like tamoxifen (Ref. 5). It is too early to say, which way clinical trials will take us, but it is an exciting time where new break-through therapies are within reach.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

The following references were used apart from my own clinical experience:

1. Cancer: Principles &Practice of Oncology, 4th edition, by V.T. De Vita,Jr.,et. al J.B. LippincottCo.,Philadelphia, 1993.Vol.2: Chapter 48.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 177.

3. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 36: 1541-1616.

4. BS Herbert et al. Breast Cancer Res 2001;3(3):146-149.

5. BS Herbert et al. J Natl Cancer Inst 2001 Jan 3;93(1):39-45.

Last Modified: Dec. 29, 2008