Breast cancer
Breast cancer is a common cancer, and there are approximately 194,000 new cases diagnosed in the United States each year. [1] The disease occurs most often in women, but can also occur in men.
Breastfeeding may be 6-9 overlapping sections called lobes and within each lobe smaller lobules, which contain many cells that produce milk. Lobes and lobules are connected by a channel called thin tube, which leads to the nipple in the middle of the breast. Spaces in all parts of the channel filled with lobules and fat. Lymph fluid called lymph nodes bear colorless, which contains important immune cells. In the lymph vessels lead to small bean-shaped structures called lymph nodes. Groups of lymph nodes in the axilla (under arm), and above the collarbone, and chest.
The suspicion of breast cancer often appear when first detected a lump in the breast during breast examination or a suspicious areas identified during mammography examinations. In order to diagnose the cause of a suspicious area or lump in the breast, the doctor will do a biopsy. Biopsy can be performed on outpatients. During the biopsy, the doctor will remove cells for examination in the laboratory to determine whether cancer was present. Other information obtained from the biopsy sample will play an important role in treatment decision making. If the biopsy shows that cancer was present, additional surgery can be performed after the patient and doctor to determine treatment.
There are many types of breast tumors. Some breast tumors, benign (not cancerous). Benign breast tumors such as fibroadenomas or papillomas do not spread beyond the breast, which was not life threatening. Other malignant breast tumors (cancer). The most common types of cancer, breast cancer called the channel and began lining the canals. Another type of cancer is called lobular cancer, which appears in the lobules.
Personalized Cancer Care
When cancer is identified in the biopsy sample may be some other tests done on the sample further classification of cancer, and to determine the best treatment strategy. Based on the stage of cancer and the results of these tests, and treatment of breast cancer is personal for each individual. Treatment may involve surgery, radiation therapy, chemotherapy and targeted therapies, and / or hormone therapy.
Stage: Stage is a measure of the extent of the spread of cancer, and based on tumor size and presence or absence of lymph node metastases and distant metastases. Determine the stage of cancer may take some action, such as blood tests and chest X-ray, mammography, CT scan) or Magnetic Resonance Imaging (MRI). For patients with early stage cancer, and the spread of cancer in the axillary (under arm) lymph nodes can be assessed through either sentinel lymph node biopsy or lymph node dissection of the axilla. Axillary lymph node dissection involves the removal of many axillary lymph node procedure can be associated with side effects such as chronic pain and limited mobility in the shoulder, numbness and swelling. Biopsy of sentinel lymph node is more recent, involving removal of only a small number of contracts, or even a single node. If the sentinel lymph node negative (no evidence of cancer), no lymph nodes required for further operations. Biopsy of sentinel lymph node more widely adopted in clinical settings to determine whether the cancer has spread to the lymph nodes in women with breast cancer.
HER2 Center: twenty to thirty percent of breast cancers overexpress (make a lot) which is known as the HER2 protein. Excess of this protein leads to increased growth of cancer cells. Fortunately, the development of treatments that specifically target HER2 positive cells – such as Herceptin ® (and rate) and Tykerb ® (lapatinib) – has been improving results among women with HER2 – positive breast cancer. For this reason, it must be measured accurately HER2 status of all breast cancers.
Hormone receptor status: Some cells of breast cancer by the abundance of receptors for the hormone estrogen in women and / or progesterone. These cancers – called hormone receptor positive – that is usually associated with a better prognosis, and treated differently from breast cancer – hormone receptor negative. Patients with hormone receptor-positive breast cancer often receive treatment with hormone therapy, like tamoxifen or hormone inhibitors. For more information, go to hormonal therapy.
Anticipating the need for chemotherapy: Among women with early stage breast cancer, expression, or activity, a specific gene has been linked with possible cancer recurrence and chemotherapy benefit; testing tumor tissue for the expression of these genes can provide important information about the diagnostic possibility of response to treatment.
A genomic test that is included in the guidelines of the American Society of Clinical Oncology ([ASC]), and a national network of comprehensive cancer control (NCCN) is Oncotype DX ®. Based on the expression of 21 genes, this test provides information about the possibility of recurrence, and possible benefits of chemotherapy, women with newly diagnosed breast cancer has not spread to the lymph nodes (node negative) and hormone receptor positive. Oncotype DX also showed promising results in women with node positive breast cancer. [2]
For more information about OncotypeDX, visit http://www.mytreatmentdecision.com/
Expected drug metabolism: other types of tests that may be important is to assess the genetic diversity and heritage, which affects the metabolism of drugs (drug-processing of the body). In the case of tamoxifen, for example, there may be differences in the effectiveness and explains at least in part by inherited differences in the gene known as CYP2D6. [3] Most people have two copies of this gene and functional, and allows the effectiveness of tamoxifen. Some people, however, have versions of this gene are less effective in dealing with tamoxifen. Testing patients for these gene variants may help doctors identify patients who are less likely to respond to tamoxifen. A test is currently available AmpliChip ®, the assess CYP2D6 and CYP2C19 (another gene involved in drug metabolism). Additional data are needed, however, before formal recommendations can be developed for this type of testing. [4]
For more information about AmpliChip, visit http://www.amplichip.us/.
Learn more
Patients who have undergone surgery, and lymph node evaluation and know the stage of cancer may select from the options below. To learn more about the surgery, and sentinel lymph node dissection, and go to breast cancer surgery.
Cancer in the original home: about 15-20% of breast cancer very early in their development. This is sometimes referred to as carcinoma in situ and consist of two types: the channel in situ cancers (DCIS), which comes from the channel and lobular cancer in situ (LCIS), which originated from the lobules. DCIS is a precursor to invasive cancer, LCIS, and is a risk factor for cancer.
Stage I: cancer limited to one site in the breast, less than 2 cm (3 / 4 inches) in size does not spread beyond the breast.
International investment stage: the cancer has spread to the lymph nodes under the armpit, and less than 2 cm (3 / 4 inches) in size or the primary cancer itself is 2-5 centimeters (3/4-2 inches) and does not spread to lymph nodes.
Stage IIB: cancer has spread to the lymph nodes under the armpit and / or primary cancer is greater than 5 centimeters (2 inches) in size and does not involve lymph nodes.
The third stage: Cancer is less than 5 centimeters (2 inches) and spread to the lymph nodes under the arm or lymph nodes that are connected with each other or other structures or the primary cancer is greater than 5 centimeters (2 inches) and has spread to the lymph nodes under the arm.
Stage IIIB: Cancer directly involves the chest wall or has spread to internal lymph nodes on the same side of the chest.
Inflammation: inflammatory breast cancer is a special type of breast cancer is rare. Breasts looked as if it was inflamed because of the red appearance and warmth. The skin may show signs of mountains and wheals or it may look warehouses. Inflammatory breast cancer tends to spread rapidly.
Phase IV: the cancer has spread to distant places in the body, which may include liver, lungs, bones or other sites.
Repeat / recurrence: Breast cancer has progressed or returned (recurrent / relapsed) following initial trea