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Breast Cancer

Breast Cancer. Introduction. As old as 1600 BC Emerges from inner lining of milk ducts Or the lobules that supply milk Types: DCIS LCIS. Genetic, Behaviour, Infectious?. Non-Functional BRAC1 & BRAC2 Genes

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Breast Cancer

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  1. Breast Cancer

  2. Introduction • As old as 1600 BC • Emerges from inner lining of milk ducts • Or the lobules that supply milk • Types: • DCIS • LCIS

  3. Genetic, Behaviour, Infectious? • Non-Functional BRAC1 & BRAC2 Genes • Age, Menstrual cycle, Drinking alcohol, Late or few Births, Smoking, Hormone replacement therapy & Having dense breast

  4. Pathology • Develops from epithelial cell lining • Invasive, stromal like adenocarcinoma • Mammography for DCIS • Biopsy is used to detect LCIS(non-palpable lesion, multifocal or bilateral) • Paget’s disease(characteristic malignant)

  5. Molecular Basis • BRCA1 and BRCA2 • Additional genes • ATM • P53 • PTEN • CDH1 • Characteristics • Have specific function in body • Their abnormal presence causes certain diseases • Risk of breast cancer is increased

  6. Diagnosis Physical examination: • First step in breast cancer diagnosis • Examination of any lump, change in the size or texture of breast and lymph node in the armpit Diagnostics mammogram: • X-ray of the breast • Screening mammograms in asymptomatic women • Diagnostic mammograms in women having breast cancer MRI (magnetic resonance imaging): • Uses radio waves and strong magnets • The pattern observed is translated to image • More expensive still used more as compared to mammogram • Too much sensitive

  7. Ultrasound (sonography): • Sound waves are used • Echo produced is converted to image Biopsy: • Only way to tell actual presence of breast cancer • Effected tissue is taken and pathologically tested Scintymammography: • New method and still under study • Radioactive tracer attached to breast cells through veins • Detected by special camera Tomosynthesis (3D mammography): • Similar to 2D mammogram • More radiation required and 3D image is formed

  8. Two types of tests: • Oncotype DX: • Helps in depicting the recurrence score • Based on this score further treatment is decided • Helpful in those who are stage 1 or stage 2 estrogen positive receptor 2.Mammaprint: • Helps in determining the recurrence score in specific part of body • Both estrogen positive and negative can be detected

  9. Prevention • Prophylactic Mastectomy or prophylactic oophorectomy • Tamoxifen and Raloxifene • Aromatase Inhibitors

  10. Treatment • Surgical Methods- Mastectomy, sentinel node biopsy • Brachytherapy • Drug Therapy • Chemotherapeutic Drugs- Cyclophosphamide, Epirubicin, Flourouracil, Methotrexate, Doxorubicin, Docetaxel • Hormonal Therapy- SERMs, Aromatase Inhibitors • Targeted Therapy- Herceptin, Lapatinib

  11. Biotechnology Applications • To understand the molecular basis, development of diagnostics and treatment. • Biomarkers • Defining gene and protein patterns • Human Growth Hormone • Biomolecules- Herceptin and Tamoxifen • Molecular Profiling- Real Time PCR & Microarray

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