2. CANCER and BREAST
Cancer is a condition
where body cells grow up
and divide unmanageably;
occupying and destroying
the healthy tissue
(MALIGNANT)
RISK FACTORS:
-Gender
-Age
-Family History
-High hormone levels: HRT, menstrual problems...
-Obesity
-Alcohol
(1)
(2)
(3)
3. TYPES OF BREAST CANCER
NON-INVASIVE
(IN SITU)
INVASIVE OTHERS
LOBULAR DUCTAL
LOBULAR DUCTAL PAGET’S
DISEASE OF
NIPPLE/AREOLA
INFLAMMATORY
RARE
TYPES
MEN
DIAGNOSIS (TRIPLE ASSESSMENT):
-PALPITATION
-RADIOLOGY (ULTRASOUND, MAMMOGRAPHY, MRI)
-FINE-NEEDLE ASPIRATION
Estrogen and progesterone
receptor statuses are also
important for classification and
treatment
(1)
(4)
(10)
4. PATHOLOGY
-p53, BRCA1(chromosome 17), BRCA2(chromosome 13)
mutations in error-correcting proteins
-PI3K/AKT, RAS/MEK/ERK apoptosis prevention pathways
mutation-“on”
MOST COMMON: INVASIVE DUCTAL CARCINOMA (~70% OF CASES)
(1)
(3)
(8)
(8)
(9)
5. STAGE 0 Non-invasive cell malformations
STAGE 1 Tumour ≤2cm, Invasive breast cancer, early stage, invasion limited to breast
STAGE 2 2A -Tumour absent/ Tumour ≤2cm, cancer present in axillary lymph nodes, no
spread to body
-2cm≤ Tumour ≤5cm, no cancer in axillary lymph nodes, no spread to body
2B - 2cm≤ Tumour ≤5cm, cancer present in lymph nodes, no spread to body
-Tumour >5cm, no cancer in axillary lymph nodes, no spread to body
STAGE 3 3A -Tumour absent/ 2cm≤ Tumour ≤5cm/ Tumour >5cm , cancer present in
axillary and may be in lymph nodes near sternum
3B -Any size tumour, cancer present in skin or chest wall, cancer present in
axillary lymph nodes or lymph nodes near sternum
3C -Any size tumour, cancer spread to lymph nodes near clavicle, , cancer
present in axillary lymph nodes or lymph nodes near sternum
STAGE 4 Spread to body (metastasis )
STAGES OF BREAST CANCER
TYPICAL PRESENTATION: MASS IN BREAST, WITHOUT ANY PAIN
(1)
(3)
(5)(6)(7)
6. IMPACT ON INDIVIDUAL AND SOCIETY
INDIVIDUAL
Emotions
Body image
Sexuality
Relationships
Motivation
Activity
Self-esteem
Concentration
Shame
Stigma
DEPRESSION
SOCIETY
Isolation
Psychological
Economic
FAMILY AND FRIENDS
Emotional
Physical
Economic
IMPROVEMENT: INCREASE AWARENESS
(38)
(1)
7. WHY I CHOSE BREAST CANCER?
1)IT IS VERY IMPORTANT
BREAST CANCER UK:
-46,010 women per year DIAGNOSED (UK)
-12,247 of this will DIE (UK)
-1 in 8 women WILL have in lifetime
-Most COMMONLY diagnosed cancer in <35
women(UK)
-In last 10 years, incidence increased by 3.6% (UK)
-In 2008, 1.38 million women diagnosed (WORLDWIDE)
2) EXPERIENCE
3)MY FUTURE PLAN
-Reconstructive Surgery
4) INCREASE AWARENESS
(1)
(11)(20)
(14)
9. CURRENT TREATMENT
CHEMOTHERAPY
Cytotoxic medication
damaging cancer cells
ALKYLATING AGENTS
PLANT ALKALOIDS
ANTIMETABOLITES
ANTITUMOUR
ANTIBIOTICS
TOPOISOMERASE
INHIBITORS
ANTINEOPLASTICS
Can be given for
NEOADJUVANT, ADJUVANT
and PALLIATIVE
management
Depending on treatment,
TRASTUZUMAB may be
additionally used
(1)
(13)
(17)
(23)
(24)
(25)
(10)
10. CURRENT TREATMENT
HORMONAL
(ENDOCRINE)
THERAPY
AROMATASE INHIBITORS
SELECTIVE ESTROGEN
RECEPTOR MODULATORS
ESTROGEN RECEPTOR
DOWNREGULATORS
Blocking action or lowering
concentration of estrogen in
body
Treat hormone-receptor-
positive cancer
TARGETED
THERAPY
HERCEPTIN (TRASTUZUMAB)
TYKERB (LAPATINIB)
AVASTIN (BEVACIZUMAB)
Damage specific
characteristics of cancer
HOLISTIC MEDICINE is also used for symptomatic relief
and eliminating side effects
(1)
(22)
(26)
(32)
(32)
11. CURRENT TREATMENT - HOW EFFECTIVE?
CANCER RESEARCH UK - MORTALITY
-2008: 12.000 WOMEN, 70 MEN DIED IN UK
89.000 WOMEN DIED IN EUROPEAN UNION
458.000 WOMEN DIED IN THE WORLD
-1.300 DEATHS PER YEAR- WOMEN UNDER 50
-IN UK, 2nd MOST COMMON COUSE OF WOMEN
DEATH (31% OF ALL CASES)
CANCER RESEARCH UK – SURVIVAL
-INCREASE IN 10 YEARS SURVIVAL
RATE FOR 32% IN 25 YEARS
(1)
(15)
(15)
(16)
(16)
12. WHY NEW TREATMENT?
SIDE EFFECTS OF CURRENT TREATMENT
-CHEMOTHERAPY: HAIR CHANGES, ANAEMIA, INFECTION, MEMORY LOSS, BRUISING,
BLEEDING, DIARRHOEA, NEUROPATHY, MOUTH SORENESS, FERTILITY PROBLEMS, NAIL
CHANGES, NAUSEA, VOMITING, DEPRESSION...
-RADIOTHERAPY: JOINT PAIN, SKIN PROBLEMS, FATIGUE, HEART PROBLEMS, BONE LOSS...
-SURGERY: LYMPHADEMA, COSMETIC PROBLEMS, PSYCHOLOGICAL PROBLEMS,
DEPRESSION, NERVE DAMAGE, SORENESS...
-HORMONE THERAPY: WEIGHT GAIN, HOT FLUSHES, IMPOTENCE, NIGHT SWEATS,
MUSCLE LOSS, FATIGUE, LOSS OF SEX DRIVE...
-TARGETED THERAPY: WEAKNESS, PAIN, THERMAL FEELINGS, DIORRHEA, VOMITING,
NAUSEA...
WE WANT:
-MINIMUM SIDE EFFECTS
-MINIMUM COST
-MINIMUM TREATMENT DURATION
-MAXIMUM SURVIVAL RATE
-MAXIMUM PATIENT HAPPINESS
-MAXIMUM LIFE QUALITY
(12)
(1)
(18)
(19)(21)
13. IMPROVE SURGERY (SENTINEL
NODE MAPPING)
NEW AND FUTURE TREATMENTS
UNDER RESEARCH
(1)
ONCOLYTIC VIRAL THERAPY
INTERVENTIONAL RADIOLOGY
GENE THERAPY
VACCINES
BREAST CANCER RESISTANCE
GENE USAGE
PRECISE DIAGNOSIS
(33)
(33)
(33)
(33)
(34)
(33)
(33)
CRYOTHERAPY
NEW HORMONAL (ENDOCRINE)
THERAPIES (35)
TURNING CANCER INTO A
CHRONIC DISEASE
ANTI-VEGF THERAPY
NEW CYTOTOXIC CHEMOTHERAPY
FORMULATIONS (36)
(36)
NOVEL MICROTUBULE
TARGETING AGENTS (36)
(38)
14. IMPACT OF INTRODUCTION AND
SUCCESS OF NEW TREATMENT
(1)
INTRODUCTION
INCREASED DIAGNOSIS
NEW HOPES
PSYCHOLOGICAL IMPROVEMENT
RESEARCH IMPROVEMENT
INCREASED SHORT TERM COSTS
SUCCESS
INCREASED SURVIVAL
DECREASED MORTALITY
DECREASED SECONDARY DISEASES
IMPROVED PSYCHOLOGY
DECREASED LONG TERM COSTS
DECREASED HOSPITALIZATION
INCREASED SATISFACTION
BETTER COSMETIC APPEARANCE
FURTHER RESEARCH
IMPROVED LIFE QUALITY
IMPROVED LIFESPAN
INDIVIDUAL FAMILY SOCIETY
15. SUMMARY
(1)
-CANCER OF BREAST TISSUE
-STAGE 0: PREMALIGNANT, STAGES 1-3: GOOD PROGNOSIS, STAGE 4: METASTASIS
-DISEASE HAS BIG IMPACT ON INDIVIDUAL, FAMILY AND SOCIETY
-DIAGNOSIS RATES INCREASING, STILL VERY HIGH MORTALITY RATES
-VARIOUS TREATMENT METHODS PRESENT, TREATMENT HAS IMPROVED IN THE LAST
30 YEARS
-TREATMENT HAS SIDE EFFECTS AND IS STILL NOT ENOUGH SO NEW TREATMENTS ARE
NEEDED
-NEW DIAGNOSTIC AND SURGICAL METHODS, PHARMACEUTICAL DRUGS AND GENE
TREATMENTS ARE UNDER RESEARCH
-SUCCESSFUL IMPLEMENTATION OF NEW TREATMENTS WILL IMPROVE THE IMPACT OF
CANCER ON INDIVIDUAL, FAMILIES AND SOCIETY
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