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Carcinoma breast etiology


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Carcinoma breast etiology

  1. 1. By: Partha Pratim Mandal Medical College kolkata
  2. 2. Risk Factors • Alcohol drinking • Being overweight • Never having children • 1st child >30yrs of age • Hormone Replacement therapy • Birth control pills • Being exposed to large amounts of radiation • Smoking Controllable • Getting older • First degree relative with breast cancer • A previous breast biopsy showing atypical changes • Being young (<12) at the time of menses • Starting menopause after age 55 • Having an inherited mutation in the breast cancer genes (BRCA 1 or 2) Uncontrollable
  3. 3. Age The risk of getting breast cancer increases with age More common at middle age but can occur at any age group after 20 years A woman is likely to develop breast cancer in her 60s than in her 20s
  4. 4. By age 30 1 out of 2,000 By age 40 1 out of 233 By age 50 1 out of 53 By age 60 1 out of 22 By age 70 1 out of 13 By age 80 1 out of 9 Lifetime risk 1 out of 8
  5. 5. Gender Breast cancer occurs nearly 100 times more often in women than in men. In a few African countries, which represent the highest incidence of male breast cancer, men account for 5–15% of breast cancer cases Because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.
  6. 6. Family History and Genetic Factors Only 5-10% of breast cancers are inherited. Families that do have genetic defects in one of two genes, breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2), have a much greater risk of developing both breast and ovarian cancer.
  7. 7. BRCA1 & BRCA2 MUTATION Both BRCA1 (located on long arm of chromosome 17) & BRCA2 (located on long arm of chromosome 13) function as a tumor suppressor genes, and for each genes loss of both alleles is required for the initiation of cancer. BRCA1 having more risk(35%-45%) than BRCA2 mutation. Commonest mutation of BRCA1 are 185delAG & 5382insC
  8. 8. HER2 OVEREXPRESSION HER2. Amplification or overexpression of this oncogene increase development and progression of certain aggressive types of breast cancer. It is located at the chromosome 17q12.
  9. 9. Occasionally mutation of BRCA3 & p53suppressor also involved. Non-BRCA1 and non-BRCA2 breast tumors may be associated to rare syndromes, of which breast cancer is only one component. Such syndromes result notably from mutations in TP53 (Li-Fraumeni syndrome), ATM (Ataxia Telangiectasia), PTEN (Cowden syndrome) RAB11FIP1, and rs4973768 are also associated with increased risk of breast cancer. rs6504950 is associated with lower risk of breast cancer
  10. 10. Early menstruation. Risk increases if menstruation begin before age 12. Late menopause. Menopause after age 55, increases risk.
  11. 11. HORMONES Estrogen. Persistently increased blood levels of estrogen are associated with an increased risk of breast cancer. estrogen does not appear to directly cause the DNA mutations
  12. 12. Controllable Risk factors Weight. Being overweight, with excess caloric and fat intake, increases risk, especially after menopause due to conversion of androstenedione to estrone by adipose tissue. Age at childbirth. Having first child after age 35 or never having children increase risk.
  13. 13. Dietary factors Alcohol. Consumption of alcohol is linked to increased risk of developing breast cancer. Consume 2 to 5 drinks daily have about 1.5 times risk. Fat . Low fat diet may significantly decrease the risk of breast cancer as well as the recurrence of breast cancer. Calcium. A high dietary intake of calcium lower the risk of breast cancer.
  14. 14. Dietary factors Vitamin D. Vitamin D is related to reduced risk of breast cancer and disease prognosis. Specific dietary fatty acids. Very high consumption of omega-6 fatty acids (PUFAs) increase the risk breast cancer in postmenopausal women.
  15. 15. Hormonal contraception. Hormonal contraceptive with estrogen content may produce a slight increase in the risk of breast cancer. women who began using hormonal contraceptives before the age of 20 or before their first full- term pregnancy are at increased risk for breast cancer Hormone replacement therapy. Taking combined hormone replacement therapy, as prescribed for menopause, can increase your risk for breast cancer and increases the risk that the cancer will be detected at a more advanced stage. Selective estrogen receptor modulators (SERMs). they selectively stimulate or inhibit the estrogen receptors of different target tissues.
  16. 16. Tobacco. Exposure to tobacco smoke is most problematic between puberty and first childbirth . The reason is that breast tissue appears most sensitive to chemical carcinogens breast cells not fully differentiated until lactation Passive smoking. it increases breast cancer risk by 70% in younger, primarily pre-menopausal women. Radiation. Women who have received high-dose radiation to the chest have a relative risk of breast cancer between 2.1 to 4.0.Radiation exposure during adolescence, magnifies deleterious effect.
  17. 17. Ethylene oxide. A direct correlation between breast cancer rates and exposure to ethylene oxide during medical sterilization processes. Benzene. High level of benzene exposure can lead to mammary cancer. DDT. Exposure to DDT before puberty increases the risk of breast cancer later in life.
  18. 18. Dioxins. Dioxin level exposure in a woman's body correlated with a more than double chance of developing breast cancer. Aromatic amines. More exposure to heterocyclic amines, have also been diagnosed with more post-menopausal breast cancer. Polycyclic aromatic hydrocarbon. PAH's bioaccumulate easily and can copy the estrogen hormone & they have the ability to harm DNA
  19. 19. Factors in the physical environment Xenoestrogens . Increasing prevalence of these substances in the environment may explain the increasing incidence of breast cancer Light at night & disturbance of circadian rhythm. Artificial light during the night can be a factor for breast cancer by disrupting melatonin levels
  20. 20. White women are more likely to be diagnosed with the disease. Black women are more likely to have estrogen receptor negative breast cancers. Mortality higher among black women.
  21. 21. Abortion. First-trimester abortion increases the risk of developing breast cancer. Deodorants. Aluminum-containing underarm antiperspirants underarm increased risk of breast cancer . Viruses. Human papilloma virus, human cytomegalovirus and the Epstein-Barr virus are suspected to play a role or cause breast cancer
  22. 22. Tea. moderate green or black tea consumption (three or more cups per day) can reduce breast cancer risk. Mammographic density. High mammographic density is associated with a higher risk of developing breast cancer. Red no 3. human breast cell DNA was found positive for damage when put into contact with Red No. 3
  23. 23. Mammographic density