Importance of genes in cancer

1. VIJAYA INSTITUTE OF PHARMACEUTICAL
SCIENCES FOR WOMEN
GENE SILENCING IN
UNDER THE GUIDENCE OF
Mrs D . Santhi Krupa
Assistant . Professor
Dept. of Pharmacology
Presented by
S . Anusha
IV B Pharmacy
137N1R0078

2. CONTENTS
 Introduction
 Classification of breast cancer
 Epidemiology
 Symptoms
 Etiology/epidemiologic risk factors
 Anatomy of the breast
 Pathology
 Stages of breast cancer
 Breast cancer and pregnancy
 Diagnosis and screening
 Treatment
 Early detection
 Conclusion

3. INTRODUCTION
 Breast cancer is characterised by the uncontrolled growth of
abnormal cells in the milk producing glands of the breast or in the
passages (ducts) that deliver milk to the nipples.
 Breast Cancer , the second-leading cause of cancer deaths in
women , is the disease women fear most.

4.  Breast Cancer can also occur in men, but it’s far less common.
 In the last 30 years, doctors have made great studies in early
diagnosis and treatment of the disease and in reducing breast
cancer deaths.
 80% of breast cancers occur in women older than age 50.In
30s,have a one in 233 chance of developing breast cancer. By
age 85 , chance is one in eight.
 In 1975 a diagnosis of breast cancer usually meant radical
mastectomy –removal of the entire breast along with under arm
lymph node and muscles underneath the breast.

5. CLASSIFICATION
 Based on histological appearance
 Ductal Carcinoma in situ (DCIS)
 Infiltrating or invasive Ductal carcinoma (IDC)
 Medullary carcinoma
 Lobular Carcinoma in situ (LCIS)
 Infiltrating Lobular Carcinoma
 Infiltrating Lobular Carcinoma
 Mucillus carcinoma or colloid
 Paget’s disease
 Inflammatory breast cancer
 Metastatic breast cancer
 Triple negative breast cancer

6. EPIDEMIOLOGY
 Breast cancer constitutes a major public health issue , resulting
in over 4,00,000 annual deaths and about 4.4 million women
living with this disease.
 It accounts for 16% of all female cancers and 22.9% of
invasive cancers in women.
 18.2% of all cancer deaths in world wide, including both males
and females, are from breast cancer.
 There is an international/geographical variation in the
incidence of breast cancer.
 Incidence rates are higher in the developed countries than in
the developing countries and japan.

7. SYMPTOMS
 A lump in a breast
 A pain in the armpits or breast that does
not seem to be related to the woman's
menstrual period
 Redness of the skin of the breast
 A rash around (or on) one of the nipples
 A swelling (lump) in one of the armpits
 An area of thickened tissue in a breast
 One of the nipples has a discharge;
sometimes it may contain blood
 The size or the shape of the breast
changes
 The nipple-skin or breast-skin may have
started to peel, scale or flake.

8. RISK FACTORS FOR BREAST CANCER
Non-modifiable
 Gender
 Age(>45y)
 Genetic changes of breast
cancer
 Family history of breast cancer
 Female Personal history of
breast cancer
 Race and ethnicity
 Dense breast tissue
 Lobular carcinoma in
situ(LCIS)
 Menstrual periods
 Diethyl still besterol exposure
 Previous chest radiation
Modifiable
 Not having children
 Contraceptives
 Harmone therapy after
menopause
 Alcohol consumption
 Breast feeding
 Obesity
 Physical exercise

9. ETIOLOGY
 General
Aging
Gender
 Genetics
Family history
Inherited factors
 Body
Obesity
Not having children
High breast density
Certain breast changes
Menstrual history
 Life style
A sedentary life style
Heavy drinking

10. ANATOMY OF BREAST CANCER

11. PATHOLOGY OF BREAST CANCER
 Hereditary cancers are primarily
caused by an inherited genetic
defect.
 Less than 0.3% of the population
are carriers of a genetic mutation
that has a large effect on cancer
risk and these cause less than
3–10% of cancer.
 Some of
these syndromes include certain
inherited mutations in the
genes BRCA1 and BRCA2 with
a more than 75% risk of breast
cancer and ovarian cancer,
and Hereditarynonpolyposiscolor
ectal cancer (HNPCC or Lynch
syndrome).

12.  GENETICS  EPIGENETICS

13. PATHOPHYSIOLOGY OF BREAST CANCER

14. STAGES OF BREAST CANCER
STAGES DESCRIPTION
Stage-0
• Abnormal cells in the lining of the ducts(or) sections of
the breast.
• Results in increased risk of developing cancer in both
breasts.
Stage-1 • Invasive breast cancer , the cancerous cells are
breaking through to or invading surrounding normal tissue.
Stage-2a
2b
• No tumour but there are cancerous cells in the lymph
nodes , or there is a tumour that has grown.
• Cancerous cells in the lymph nodes and/or tumour has
grown.
Stage-3 • Cancer has spread to lymph nodes near breastbone and
chest wall.
Stage-4 • Cancer has spread to other parts

15. BREAST CANCER AND PREGNANCY
Breast cancer and pregnancy can be classified into three main
situations; these are
(a) breast cancer that is detected during the evolution of pregnancy
(b) breast cancer that is detected during lactation or postpartum, and
(c) pregnancy in patients who have had a previous breast cancer.
Cancer complicates approximately 1 per 1000 pregnancies
and accounts for one-third of maternal deaths during gestation.
The prevalence of breast cancer during pregnancy is increasing
due to delayed onset of childbearing.

16. DIAGNOSIS OF BREAST CANCER
 PHYSICAL EXAM AND HISTORY:
 MAMMOGRAM
 ULTRASOUND EXAM
 MRI (MAGNETIC RESONANCE IMAGING)
 BLOOD CHEMISTRY STUDIES:
 BIOPSY:
 Excisional biopsy
 Incisional biopsy
 Core biopsy
 Fine-needle aspiration (FNA) biopsy
 Biopsy samples are tested for the following
 ESTROGEN AND PROGESTERONE
RECEPTOR TEST
 HUMAN EPIDERMAL GROWTH FACTOR
TYPE 2 RECEPTOR(HER2/neu)TEST
 MULTIGENE TESTS

17. DIGITAL MAMMOGRAPHY
MAMMOGRAPHY

18. SCREENING
 Average –size lump found by women practicing
occasional breast self exam.
 Average –size lump found by women practicing
regular breast self exam.
 Average –size lump found by first mammogram.
 Average –size lump found by getting regular
mammograms.

19. TREATMENT OF BREAST CANCER
 Surgery
Breast conserving or mastectomy , with lymph node
examination(ALND or SLNB)
 Chemotherapy
Before or after surgery. Anthracyclins, Taxanes etc
 Hormonal therapy
SERMs, Als, LHRH analogues, oophrectomy
 Targeted biological therapy
Tratuzumab, new dual therapies very promising
 Radiotherapy
Teletherapy , brachytherapy, intraop RT (TARGIT trail)

20. MANAGEMENT OF BREAST CANCER

21. EARLY DETECTION
 Early detection of breast cancer plays the leading
role in reducing mortality rates and improving the
patient’s prognosis(Elmore et al.,2005)
 The survival rate is higher with early detection of
breast cancer. However, with local invasion, the
survival rate decreases and if it is diagnosed at the
latest stage, only a very low numbers of patients
will survive.
 For primary prevention of breast cancer, women
need to be adequately informed about risk factors
and risk reduction strategies of breast cancer.

22. CONCLUSION
Management of breast cancer is a major
challenge in resource limited countries. Efforts
should be geared towards early diagnosis, prompt
and standardized treatment to reduce the burden of
advanced disease in women, majority of who are
worse hit in the most productive part of their life
time.