Breast cancer is characterised by formation of tumor in tissues of breast. Four type and stages of breast cancer have been identified. Disease majorly affects females and incidence rate is increasing day by day. Different forms of treatments are available to treat this disease. Following a particular treatment depend on condition of patient and desired outcome demanded by patient. All current treatment possesses side effects and need to be rectified. New treatment need to be generated focusing on optimizing the efficacy and minimising the side effect. New treatment can be obtained by promoting the research work in cancer. New treatments are rising hope to obtain cancer free world.
Breast cancer is a disease where in which the tissue from breast forms of malignant cancer. Usually a tube carries milk to nipple (duct) and to words gland that that from milk. It is most common for men and women, although in male disease diagnosis is rare. It is a heterogeneous that differs by indusial age group and kind of cell in the tumor.
Breast cancer is oldest form of carcinoma. The oldest description of cancer was done in Egypt in 1600 BC. Written literature shows that there is no treatment available for cancer.
William Stewart Halsted performed mastectomy in Halsted radical mastectomy both breasts are removed along with associated lymph nodes and underlying chest muscles. It can lead to long term and person and suffering, but it prevents cancer from reoccurring.
Till 1970 radical mastectomies was considered as standard but later metastasis that is migration of cancerous cells from region of origin to other parts of body. This provided First experimental transmission was done by a French surgeon Bernard Peyrilhe realized the he injected extracts of breast cancer in animal.
Janet Lane-Claypon did the first case control study on breast cancer in 1926 which was a comparative study comrising of 500 breast cancer cases and 500 control patients .one variable method was used.
Classification of breast cancer:
Ductal carcinoma: it is non invasive form of the breast which starts with in cell line of breast duct below the nipple and areola. Milk is supplied by the duct.
Lobular carcinoma: it starts in lobes or glands that form milk. 8% of the breast cancer accounts to be lobular.
Inflammatory breast cancer: it is the least common form of breast cancer which progress approximately 1% to 3% to diagnose the breast will appear swollen and inflame it cause by inflammation by nets or sheets.
Paget’s disease: this type of breast cancer appears as skin rashes over nipple. It shows science of itchy, these signs of itching under the skin. This will indicate small ductal carcinoma in suit (disc)
Breast cancer stages:
Stage 0: this can be use to explain abnormal invasive of breast, it can be use in DCIS. These are diagnosed in which abnormal cells lining to the breast duct, the abnormal cell surrounding breast tissue or progress outside the duct. DCIS can progress to invasive breast cancer if it is left untreated
Stage 1: it’s an early type of invasive breast cancer in which cancer cell penetrate breast tissue from the starting point of cancer the size of tumor is not more than 2 cm
Stage 2: in this cancer progress to the lymph node the size of the tumor is between 2 and 5 cm, it does not progress to the lymph node it’s around 5 cm.
Stage 3: it consist of two type stage’s
Stage 3A: in this type of cancer the tumor size is large than 2 centimetres and smaller than 5cm and it spread under arm of the lymph nodes.
Stage 3B: cancer progress to tissue surrounding breast along with skin chest wall, ribs, and lymph nodes, in the wall of the cheats.
Stage 4: it is a distant metastatic cancer. This type of cancer is spread whole part of the body, like bones, liver etc.
How common is breast cancer:
As per the report in 2007, 45,700 women were victim of the breast cancer. While in the same year the men count goes to 277 were diagnosed. Incidence rate of breast cancer in females around by 50% over the last twenty five. Out of ten eight of women age of fifty were sufferings from breast cancer.
Breast cancer rates have increased up to 5% in last ten years.National Health Service (NHS) screening programmes were conducted in that more than 16,000 cases found in UK in 2007/2008. Among that NHS screening programme claim to save 1,000 lives each year. Throughout the world 1.38 million women were treated with the breast cancer.
Breast cancer incidence were highly considerable in western and Europe as per the low rate considerable in Africa and Asia. Europeans union shows cancer diagnosed around 332,000 in the year of 2008. Twelve thousand women and seventy men were died from breast cancer in 2008 in united Kingdome. More than half of seventy years of age are died from breast cancer. Worldwide 448,000 women are died cause of the breast cancer in the year of 2008.
Major symptoms can be characterised as
Formation of lump or thickening inside or surrounding portion of breast
Alteration in shape and size of breast
In certain cases unusual discharge from nipples may be diagnosed
Breast skin may show phenomena like dimpling or puckering
There can be alteration in size and shape of breast
Breast cancer may be associated with several common disorders like fibro adenoma and mastitis. Care provider must be consulted in regard of appearance of any such symptoms. Over 80% of total cases diagnosed with breast cancer are diagnosed at the time when women feel lump. Mammogram is the tool to detect earliest breast cancer. Breast cancer can also be indicated by means of lumps that are found in lymph node. Which is present in armpits? Alteration in shape and size of breast can also be indicating that a person is suffering from breast cancer. Pain is another factor which can suggest that a person has became victim of breast cancer.
Age: most of the women above the age of 50 to 60 years are suffering from breast cancer and they diagnosed.
Health history of the perso0n: breast cancer in one of the breast will increase the risk of getting cancer in other breast. It consists of certain types like ductal carcinoma in suit (DCIS), lobular carcinoma in suits (LCIS) increase the risk of cancer. These are seen in biopsy of the breast.
Family history: chances of breast cancer are getting higher from ancestors either from mothers or fathers family. There are chances of ovarian cancer with breast cancer also increase risk.
Risk factors which can be control:
Epically heavy weight women, are in risk of getting breast cancer mainly after menopause. Estrogens are the main source for body’s fat tissue after menopause, when hormones are not secreted from ovaries, estrogens can causes cancer risk
Regular exercise: regular exercise can decrease the cancer risk; daily 25-35 minutes of exercise can reduce cancer.
Alcohol taking: in women’s excess of alcohol taking causes by breast cancer and it reaches its ability to control limits of liver.
Smoking: smoking can causes high risk of breast cancer.
Now a day’s who r suffering from breast cancer have many types of treatment and therapy are available, some of treatment are
Among this all therapy’s most common therapy is radiation therapy in which we can destroy the cancer cells in breast Systemic therapy are hormonal therapy and targeted therapy in this the blood enters and destroy the control system of the body Stage of cancer mainly depends on,
The treatment which is treated most commonly in breast cancer is surgery these are two types they are:
Breast- sparing surgery
Breast-sparing surgery: the target of breast sparing surgery is to specifically remove tissue’s surrounding the tumor which may involve removal of the lump or quarter of breast.
Mastectomy: in women’s suffering from mastectomy will remove the whole breast if needed will have suitable treatment in case of lump enlargement in small breast or a lump situated middle of the breast. There are various type of mastectomy are differentiate
Either it remove the breast tissue these breast tissue includes skin and nipple
The other type is radical mastectomy which removes the muscle of the chest wall
Radio therapy is use for the radiations like x-rays; it can destroy the cancer cells were it is treated and the effects go to the normal cells by radiation. These are two types they are
External radio therapy
Internal radio therapy
External radio therapy: these are use in high energies of x-rays like irradiation and cobalt.
These can be destroyed the cancer cell to stop growing or die when the DNA is damage.
Internal radio therapy: in this to treat the cancer by using radioactive metals, in this two types of radioactive therapy are there 1) radioactive implement 2) radioactive liquids
Hormone therapy is based on use of naturally produced chemicals as a treatment approach. Two harmones that are estrogen and progesterone manages various activities inside the body. Hormone therapy focus on shrinkage of cancer area .if further surgery is required then harmone therapy is used before it as it decreases the task of removing whole breast during surgery. Harmone therapy works only in the presence of oestrogen receptors. Tamoxifen and aromatase inhibitor lies in this category. Tamoxifen is known to be an estrogen antagonidst because its structure resembles alot with synthetic oestrogen. Being structurely similar to estrogen it act by binding to oestrogen receptor and leads to formation of non productive complex so oestrogen receptor count decreases and growth promotion effect of oestrogen get suppressed. Side effect of tamoxifen includes hot flashes, vomiting, and skin rashes.
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Chemo therapy and their assessment:
Medications for treatment of breast cancer belong to four categories. First category is of ant metabolites which inhibits action of metabolite as these compounds are similar in structurally to metabolites. Medications belonging to this category are 5 fluorouracil and methothrexate. Second categories of medication are antibiotics like doxorubicin and epirubicin. Third categories of medications are inhibitors of microtubule formation like paclitaxel which belong to taxol group. Forth category of medication is alkylating agents like cyclophosphamide. All these medicatins act differently. Alkylating agents like cyclophosphamide gets activated in liver by cyt p450 enzyme and leads to alkylation of DNA. Antibiotic like doxorubicin acts by intracting with molecular oxygen leading to formation of superoxide and hydrogen peroxide which ultimately leads to single step breakdown of DNA. Taxol group act by binding reversibly to beta tubulin and leads to over stabalization of beta tubulin which is non functionalthis result in cell death of infected cells. All treatment possesses a number of side effects. Cyclophosphamide causes bone marrow depression. Paclitaxel causes neutropenia that is decrease in number of neutrophils. Methothrexate shows renal demage, hepatic function alteration and pulmonary toxicity. Fluoro uracil shows bone marrow depression as major toxicity.
All these medication possess lot of side effect so research work need to be done at a faster pace to obtain a treatment with good therapeutic effect and least side effects.
Target therapy has emerged as a new approach now days. It involve use of drug that stabilizes breast cancer as targeted therapy can block action of certain undesired proteins like HER2 that promote growth of breast cancer cells.
Trastuzumab: it is provided intravenously that is through vein. It can be used as mono therapy or in combination with chemotherapy. Side effects related to first treatment include fever, chills, weakness, nausea, vomiting, diarrhoea, headaches, difficulty in breathing, and rashes.
After first treatment side effects become less severe as tolerance develops. Trastuzumab can lead to heart problem, and serious breathing problems. Doctor need to check status of heart and lungs both before and in between of treatment.
Lapatinib: it is orally available medication which is given in combination with chemotherapy Side effects of this are nausea, vomiting, diarrhoea, tiredness, mouth sores, and rashes. It can also lead red, painful hands and feet.
Treatment classification on basis of stage of disease:
First factor need to be considered is size of the tumour with respect to size of breast
Laboratory result for status of breast
Factors related to age as patient is in menopause or not General health of patient.
Breast cancer can be diagnosed by presence of tumour cells surrounding the breast. This disease primarily affect females .variety of treatments are available .each treatment follow different method to change the state of disease. Side effects of current treatment are severe so new treatment need to be developed which can effectively treat this disorder. Reseach work need to be promoted to obtain a good treatment with least side effect and that can specifically target cancer cells.
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