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Breast Cancer and Precision Medicine

HIGHLIGHTS:

  • Breast cancer is the most common form of cancer among women, and there is currently no vaccination available to offer protection against this deadly disease. Risk factors associated with the onset of breast cancer include receiving estrogen hormone therapy, regularly alcohol consumption, the aging process and genetics.
  • If there are irregularities affecting a woman’s genetic code, the BRCA gene, which is passed down from either the mother or father, it could increase her risk of developing breast cancer by up to 90%.
  • It is recommended that women over the age of 40, those under this age but who are categorized as being at high risk, and those who have found a lump during self-inspection of the breasts should all attend mammogram screening, as well as undergo an ultrasound scan of the breasts.

Breast Cancer and Precision Medicine

Breast cancer is yet another potentially deadly disease which is often symptomless during its initial stages, meaning that by the time symptoms do become apparent, the cancer cells have already spread to other nearby organs, thereby increasing the risk of the disease being fatal for the sufferer. Nevertheless, if it can be detected and properly treated at an early stage, breast cancer can be cured.

Screening and prevention for breast cancer

Breast cancer is the most common form of cancer among women, and there is currently no vaccination available for the disease, unlike for ovarian cancer. Moreover, there are a number of crucial risk factors that can increase a woman’s chance of developing the disease, such as degeneration of organs, receiving estrogen, regularly drinking alcohol and genetics. Five to ten percent of cases occur as a result of a person’s genes, which are passed down from one generation to the next. Hence, the most effective way to reduce the rate of fatalities resulting from this disease is regularly undertaking the following forms of screening:

  • Self-inspection: All women should carry out a self-inspection of the breasts once they reach the age of 20 in order to build a familiarity with their breasts that will make detecting any irregularities much simpler. Once a month is sufficient for such inspections.
  • Mammogram screening and ultrasound scans: It is recommended that all women undergo such screening once they reach the age of 40, although those aged under 40 who are categorized as being at high risk due to their genetics, as well as those who suspect they may have identified an abnormality upon self-inspection, should also undergo these forms of screening 1–2 times per year.
  • Faulty BRCA gene screening as a form of precision medicine: This will enable detection of any irregularities affecting the BRCA gene, which can be transferred from mothers or fathers to their children, placing offspring at up to a 90% greater risk of developing breast cancer. Therefore, if a faulty BRCA gene is detected, patients will be able to consult a doctor at the outset on the best methods of subsequent screening and prevention.

Breast cancer and its links to genetics

The number of breast cancer cases in Thailand continues to increase annually due to the genes passed down from one generation of a family to the next, which is a vital factor in terms of increasing a woman’s risk of developing the disease. Being in possession of such genes means a woman is 2–5 times more likely to suffer from breast cancer than those without the gene in their family. There have been confirmed cases of breast cancer resulting from genetics in women as young as 18.

Therefore, if you have a family history of breast cancer, especially in your mother, father, siblings or grandparents, you should be attending breast cancer screening, even if you are still young yourself. This is because identifying cancer genes can improve the chances of prevention, and detecting breast cancer during its initial stages increases the likelihood of successful treatment.

Identifying the presence of a faulty BRCA gene in your family can be achieved by mapping out a family tree to see who suffered from this disease in the past. If the occurrences of breast cancer are found to have affected every generation of your family, increasing in number of cases while the ages of those affected decreases – particularly where family members under the age of 40 contracted the disease – it is a sign that both males and females of the same family are at a heightened risk of developing breast cancer.

Treating breast cancer

There are numerous forms of treatment available for breast cancer. These may be used separately or in conjunction with one another, depending on the severity of the disease, the health of the patient involved, and the discretion of the doctor in charge. Nevertheless, patients should be sure to study information regarding each course of treatment, as well as consult with medical staff before commencing any treatment program in order to prepare the most effective treatment plan possible.

Surgery

Primarily used to treat early stage cancer, surgery comes in the following 2 forms:

  • Partial mastectomy: A form of surgery that conserves part of the breast(s), with surgeons only removing the affected tissue. However, in cases where the cancer has spread to the lymphatic nodes, it may be necessary to surgically remove any nodes located under the arms in conjunction with administering a course of radiation therapy to ensure the disease does not make a comeback.
  • Mastectomy: Surgically removing the whole of the affected breast. Again, in cases where the cancer has spread to the lymphatic nodes located under the arms, these will need to be removed during the same procedure, with post-surgery radiation therapy not usually being necessary in such cases. Although this form of treatment is highly effective in destroying the cancer, there may be some side effects, including infections affecting the surgical scarring, hemorrhaging during surgery, inflammation or numbness in the wound area, and prolonged recovery times.

Radiotherapy

Focusing high-powered radio waves on the affected area to destroy the cancer cells, this form of treatment may also damage healthy cells nearby, often resulting in side effects, such as skin irritation leading to dryness and bruising. Radiotherapy is commonly used alongside other forms of treatment, including surgery or chemotherapy.

Chemotherapy or ‘chemo’

A form of treatment that relies on both orally and intravenously administered drugs focused on regulating and limiting the growth of cancer cells. However, these drugs also impact upon healthy cells, resulting in patients experiencing nausea, vomiting and hair loss, which are all aspects that cause many patients to feel anxiety regarding the chemo process. Moreover, chemotherapy places patients at greater risk of other, more serious health disorders, including an increased susceptibility to infection due to the low levels of white blood cells remaining in their bodies.

Targeted therapy

Drugs used in targeted therapy exclusively target cancer cells, meaning that other, healthy cells are left unaffected by the process. There are 2 main forms of drugs used in targeted therapy, each with its own effects, as follows:

  • Monoclonal antibodies are usually administered intravenously, and destroy cancer cells by obstructing reproduction and growth.
  • Small molecule drugs are orally administered, and are therefore able to pass through the cell membrane, specifically targeting and destroying cancer cells.

The most effective form of prevention for breast cancer is to reduce potential risk factors. This means managing your weight, reducing your alcohol intake, and ensuring that you undergo breast cancer screening as and when it is appropriate to your individual situation. Regular screening will help you detect the disease during its initial stages. Such early identification will then increase the likelihood of curing the disease, and consequently reducing the overall fatality rate for this potentially deadly condition.


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