Essay: Cellular and Molecular Biology – Breast Cancer

In humans, the body cells usually divide into new cells only as they are needed. However, when one develops cancer, their body cells begin to divide incessantly. They then spread to the surrounding tissues (National Cancer Institute) creating a mass known as a tumor. Cancer doesn’t just describe one disease. It is a collection of similar diseases, but of different parts of the body. The types of cancer are typically named for the place that they originate; because of this, there are over 100 types of cancer (National Cancer Institute). Of these 100 plus types of cancer, one of the most common is breast cancer. Seeing that it is one of the most common types, money and research should be put in to find a cure once and for all.
Not only is breast cancer one of the most common types of cancer overall, it is the most common type of cancer diagnosed in women (National Breast Cancer Foundation). There were roughly 250,000 new cases of breast cancer that were expected in 2016 (National Cancer Institute). Each year, it is estimated that more than 40,000 women will die of breast cancer (NBCF). But contrary to popular belief, women aren’t the only ones who can develop breast cancer. Men can get it too, but it is rare. Approximately 2,600 men will be diagnosed and about 440 will die as a result of breast cancer (NBCF). In the United States, 1 in 8 women will be diagnosed with breast cancer (NBCF); while 1 in 100 men will develop it during their lifetime (American Cancer Society). Due to the fact that breast cancer can appear in both men and women, and that it is one of the most common cancer types, it should be prioritized.
Like cancer as a whole, there are many types of breast cancer. The most common types include ductal carcinoma in situ, invasive ductal carcinoma, triple negative breast cancer, inflammatory breast cancer, and metastatic breast cancer (NBCF). Ductal carcinoma in situ is a non-invasive cancer in the lining of the milk duct (NBCF). This is an early stage cancer and is very treatable (NBCF). Invasive ductal carcinoma is when the cancer cells originate in the milk ducts and spread into other parts of the tissue around the breast (NBCF). Triple negative means that the tumor doesn’t have the estrogen, progesterone, and HER2 receptors that fuel cancer growth (NBCF). Inflammatory breast cancer is a fast-growing and aggressive cancer; the cancer cells ever the lymph vessels of the breast and doesn’t create a lump that can be felt (NBCF). It is when the lymph vessels are blocked that the symptoms appear (NBCF). Finally, metastatic breast cancer is cancer that originated in the breast tissue but has spread to other parts of the body (NBCF). Because of this, metastatic cancer is classified as stage 4 (NBCF). Finding a cure for breast cancer isn’t as simple as just one type of cancer. All of the breast cancer types need to be taken into consideration. More research should be carried out in order to put an end to this awful disease once and for all.
As it is with most diseases, breast cancer has signs and symptoms of the disease. The most prevalent symptom is a lump or mass in the breast. These can be detected either through a breast self-exam or a mammogram. Self-exams should be done by yourself once a month to look for any abnormalities. Mammograms are x-rays of the breast that enable the doctors to see if there are any otherwise undetectable suspicious lumps (NBRC). It is very important to have any lumps assessed by a professional so the disease is caught in the early stages. Some of the other symptoms of breast cancer include: “swelling of all or part of the breast, skin irritation or dimpling, breast or nipple pain, nipple retraction, redness, scaliness, or thickening of the nipple or breast skin, and a nipple discharge other than breast milk” (American Cancer Society). If one experiences any of these symptoms, it’s a good idea to see a doctor to get it assessed. If the doctor is unsure about a mass or lump in the breast, a biopsy will occur most likely. That biopsy goes to a pathologist to examine and is run through many tests to diagnose the problem. The biopsy then comes back positive or negative for cancer. If the results are positive, the stage of cancer is also revealed based on the state of the cancer cells.
Breast cancer is similar to the fact of all cancers that it too has stages. There are five stages of cancer, ranging from 0 to 4. The stage is based on how developed the tumor is, it’s size, if the cancer has spread, and how many lymph nodes are affected. The lowest numbered stages are Stages 0 and 1. In these stages, “the cancer cells are confined to a very limited area” (NBCF).  The cancers classified as Stage 0 cancers are called carcinoma in situ. This means that abnormal cells have been identified in the milk duct (NBCF). Stage 0 is a highly treatable early cancer. In Stage 1, the cancer is evident but only where the cancer originated. In other words, it hasn’t spread. Stage 1 cancer can be divided into two more substages: Stage 1A and Stage 1B. In Stage 1A, the tumor is smaller than 2 centimeters and hasn’t been able to spread to the lymph nodes (NBCF). In Stage 1B, there is evidence of cancer in the lymph nodes and the cell clusters are about 0.2mm to 2.0mm (NBCF). As with Stage 0, this is an early cancer and highly treatable. For both Stages 0 and 1, chemotherapy is not necessary because it isn’t as aggressive as some of the other stages.  Stage 2 breast cancer implies that the cancer is growing, but it hasn’t left the breast area or gone farther than the nearby lymph nodes (NBCF). Like Stage 1, Stage 2 is split up into two groups: Stage 2A and Stage 2B (NBCF). There are a couple of situations that classify as Stage 2A. The first thing that classifies as 2A is there is no physical tumor associated with the cancer cells and there are less than four lymph nodes that show evidence of cancer cells (NBCF). Another thing that could be 2A is there is a tumor, smaller and 2 centimeters, and less than four lymph nodes have cancer cell evidence (NBCF). The last thing that is Stage 2A breast cancer is if the tumor is 2 to 5 centimeters but hasn’t spread to any lymph nodes (NBCF). In Stage 2B, the tumor can be between 2 and 5 centimeters and is found in less than four lymph nodes or it can be larger than 5 centimeters but not found in any lymph nodes (NBCF). Stage 3 is again split into groups, but it has 3 groups: Stage 3A, Stage 3B, and Stage 3C (NBCF). There are three descriptions that classify as Stage 3A. First, there isn’t a physical tumor, or the tumor can be any size, and there are four or more lymph nodes affected (NBCF). Secondly, the tumor is larger than 5 centimeters, and small clusters of cancer cells are in the lymph nodes (NBCF). Thirdly, the tumor is larger than 5 centimeters, and “the cancer has spread to 1, 2, or 3 lymph nodes under the arm or near the breastbone” (NBCF). In Stage 3B, the tumor can be any size, and cancer has spread to lymph nodes, the chest wall, or the breast skin (NBCF). Stage 3C has three descriptions as well. The first description of Stage 3C is that there is either no tumor, or the tumor is any size, and the cancer has spread to more than ten lymph nodes (NBCF). The second description is that there is either no tumor or the tumor is any size, and it has spread to the lymph nodes by the clavicle (NBCF). The third and final description is that there is either no tumor or the tumor is any size, and that it has spread to the lymph nodes near the breastbone or the underarm (NBCF). Lastly, Stage 4 breast cancer means that the cancer has spread to other regions of the body. It is considered incurable, however, medical advancements today allow more women to live longer (NBCF). Nevertheless, the earlier you catch the cancer, the easier it is to treat it. As the cancer gets into the latter stages of Stage 3 and 4, the more aggressive the treatment needs to be to be able to treat it, or in the case of Stage 4, manage it. There needs to be more research done surrounding breast cancer in order to be able to cure it.
Like most cancers, breast cancer can be treatable. Fortunately, there are many treatment options such as surgery, chemotherapy, radiation, hormone therapy, and targeted therapy. Usually the first and most common step of breast cancer treatment is surgery (NBCF). The surgery calls for the removal of the tumor and the margins. The margin is “the surrounding tissue that might be cancerous” (NBCF). The margins are tested to see if the cancer is spreading to outside tissue. Though surgery is typically the first step for most patients, those with Stage 2 or Stage 3 cancer may receive chemotherapy first (NBCF), which leads me to my next point. Chemotherapy is another form of breast cancer treatment. The purpose of chemotherapy is to slow down the growth of cancer cells or destroy them altogether using a combination of different drugs (NBCF).  Not all cancer patients need chemotherapy. It is offered to most cancer patients depending on the tumor type, size, the risk of cancer spreading, the number of lymph nodes involved, etc (NBCF).  What drugs are used greatly depend on all of these factors so that they work effectively. Another treatment that many patients receive is radiation. Radiation therapy consists of high-energy rays to kill the cancer cells (NCBF). It is started after surgery to eliminate any remaining cancer cells and to reduce the risk of recurrence (NBCF). An additional treatment method for breast cancer is hormone therapy. Breast cancer cells can feed off of hormones such as estrogen or progesterone; this encourages their growth (NBCF). Tests will be performed to indicate whether these cells feed on either estrogen or progesterone (NCBF). Based on the results of the test, hormone therapy drugs such as blockers or inhibitors might be suggested (NBCF). The drugs help destroy the cells as they cut off the hormone supply (NBCF). One of the last treatments for breast cancer patients is targeted therapy. Targeted therapy is frequently used with chemotherapy. The drugs used in targeted therapy inhibits the growth of the cancer cells (NBCF). For example, a drug called Herceptin® will be given to a patient to eliminate HER2, which is an “abnormal protein . . . that stimulates the growth of breast cancer cells” (NBCF). Though these treatments may take care of the disease, it doesn’t mean that you’re done with it. After the cancer is treated, there are still things you have to do afterward to make sure it doesn’t come back. There are many follow-up appointments with oncologists, medications to take, and much more. Through the treatment and even after the cancer, it takes both an emotional and physical toll on the patients. While there are all these treatments currently in use, there is always room for new treatments and new ways to make it less emotionally and physically draining on the patients.
While cancer can be caused by lifestyle factors, it can also be caused by genetic factors. Breast cancer is no different as it can be hereditary. In fact, about 5 to 10% of  breast cancers are believed to be hereditary (breastcancer.org). The hereditary cases of breast cancer are linked to the two genes, BRCA1 and BRCA2 (breastcancer.org). These genes produce tumor repressor proteins (National Cancer Institute) which prevent the abnormal growth of the cells. But when these cells develop mutations through generations, the risk of cancer increases (breastcancer.org).   BRCA 1 and BRCA2 can not only be responsible for breast cancer, it can also be responsible for ovarian cancer too. Today, there is also genetic testing available. There are many different tests, including some that look for “a known mutation in one of the genes . . . and tests that check for all possible mutations in both genes” (National Cancer Institute). These tests should be performed on individuals when they themselves or family members have a history of breast or ovarian cancer. There are some factors that are associated with an increased chance of having BRCA gene mutations. Some of these include breast cancer diagnosed before age 50, cancer in both breasts in the same woman, both breast and ovarian cancers in the same family, multiple breast cancers, cases of male breast cancer, and two or more primary gene-related cancers in a single family member (National Cancer Institute).
When it comes to diseases, everyone wants to know how they can lower the risks of it. This is especially true for breast cancer. There are some factors that are linked to breast cancer that cannot be avoided. For example, the most obvious and largest risk factor for breast cancer is being a woman. Needless to say, men can get it too. However, it is far more common in women than it is in men. Another unchangeable factor is your genetics and family history. If your family has a history of breast cancer or even ovarian cancer, you are already at a higher risk of developing breast cancer. Even if you yourself have already been diagnosed with breast cancer once, your risk of developing new cancer in the other breast is 3 to 4 times greater (breastcancer.org). One last factor that you cannot change that contributes to the risk of breast cancer is age. The older one gets, the more likely they become to develop breast cancer. There are also some risk factors that you have the power to change. These can include being overweight, smoking, unhealthy eating, lack of exercise, and more (breastcancer.org).
Going along with lowering the risk of breast cancer, there are ways to catch it early enough so that it is easier to treat. There are a number of preventative screening options that patients can either do themselves or …. The first preventative screening that one can do is a self-breast exam. By doing this, you can become familiar with what is normal and when something doesn’t seem right. Another test exam that you can do is a mammogram. This is the most common, more known exam when it comes to breast cancer. As previously mentioned, these are x-rays of the breast. Breast MRIs are another option to get screened for breast cancer. These usually accompany mammograms. They are used for women with higher risk of breast cancer. A fourth thing one can do is get a clinical breast exam. This is an exam by a doctor to feel if there are any lumps or abnormalities. Preventative screening is an important feature when trying to prevent breast cancer.
In conclusion, breast cancer is a disease that not only affects women but men too. It is one of the most common cancers as about 1 in 8 women will develop it in their lifetime. Due to it being one of the most common cancers that affect people, money and time should be spent researching and trying that much harder to find a cure. Over the years, there have been many medical advancements regarding breast cancer and it’s treatment. For example, even though Stage 4 breast cancer is incurable, these advancements have allowed doctors to more and more women to live longer than in the past. Genetic testing for the BRCA genes has been available to be able to test for mutations in those genes. This is especially helpful to look for hereditary breast cancer and even ovarian cancer. The genetic testing allows the knowledge of any hereditary cancer and one knows to watch for any signs. Catching cancer early is the best way to ensure that it can be treated. By advocating self-exams and mammograms as early as possible, the probability of catching the breast cancer earlier increases and so does the survival rate. There are well over 2.8 million breast cancer survivors that are alive in the U.S. today (NBCF). While that is an exceptional number, it isn’t 100 percent. Hopefully, with time, money, and research, in the future, breast cancer will be overcome, and the survival rate of will be 100 percent.