Chris Vi, PhD Candidate (Medicine), B.H&MedSci(Hons), B.BioMedSci
Deeya Mahadooa, MSc Mental Health Psychology, BA(Hons) Psychology
Breast cancer accounts for 1 in 10 cancer diagnoses each year (Alkabban & Ferguson, 2020).
Most breast cancers start in the cells which line the ducts. Some start in the cells which line the lobules.
Lobular/lobules: milk-producing glands.
Ducts: milk passages.
Two main types: Lobular and Ductal which can be non-invasive or invasive.
Breast Cancer Now (2020)
Non-invasive: confined to the ducts, does not go further into connective or fatty tissues of the breast.
- Ductal carcinoma in situ (DCIS) – accounts for 90% of non-invasive BCs.
- Lobular carcinoma in situ (LCIS) – less common, is considered a marker for increased risk of BC.
Invasive: cells break through the duct or lobular wall, invade the connective and fatty tissues of the breast (Sharma et al., 2010).
- Invasive ductal carcinoma (IDC)
- Begins in the milk ducts
- Tends to grow as a cohesive (solid) mass
- Discrete abnormalities/lump
- Most common form of cancer – accounts for 50-70% of invasive BCs
- Invasive lobular carcinoma (ILC)
- Begins in the milk glands
- Spreads in the breast tissues
- Often escapes detection on mammograms or physical examinations
- Usually detected when disease has metastasised/progressed to other regions of the body
- Accounts for 10-15% of BCs
To confirm BC, a biopsy is taken. Confirmation of BC will lead to treatment and management options (Moo et al., 2018; Sharma et al., 2010).
- Surgical resection: remove localised primary tumour for a curative approach
- Mainstay (preferred) treatment, however this may not always be the only option if the cancer has progressed (Moo et al., 2018; Sharma et al., 2010).
Based on the histological and molecular profile of the BC, the treatment options change for more targeted approach.
- Endocrine therapy: for ER/PR positive BC (Awan & Esfahani, 2018).
- Anti-body therapy: trastzumab for HER2 (Kreutzfeldt et al., 2020)
- Chemotherapy or radiotherapy: for triple negative as there are no identifiable molecular targets for drugs to read (still being investigated, EpCAM and LHRH receptors over expressed in TNBC) (Obayemi et al., 2020; Wahba & El-Hadaad, 2015)
Subject to copyright Rehab Plus, 2020
References
Alkabban F. M., & Ferguson, T. (2020). Breast Cancer. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482286/
Awan, A., & Esfahani, K. (2018). Endocrine therapy for breast cancer in the primary care setting. Current Oncology (Toronto, Ont.), 25(4), 285–291. https://doi.org/10.3747/co.25.4139
Breast Cancer Now (2020). Ductal carcinoma in situ (DCIS). Retrieved from https://breastcancernow.org/information-support/facing-breast-cancer/diagnosed-breast-cancer/primary-breast-cancer/ductal-carcinoma-in-situ-dcis
Kreutzfeldt, J., Rozeboom, B., Dey, N., & De, P. (2020). The trastuzumab era: current and upcoming targeted HER2+ breast cancer therapies. American Journal of Cancer Research, 10(4), 1045–1067. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191090/
Moo, T. A., Sanford, R., Dang, C., & Morrow, M. (2018). Overview of breast cancer therapy. PET Clinics, 13(3), 339–354. https://doi.org/10.1016/j.cpet.2018.02.006
Sharma, G. N., Dave, R., Sanadya, J., Sharma, P., & Sharma, K. K. (2010). Various types and management of breast cancer: An overview. Journal of Advanced Pharmaceutical Technology & Research, 1(2), 109–126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255438/
Obayemi, J. D., Salifu, A. A., Eluu, S. C., Uzonwanne, V. O., Jusu, S. M., Nwazojie, C. C…Soboyejo, W. O. (2020). LHRH-Conjugated drugs as targeted therapeutic agents for the specific targeting and localized treatment of triple negative breast cancer. Scientific Reports, 10(8212), 1-18. https://doi.org/10.1038/s41598-020-64979-1
Wahba, H. A., & El-Hadaad, H. A. (2015). Current approaches in treatment of triple-negative breast cancer. Cancer Biology & Medicine, 12(2), 106–116. https://doi.org/10.7497/j.issn.2095-3941.2015.0030