Pathophysiological Development of Breast Cancer
|Subject:||🏥 Health Care|
|Topics:||Breast Cancer, Cancer, Disease, Health, Medicine|
Table of Contents
Breast cancer is identified as one of the most prevalent type of cancer and the main cause of mortality associated with cancer in women across the women. About 1.39 million new cases of breast cancer were diagnosed in 2012 with about 50% of all cases of breast cancer and estimate of 60% of deaths happening in lower income nations. There is a huge variation in the survival rates of breast cancer around the globe, with about 5- year survival of 80% in developed nations to below 40% for developing nations (Allen, Burrell, Caplice, Collins, McGreal, and Purcell, 2013). Middle and low income nations face constraints of infrastructure and resources which hinder the goal of improving the outcomes of breast cancer by treatment, diagnosis, and early detection. In high income nations such as the United States, about 2 million women were diagnosed and 23,000 died of breast cancer in 2013. For a US woman, the lifetime risk of developing breast cancer is 12.4% or 1 in 8. The significant reduction of the mortality associated with breast cancer in the US from 1975 to the present time is attributed to constant improvement in both treatment and screening mammography. According to the WHO, improving the survival and outcomes of breast cancer by early detections remains the key control of breast cancer.
Progesterone and estrogen are vital regulators of normal breast development and growth including breast involution and contribute vital roles in the pathogenesis of breast cancer. According to Kabel and Baali (2015), various factors, both environmental and genetic, may interfere with the normal growth regulatory pathways leading to the development of cancer. Genetic mutations in DNA repair genes, ionizing radiation exposure, and exogenous and endogenous hormone exposure are among most recognized factors that cause the development of breast cancer. Similar to other cancers, breast cancers happen due to the interactions between a genetically susceptible host and an environmental (external) factor. Normal cells split as several times as required and halt. They connect to other cells and remain in tissues. Normally cells turn to be cancerous when they lose their capability of stopping splitting to connect with their cells, to remains where they are, and to die at the appropriate time.
Normal cells do what is called “cell suicide” (i.e. are programmed cell death) whenever they are not required. Till then, they are safeguarded from cell suicide by many protein pathways and clusters. PI3K/AKT and RAS/MEK/ERK are recognized as popular pathways. In certain case, the genes in such protective pathways are normally mutated in a manner which makes them incapables of committing suicide whenever they are not required (Ostad and Parsa, 2013). It is recognized as one of the stages which cause cancer together with other kinds of mutations. The PTEN protein normally switches off the AKT/PI3K pathway whenever the cells are prepared for committing cell suicide. In certain breast cancers, the gene in the PTEN protein is mutated, thus the AKT/P13K pathway is tuned “on” status, and therefore cancer cell is not enabled to commit suicide. Typically mutations which cause breast cancer have been associated with the exposure of estrogen. The issue of abnormal growth happening in the interaction between epithelial cells and stromal cells can cause the growth of malignant cell. In breast tissue, overexpression of leptin causes increased cell proliferation as well as cancer.
In the US, 10%-20% of people with ovarian cancer and people with breast cancer have a 1st-2nd degree with respect to such diseases. The history with a family to develop such cancers is identified as “hereditary cancer disorder”. The BRCA mutations are a good example of these known to cause the problem of breast cancer of between 60%-85% and risk of ovarian cancer of between 15%-40% (Angahar, 2017). Some of the mutations that are related to cancer include BRCA2, BRCA1, and p53. These mutations happen in systems to rectify mistakes in DNA. Such mutations are either acquired or inherited after birth. However, risk factors to breast cancer go beyond the hereditary of gene mutations. Environmental factors and other factors also are known to cause breast cancer.
One in eight women develops breast cancer in their lifetime, although the risk of everyone is not the same. But having one or even many risk factors associated with breast cancer does not necessarily imply that a woman will develop the cancer. Several women who get breast cancer have no known risk factors besides just being a woman. Some women have a lower or higher risk than others. The chances of women developing breast cancer are dependent on a combination of their bodies and genes, life choices and lifestyle, and the surrounding environment (Abdulkareem, 2013). There are things that cannot be changed which affect risk of getting breast cancer. Such things include being a woman, getting older, and family history. However, there are things that can be changed. Women have more likelihood of getting breast cancer than men. Therefore, being a woman implies they are at a greater risk of developing the illness. Age also is a risk factor. As women get older, their risk of developing breast cancer increases. More than four out of five of all cases about breast cancer in the UK are in women of at least 50 years of age. The illness is not common in women under 40 years of age. There is nothing people can go about getting older. However, all women need to be aware about the breast cancer.
Apart from that, a history of breast conditions of a person increases the risk. If a person has had breast biopsy which found atypical hyperplasia of the breast or LCIS (Lobular Carcinoma in Situ), she has an increased risk of getting the illness (Komen, 2016). Furthermore, family history of the disease is a risk. If a daughter, sister, or mother was diagnosed with breast cancer, especially at a young age, then the risk of getting breast cancer is high in a woman. Apart from that inherited genes increase the chances of developing breast cancer. Coughlin and Cypel (2013) explained that certain gene mutations which increase the risk of developing the illness can be passed to children from parents. BRCA2 or BRCA1 are the most well recognized gene mutations. Such genes can significantly increase the risk of developing breast cancer including other cancers. Also, radiation exposure increases the chance of developing the disease. Obesity also increases the risk of the illness. According to Allen, Burrell, Caplice, Collins, McGreal, and Purcell, 2013), the beginning period at a younger age before age of 12 years put girls at risk of the disease. Also, starting menopause at an older age is believed to put women at risk of developing breast cancer. Moreover, having never been pregnant, having he first child at an older age, and taking alcohol are known to increase risks of developing the illness. Furthermore, women who undertake postmenopausal hormone therapy (hormone therapy medications which combine progesterone and estrogen to treat the symptoms and signs of menopause) have increased chances of developing the illness. The risk of the disease reduces when women stop taking such medications.
Increased education to women to be aware of the symptoms and signs of breast cancer is significantly important. Acquiring such knowledge is vital and can significantly help women to reduce the risk of the illness. Such knowledge can help women to regularly go for breast cancer screening and tests. Having self-examination knowledge of their breast is vital for women to periodically assess their breasts, a skill that can help them to detect unusual signs in their breasts and talk to physicians immediately. Avoiding taking alcohol, engaging in physical exercise, limiting postmenopausal hormone therapy, maintaining health weight and choosing healthy diets are vital ways to reduce and prevent risk of the development of breast cancer.
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