Free Press Journal

Breast Cancer: Prevention is better than cure

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Dr Debayan Ghosh of Epygen Biotech informs about breast cancer and how can one fight it

Breast cancer cells are not alien to human tissue. It is nothing but an uncontrolled growth of cells that starts in the breast tissue. About one in eight women will develop the condition in her lifetime, making it one of the most common cancer in women.

While a 5-year survival rate is 90% in developed countries, not more than 60% breast cancer patients in India makes it through a 5 year period. Alarming part is that, breast cancer cases in young patients in India has increased by nearly 100% in the last decades.


Causes

The exact cause of breast cancer is still elusive, with several possibilities in presentation. In about 5 to 10 percent of breast cancer cases, genetic mutations are linked to the disease. E.g. a mutation in the BRCA gene have a 70 percent chance of getting breast cancer by age 70, as this gene codes for a protein that repairs DNA and keeps the genetic material in shape, preventing a mutation and suppressing tumors.

Other commonly considered risk factors include a family history of breast cancer, starting menstrual periods before an age of 12 or going through menopause after age 55, not having children, having dense breast tissue, and using hormone therapy after menopause.

Symptoms

Not everyone with breast cancer will have symptoms before they are diagnosed. Some commonly considered symptoms are:

  • A lump in the breast or armpit
  • A thickening or swelling of the breast
  • Dimpling of the breast or skin irritation
  • Red or flaky skin in the nipple area
  • Nipple discharge other than breast milk

It should be noted that many of these symptoms may be caused due to a relatively benign condition like a cyst or infection.

Detection

Breast cancer screening tests are done on symptom-free women, with the goal of catching the disease early. If detected early, breast cancer can be treated today like many other chronic disorders, with substantially good prognosis. One of the main screening tests is a mammogram, or an X-ray of the breast. Women should get their first mammogram starting at age 40 and get them every year after. Though there are debates regarding overdiagnosis of breast cancer due to extensive mammograms conducted on healthy patients, prevention is still considered a much safer option than trying to cure this disease, at an advanced stage.

Other screening tests for breast cancer include a clinical breast exam, in which a doctor feels for lumps or changes in the breast, or a self-exam, when a woman checks her own breasts for lumps or changes in size or shape.

Diagnosis

Post initial detection, a potential case is subjected to imaging tests such as mammograms, MRI scans or breast ultrasound. Each of these methods produces internal pictures of the breast that help doctors see a potential mass. Biopsies are methods which take cells from suspicious lumps to study in a pathology lab to determine if they are malignant. Cells are extracted through special needles or during surgery.

Treatment: Beating Breast Cancer with the latest Biotechnology drugs

Targeted Therapy for Breast Cancer

As researchers understand more about the mechanism of how these tumors grow and spread, they developed new types of Biopharmaceuticals based protein drugs that target these cell changes. These therapeutic protein drugs work differently from chemotherapy drugs, which attack all cells that are growing quickly (including cancer cells). These targeted drugs often work even when chemo drugs do not.

Targeted therapy for HER2-positive breast cancer

HER2 protein promotes unusually fast growth of tumor and found in 1 in 5 women with breast cancer. Following targeted therapies have been developed for this type of patients:

Trastuzumab: This is a monoclonal antibody, often given along with chemo, or for patients after exhausting chemo options. Trastuzumab can be used to treat both early and late stage breast cancer. When started before or after surgery to treat early breast cancer, this drug is usually given for a total of a year. For advanced breast cancer, treatment is often given for as long as the drug is helpful.

Pertuzumab: Another Biopharmaceutical protein monoclonal antibody drug can be given with trastuzumab and chemo, either before surgery to treat early-stage breast cancer, or to treat advanced breast cancer.

Ado-trastuzumabemtansine (TDM-1): This is a monoclonal antibody loaded with a chemotherapy drug. It is used by itself to treat advanced breast cancer in women who have already been treated with trastuzumab and chemo.

Lapatinib: This is a kinase inhibitor pill to treat advanced breast cancer, and might be used along with certain chemotherapy drugs, trastuzumab, or hormone therapy drugs.

Neratinib: This is another kinase inhibitor pill used to treat early-stage breast cancer after a woman has completed one year of trastuzumab.

Targeted therapy for hormone receptor-positive breast cancer:

Being most common, about 2 of 3 breast cancers are hormone receptor-positive (ER-positive or PR-positive), who require hormone therapy drugs that can also be targeted using protein drugs working in combination.

Palbociclib, ribociclib, and abemaciclib are drugs that block proteins in the cell called cyclin-dependent kinases (CDKs), particularly CDK4 and CDK6. Blocking these proteins in hormone receptor-positive breast cancer cells helps stop the cells from dividing. This can slow cancer growth.