There are many different diseases that terrorize the human race every day. Of all of these sicknesses, one of the most devastating is breast cancer. Breast cancer touches all types of people all over the world each day. It is actually the second most common cancer amongst women in the United States. One in every eight women in the United States has some form of breast cancer and currently, the death rates are higher than any other cancer with the exception of lung cancer.
Cancer is defined by the Merriam-Webster Online dictionary as “a malignant tumor of potentially unlimited growth that expands locally by invasion and systemically by metastasis. ” Therefore, breast cancer is a disease of life-threatening tumors that continue to grow and invade the body, destroying all in its path. Although this is an accurate explanation of what breast cancer actually is, there really is so much more to it. Understanding Breast cancer at the cellular level gives us greater opportunities for treatment development as well as a better insight to what is actually happening in the body when afflicted with breast cancer.
It all starts with an alteration to the genetic code of the DNA of the breast cell. This change in the original code is referred to as a mutation. Mutations may occur randomly or they may be caused by substances called mutagens. There are an assortment of different factors that may contribute to the occurrence of mutations other than the errors that happen spontaneously. Environmental and chemical influences are two more common other factors. DNA interacts with the environment constantly, and at times these interactions can effect the DNA in a negative manner.
For example, the ultraviolet light rays given off by the sun may react with a person’s DNA and cause mutations to occur in his or her skin cells that may subsequently lead to skin cancer. In the case of breast cancer, ionizing radiation such as cosmic rays, gamma rays, and X-rays are the environmental factors that can cause mutations in the breast cells. The reason for this is that these types of radiation can penetrate tissue much better than ultraviolet light rays and therefore have the ability to spread to other parts of the body, such as the breast tissue.
Researchers currently believe that a woman’s predisposition to breast cancer causing mutations due to chemical influences, mainly occur in the womb when the woman’s breast tissue is initially forming. Any hazardous chemical eaten, breathed in or absorbed by the mother may be passed onto the fetus, and since the breast tissue is rapidly growing and developing at this time, it is the time when the woman is actually at the greatest risk of developing mutations due to chemical exposure. Later on in life, these mutations may cause cancer in the breasts of that woman.
When a mutation happens, it interferes with the genetic code which produces the signals for specific proteins, and if not caught and corrected by the cell it gets inherited by the new daughter cells and becomes permanent. The proteins carry the instructions for the manner in which the cell is supposed to function. If these instructions have been altered, then the cell will not know what it is supposed to do and may function in now harmful way in the body. Whether or not a cell becomes cancerous, however depends on two regulatory genes known as proto-oncogenes and tumor suppressor genes.
The proto-oncogenes are genes that code for a signal for the cell to enter the cell cycle. They also instruct the cell on how long it should stay in the cycle and continue to divide. If these genes are coded incorrectly due to a mutation, they lose the ability to regulate the cell’s activity in the cell cycle. The mutated cell will remain in the cell cycle and continue to reproduce thus forming a tumor. Tumor suppressor genes are in charge of sending the message for the cell to cease cellular division and go through a checkpoint to ensure that there is no damage to its DNA.
This is the point where any mistakes in the code would be corrected before allowing the cell to continue on its cycle. When a tumor suppressor gene is effected by a mutation, it loses its control over the cell and the cell does not stop to get inspected. When this happens, the mutation is copied, the cell divides and damage is passed down to the newly formed daughter cells. The mutation then becomes permanent and the now mutated cell will continue to divide and proliferate when it normally would not. Another factor that contributes to the development of breast cancer is actually the hormone estrogen.
This seems unusual because estrogen is a hormone that is essential to the bodies of women in various ways. Estrogen is necessary for normal growth and development of breasts and reproductive organs, as well as for the maintenance of a healthy heart and bones. However, lifetime estrogen exposure may increase a woman’s risk of developing breast cancer. It does not actually produce the mutation in the DNA, nevertheless Estrogen stimulates the proliferation of breast cells that already contain a mutation. These mutated cells will continue to reproduce and have an increased chance of becoming cancerous.
The breasts are essentially a milk factory. Inside the breasts there are glands called lobules that are responsible for producing the milk. These glands contain branches of little sacs that hold the milk called alveoli. The lobules are positioned around ducts that carry milk to the nipple. Also, a layer of fatty tissue surrounds the breast glands and extends throughout the breast. All Cancer in the breasts begins in the cells that line the ends of the lobules and the cells in the ends of the ducts, therefore the cancer can be either lobular or ductal.
From here the cancer may metastasize and spread to nearby tissues. Nowadays, there are numerous methods of treating cancer, varying from medication to radiation to surgery. One of the most radical and controversial of these treatments is mastectomy surgery. A mastectomy is the oldest known treatment for breast cancer. It removes the entire breast and may include the removal of skin and muscle as well. A similar yet more conservative surgery option is called lumpectomy. A lumpectomy is a surgery where a small tumor or lump that may or may not be malignant, is removed.
Basically, only part of the breast is removed, and because of this lumpectomy surgery is also referred to as breast conserving surgery. This type of surgery was developed in the early eighties, in the attempt to try to give women a less invasive option. After the lumpectomy however, the woman receives five to seven weeks of radiation in order to eradicate any cancerous breast cells that may be have been left behind in the breast tissue that remains. One would assume that the mastectomy, although more extreme, is the most effective of the two surgeries.
However, doctors are now saying that the effectiveness of each of the procedures is actually equivalent. Dr. Susan Love, a professor of surgery at UCLA when interviewed by Discovery Health stated, “Well I think we have certainly changed the attitude toward mastectomy a lot in the last decade. It used to be that we felt like you had to cut the breast off because it was the only way to prevent it from spreading. And now that we have realized that breast cancer has been there eight to ten years by the time we come around it and rushing in and cutting the breast off is not what is going to save somebody.
When you do a mastectomy you never get all the breast tissue and so there still is a local recurrence rate of about five to ten percent in the scar. If you do a lumpectomy and radiation there is a local recurrence rate in the breast of about five to ten percent. So they are equal in terms of preventing breast cancer from coming back in the breast. ” In a ten year clinical study conducted by the National Cancer Institute, this statement made by Dr. Susan Love is supported by scientific data.
Two hundred and forty-seven patients with clinical stage I and II breast cancer were randomly divided into two groups. One group was instructed to undergo mastectomy surgery as a treatment for their breast cancer. The second group was instructed to have lumpectomy surgery, axillary dissection, and radiation therapy. All of the patients were followed for approximately ten years and then compared in regards to disease- free survival and overall survival. For the patients who had the mastectomies, the overall survival rate after ten years was seventy-five percent.
The overall survival rate for the lumpectomy plus radiation patients was seventy-seven percent, yielding a two percent difference in survival in the favor of lumpectomy with radiation therapy. In the case of disease free survival after ten years, the rate of survival was sixty-nine percent for mastectomy patients, and seventy-two percent for the patients who underwent lumpectomy plus radiation. This generates a difference of three percent also favoring the lumpectomy with radiation. This clinical trial illustrated that there is barely a difference between mastectomy and lumpectomy when concerning survival rates.
There have been countless medical advances as far as Breast Cancer is concerned in the past few years. This is due to the amount of time that has been dedicated to analyzing the biology of Breast cancer. We comprehend that the cancer arises from a mutation of the DNA of a breast cell. The mutation alters the genetic code of the DNA causing the directions for the cell to be incorrect, and the cell to function abnormally. When the abnormally behaving cell ceases to stop dividing, it becomes a cancerous tumor that may metastasize and spread to other tissues of the body.
Reflecting on the progress of medical research of Breast Cancer, The National Cancer Institute states, “We will exploit our rapidly increasing knowledge of genetics, molecular biology, and immunology to develop even more effective and less toxic treatments for breast cancer. We will expand our ability to target and disrupt the effects of molecular changes that cause breast cells to become cancerous. ” It is evident that understanding Breast Cancer on a cellular level is extremely beneficial to the evolution of Breast Cancer Research and treatment.
The more we study and learn about the disease on a cellular level, the more we can assess how to better treat it as well as prevent it. With knowledge of the molecular properties of Breast Cancer, scientists are able to aid in the improvement of current treatments and the development of additional treatments. Over time, science will continue to examine more and more closely what takes place in and around the cells of a Cancer afflicted breast, and therefore we can hope that perhaps someday we can develop a cure for this monster of a disease that claims the lives of too many women each day. Batista “ConsumerReports. Org”.
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19 July 2010 http://envirocancer. cornell. edu/Factsheet/General/fs10. estrogen. cfm “ConsumerReports. Org”BMJ Publishing Group . 0 19 July 2010 http://www. consumerreports. org/health/conditions-and-treatments/breast-cancer/what-is-it. htm. Love, Susan. “abcNews/Health”. Susan Love Research Foundation. 23 July 2010 . “Healthy For Life”. Ivanhoe Broadcast News Inc.. 20 July 2010 . “Discovery Health”. Discovery Communications Inc. . 19 July 2010 . “The New England Journal of Medicine “. The National Cancer Institute . 20 July 2010 . The National Cancer Institute “. The National Cancer Institute . 23 July 2010 .