Breast Pathology and Cancer Diagnosis

To reduce the chances of developing breast cancer for women at higher risk, healthcare providers may recommend therapy along with one of several medications based upon careful risk assessment. Selective Estrogen Receptor Modulators (SERM) is another name for these medications, these include tamoxifen and raloxifene. Aromatase inhibitors are a group of medications; they are effective for breast cancer prevention. These medications prevent tumor which is known to be responsive to female hormones. The treatment plan to achieve good outcomes is affected by the biology of breast cancer. Breast Therapy includes Mastectomy, breast-sparing surgery and radiation therapy, Chemotherapy, Stereotactic Radiosurgery, Hormone Therapy, and Targeted Therapy.

Breast cancer treatment team mainly includes Breast surgeon, surgical oncologist, radiation oncologist, medical oncologist, plastic surgeon. It also includes a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counsellors, nutritionists, and others. The biology and behaviour of a breast cancer affects the treatment plan. Treatment options and recommendations are very personalized and depend on several factors, including: stage of tumour, tumour subtypes, genomic maker, patient age, and patient menopausal status, mutations in inherited breast cancer genes, such as BRCA1 or BRCA2. For both DCIS and early-stage invasive breast cancer, doctors generally perform surgery to remove the tumour. For larger cancers, or those that are growing more quickly, doctors may recommend systemic treatment with chemotherapy or hormonal therapy before surgery, called neoadjuvant therapy.

Breast surgery may be done for many causes, depending on the condition of the patient. Most women with breast cancer have some type of surgery as part of their treatment. Surgery may be done to remove the maximum cancer cells as possible (breast-conserving surgery or mastectomy) and to find out whether the cancer has spread to the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection) and/or restore the breast’s shape after the cancer is removed (breast reconstruction) and to relieve symptoms of advanced cancer.

Breast cancer is found in about 1 in every 3,000 pregnant women. Breast cancer is the most common type of cancer found during pregnancy, while breastfeeding, or within the first year of delivery. You may hear this called gestational breast cancer or pregnancy-associated breast cancer (PABC). Sometimes due to hormonal changes in pregnancy, cancer may spread to lymph nodes. Pregnancy and breast feeding can also make breast tissue denser. Breast cancer may occur during the pregnancy and after the birth of child although the chances are less. Woman who is previously diagnosed with breast cancer and is now pregnant should take advice of consultant. Pregnancy is not a reason of breast cancer, but chances can be there in the women who are diagnosed from breast cancer. Treatment of breast cancer during the pregnancy depends upon size of tumour. Decisions should there between the consultant, surgeon and oncologist. And family support is also required at the same time.

Women may reduce their risk of breast cancer by maintaining a healthy weight, drinking less alcohol, being physically active and breastfeeding their children. Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer: Older age, A personal history of breast cancer or benign (no cancer) breast disease, A family history of breast cancer, Inherited gene changes, Dense breasts, Exposure of breast tissue to oestrogen, made in the body, Taking hormone, therapy for symptoms of menopause, Radiation therapy to the breast or chest, Obesity, Drinking alcohol.

The two most common genetic risk factors for breast cancer are the BRCA1 & BRCA2 genes. Approximately 5% of all breast cancers are caused by a recognised specific genetic predisposition due to germ line mutations of one of two different genes: BRCA1 located on Chromosome 17q, BRCA2 located on Chromosome 13q. BRCA1 mutations also predispose to carcinoma of the ovary and possibly carcinoma of the Fallopian tube. The risk of developing breast cancer among carriers is around 55% by age 70. BRCA2: The product of BRCA2 is involved in controlling gene function and DNA repair. Gene function involves in transcriptional activation and completion of cell division by cytokinesis.  Majority of BRCA2-associated tumours are invasive ductal, no special-type tumours.

Immunohistochemistry is a special staining process performed on fresh or frozen breast cancer tissue removed during biopsy. IHC is used to show whether or not the cancer cells have HER2 receptors and/or hormone receptors on their surface. This information plays a critical role in treatment planning. Immunohistochemistry (IHC) is used to characterize intracellular proteins or various cell surfaces in all tissues. Individual markers, or more often panels of various marker proteins, can be used to characterize various tumor subtypes, confirm tissue of origin, distinguish metastatic from primary tumor, and provide additional information which may be important for prognosis, predicting response to therapy, or evaluating residual tumor post-treatment. There is a growing list of available antibodies, which contribute to the broader utility of immunohistochemistry for solving diagnostic problems or for determining prognosis and response to therapy in breast pathology.

In medicine, a case report contains detailed report of the symptoms, signs, diagnosis, treatment, and follow-up of an individual patient. Case report usually describes an unusual or novel occurrence. Case reports are an unexpected association between diseases or symptoms. It may result in finding the shed new light on the possible pathogenesis of a disease or an adverse effect. It may contour Unique or rare features of a disease, unique therapeutic approaches.

20% of breast carcinomas are of special type and the majority of these are lobular carcinomas. Tubular and mucinous carcinomas occur next most frequently and thereafter the remaining special types are seen infrequently. Special types of carcinoma should be distinguished from mixed carcinomas where the special type areas occupy between 50 and 90% of the tumour area with the remaining area being usually of no special type.

Breast health begins with a sense of what's normal for your breasts (breast awareness). To promote breast health, consider doing regular breast self-exams. For many women, breast health includes concerns about breast lumps, breast pain or nipple discharge. It's also important to understand common screening and diagnostic tests for breast health, such as clinical breast exams, mammograms and breast ultrasounds.

Breast cancer is the second most common cancer diagnosed after lung cancer and is the main cause of cancer demise in women. The heterogeneity of breast cancer such as ductal carcinoma in situ, triple negative breast cancer, HER2 negative among the women makes it difficult for the doctors to provide ideal medications for the cure. The major treatment methods are chemotherapy, radiation therapy, targeted drug therapy, oncoplastic surgery etc. Recent oncology research lead to the developments in neoadjuvant therapies, have also been benefited in treatment of breast cancer. Complete cure through Ayurveda was another major breakthrough in breast cancer treatment.

There are three general types of breast implant devices, defined by their filler material saline solution silicone, silicone gel and composite filler. The saline implant has an elastomer silicones shell filled with sterile saline  solution during surgery the silicone implant has an elastomer silicone shell pre-filled with viscous silicone gel and the alternative composition implant featured miscellaneous fillers such as soy oil, polypropylene string etc.

Furnishing the proper treatment to the right person at the right time is the primary goal of personalized medicine. Precision medicine is another term used for personalized medicine; it is a medical procedure in which patients are segregated into different groups. Based upon their predicted response or risk to disease after medical decisions, practices, interventions or products given to individual patients. Personal genetic or protein profiles are integrated for personalized medicine so that healthcare can be strengthened at a more personalized level. A positive effect on patient’s disease is the main target of personalized medicine so that effective treatment for a particular disease can be achieved. Knowledge of patients’ genetic profiles is required for proper medication or therapy. For the development of personalized medicine for breast cancer, knowledge of genetic profile is taken into consideration.

Lifestyle changes are shown to be important in the prevention of breast cancer. Diet, physical activity, smoking, alcohol use, and vitamin and mineral use are key factors influencing the risk of breast cancer among women. Because these factors are related to each other, it is difficult to assess their individual roles in breast cancer. Some of these factors are alterable, meaning that women can decrease their risk of breast cancer by changing their behaviour. Breast cancer is associated with a high rate of mortality and morbidity among women. Therefore, it is logical to try to find ways to decrease the risk of developing breast cancer. Lifestyle changes seem to be an easy, effective, and economical way to help prevent breast cancer. In women with a confirmed breast cancer diagnosis who are under radiotherapy treatment after undergoing a mastectomy, lifestyle changes are still very important. Some factors, such as smoking cessation and prevention of weight gain, may improve the long-term survival chances of these patients. Therefore, ways to increase women’s knowledge about the role of lifestyle changes in the prevention of breast cancer and in the survival of patients with diagnosed breast cancer should be considered and studied.

Medicine that is used along with conventional medicine is known as complementary medicine. On the other hand, alternative medicine is the medicine that is used in place of conventional medicine. Optimization of combined treatment by using conventional medicine and complementary medicine is very important for better results. Use of Mediation, Massage, Acupuncture, and herbs come under the category of complementary medicine. Studies have shown that the intake of supplements like vitamins can increase the risk of breast cancer, as some supplements might be having anti-cancer properties. So, alternative, complementary medicine and intake of supplements can minimize the risk of breast cancer.

Discussion on latest technologies and applications in breast cancer treatment is important to improve the treatment of breast cancer as well as for awareness against breast cancer. Breast cancer is the most affecting disease among women worldwide. Chances of survival from breast cancer are higher today than ever before. Latest technologies and outstanding clinical applications have helped the mortality to reduce. Latest technological advancements or advanced treatment methodologies can be shared during the workshop between the speakers and participants.

Prevention, Detection and cure of breast cancer depend upon a better understanding of biology of breast cancer cell. Understanding of signal transduction and protein interactions at molecular level helps in understanding the biology of breast cancer cell more clearly. Imaging techniques are there which help in early detection of Breast Cancer. Molecular Imaging helps in detection of different changes that occurs in body due to the therapy used for treatment. Use of different therapeutic and gene targeted cells for the treatment of breast cancer will affect mortality and modalities in the future. Molecular Imaging in Oncology, Gene therapy is new emerging era in the field of breast cancer treatment. Challenges are there using the molecular imaging for the treatment of breast cancer.