Breast cancer and Related Topics

A coronal CT scan showing a malignant mesothelioma
Legend: → tumor ←, ✱ central pleural effusion, 1 & 3 lungs, 2 spine, 4 ribs, 5 aorta, 6 spleen, 7 & 8 kidneys, 9 liver

Cancer

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Group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.

Symptoms of cancer metastasis depend on the location of the tumor.

The GHS Hazard pictogram for carcinogenic substances

Share of cancer deaths attributed to tobacco in 2016.

The incidence of lung cancer is highly correlated with smoking.

Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat.

The central role of DNA damage and epigenetic defects in DNA repair genes in carcinogenesis

Chest X-ray showing lung cancer in the left lung

Three measures of global cancer mortality from 1990 to 2017

Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689

An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue and yellow fatty tissue

An invasive colorectal carcinoma (top center) in a colectomy specimen

A squamous-cell carcinoma (the whitish tumor) near the bronchi in a lung specimen

A large invasive ductal carcinoma in a mastectomy specimen

The benefits of screening for breast cancer are controversial.

Tamoxifen

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Crystallographic structure of afimoxifene (carbon = white, oxygen = red, nitrogen = blue) complexed with ligand binding domain of estrogen receptor alpha (ERα) (cyan ribbon).

Tamoxifen, sold under the brand name Nolvadex among others, is a selective estrogen receptor modulator used to prevent breast cancer in women and treat breast cancer in women and men.

Endometrial cancer

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Cancer that arises from the endometrium .

The autosomal dominant inheritance pattern seen in Lynch syndrome

Immunohistochemistry of endometrial endometrioid carcinoma with wild-type pattern of p53 expression, with variable proportion of tumor cell nuclei staining with variable intensity.

Vaginal ultrasonography with an endometrial fluid accumulation (darker area) in a postmenopausal uterus, a finding that is highly suspicious for endometrial cancer

Relative incidences of endometrial carcinomas by histopathology.

Endometrioid endometrial adenocarcinoma—very high magnification—H&E stain

A keyhole hysterectomy, one possible surgery to treat endometrial cancer

alt=A diagram of stage IA and IB endometrial cancer|Stage IA and IB endometrial cancer

alt=A diagram of stage II endometrial cancer|Stage II endometrial cancer

alt=A diagram of stage III endometrial cancer|Stage III endometrial cancer

alt=A diagram of stage IV endometrial cancer|Stage IV endometrial cancer

Risk factors for endometrial cancer include obesity, insulin resistance and diabetes mellitus, breast cancer, use of tamoxifen, never having had a child, late menopause, high levels of estrogen, and increasing age.

Micrograph of a mucinous ovarian carcinoma stained by H&E.

Ovarian cancer

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Cancer that forms in or on an ovary.

Women with ovarian or breast cancer in a pedigree chart of a family

A very large ovarian cancer as seen on CT

Micrograph of serous carcinoma, a type of ovarian cancer, diagnosed in peritoneal fluid

Ovarian cancers in women aged 20+, with area representing relative incidence and color representing five-year relative survival rate

A pathological specimen of ovarian carcinoma

Hobnail cells seen in a clear cell carcinoma sample

Ovarian adenocarcinoma deposit in the mesentery of the small bowel

Relative five-year survival of invasive epithelial ovarian cancer by stage

Ovarian tumors (including non-cancerous tumors) by incidence and risk of ovarian cancer.

Ovarian cancer cases diagnosed by age group in the US

Age-standardized death from ovarian cancer per 100,000 inhabitants in 2004
no data
less than 0.6
0.6–1.2
1.2–1.8
1.8–2.4
2.4–3
3–3.6
3.6–4.2
4.2–4.8
4.8–5.4
5.4–6
6–7
more than 7

Because these tumors produce estrogen, they can cause or occur at the same time as endometrial cancer or breast cancer.

BRCA1

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Protein that in humans is encoded by the BRCA1 gene.

Absolute risk of cancers in BRCA1 or BRCA2 mutation.

If BRCA1 or BRCA2 itself is damaged by a BRCA mutation, damaged DNA is not repaired properly, and this increases the risk for breast cancer.

Histopathologic types of breast cancer, with relative incidences and prognoses.

Breast cancer classification

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Ducts and lobules, the locations of ductal and lobular carcinoma, respectively.

Tubule formation score in the Nottingham system

Molecular classification of breast cancer from mRNA expression profiles

Ductal carcinoma with mild nuclear pleomorphism.

Invasive ductal carcinoma with moderate nuclear pleomorphism.

Invasive lobular carcinoma with moderate nuclear pleomorphism.

Invasive ductal carcinoma with marked nuclear pleomorphism.

Breast cancer classification divides breast cancer into categories according to different schemes criteria and serving a different purpose.

A dimer of the ligand-binding region of ERβ (PDB rendering based on ).

Estrogen receptor

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Estrogen receptors (ERs) are a group of proteins found inside cells.

The domain structures of ERα and ERβ, including some of the known phosphorylation sites involved in ligand-independent regulation.

A dimer of the ligand-binding region of ERα (PDB rendering based on ).

The ERα is found in endometrium, breast cancer cells, ovarian stromal cells, and the hypothalamus. In males, ERα protein is found in the epithelium of the efferent ducts.

Radiation therapy

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Therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator.

Radiation therapy for a patient with a diffuse intrinsic pontine glioma, with radiation dose color-coded.

Histopathology of radiation cystitis, including atypical stromal cells (“radiation fibroblasts”).

The beam's eye view of the radiotherapy portal on the hand's surface with the lead shield cut-out placed in the machine's gantry

A teletherapy radiation capsule composed of the following:

Varian TrueBeam Linear Accelerator, used for delivering IMRT

X-ray treatment of tuberculosis in 1910. Before the 1920s, the hazards of radiation were not understood, and it was used to treat a wide range of diseases.

For example, non-melanoma skin cancer, head and neck cancer, breast cancer, non-small cell lung cancer, cervical cancer, anal cancer, and prostate cancer.

BRCA mutation

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Mutation in either of the BRCA1 and BRCA2 genes, which are tumour suppressor genes.

BRCA mutations are inherited in a genetically dominant fashion, from either parent.

The BRCA genes are tumour suppressor genes pictured here on their respective chromosomes. BRCA 1 has the cytogenetic location 17q21 or the q arm of Chromosome 17 at position 21. BRCA 2 has the cytogenetic location 13q12.3 or the q arm of Chromosome 13 at position 12.3. Both genes produce proteins that help repair damaged DNA, keeping the genetic material of the cell stable. A damaged BRCA gene in either location can lead to increased risk of cancer, particularly breast or ovarian in women.

Only 5–10% of breast cancer cases in women are attributed to BRCA1 and BRCA2 mutations (with BRCA1 mutations being slightly more common than BRCA2 mutations), but the impact on women with the gene mutation is more profound.

Raloxifene

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Medication used to prevent and treat osteoporosis in postmenopausal women and those on glucocorticoids.

It is also used to reduce the risk of breast cancer in those at high risk.

A report on Breast cancer

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