Breast Cancer Associated Factors and Treatment Options

Introduction

Breast cancer is a cancer which occur in breast cells. It can find in both men and women, but it’s mostly available in women. It is the second cause of death and also the most important type of cancer. Breast cancer is the primary cause of death among women age between 45–55 years, and is the second leading cause of cancer-induced death. Breast cancer is a multiphase disease, here viruses play a role in one stage of this pathogenic process. Breast cancer is a known disease of women and the highest rate of mortality in women occurred by breast cancer. This problem can arise only for women and men.

However, doctors believe that the prevention of treatment is the biggest treatment for the disease. Surprisingly, it was hard to make women aware of this cancer so much, but now it is being stressed to make men aware too. Because, men may also have breast cancer. But the rate of men’s breast cancer is very low.

Breast Cancer Associated Factors

Family and breast cancer:

• Some therapeutic complications affect the patient’s self-awareness, sense of self worthlessness, self-confidence, and -acceptance.
• Suffering from disease, fear of death, therapeutic complications, reduced performance, concerning about family future, and mental imagery disorder are among factors that affects the mental health of patients.
•  It affects the quality of life of patients and impairs their physical, mental, social, although chemotherapy is an important cancer treatment method.

Social support and breast cancer:

• Breast cancer is the diseases in which the death and mastectomy cause fear and anxiety in the patient. The patient goes through various psychological stages in diagnosing this disease.
• The world of a woman with cancer dramatically collapses in the blink of an eye. The patient becomes confused and her small hopes fade away to great disappointments. Nobody can deeply understand her feelings; while, she strongly needs support.
• Studies show that support is a vital and multi-dimensional need that should frequently be provided to clients. Nurses and physicians usually prioritize psychological-mental supports, physical support; whereas, are polled as more important than other things by such patients. They collected different reports of change in life cycle and style, in which various concepts such as overcoming and exploration and transition, transformation.

Cancer and genetic factors

Genetic risk factors developed the breast cancer heterogeneous disease. Progressive aggregation of genetic and epigenetic changes in breast cancer cells. If the presence of risk factors (such as age, obesity, alcohol use, and exposure to estrogen in lifetime), family history of breast cancer is the strongest one.

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Cigarette smoking and breast cancer

• However, the role of cigarette has not been considered as a cause until recently, Identification of Breast cancer, as the most important cancer in women, and exploring its risk factors have interested researchers for many years;
• It is almost for two decades that researchers have addressed the relationship between breast cancer and cigarette smoking, leading to at least 22 published articles only by the late 80s. Different studies have suggested a weak relationship, or supportive effect, lack of relationship.
• Rousseau et al. determined the susceptibility of breast tissue through growing and differentiating it. Breast cells differentiated from the parts 1 and 2 that occur before menopause; whereas, those differentiated from the part 3 are mutagen-immune. The exposure period to breast carcinogens determines susceptibility to carcinogenesis.

Nutritional factors and breast cancer:

• Weight gain and high calorie intake are two causes of breast cancer development, among the nutritional factors,
• Obesity and high BMI in post-menopause enhances the risk of breast cancer; whereas, this is not a relationship in pre-menopause women.
• Other positive significant relationship among animal protein intake and the risk of breast cancer. One, calorie intake leads to weight gain and obesity; on the other hand, it increases height in childhood and preterm menopause. These factors can develop the context for cancer development in future.

Immune system and breast cancer

The immune system is totally able to combat tumors and many immunological parameters applying cytokines for example IL-12 & IFN-γ. The differentiation of TH1 cells by IL-12 which are potent producers of IFN-γ, IFN-γ in turn has a powerful enhancing effect on the capability of phagocytes to produce IL-12 in cellular immune response.

Religion and breast cancer

Religion is another positive framework for grasping hidden in disease. Faith was considered as a powerful resource that alleviates concern, and brings real comfort, which can be effective in adaptation with and return to the life

Treatment options

The therapeutic agents used for breast cancer treatment cause adverse drug reactions in addition to their therapeutic outcomes18 and such adverse reactions discourage patient adherence to the therapy. There are various therapeutic agents employed for treatment of breast cancer:

a. cyclophosphamide (nitrogen mustard)- Alkylating agent
b. methotrexate (folic acid analogue), 5-fluorouracil & capacitabine -Anti-metabolite
c. vinorelbine, paclitaxel (taxane), doxorubicin (antibiotic) – Natural product:
d. tamoxifen (anti estrogen), letrozole & anastrazole – Hormone and antagonist
e. trastuzumab (monoclonal antibody), lapatinib (Protein tyrosine kinase inhibitor)- Miscellaneous.

Endocrine treatment

• Specific estrogen receptor modulator, Tamoxifen that are bound to Estrogen Receptor and has mixed agonist and antagonist features i.e. it is occurred by its binding to the estrogen receptor and the proliferative activities inhibition of estrogen on mammary epithelium;
• 20 mg Tamoxifen tablets are developed for therapy of this breast cancer.
• The risk of ER+ breast cancer recurrence is reduced to 50% and also there is about 28% decrease in morbidity rates by the help of the use of tamoxifen.

Chemotherapeutic agents

• Cyclophosphamide is worked for the treatment of breast cancer metastasis. This drug converted into active form via hepatic intracellular enzymes to active metabolites.
• The drug referred to as an adjuvant therapy in combination of CMF or with an anthracycline for breast cancer treatment. Carboplatin and cisplatin (like Platinum compounds) are worked against several cancers.
• Taxanes are the drugs used generally in combination with Platinum compounds.
•  The surgery is done to remove the tumor and it is used to test the arms of Armli lymph nodes. The doctor who specializes in cancer treatment with surgery. The type of operation includes the following:
• Lumptomy – Removal of tumors and cancer-free margins of a small, healthy tissue.

For attacking cancer, the remaining breast tissue is usually recommended after the operation of radiation therapy and Breast-saving surgery can also be called. For DCIS, radiation therapy after surgery may be an option depending on the patient and the tumor. There are several types of mastectomies Talk to your doctor about whether to keep your skin safe, it is known as skin-consuming massacety

Radiotherapy

A little data is available regarding the use of radiotherapy in HIV-infected BC patients. In a recent prospective study (n=160), 12 (86%) and 40 (98%) of HIV-infected and HIV-non-infected patients respectively completed their course of radiotherapy with no increase mucosal toxicity and in acute infection. Patients with BC and HIV treated according to the immunocompetent.

Surgery

Lumpectomy (removal of the lump only), or surgical removal of the entire breast (mastectomy) is performed based on the stage of the tumor. To remove more tissue may be necessary if the removed tissue does not have clear margins. The pectoralis muscle is the main muscle of the anterior chest wall. Nowadays, lymph node (SLN) dissection technique has become famous, as it helps the removal of far fewer lymph nodes.

Adjuvant therapy

Systemic adjuvant treatment should be based on individual risk of relapse, predicted sensitivity to particular treatment methods and benefit from their use and the patient’s comorbidities, and preference, final decision, biological age, general health status, should also incorporate the predicted treatment sequelae.

Depending on the surrogate intrinsic phenotype systemic adjuvant therapies should be determined by ER/PR, HER-2, and Ki-67 assessment. Due to special histological types, St Gallen 2013 recommends ET for endocrine-responsive histology (cribriform, tubular, and mucinous) and CT for endocrine-nonresponsive.

Conclusion

Breast cancer is a multiphase disease, here viruses play a role in one stage of this pathogenic process. Breast cancer is a known disease of women and the highest rate of mortality in women occurred by breast cancer. This problem can arise only for women and men. However, doctors believe that the prevention of treatment is the biggest treatment for the disease. Surprisingly, it was hard to make women aware of this cancer so much, but now it is being stressed to make men aware too. Because, men may also have breast cancer. But the rate of men’s breast cancer is very low.