Breast Cancer

Introduction:

    Breast cancer is a glandular cancer of breast tissue, the most common cancer among women. More women die of cancer of the lung because of its poor prognosis, but breast cancer is more frequent and accounts for about 27% of all cancers among women. Each year in the US alone 181,000 women will be diagnosed with breast cancer. In addition to that another 46,000 women are killed by this disease every year. Expressed in another way a woman in the US has a lifetime chance of 1 in 8 women (or about 12%) to get breast cancer (Ref. 1 and 3). 

 Fortunately, breast cancer is a slow growing cancer. Breast self examination every month has been shown in combination with mammography in women beyond the age of 50 years to lead to an early diagnosis of this disease and a high cure rate in a lot of women. A localized breast cancer has a 5-year survival rate of 92%. If women are conscientious about regular monthly self breast examinations, the breast cancer is usually caught at stage I where breast conserving surgery (=lumpectomy) rather than the more invasive, disfiguring modified mastectomy can be utilized. This fact has now been widely publicized in TV shows and magazines and acceptance of breast cancer screening among women is rising thus improving the cure rates for breast cancer.

"Telomerase inhibitors" is a buzz word that you will hear more often in future. This is an enzyme, which repairs the ends of the DNA in chromosomes as they divide in rapidly dividing cells. If cells are bathed in this enzyme telomerase, they would divide forever and ever: this is what happens with resistant cancer cells. They found a way by genetic mutation to have a constant supply of this enzyme and that's why cancer cells can multiply so well contrary to the normal cells. A new class of drugs has been developed and is further being refined that specifially targets this enzyme system. They are called telomerase inhibitors. This new knowledge will be used for diagnostic purposes on the one hand, but also for therapy on the other (Ref. 4). Finally, there might be a place for telomerase inhibitors as a preventative regimen like tamoxifen (Ref. 5). It is too early to say, which way clinical trials will take us, but it is an exciting time where new break-through therapies are within reach.

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

The following references were used apart from my own clinical experience:

1. Cancer: Principles &Practice of Oncology, 4^th edition, by V.T. De Vita,Jr., et. al J.B. Lippincott Co.,Philadelphia, 1993. Vol.2: Chapter 48.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 177.

3. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T.     DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 36: 1541-1616.

4. BS Herbert et al. Breast Cancer Res 2001;3(3):146-149.

5. BS Herbert et al. J Natl Cancer Inst 2001 Jan 3;93(1):39-45.

6. Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

7. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc