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Robert Edgeworth

4/8/2012

Breast Cancer

Genetic diseases are widespread. Cancer is a genetic disease and is a major cause of death. Cancer is caused by mutations within the genome that result in the development of oncogenes or tumor suppressor genes which both cause the uncontrolled proliferation of cells in opposed ways. The oncogenes are mutated genes that in their pre-mutated state, promote cell replication. However, due to the mutation, these oncogenes cause either enhanced expression or altered nature of protein products. Tumor suppressor genes (TSG) are mutant genes that normally restrain cell growth. It is the most common cause of death for women with statistics showing one in 13 Australian women who live to the age of 74 will be diagnosed with it sometime during their lifetime. This essay will discuss the nature of breast cancer, the factors causing breast cancer with an emphasis on familial inheritance, methods for testing for breast cancer and available treatments. The prevalence of breast cancer and the high mortality rate especially for women above the age of 70 signifies a need for increased awareness in the community both for prevention and support for those affected by this destructive disease. Cells make up many different parts of the body skin, bones, brain, heart, and breasts. These cells are replaced when they become old or injured by replication at varying rates depending on the part of the body. The replication process is regulated by genes that code for proteins which increases or decreases the rate of division. These genes are proto-oncogenes (when mutated become oncogenes) and TSGs.The abnormal genetic material translates into non-functional products which causes the cells to multiply without restraint. Most breast cancers are caused by a mutant inactivation of

TSG. In breast cancer, the proliferated cells form a hard mass of cancer that can sometimes be felt upon self-examination. The proliferated cells can detach from the tumor and invade other tissue in a process called metastasis. This process changes the tumor from being classified as benign to malignant increasing the threat to the life of the person. Malignancy is a great threat as such cancerous cells can migrate throughout the body and to vital organs such as the brain or the lungs thus deleteriously altering their functional capacity. To understand where these proliferated cells can form within the breast, the anatomy of the breast will be discussed. The breasts main function is to supply a newborn baby with milk via the mammary glands made up of glandular units. These units are joined by ligaments and fatty adipose tissue. The breast is a sexual organ controlled mainly by hormones released from the pituitary gland and the ovaries. During the menstrual cycle, the hormones progesterone and estrogen cause changes to the breast. The underlying muscles consist of the pectoralis major, pectoralis minor, serratus anterior and the latissimus dorsi.Breast cancer mainly occurs in the epithelial lining of the terminal duct lobular unit. These cancers are termed adenocarcinomas. Depending upon the size and aggressiveness of the tumor, the tissues within and the muscles surrounding the breast can all be affected.

Although breast cancer in men does occur, it is uncommon with only 0.8% of breast cancers affecting males. The rarity of the illness does not detract from its physical severity or psychological effects. The affected male would need the same care as a woman as well as an understanding of the unique situation as a man with the disease. Breast cancer is caused by a combination of factors that cause mutation in the DNA. These mutations can be inherited, due to the environment or both. These factors will be discussed individually as follows. The lifestyle of a person, their diet, the chemicals around them, and their reproductive natures are factors which contribute to whether or not such person is susceptible to the development of breast cancer.

Knudsons Two Hit Hypothesis states that for cancer to develop, there needs to be mutations in both functional copies of TSG in a cell. If a mutated allele was inherited, the second allele would have to be mutated due to environmental factors for cancer to develop. Thus both functional copies of the gene are altered. Some environmental factors that may cause the mutation both or the second allele in a cell will be discussed. There are several substances that are known to increase the risk of cancer whether by exerting carcinogenic effects indirectly or acting directly as a carcinogen. Alcohol is such a substance that is known to exert toxic effects on the liver. However, it can also exert a carcinogenic effect indirectly to the breast by cell stimulations. The breasts being affected by hormonal stimulus, especially during the menstrual cycle, can also be affected by hormone replacement therapy after menopause. Studies have shown the risk of cancer was even higher in women who used a combined estrogen and progesterone therapy. There has been significant evidence of women development breast cancer after they have been treated with radiotherapy and chemotherapy for Hodgkin disease. This is especially significant with those who were treated for Hodgkin at a very young age. This is similar to the breast cancer caused by exposure to the radiation from atomic bombs. The aromatic hydrocarbons in cigarette smoke is carcinogenic not only causing lung cancer but also other cancers such as breast cancer. The effect of smoking acts in a similar way as the poly-cyclic hydrocarbons in well done meat which is also carcinogenic. A correlation was shown between a diet high in animal fat and high fat dairy products in pre-menopausal women causing an increase in the risk of breast cancer. Therefore, exposure to substances such as such as alcohol, tobacco, hormone replacement therapy, high fat diet, chemotherapy and radiotherapy may lead to an increased risk of breast cancer.