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Breast Cancer - Coggle Diagram

- - - - BRCA mutation
        
        The most common risk factor is if the patents has a genetic mutation of either the BRCA1 or BRCA2 gene. This gene is sometimes called a tumor suppressor gene as this gene normally produces proteins that help repair damaged DNA, but if one were to inherit a mutation of this gene the probability for cancer to develop increases. Those with a family history of ovarian or breast cancer thus are at an increased risk of breast cancer as this BRCA gene can be passed down genetically. The lifetime risk for patients with the BRCA1 mutation is 65% to 81% and for the BRCA2 there is a 45% to 85%.
      - Female sex
        
        Being a female alone will increase one's chances of getting breast cancer, but men can also get breast cancer. Females have more estrogen hormones released giving them a higher chance of breast cancer.
      - Getting older
        
        The risk for breast cancer increases with age as one are exposed to more estrogen, which is why breast cancer is usually diagnosed around age 50.
      - Dense breast
        
        Dense breasts have more connective tissue than fatty tissue which makes it harder to see potential tumors on mammograms. Connective tissue may also produce growth factors that cause cells to divide and reproduce more than cells in fatty tissue do, promoting cancer growth.
      - Exposure to estrogen
        
        Women are exposed to estrogen for majority of their life since they start puberty to when they start menopause; this exposure would last from around the age of 12 to 55. Prolonged exposure to estrogen will increase the risk for breast cancer. Estrogen can be prolonged by having an early puberty and/or a late menopause.
      - Family history
        
        A patient's risk for breast cancer is increased if they have a family history of the disease.
  - - - Older women who are less physically active and obese will have a higher risk for breast cancer than one that is healthy and active.
    - - Any form of hormone replacement therapy that contains estrogen or progesterone taken during menopause can increase the risk for breast cancer if taken for more than 5 years. Breast cancer related to hormone exposure are usually hormone receptor positive.
    - - Alcohol will increase the risks of getting breast cancer the more one drinks, as alcohol is a carcinogen. So drink minimal amount of alcohol is the best.
    - - Taking oral contraceptives can increase the risk of getting breast cancer as all oral contraceptives have estrogen and/or progesterone. This is more estrogen and progesterone exposure to the body.
    - - Certain environmental factors such as ionizing radiation, pollutants, and chemicals (xenoestrogens) can be carcinogenic and therefore increase breast cancer risk.
- - - - Fine needle aspiration biopsy
      - core needle biopsy
      - image-guided biopsy
      - surgical biopsy
      - sentinel lymph node biopsy
      - A biopsy is when small pieces of breast tissue or fluid from the breast will be removed from the area where there is a suspected tumor. The specimen will then be taken to the lab to see if it contains cancerous cells. When analysing a biopsy we will be looking for tumor features, estrogen receptors and progesterone receptors, human epidermal growth factor receptor 2, and the tumor grade (slow growing or fast growing). There are many different types of biopsies depending on the type of needle and how and where the biopsy is taken.
  - - - A mammogram is an x-ray picture of the breast. There are two different types of mammograms: screening and diagnostic. Screening mammograms are used to look for early signs of breast cancer for a patient who does not have signs or symptoms of breast cancer. If there are signs of breast cancer then a diagnostic mammogram is used to investigate suspicious breast cancer. The main difference between the two is that a diagnostic mammogram includes additional mammogram images.
    - - Ultrasounds use sound waves to identify lumps and tumors in breasts. This is the best way to diagnosis breast cancer with patients with dense breast tissue as abnormalities are more difficult to see on mammograms. This is also a good way for younger women to get diagnosed with breast cancer as younger patients tend to have dense breasts.
    - - A MRI is a body scan that will make detailed images by using magnets and radio waves to see the inside of the breast. MRIs can see skin lesions in the breast tissue that Mammograms might of missed. This is why MRIs are the best way for younger adults to identify breast cancer as they typically have denser breast tissue.
- - - - Surgery as a treatment for breast cancer is where the tumor is surgically removed from the breast to prevent it from further spreading. There are two different surgical removals: lumpectomy (breast-conserving surgery) and mastectomy. Lumpectomy is where only the part of the breast containing cancerous cells is removed. This option is mainly for patients with early stages of breast cancer. Most will still need radiation after the surgery. A mastectomy is where the entire breast is removed including nearby tissues. Some may have either one breast removed or both which would be called a double mastectomy. This option might be better if the tumor is large in size.
    - - Radiation uses high energy rays to kill the cancerous cells. By using images from a CT scan the radiation oncologist will then determine the dose of radiation needed for the cancerous area. This treatment usually takes around 3-6 weeks of daily treatment.
    - - Chemotherapy is an injection or oral medication that is used to shrink or kill the cancerous cells. There are two different types of chemotherapy: adjuvant(after surgery) and neoadjuvant(before surgery). Adjuvant chemotherapy is given after surgery to kill cancerous cells that might of been left behind after the surgery. Neoadjuvant chemotherapy might be given to shrink the tumor to lesson the amount that needs to be surgically removed. This is often used when the tumor is too large to be surgically removed. Neoadjuvant chemotherapy is favored among most young women with early stages of breast cancer.
        
        Adjuvant and neoadjuvant chemotherapy drugs
        
        Anthracyclines (doxorubicin and epirubicin)
        
        Taxanes (paclitaxel and docetaxel)
        
        Capecitabine (Xeloda)
        
        Cyclophosphamide (Cytoxan)
        
        Carboplatin (Paraplatin)
    - - Hormone therapy blocks the cancerous cells from receiving the hormones they need to grow, such as estrogen and progesterone, by using hormone blockers. This is recommended to patients with tumors that are hormone receptor-positive. This is usually taken for at least 5 years, as if it is taken for longer than it can cause the tumor to have a higher chance of coming back.
        
        Tamozifen
        
        Toremifene (Fareston)
        
        Fulvestrant (Faslodex)
        
        Elacestrant (Orserdu)
    - - Biologic therapy (targeted therapy) works in two different ways: it helps the body's immune system to start attacking the cancerous cells or it makes the cancerous cells easier for the immune system to identify.
        
        Monoclonal antibodies
        
        Trastuzumab (Herceptin)
    - - Bone marrow transplant is used to replenish the loss of healthy bone marrow due to other breast cancer treatments. These transplants are usually autologous meaning healthy bone marrow is taken from the patient before chemotherapy or radiation and then reinjected after the treatment. The reason for this procedure is that in some cases the doses of chemotherapy or radiation is so high that the bone marrows stem cells are either permanently damaged or completely destroyed.