ukessays on breast cancer

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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Breast cancer.

Gopal Menon ; Fadi M. Alkabban ; Troy Ferguson .

Affiliations

Last Update: February 25, 2024 .

Continuing Education Activity

Breast cancer is the most common cancer diagnosed in women, accounting for more than 1 in 10 new cancer diagnoses annually, and is the second most common cause of cancer death among women worldwide. The risk factors for breast cancer are well established, and risk reduction plays a vital role in reducing the incidence of breast cancer. Breast cancer typically evolves silently, usually discovered on routine screening in the Western world. Without screening, breast cancer is often detected as a palpable breast mass. Surgery, radiation, chemotherapy, and immunotherapy are used in combination to treat breast cancer, depending on the stage and type of tumor. Improvements in these treatment modalities have resulted in significant improvements in overall survival and patient-reported outcomes.

This activity for healthcare professionals is designed to enhance the learner's competence when managing breast cancer, equipping them with updated knowledge, skills, and strategies for timely identification, effective interventions, and improved coordination of care, leading to better outcomes for patients outcomes and reduced morbidity.

Identify the risk factors for breast cancer.
Differentiate the various types of breast cancer.
Compare the recommended treatment options for breast cancer.
Strategize with interprofessional team members to improve patient care and optimize outcomes for patients affected by breast cancer.
Introduction

Breast cancer is the most common cancer diagnosed in women and the second most common cause of death from cancer among women worldwide. [1] The breasts are paired glands of variable size and density that lie superficial to the pectoralis major muscle. They contain milk-producing cells arranged in lobules; multiple lobules are aggregated into lobes with interspersed fat. Milk and other secretions are produced in acini and extruded through lactiferous ducts that exit at the nipple. Breasts are anchored to the underlying muscular fascia by Cooper ligaments, which support the breast. [2]

Breast cancer most commonly arises in the ductal epithelium (ie, ductal carcinoma) but can also develop in the breast lobules (ie, lobular carcinoma). Several risk factors for breast cancer have been well described. In Western countries, screening programs have succeeded in identifying most breast cancers through screening rather than due to symptoms. However, in much of the developing world, a breast mass or abnormal nipple discharge is often the presenting symptom. [3] Breast cancer is diagnosed through physical examination, breast imaging, and tissue biopsy. Treatment options include surgery, chemotherapy, radiation, hormonal therapy, and, more recently, immunotherapy. Factors such as histology, stage, tumor markers, and genetic abnormalities guide individualized treatment decisions. [1]

Breast Cancer Risk Factors

Identifying factors associated with an increased incidence of breast cancer development is important in general health screening for women. Risk factors for breast cancer include: [4] [5] (see Image. Breast Cancer Risk Factors)

Age : The age-adjusted incidence of breast cancer continues to increase with the advancing age of the female population.

Gender : Most breast cancers occur in women.

Personal history : A history of cancer in one breast increases the likelihood of a second primary cancer in the contralateral breast.

Histologic : Histologic abnormalities diagnosed by breast biopsy constitute an essential category of breast cancer risk factors. These abnormalities include lobular carcinoma in situ (LCIS) and proliferative changes with atypia.

Family history and genetic mutations : First-degree relatives of patients with breast cancer have a 2-fold to 3-fold excess risk for the development of the disease. Genetic factors cause 5% to 10% of all breast cancer cases but may account for 25% of cases in women younger than 30 years. BRCA1 and BRCA2 are the most important genes responsible for increased breast cancer susceptibility.

Reproductive : Reproductive milestones that increase a woman’s lifetime estrogen exposure are thought to increase breast cancer risk. These include the onset of menarche before age 12, first live childbirth after age 30 years, nulliparity, and menopause after the age of 55.

Exogenous hormone use : Therapeutic or supplemental estrogen and progesterone are taken for various conditions, with the most common scenarios being contraception in premenopausal women and hormone replacement therapy in postmenopausal women.

Other : Radiation, environmental exposures, obesity, and excessive alcohol consumption are some other factors that are associated with an increased risk of breast cancer.

Epidemiology

Invasive breast cancer remains the most common cancer among women worldwide, accounting for approximately 11.7% of new cases in 2020. [6] In the US, 1 in 8 women and 1 in 1000 men will develop breast cancer during their lifetime. [7] [8] [9] The incidence rate of breast cancer increases with age, from 1.5 cases per 100,000 in women aged 20 to 24 to a peak of 421.3 cases per 100,000 in women aged 75 to 79; 95% of new cases occur in women aged 40 years or older. The median age of women at the time of breast cancer diagnosis is 61 years.

A rapid increase in the incidence of breast cancer was noted until 2000, after which the incidence began to decline. More significant decreases occur in women younger than 50 years. With early detection and significant advances in treatment, breast cancer death rates have decreased over the past 25 years in North America and parts of Europe. In the US, breast cancer-related mortality dropped by 43% from 1980 to 2020. However, in many African and Asian countries (eg, Uganda, South Korea, and India), breast cancer incidence and death rates continue to rise. [6] Even within the US, marked disparity exists in detection and survival rates based on socioeconomic status and race. Although the incidence is highest among non-Hispanic whites, the mortality rate is significantly higher among African Americans. According to the American Cancer Society (ACS), breast cancer rates among women from various racial and ethnic groups are as follows: [10]

Non-Hispanic white: 128.1 in 100,000
African American: 124.3 in 100,000
Hispanic/Latina: 91.0 in 100,000
American Indian/Alaska Native: 91.9 in 100,000
Asian American/Pacific Islander: 88.3 in 100,000
Pathophysiology

Most breast cancer is sporadic (90%-95%), with only 5% to 10% of patients having an identifiable genetic mutation. [11] BRCA 1 and 2 are the most common associated genetic conditions. Invasive ductal and invasive lobular carcinoma are the most common pathologic forms of invasive breast cancer. Carcinogenesis occurs due to a complex interplay of genetic and environmental risk factors, hormonal influences, and patient-related factors. The pathogenesis, treatment, and prognosis are closely associated with the following molecular subtypes of breast cancer:

Luminal A : Hormone receptor-positive, human epidermal growth factor receptor (HER)-2 negative
Luminal B : Hormone receptor-positive, HER-2 positive
Basal-like : Hormone receptor and HER-2 negative
HER-enriched : HER-2 positive, hormone receptor-negative

Hormone receptor-positive tumors (ie, luminal A and B) tend to be less aggressive, with improved survival rates. [12] HER-2 enriched tumors are more aggressive, with a poor prognosis without targeted therapy. In the era of targeted anti-HER therapy (eg, trastuzumab), the paradigm has shifted. [13] Basal-like tumors are negative for the molecular markers and tend to have a worse prognosis with poor survival rates. [14]

Histopathology

Invasive breast cancer is characterized by the invasion of neoplastic cells beyond the basement membrane that can be morphologically varied, with several subtypes described. All specimens should be tested for hormone receptors (ie, estrogen and progesterone) and HER-2 receptors. (see Image. Breast Estrogen Receptor Staining) Other critical components assessed on the histopathologic exam include tumor grade, pleiomorphism, Ki-67 index, morphology, tumor necrosis, multifocality, and precancerous lesions. The following are the most common histologic types of invasive breast cancer.

Ductal adenocarcinoma : This histologic type comprises 50% to 75% of all invasive breast cancers. Clinically, these tumors are often felt as a breast mass secondary to a significant fibrotic reaction. Microscopically, the lesion arises in the terminal duct-lobular unit with abnormal epithelial cells with varying degrees of atypia. These cells invade the basement membrane. However, there are no pathognomonic histologic features of invasive ductal carcinoma. [1] (see Image. Invasive Ductal Carcinoma).

Lobular carcinoma : Invasive lobular cancer makes up 10% to 15% of breast cancer and tends to permeate the breast in a single-file nature. This results in tumors that typically remain clinically occult, escaping detection on mammography or physical examination until the disease becomes extensive. A discrete mass is seldom palpated. Multifocal tumors and bilateral disease are more common with invasive lobular carcinoma. Characteristically, these tumors stain negative for E-cadherin. [15] (see Image. Pleomorphic Lobular Breast Carcinoma).

Mucinous carcinoma : Also known as colloid carcinomas, these tumors, which make up 2% to 5% of breast cancers, are well-demarcated in older women, typically characterized by mucin production. [16]

Tubular carcinoma : Microscopically characterized by infiltrating cells with minimal atypia that form small glands and tubules, 1% to 2% of breast cancers are among this subtype. [16]

Medullary carcinoma : These aggressive tumors are poorly differentiated and seen more commonly in BRCA mutant and younger patients. [17]

History and Physical

A periodic review of patient history for breast cancer risk assessment is recommended by the American College of Obstetricians and Gynecologists (ACOG). [18] Clinicians can use online assessment tools to help calculate a patient's breast cancer risk. Most breast cancer patients are asymptomatic, and lesions are discovered during routine breast examination or screening mammography. With increasing size, the patient may notice a palpable lump. Breast pain is an unusual symptom that happens 5% of the time. [19] More advanced disease may present with symptoms including peau d'orange, frank ulceration, axillary lymphadenopathy, or signs of distant metastasis. Inflammatory breast cancer, an advanced form of breast cancer, may have clinical features similar to breast abscess (eg, swelling, redness, and other local signs of inflammation). [20] (see Image. Breast Cancer Axillary Lymphadenopathy)

A thorough physical exam is a vital part of the clinical assessment for breast cancer. Both breasts must be examined in the sitting, standing, and supine positions, with the arm abducted, extended, and externally rotated. Palpation Overlying skin changes, nipple discharge, edema, peau d'orange, and ulceration should be noted. (see Image. Clinical Signs of Breast Carcinoma). Careful palpation of the regional lymph node basins for lymphadenopathy is also essential. Although some societies (eg, American Cancer Society) no longer recommend routine clinical breast examinations in asymptomatic, low-risk women as it has not been found to have a significant benefit, ACOG states that routine clinical breast examinations may be offered to these women, though not required. Furthermore, ACOG recommends an interval of every 1 to 3 years for women aged 25 to 39 years, and every year for women >40 years is appropriate if a screening breast examination is performed. However, a clinical breast examination should always be done for high-risk women and symptomatic women. [18] See StatPearls' companion topic, "Breast Examination Techniques," for additional information on clinical breast exams. [21]

Diagnostic Breast Imaging

Mammography is the most commonly used modality for screening and diagnosis of breast cancer. [22] Abnormal findings on mammography include mass lesions, calcifications, or architectural distortion. When identified on screening mammography, diagnostic mammography, which utilizes higher quality imaging with several views, is indicated. Mammography is of limited utility in patients with dense breasts, in younger patients, and in those who cannot tolerate the breast compression that is required. Breast ultrasound or magnetic resonance imaging (MRI) with contrast may be utilized in such cases. Breast ultrasound is similar in sensitivity to mammography and can be used to obtain image-guided biopsy. Though MRI is the most sensitive imaging study, it is time-consuming, has limited availability, and is expensive. [23] Indications for MRI include axillary lymph node disease and an occult primary malignancy, Paget disease, multifocal or bilateral cancers, neoadjuvant chemotherapy treatment response assessment, and high-risk patient screening. [24] (see Image. Breast Mammogram)

Breast imaging findings are classified by their Breast Imaging Reporting and Data System (BI-RADS) category, which correlates imaging findings with their probability of underlying malignancy and recommends a broad treatment strategy. The BI-RADS categories range from 0 to 6. [25]

Tissue Biopsy

Once a suspicious lesion is identified, tissue biopsy with stereotactic core needle biopsy is performed with imaging guidance. [26] [27] [28] Core needle biopsy is superior to fine needle aspiration and should be performed whenever possible. [29] In patients with clinically positive regional lymph nodes, an ultrasound-guided core needle biopsy is performed. Radiographically identifiable markers should be placed during the biopsy to mark the site in both the primary cancer and the lymph node basin to help identify and localize the lesion later. Breast tissue must be sent for a pathologic exam, including hormonal and Herceptin receptor testing.

Staging Imaging

Routine laboratory investigations and imaging for systemic disease are not recommended for operable breast cancer in the absence of symptoms. If associated symptoms are present, an MRI brain, chest CT scan, bone scan, or CT of the abdomen and pelvis may be performed as indicated. Baseline complete blood count and comprehensive metabolic panel, including liver function tests, are indicated if neoadjuvant chemotherapy is planned. For clinically advanced breast carcinoma (eg, inflammatory breast cancer, chest wall or skin involvement, and bulky axillary lymphadenopathy), a chest, abdomen, and pelvis CT along with a bone scan or an FDG-PET scan is often used. [30]

Treatment / Management

Breast cancer treatment is nuanced and based on various factors, including the disease stage, pathology, patient preference, and available resources. In general, breast cancer management approaches are divided into early breast cancer, locally advanced breast cancer, and metastatic breast cancer treatment. [30]

Early Breast Cancer

Early breast cancer includes tumors <5 cm in size without clinically positive lymph nodes. Treatment involves surgery, chemotherapy, radiation, and hormonal therapy, depending on the stage and molecular profile. [30] The modalities used include:

Surgical treatment : Options to excise the primary tumor include breast conservation surgery (eg, partial mastectomy or lumpectomy) or a total mastectomy.
Axillary lymph node management : Sentinel lymph node biopsy is performed during the operation. Without extranodal extension, no further axillary surgery is required if 2 to 3 axillary lymph nodes are microscopically positive. A completion axillary dissection or axillary radiation is indicated in patients with >3 positive lymph nodes or extranodal extension.
In hormone receptor-positive tumors, the decision to initiate chemotherapy is based on risk stratification using genomic analysis of the primary using commercially available kits (eg, Oncotype Dx). High-risk patients benefit from chemotherapy in addition to hormonal therapy.
All HER2-positive patients with tumors >1 cm should receive anti-HER2-directed therapy.
All triple-negative patients with tumors > 1 cm should receive systemic chemotherapy.
Radiation : Patients undergoing breast conservation surgery (BCS) must receive radiation to the breast with a boost to the tumor bed to reduce local recurrence. Patients who undergo mastectomy do not need breast radiation, except in certain circumstances (eg, >5 cm tumor, chest wall invasion, skin involvement, multifocal tumor, ≥4 positive nodes).
Hormonal therapy : Anti-estrogen or aromatase inhibitor therapy is indicated in all hormone receptor-positive patients.

Up-front chemotherapy (ie, neoadjuvant therapy) has been increasingly used in early-stage triple-negative and HER2-positive tumors. Delivering the chemotherapy up-front has several advantages, including allowing response assessment, a greater likelihood of completing chemotherapy, and an increased likelihood of breast conservation therapy; therefore, clinicians will likely use this strategy more extensively. [31] [32]

Locally Advanced Breast Cancer (LABC)

Locally advanced breast cancer (LABC) primarily consists of tumors larger than 5 cm or those with clinically positive lymph nodes. Most patients with LABC will receive some form of neoadjuvant therapy, with adjunct surgery and radiation therapy. Patients with LABC typically undergo a breast MRI at baseline. The primary tumor and the involved lymph nodes must have radiographically detectable markers placed before initiation of chemotherapy, as tumors can shrink and disappear after therapy. [30]

Chemotherapy regimens vary based on the tumor pathology (eg, hormone receptor-positive, HER2-positive, or triple-negative), the patient's age and physical status, and locally available resources. The goals of upfront chemotherapy are to reduce the size of the primary, eradicate micrometastatic disease, and assess disease biology based on the responsiveness of the tumor to chemotherapy. After completion of the chemotherapy regimen, breast and axillary imaging are repeated to assess response to chemotherapy and determine further management, including:

Surgical treatment : Options to excise the primary tumor include BCS or a total mastectomy. Contraindications to BCS include large tumors, chest wall or skin involvement, multifocal disease, inability to receive radiation, and large tumor size to breast size ratio.
Axillary lymph node management : In patients with a clinically positive axilla at diagnosis, an axillary dissection is always performed, regardless of the response of the tumor to neoadjuvant chemotherapy. In patients with a clinically negative axilla, sentinel lymph node biopsy is performed at the time of surgery. At least 3 lymph nodes should be harvested using a dual-tracer technique. Patients with residual disease should undergo a completion axillary dissection or axillary radiation.
Systemic chemotherapy : Patients with residual disease after systemic chemotherapy may benefit from additional chemotherapy based on the molecular characteristics.
Radiation therapy : The indications for radiation are similar to BCS.
Hormonal therapy : Anti-estrogen or aromatase inhibitor therapy is indicated in all hormone receptor-positive patients.

Metastatic Breast Cancer

Metastatic breast cancer is managed primarily with systemic therapy. Chemotherapy, targeted therapy, immunotherapy, and hormonal therapy are all options, depending on the molecular profile and patient fitness. Palliative radiation may be used in controlling bulky primary disease and metastases to the brain, bone, and lung. Surgery is not recommended except for symptom control and palliative therapy. [33]

Differential Diagnosis

The differential diagnosis for breast cancer includes the following:

Mastitis or breast abscess: Mastitis can be confused with inflammatory breast cancer. Inflammation or cellulitis that does not respond to antibiotics should be evaluated further.
Fat necrosis: Traumatic fat necrosis can harden and present as a mass that mimics breast cancer.
Fibroadenoma: Fibroadenomas >2 cm are typically excised to rule out coexisting breast cancer.
Surgical Oncology

Surgery plays a central role in managing breast cancer. [30] With the increased use of highly effective chemotherapy and targeted therapy, operations have become less extensive and morbid, while survival has improved. In current practice, surgery helps manage the primary tumor and provides essential staging information. BCS can be performed in most patients with tumors <5 cm, provided that the breast is large enough for a cosmetic result. Mastectomy is indicated in large primary tumors, tumors invading the skin or chest wall, multifocal cancers, inflammatory breast cancer, and in patients who are unable to have radiation. Sentinel lymph node biopsy is a vital staging procedure in patients with a clinically negative axilla. Those with 1 to 3 positive lymph nodes on sentinel node biopsy and without gross extranodal extension can safely avoid axillary lymph node dissection. Patients with clinically positive axillary nodes typically require an axillary lymph node dissection. [34] The following are the primary operations performed for breast cancer and in the axilla.

Partial Mastectomy or Lumpectomy

Partial mastectomy or lumpectomy involves the excision of a portion of the breast tissue with a margin of healthy tissue. [35] The incision can vary based on the location of the tumor and the desired cosmesis. Typically incisions are circumareolar, radial, or along the breast skin crease. Partial mastectomy is the centerpiece of BCS, allowing for the conservation of most of the breast. The cosmetic results depend on the amount of breast tissue removed compared to the remaining breast tissue and the nipple preservation. For nonpalpable lesions, the lesion must be localized preoperatively, usually with a wire or radioactive seed, to ensure the removal of the entire tumor.

Simple Mastectomy and Nipple-sparing Mastectomy

Simple mastectomy involves excision of the entire breast and nipple-areola complex. [34] The underlying pectoralis major fascia is removed as well. The amount of skin preserved can vary based on whether reconstruction is planned and on the type of reconstruction. A nipple-sparing mastectomy is a relatively recent modification of the simple mastectomy in which the nipple-areolar complex is spared, and the breast tissue is excised through a small circumareolar incision. The cosmetic results of reconstruction are superior to a conventional mastectomy, with a slightly increased but acceptably poorer oncologic outcome.

Modified Radical Mastectomy

Modified radical mastectomy combines the simple mastectomy technique with axillary lymph node dissection. The mastectomy incision is usually extended for the axillary contents to be removed. Radical mastectomy, which includes the removal of the pectoral muscles and sacrifice of the nerves, is seldom performed.

Axillary Sentinel Lymph Node Biopsy and Axillary Lymph Node Dissection

The axillary lymph nodes drain much of the ipsilateral breast and are divided into 3 levels by the pectoralis minor muscle. A radiotracer or blue dye is injected near the primary, and 1 to 3 lymph nodes in the axilla that have the highest uptake of radiotracer or are blue are excised. When done with a lumpectomy, the same incision can sometimes be used, or a separate incision at the axillary hairline may be required. Axillary lymph node dissection involves the removal of all the fibrofatty and lymphoid tissue in levels 2 and 3, with preservation of the long thoracic nerve and thoracodorsal nerve. [36] [37]

Radiation Oncology

Radiation therapy has a significant role in local disease control, primarily in the adjuvant setting, but may also be used for palliative therapy. In early-stage breast cancer, adjuvant radiotherapy has been shown to reduce the risk of breast recurrent disease by approximately 50%. [38] [39] While adjuvant radiotherapy in early-stage breast cancer has not been shown to improve overall survival, it is an essential part of the breast conservation approach as radiotherapy reduces the risk of recurrence and the need for additional surgery. Modalities to deliver adjuvant radiotherapy include external beam radiation, brachytherapy, or a combination. [40] [41]

Radiation Therapy Delivery Techniques

Accelerated Partial Breast Irradiation

A select number of patients may qualify for Accelerated Partial Breast Irradiation (APBI). The American Society of Radiation Oncologists (ASTRO) appropriateness guidelines consist of suitable, cautionary, and unsuitable candidates for this treatment. [42] APBI may be delivered using surgically implantable single or multi-channel channel catheter devices. These implants rely on an Ir-192 HDR afterloader to deliver conformal radiotherapy via brachytherapy. (See StatPearls' companion topic, "Brachytherapy," for additional information.) Alternatively, APBI may be delivered using external beam radiotherapy. In this case, an implantable device is unnecessary, but surgical clips, coils, or 3D implantable markers may be used to delineate the surgical cavity for external beam radiotherapy planning. The dosing is 34 to 38.5 over 10 fractions delivered twice a day. The advantage of APBI is that it can be delivered over 1 week as opposed to 3 to 6 weeks with whole breast radiation. However, if the patient opts for APBI delivered via catheter, there may be additional delays as the patient would likely need to return for further surgery. In terms of outcomes, the 10-year cumulative incidence of breast cancer recurrence for patients treated with APBI was 4.6%. [43]

Whole Breast Radiation

Whole breast radiotherapy (WBRT) is a well-studied technique employed in patients with early-stage breast cancer and continues to be the mainstay treatment for many patients. WBRT is delivered in the adjuvant setting either after breast-conserving surgery or after the completion of chemotherapy. The treatment technique is designed to cover all visible breast tissue on CT simulation. This can be safely planned and delivered using a 3D conformal plan. The ipsilateral lung and heart doses are the most important to consider when planning these cases. Dosing varies from 40.05 to 50.4 Gy in 15 to 25 fractions. The 10-year ipsilateral breast recurrence rate in these patients is approximately 3.9%. [43]

An additional radiation dose, a boost, may be given to the surgical cavity upon completion of whole breast radiation. Several randomized trials have demonstrated an improvement with local control. Early-stage breast cancer patients who received a 10 Gy boost to the surgical cavity after whole breast radiation had a 5-year local recurrence rate of 3.6% compared to 4.5% without a boost. The EORTC demonstrated a 10-year local control rate of 6% versus 10% without a boost. [44] The benefit of a radiation boost appears to be confined to younger women aged <60 years. [44] The dosing ranges from 10 to 16 Gy. The boost is not without a cost, as there is a risk of breast fibrosis that may impact cosmesis. The EORTC trial found a 4.4% rate of severe fibrosis in patients receiving a boost compared to 1.6%. [44]

Post-Mastectomy Radiation

Post-mastectomy radiation (PMRT) is indicated in patients with nodal disease after axillary staging, positive margins, and in patients with primary breast tumors >5 cm. PMRT may also be considered in patients with high-risk pathologic features, including central or medial tumors ≥2 cm with either lymphovascular invasion, grade 3, or hormone receptor-negative. Coverage includes the chest wall with or without regional lymphatics. PMRT has been extensively studied in several prospective trials. The Danish 82bc trials investigated the benefit of PMRT in premenopausal and postmenopausal high-risk patients (ie, >5 cm, locally invasive, or node-positive). The study demonstrated long-term breast cancer mortality, locoregional recurrence, and overall survival benefits. [45] The 30-year follow-up data continues to show overall survival (19% versus 14%), breast cancer mortality (56% versus 67%), and locoregional recurrence (9% versus 37%) benefits. [45]

Comprehensive Nodal Irradiation

Comprehensive nodal radiation (CNI) covers all lymphatics draining the breast and chest wall, which consists of the levels I to III axilla, supraclavicular nodes, and internal mammary nodes. CNI can be incorporated into WBRT or PMRT and is indicated in node-positive patients, either from a sentinel node biopsy or axillary dissection. In patients undergoing an axillary dissection, the radiotherapy typically includes undissected areas and areas at risk for nodal involvement. CNI is technically more challenging than WBRT alone, requiring additional fields (ie, 3 or 4 field plans). CNI also increases the dose to uninvolved structures such as the lungs and heart. Meeting heart constraints may become especially challenging when treating the left breast. Certain techniques such as deep inspiratory breath hold (DIBH) or intensity-modulated radiation therapy (IMRT) may be helpful in these circumstances to minimize the amount of dose received by these structures. CNI has been prospectively compared to axillary dissections in patients with 1 to 3 nodes positive and was found to have similar rates of axillary control (0.93% versus 1.82%). [46] In addition, CNI has also been shown to improve 10-year disease-free survival (77% versus 82%) without an improvement in overall survival in high-risk patients. [47] Using CNI may also increase the risk of lymphedema as the regional lymphatics are radiated, making it more difficult to drain the breast and upper extremity. The additional dose to the lung may also increase the risk of radiation pneumonitis.

Intensity-Modulated Radiation Therapy

Breast intensity-modulated radiation therapy (IMRT) may be used as an alternative to conventional 3D planning in certain circumstances, such as failure to meet heart dose constraints, which is common, especially in patients with left-sided disease. Several prospective randomized trials have compared 3D or 2D planning to IMRT. They have consistently demonstrated that grade 2 or higher radiation dermatitis was significantly lower with IMRT than with 3D. [48] [49] No differences in recurrence or survival were noted.

Radiation Therapy Complications

Cardiac toxicity

The risk of major coronary events as a long-term complication of breast irradiation has been well documented. Exposure of the coronary arteries may lead to accelerated atherosclerosis of the vessel, resulting in significant coronary events years after radiotherapy. A population case-control study demonstrated that the risk increases linearly with the dose to the heart, increasing the relative risk by 7.4% per gray without an apparent threshold. [50] Women with preexisting cardiac risk factors may have an even higher risk. [50]

Pneumonitis

The development of radiation pneumonitis in patients receiving adjuvant radiotherapy for breast cancer ranges from 0.8% to 2.9%. [51] Radiation pneumonitis has been documented in patients up to 1-year post-radiation and can require steroid treatment, oxygen therapy, and, in severe cases, intubation. The risk of pneumonitis increases with the volume of lung irradiated. Patients receiving comprehensive nodal RT are known to have higher rates of pneumonitis. The MA.20 study reported pneumonitis in 1.2% of their patients receiving regional nodal RT versus 0.2% in those treated to the breast only. [47] Concurrent use of taxanes such as paclitaxel, common in modern breast cancer chemotherapy regimens, may substantially increase the risk of pneumonitis in patients receiving radiation. [52] The most effective preventative measure is meticulous radiation planning and adherence to published lung dose constraints.

Breast fibrosis

Fibrotic changes in the breast are relatively common among patients receiving adjuvant radiotherapy. Onset is typically 4 to 12 months posttreatment, and the symptoms include breast shrinkage, hardening, pain, and poor wound healing. These changes can significantly affect cosmesis. The incidence in the literature ranges from 10% to 15%. [53] However, this risk of moderate to severe fibrosis may be influenced by several risk factors such as whole breast radiation dose, beam energy, dose heterogeneity, boost to the surgical cavity, and chemotherapy. A nomogram was developed using the data from the "Boost Versus No Boost" EORTC 22881-10882 trial to predict the risk of moderate to severe fibrosis in patients receiving whole breast radiation. [54] Preventative measures included weighing the risks and benefits of a breast boost, lowering beam energies, and limiting hot spots to <107% of the prescribed dose. In addition, patients at high risk for fibrosis may also take pentoxifylline with vitamin E for 6 months after radiation. This regimen has been shown in small randomized trials to reduce the risk of radiation fibrosis measured by a tissue compliance meter. [55] Unfortunately, once a patient has developed breast fibrosis, these changes are mostly irreversible. Management of patients with breast fibrosis consists mainly of symptomatic treatment, including NSAIDs, SNRIs, and anticonvulsants such as gabapentin.

Progressive swelling of the upper extremity may occur in patients treated 6 months after radiation. The patient may notice increasing arm girth, swelling, heaviness, poor wound healing, and infection. The risk of developing lymphedema depends on the disruption to the regional lymphatics. The risk factors include the number of lymph nodes removed, body mass index, and amount of irradiated lymphatics. [56] A nomogram developed by Gross et al in 2019 may help quantify this risk. [56] Patients undergoing a sentinel node biopsy have a 5.6% risk of developing lymphedema compared with a 19.9% risk in those undergoing a full axillary dissection. [57] The AMAROS trial had a 5-year lymphedema rate of 25% in patients receiving an axillary dissection versus 12% in those receiving regional nodal radiation alone. [58] Patients receiving axillary dissection and regional nodal RT would be at the highest risk of developing lymphedema. Evidence for prevention is sparse but includes weight-bearing exercise and maintaining appropriate body weight. Patients with lymphedema may be managed with fitted compression garments, arm elevation, and exercise.

Brachial plexopathy

The brachial plexus trunks may be exposed to radiation doses in patients requiring regional nodal radiation. Symptoms include hand and arm paresthesia, weakness, and pain in the affected arm and shoulder. Onset is typically 8 to 12 months after treatment. Fortunately, this rare complication only affects approximately 1% of all patients. The risk may be increased in patients who have received chemotherapy or doses of radiation exceeding 50 Gy. [59] Primary prevention consists of limiting radiation doses to <50 Gy. Patients with brachial plexopathy may be managed with gabapentin and physical therapy.

Rib fracture

Rib fractures are another rare complication of breast radiotherapy, ranging from 0.3% to 1.8% of patients. [59] [60] The median time to onset is approximately 12 months. The risk is associated with lower energies and higher doses of radiation. Treatment is generally conservative.

Secondary malignancy

Radiotherapy can induce DNA damage in both cancerous as well as normal tissues, which can lead to the development of radiation-induced malignancies years after treatment. Large meta-analyses have shown that patients receiving radiotherapy for breast cancer have an increased risk of non-breast cancers, including sarcomas, lung, and esophageal cancers. [61] However, the absolute risk of developing a secondary malignancy is low at 1% to 2% at 10 years. [62] Risk factors include age, gender, radiation field size, and radiation dose. [63]

Medical Oncology

Chemotherapy, hormone therapy, immunotherapy, and targeted therapy are the systemic therapies used in breast cancer management and are described below.

Cytotoxic Chemotherapy

Cytotoxic chemotherapy is used in the neoadjuvant and adjuvant setting. Chemotherapy is most effective in high-grade, poorly differentiated tumors that have a high cell turnover rate, such as triple-negative and HER2-positive tumors. The chemotherapy regimen depends on tumor characteristics, the patient's ability to tolerate chemotherapy, and the degree of potential benefit. [64]

Adjuvant chemotherapy is associated with improved overall survival, disease-free survival, and reduced local recurrence. [65] Cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) combination was one of the early regimens used in the adjuvant treatment of breast cancer. More modern regimens use anthracyclines (eg, doxorubicin or epirubicin) and taxanes in regimens such as TAC (ie, docetaxel, adriamycin, and cyclophosphamide). Adjuvant chemotherapy is recommended for most patients with triple-negative and HER2-positive tumors that are >T1 stage. Treatment recommendations for HR-positive tumors are more nuanced and are guided by commercially available genetic analysis kits (eg, Oncotype Dx, Mammaprint). [66] [67] Neoadjuvant chemotherapy is increasingly used for triple-negative and HER2-positive tumors, which leads to increased compliance and tumor downstaging and allows assessment of the tumor's biological response. [68] [69]

Targeted Therapy

Anti-HER2 therapy is indicated in 17% of breast cancers that overproduce the growth-promoting protein HER2/neu. Trastuzumab, the first approved drug, is a monoclonal antibody directly targeting the HER2 protein. It reduces the risk of recurrence and death by 52% and 33%, respectively, if combined with chemotherapy in HER2-positive early breast cancer if compared to chemotherapy alone. [70] [71] More recent data advocates for dual HER2 blockade with trastuzumab and pertuzumab, which improves response rates.
PARP inhibitors (eg, olaparib and talazoparib) are monoclonal antibodies that prevent the activation of PARP, which are DNA repair enzymes. They are indicated in the adjuvant setting in individuals with BRCA mutations and HER2-negative breast cancer. [72]
CDK4/6 inhibitors (palbociclib, target the CDK4/6 proteins, which promote cell division. Inhibition of this pathway promotes tumor lytic activity in HR-positive HER2-negative tumors. They are indicated in metastatic HR-positive, HER2-negative tumors and selected patients with early HR-positive tumors. [73]
Immune checkpoint inhibitors (pembrolizumab, nivolumab) act on the PD-1, PD-L1 pathway to activate the host immune system. They are currently indicated in triple-negative breast cancer and the metastatic setting. [74]

Hormonal Treatment

Selective estrogen receptor modulators (eg, tamoxifen) or aromatase inhibitors (eg, exemestane and letrozole) are indicated in HR-positive breast cancers. Estrogen receptor modulators are especially indicated in premenopausal women, while both drugs can be used postmenopausal. Hormonal therapy reduces the risk of breast cancer recurrence and mortality and is indicated from 5 to 10 years. [69] [31] Premenopausal women may also benefit from oophorectomy or chemical suppression of the ovaries (eg, GnRH antagonists), which are the primary source of estrogen before menopause. [75]

Breast cancer staging is determined clinically and histologically. Clinical breast cancer staging is based on physical examination and imaging studies before treatment. Histopathologic breast cancer staging is determined by pathologic examination of the primary tumor and regional lymph nodes after definitive surgical treatment. Staging is performed to group patients into risk categories that define prognosis and guide treatment recommendations for patients with a similar prognosis. Breast cancer is classified with the TNM classification system, which groups patients into 4 stage categories based on the primary tumor size (T), the regional lymph nodes status (N), and if there is any distant metastasis (M). [30] The most widely used TNM system is that of the American Joint Committee on Cancer.

Primary Tumor (T)

Tis: Carcinoma in-situ, Paget Disease With no Tumor

T1 : <2 cmT1a: 0.1 to 0.5 cmT1b: 0.5 to 1.0 cmT1c: 1.0 to 2.0 cm
T2 : 2 to 5 cm
T3 : >5 cm
T4 T4a: Chest wall involvementT4b: Skin involvementT4c: Both 4a and 4bT4d: Inflammatory ca

Regional Lymph Nodes (N)

N1 : Mobile ipsilateral axillary nodes
N2 : Fixed/matted ipsilateral axillary nodes
N3 N3a: Ipsilateral infraclavicular nodesN3b: Ipsilateral mammary nodesN3c: Ipsilateral supraclavicular nodes

Distant Metastases (M)

M1 : Distant metastases

Breast Cancer Staging

Stage 0 comprises ductal carcinoma in situ (DCIS) and noninvasive breast cancer. Early invasive cancer includes stages I, IIa, and IIb. Stages IIIa, IIIb, and IIIc primarily involve locally advanced disease. Stage IV is all metastatic breast cancer. [68] (see Image. Breast Cancer Metastasis Sites)

The prognosis of breast cancer depends on the stage. Stage 0 and Stage I both have a 100% 5-year survival rate. The 5-year survival rate of Stage II and Stage III breast cancer is about 93% and 72%, respectively. When the disease spreads systemically, its prognosis worsens dramatically. Only 22% of Stage IV breast cancer patients will survive their next 5 years. [30]

Complications

Complications can arise from the treatment, whether chemotherapy, radiation, hormonal therapy, or surgery.

Cosmetic issues
Permanent scarring
Alteration or loss of sensation in the chest area and reconstructed breasts

Chemotherapy

Nausea/vomiting and diarrhea
Memory loss "chemo brain"
Vaginal dryness
Menopausal symptoms/fertility issues

Hormonal Therapy

Hot flashes
Vaginal discharge dryness
Impotence in males with breast cancer
Pain and skin changes
Chronic heart and lung issues
Neuropathyy [76] [30]
Deterrence and Patient Education

Breast cancer is the most commonly diagnosed cancer in women. Addressing the environmental and personal factors that increase the risk of breast cancer is vital in reducing breast cancer incidence. Screening helps detect premalignant lesions and breast cancer before it is clinically evident. Early detection leads to improved survival. Identifying patients at high risk for breast cancer is also crucial, as these individuals need to be monitored closely. Mammography, ultrasound, and MRI may be used for screening and diagnosis. A biopsy with histopathology and molecular markers should be performed on all patients. Early breast cancer is typically treated with breast conservation surgery, radiation, chemotherapy, or hormonal therapy. More advanced tumors require a mix of different modalities to obtain the best outcome. Long-term surveillance and compliance with therapy help improve survival.

Enhancing Healthcare Team Outcomes

Patient-centered care for individuals with breast requires collaboration among healthcare professionals, including physicians, advanced practice clinicians, nurses, pharmacists, and others. These neoplasms are often discovered during screening. The necessary skills involve interpreting radiological findings, identifying potential complications, effectively communicating these findings to the patient and their care team, and understanding the intricacies of breasts. Medical oncology, interventional radiology, pathology, general surgery, plastic surgery, and primary care practitioners typically play a role in coordinating and delivering care to patients with breast cancer. The entire healthcare team also plays a crucial role in ensuring that patients continue on surveillance pathways.

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Breast Cancer Metastasis Sites Medical Gallery of Mikael Häggström, Public Domain, via Wikimedia Commons

Breast Mammogram. A mammographic view of the left breast demonstrates skin thickening, diffusely increased breast density, and malignant-type calcifications in this patient with biopsy-proven inflammatory breast cancer. Contributed by H Barazi, (more...)

Breast Cancer Risk Factors 5. Kerlikowske K, Gard CC, Tice JA, et al. for the Breast Cancer Surveillance Consortium. Risk factors that increase risk of estrogen receptor-positive and -negative breast cancer. J Natl Cancer Inst. 109(5): djw276, 2016.

Breast Estrogen Receptor Staining Contributed by Fabiola Farci, MD

Breast Cancer Axillary Lymphadenopathy Contributed by Sunil Munakomi, MD

Breast Cancer Fine Needle Aspiration Cytology Contributed by Sunil Munakomi, MD

Clinical Signs of Breast Carcinoma Contributed by Sunil Munakomi, MD

Pleomorphic Lobular Breast Carcinoma Contributed by Emma Gregory

Invasive Ductal Carcinoma. Histological slide of high-grade ductal carcinoma in situ with invasive ductal carcinoma (×10). The left side of the image shows a sheet of cells with pleomorphic nuclei, arranged in tubules, infiltrating into (more...)

Disclosure: Gopal Menon declares no relevant financial relationships with ineligible companies.

Disclosure: Fadi Alkabban declares no relevant financial relationships with ineligible companies.

Disclosure: Troy Ferguson declares no relevant financial relationships with ineligible companies.

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Breast Cancer - Free Essay Examples And Topic Ideas

Breast cancer is a type of cancer that develops from breast tissue. Essays on this topic could explore the causes, diagnosis, treatment, and prevention of breast cancer. Additionally, discussions might delve into the psychological and social impact of breast cancer on patients and their families, the ongoing research towards finding a cure, and the broader societal awareness and support systems available for those affected. We have collected a large number of free essay examples about Breast Cancer you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Micro Needle Thermocouple for Detection of Breast Cancer

Hundreds and thousands of people are affected by cancer each year; it is one of the most fatal diseases and a leading cause of death and disability for humans (Iranifam 2014). There are several types of cancer than can affect different areas of the body, some being less life-threatening than others. A vast amount of patients suffer from late diagnosis or recurrence of their disease in spite of all the advances in diagnosis and treatment of breast cancer. Modern cancer […]

The Role of Histology in the Breast Cancer

Breast cancer is an uncontrolled growth of breast cell that can be benign, not dangerous, but it can also metastasize and invade different and distant tissues in our body. Breast Cancer is the most common cancer in female of any age and although the risk increases, as you get older, many different factors affect the chance of a woman to get breast cancer. I chose this specific topic because breast cancer is something that I’ve dealt with in my personal […]

Corporate Social Responsibility against Cancer

Abstract As an assistant manager at Kenta Law Firm, based in Monroe, I intend to collaborate with the Susan B. Komen Foundation a non-organization corporation that is interested in reducing issues of breast cancer among women. Kenta law firm has noted that a significant populace of Monroe’s youth especially women and young children specifically those who are homeless are suffering from breast cancer. In this CSR partnership, our law firm will collaborate with the Susan B. Komen Foundation in addressing […]

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Why is Screening for Breast Cancer Important

The impact this disease has, on not only the individual but the people around them, is powerful. Even though the tests show cancer, I am thankful that I had the annual test. It is true that stress, anxiety, and money can be saved by waiting until the age of 50 years old because of misinterpretation and overdiagnosis. However, early detection is the key to success in the battle against breast cancer. There are many different options for detection scans that […]

Breast Cancer: Casuses and Treatment

Cancer is defined as “when the body’s cells begin to divide without stopping and spread into surrounding tissues.” (“What is cancer?”, 2017), caused by mutations that lead to the cell cycle to proceed, regardless if the cell is qualified to. The mutations block the use of the G1, G2, and M checkpoints in the cell cycle. These checkpoints are important in “sensing defects that occur during essential processes, and induce a cell cycle arrest in response until the defects are […]

Breast Reconstruction after Mastectomy

Breast cancer is always personal. As a physician who counsels women at different steps during the healing process, I am acutely aware of this undeniable fact. Every decision she makes from the point at which she is diagnosed with breast cancer will require her focused engagement and a physician who is central to understanding her need for clarity of options. It is an intimate relationship where trust is a requirement and every woman faced with the many unknowns ahead will […]

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Breast cancer is a disease in which most commonly occurs in all women no matter their size, shape, race, or ethnicity. About one in eight women will be diagnosed with breast cancer every year, a fatal disease if not discovered early. Early detection of breast cancer is key so that cancerous cells found in the breast do not spread through other parts of the body. With an increasing prevalence in breast cancer today, the evolution of technology has been improved […]

New Healthcare Inventions on Breast Cancer

Abstract Background: The Ki67 labeling index (LI) for breast carcinoma is essential for therapy. It is determined by visual assessment under a microscope which is subjective, thus has limitations due to inter-observer variability. A standardized method for evaluating Ki67 LI is necessary to reduce subjectivity and improve precision. Therefore, automated Digital Image Analysis (DIA) has been attempted as a potential method for evaluating the Ki67 index. Materials and Method: We included 48 cases of invasive breast carcinoma in this study. […]

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This paper will clarify what Breast Cancer is. It will explain the symptoms, treatment options, and other useful information regarding this disease. The first thing to know about Breast Cancer is understanding what it is. According to the Cancer.org website, breast cancer begins when cells in the bosom begin to spread out of control. The tumor that is formed from these cells may be detected on an x-ray or can be felt as a lump. Malignancy can advance into neighboring […]

Breast Cancer in African American Women

Summary Despite the fact that Caucasian women in the United States have a higher incidence rate of breast cancer than any other racial group, African-Americans succumb notably worse to the disease and record the highest mortality rate. To comprehend the barriers and challenges that predispose African-American women to these disparities, this research was conducted to get a better understanding from the perspective of oncologists. With diverse ethnicity and gender representation, the participation of seven medical, surgical and radiation oncologists that […]

Essential Breast Cancer Screening Techniques and their Complements

It is with great distress that each year a large number of females suffer and die from breast cancer. Medicine practitioners and researchers have been striving to save lives from breast cancer, and how they manage to do this includes two major parts—diagnosis and treatment. What comes first on the stage of diagnosis is the detection of tumor. Thus, the development of breast imaging techniques is at the highest priority for diagnosing breast cancer, and individuals’ focus is on earlier […]

Breast Cancer Prevention and Treatment

The human body is made up of cells. When a cell dies the body automatically replaces it with a new healthy cell, but sometimes the cell is not healthy and grows out of control. These cells group together and form a lump that can be seen on an x-ray. Breast cancer is a tumor in the cells of person’s breast. It can spread throughout the breast to the person’s lymph nodes and other parts of the body. Sometimes it occurs […]

Breast Cancer Diagnosis

I. Executive Summary Breast cancer is concerning a large number of female individuals worldwide. This disease comes from abnormally developed breast tissue, which usually begins in either lobules or ducts of the breast. Generally speaking, breast cancer is divided into two types—non-invasive and invasive. The core criteria to distinguish in between these two types of breast cancers is the location of cancer cells. Cancer cells remain on their initial positions for a non-invasive breast cancer, whereas they grow, or “invade”, […]

Understanding a Breast Cancer Diagnosis

Breast cancer is often known as an aggressive cancer. It forms when cells grow uncontrollably in the tissues of the breast, leading to a tumor. Over 190,000 individuals are diagnosed yearly (Cancer Center). Breast cancer is the second leading cause of death, and the rate increases every year in women, and occasionally in men. Over 12 percent of women in the United States of America will face breast cancer in their lifetime. It is the most common cause of death […]

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Exome Sequencing to Identify Rare Mutations Associated with Breast Cancer Susceptibility

Abstract Background - Breast cancer predisposition has been known to be caused by hereditary factors. New techniques particularly exome sequencing have allowed/ helped us to identify new and novel variants that exhibit a phenotype. Method - In this review we discuss the advantages of exome sequencing and how it could help in understanding the familial breast cancer. In particular, we will discuss about the studies by Noh et al.(1), Thompson et al.(2), and Kiiski et al.(3), on how they have […]

A Novel Therapeutic Strategy for HER2 Breast Cancer by Nanoparticles Combined with Macrophages

Abstract:In recent years, the cell membrane bionic nanoparticles as a new drug delivery system is widely used in small molecule drugs, vaccines and targeted delivery of macromolecular drugs, because of its inherited the specific receptors on the cell membrane and membrane proteins can be used to implement specific targeted delivery, and the tumor showed a good treatment effect on the disease such as model, this topic with a huge bite cell membrane of the role of tumor capture, chemical modification, […]

Essays About Breast Cancer Breast Cancer is one of the most common cancers in women and is a disease by which the cells in the breast area grow out of control. Breast cancer tends to begin in the ducts or lobules of a breast and there are different types of cancer. In the US alone 1 in 8 women will develop breast cancer at some stage in their lives. In many academic fields; from science to medicine the study of breast cancer and essays about breast cancer are required as part of the curriculum. An essay on breast cancer can seem daunting due to the amount of research and several varying scientific approaches used to talk about the topic. We offer essay examples, or research paper guidance and free essay samples. These can be used to gauge how to approach the topic and are an informative look at all factors that contribute to breast cancer and prevention. We also factor breast cancer awareness into our essay samples and ensure essays for both university and college build a strong foundation to understanding the disease, but also draw criticism when necessary and a strong conclusion on whatever element of breast cancer the focus of the essay is on.

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Key discovery advances fight to reduce breast cancer recurrence

by Duke-NUS Medical School

Key discovery by Duke-NUS advances fight to reduce breast cancer recurrence

In looking for new ways to fight breast cancer, scientists from Duke-NUS Medical School have unmasked a surprising role of a protein generally associated with cancer growth. They have discovered that in estrogen receptor-positive (ER+) breast cancer, this protein acts as a tumor suppressor instead.

ER+ breast cancer constitutes about 80% of all breast cancer diagnoses, yet nearly 50% of women diagnosed with it experience a relapse after initial treatment .

The unexpected finding counters long-held views that the protein, known as Gα13, acts as an accelerator of cancer cell growth, as seen with similar G-proteins. This latest discovery, published in the journal Breast Cancer Research , is the first study to identify Gα13 as a tumor suppressor in solid tumors. This could lead to new personalized approaches to breast cancer treatment involving examining levels of Gα13 and other proteins.

Dr. Lalitha Subramanyan, a Ph.D. graduate from Duke-NUS and now a postdoctoral fellow at Duke University's Department of Pharmacology and Cancer Biology, who is the first author of the paper, said, "Our findings challenge the previous notion that Gα13 universally promotes cancer growth across different tumor types. Instead, we found evidence suggesting that Gα13 may help disrupt harmful pathways in estrogen receptor-positive breast cancer, potentially slowing or stopping the growth of cancer cells.

"This makes the discovery of a protective role of Gα13 even more significant, as it addresses a critical gap in understanding how different molecular pathways contribute to cancer progression."

The study's findings hold implications for a new direction in treatment strategies. Associate Professor Yap Yoon Sim, Department of Breast & Gynecological Medical Oncology of National Cancer Center Singapore, who was not involved in the research, said, "It is interesting that the effects of the GNA13 protein differ in different types of breast cancer cells.

"These findings highlight the complexity of cancer biology and the need to understand the role of different molecules and pathways in various settings. It is hoped that this knowledge can facilitate the development of novel strategies to treat breast cancer in the near future."

Despite various advances in treatment, breast cancer remains the most diagnosed cancer worldwide and is a leading cause of cancer-related death in women, causing roughly 685,000 deaths in 2020.

In Singapore, breast cancer is the most commonly occurring cancer among women, accounting for almost one in three cancer diagnoses in women, according to the Singapore Cancer Society. This highlights the profound impact of the disease on women's health, as well as the urgent need for more effective treatments.

Breast cancer is a complex disease, comprising varying types that respond differently to treatments. The treatment approach varies depending on the molecular subtype.

Gα13 acts as a messenger within cells, transporting signals from the cell surface to the inside of the cell, activating a cascade of reactions that influence the cell's behavior, including how it grows, divides, and responds to its environment. The study's findings reveal a previously unknown connection between Gα13 signaling and that of the hormone estrogen, an important determinant in breast cancer. Together, they control a prominent oncogene, MYC, and cancer cell growth.

Associate Professor Mei Wang from Duke-NUS' Cancer and Stem Cell Biology Program and co-corresponding author of the study, commented, "Apart from expanding our understanding of Gα13 and related proteins in cancer formation, our findings also offer a fresh perspective on targeting recurrent ER+ cancers.

"While treatments for ER+ breast cancers primarily target ER signaling, nearly half of these patients develop resistance to such therapy over time. The discovery of Gα13 control of estrogen signaling, and of MYC function, offers new ways to counter resistant ER+ breast cancers."

During the study, a correlation between lower levels of Gα13 and poorer patient survival outcomes in ER+ breast cancer patients was also observed, further supporting the protective role of Gα13 against ER+ breast cancer.

The researchers plan to expand their study to explore Gα13's role in other hormone-sensitive cancers, and by applying these principles to other solid cancers.

Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, added, "This study marks a defined and significant advance, with potential implications for cancer treatment strategies. Understanding these molecular mechanisms paves the way for targeted drug development, which could enhance the efficacy of breast cancer treatments and ultimately improve survival rates and quality of life for those affected by this devastating disease."

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125 Breast Cancer Essay Topic Ideas & Examples

🏆 best breast cancer topic ideas & essay examples, 💡 most interesting breast cancer topics to write about, 📌 simple & easy breast cancer essay titles, 👍 good essay topics on breast cancer.

Breast Cancer: Concept Map and Case Study Each member of the interdisciplinary team involved in treating patients with cancer and heart disease should focus on educational priorities such as:
Breast Cancer Symptoms and Causes The mammogram is the first indication of breast cancer, even though other indications such as the presence of the lymph nodes in the armpits are also the early indications of breast cancer.
Breast Cancer and Its Population Burden The other objectives that are central to this paper are highlighted below: To determine which group is at a high risk of breast cancer To elucidate the impact of breast cancer on elderly women and […]
Mindfulness Practice During Adjuvant Chemotherapy for Breast Cancer She discusses the significance of the study to the nursing field and how nurses can use the findings to help their patients cope with stress.
Breast Cancer: The Effective Care Domain Information about how the patient is seen, how often the patient is seen, and whether she will return for mammograms can be collected and analyzed to verify the successful intervention to extend consistency with mammograms.
Garden Pesticide and Breast Cancer Therefore, taking into account the basic formula, the 1000 person-years case, the number of culture-positive cases of 500, and culture-negative of 10000, the incidence rate will be 20 new cases.
Breast Cancer as a Genetic Red Flag It is important to note that the genetic red flags in Figure 1 depicted above include heart disease, hypertension, and breast cancer.
Breast Cancer Surveillance Consortium Analysis Simultaneously, the resource is beneficial because it aims to “improve the delivery and quality of breast cancer screening and related outcomes in the United States”.
Drinking Green Tea: Breast Cancer Patients Therefore, drinking green tea regularly is just a necessity- it will contribute to good health and physical vigor throughout the day and prevent severe diseases.
Breast Cancer Prevention: Ethical and Scientific Issues Such information can potentially impact the patient and decide in favor of sharing the information about the current condition and risks correlating with the family history.
Breast Cancer: Epidemiology, Risks, and Prevention In that way, the authors discuss the topics of breast cancer and obesity and the existing methods of prevention while addressing the ethnic disparities persistent in the issue.
Breast Cancer Development in Black Women With consideration of the mentioned variables and target population, the research question can be formulated: what is the effect of nutrition and lifestyle maintained on breast cancer development in black women?
Breast Cancer in Miami Florida The situation with the diagnosis of breast cancer is directly related to the availability of medicine in the state and the general awareness of the non-population.
Breast Cancer: Genetics and Malignancy In the presence of such conditions, the formation of atypical cells is possible in the mammary gland. In the described case, this aspect is the most significant since it includes various details of the patient’s […]
Genes Cause Breast Cancer Evidence suggests the role of BRCA1 in DNA repair is more expansive than that of BRCA2 and involves many pathways. Therefore, it is suggested that BRCT ambit containing proteins are involved in DNA repair and […]
Breast Cancer. Service Management The trial specifically looks at the effect on breast-cancer mortality of inviting women to screening from age 40 years compared with invitation from age 50 years as in the current NHS breast-screening programme.
Fibrocystic Breast Condition or Breast Cancer? The presence of the fibrocystic breast condition means that the tissue of the breast is fibrous, and cysts are filled with the liquid or fluid. The main characteristic feature of this cancer is that it […]
Coping With Stress in Breast Cancer Patients Therefore, it is important for research experts to ensure and guarantee adherence to methodologies and guidelines that define scientific inquiry. However, various discrepancies manifest with regard to the initiation and propagation of research studies.
Breast Self-Examination and Breast Cancer Mortality Though it is harsh to dismiss self-exams entirely due to studies that indicate little in deaths of women who performed self-exams and those who did not, the self-exams should not be relied on exclusively as […]
Breast Self-Exams Curbing Breast Cancer Mortality The results of the study were consistent with the findings of other studies of the same nature on the effectiveness of breast self-examination in detecting and curbing breast cancer.
Taxol Effectiveness in Inhibiting Breast Cancer Cells The following were the objectives of this experiment: To determine the effectiveness of Taxol in inhibiting breast cancer cells and ovarian cancer cells using culture method.
Control Breast Cancer: Nursing Phenomenon, Ontology and Epistemology of Health Management Then, the evidence received is presented in an expert way leading to implementation of the decision on the management of the disease.
Breast Cancer: Effects of Breast Health Education The design of the research focused on research variables like skills, performance, self-efficacy, and knowledge as the researchers aimed at examining the effectiveness of these variables among young women who underwent training in breast cancer […]
Community Nursing Role in Breast Cancer Prevention However, early detection still remains important in the prevention and treatment of breast cancer. The community has thus undertaken activities aimed at funding the awareness, treatment and research in order to reduce the number of […]
Self-Examination and Knowledge of Breast Cancer Among Female Students Shin, Park & Mijung found that a quarter of the participants practiced breast self-examination and a half had knowledge regarding breast cancer.
“Tracking Breast Cancer Cells on the Move” by Gomis The article serves the purpose of examining the role of NOG, a gene that is essential in bone development and its role in breast cancer.
Breast Cancer Survivorship: Are African American Women Considered? The finding of the analysis is that the issue of cancer survivorship is exclusive, developing, and at the same time it depends on what individuals perceive to be cancer diagnosis as well as personal experiences […]
Gaining Ground on Breast Cancer: Advances in Treatment The article by Esteva and Hortobagyi discusses breast cancer from the aspect of increased survival rates, the novel treatments that have necessitated this and the promise in even more enhanced management of breast cancer.
Effects of Hypoxia, Surrounding Fibroblasts, and p16 Expression on Breast Cancer The study was conducted to determine whether migration and invasion of breast cancer cells were stimulated by hypoxia, as well as determining whether the expression of p16 ectopically had the potential to modulate the cell […]
Breast Cancer: Preventing, Diagnosing, Addressing the Issue In contrast to the MRI, which presupposes that the image of the tissue should be retrieved with the help of magnetic fields, the mammography tool involves the use of x-rays.
Dietary Fat Intake and Development of Breast Cancer This study aimed to determine the relationship between dietary fat intake and the development of breast cancer in women. The outcome of the study strongly suggests that there is a close relationship between a high […]
The Detection and Diagnosis of Breast Cancer The severity of cancer depends on the movement of the cancerous cells in the body and the division and growth or cancerous cells.
Breast Cancer: WMI Research and the Current Approaches Although the conclusions provided by the WHI in the study conducted to research the effects of estrogen and progesterone cessation on the chance of developing a breast cancer do not comply with the results of […]
Breast Cancer Susceptibility Gene (BRCA2) The mechanisms underlying the genetic predisposition to a particular disease are manifold and this concept is the challenging one to the investigators since the advent of Molecular Biology and database resources.
Prediction of Breast Cancer Prognosis It has been proposed that the fundamental pathways are alike and that the expression of gene sets, instead of that of individual genes, may give more information in predicting and understanding the basic biological processes.
Breast Cancer Survivors: Effects of a Psychoeducational Intervention While the conceptual framework is justified in analysis of the quality of life, there is the likelihood of influence of the context with quality of life adopting different meanings to patients in different areas and […]
Providers’ Role in Quality Assurance in Breast Cancer Screening In order to ensure the quality assurance of mammography, the providers involved in the procedure need to be aware of the roles they ought to play.
Clinical Laboratory Science of Breast Cancer The word cancer is itself so much dreaded by people that the very occurrence of the disease takes half of the life away from the patient and the relatives.
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Breast Cancer Genetics & Chromosomal Analysis In this paper, the chromosomal analysis of breast cancer will be assessed, and the causes of the disorder will be detailed.
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Breast Cancer Screening in Young American Women It is proud to be at the forefront of widespread public health initiatives to improve the education and lives of young women.
Screening for Breast Cancer The main goal of this paper is to describe the specific set of clinical circumstances under which the application of screening is the most beneficial for women aged 40 to 74 years.
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Breast Cancer Patients’ Functions and Suitable Jobs The key symptom of breast cancer is the occurrence of a protuberance in the breast. A screening mammography, scrutiny of the patient’s family history and a breast examination help in the diagnosis of breast cancer.
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Patient Care & Health Information
Diseases & Conditions
Breast cancer

Breast anatomy

Each breast contains 15 to 20 lobes of glandular tissue, arranged like the petals of a daisy. The lobes are further divided into smaller lobules that produce milk for breastfeeding. Small tubes, called ducts, conduct the milk to a reservoir that lies just beneath the nipple.

Breast cancer is a kind of cancer that begins as a growth of cells in the breast tissue.

After skin cancer, breast cancer is the most common cancer diagnosed in women in the United States. But breast cancer doesn't just happen in women. Everyone is born with some breast tissue, so anyone can get breast cancer.

Breast cancer survival rates have been increasing. And the number of people dying of breast cancer is steadily going down. Much of this is due to the widespread support for breast cancer awareness and funding for research.

Advances in breast cancer screening allow healthcare professionals to diagnose breast cancer earlier. Finding the cancer earlier makes it much more likely that the cancer can be cured. Even when breast cancer can't be cured, many treatments exist to extend life. New discoveries in breast cancer research are helping healthcare professionals choose the most effective treatment plans.

Breast cancer care at Mayo Clinic

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Angiosarcoma
Ductal carcinoma in situ (DCIS)
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Lobular carcinoma in situ (LCIS)
Male breast cancer
Paget's disease of the breast
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Nipple changes

Breast and nipple changes can be a sign of breast cancer. Make an appointment with a healthcare professional if you notice any changes.

Signs and symptoms of breast cancer may include:

A breast lump or thickened area of skin that feels different from the surrounding tissue.
A nipple that looks flattened or turns inward.
Changes in the color of the breast skin. In people with white skin, the breast skin may look pink or red. In people with brown and Black skin, the breast skin may look darker than the other skin on the chest or it may look red or purple.
Change in the size, shape or appearance of a breast.
Changes to the skin over the breast, such as skin that looks dimpled or looks like an orange peel.
Peeling, scaling, crusting or flaking of the skin on the breast.

When to see a doctor

If you find a lump or other change in your breast, make an appointment with a doctor or other healthcare professional. Don't wait for your next mammogram to see if the change you found is breast cancer. Report any changes in your breasts even if a recent mammogram showed there was no breast cancer.

The exact cause of most breast cancers isn't known. Researchers have found things that increase the risk of breast cancer. These include hormones, lifestyle choices and things in the environment. But it's not clear why some people who don't have any factors get cancer, yet others with risk factors never do. It's likely that breast cancer happens through a complex interaction of your genetic makeup and the world around you.

Healthcare professionals know that breast cancer starts when something changes the DNA inside cells in the breast tissue. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

The DNA changes that lead to breast cancer most often happen in the cells that line the milk ducts. These ducts are tubes designed to carry milk to the nipple. Breast cancer that starts in the ducts is called invasive ductal carcinoma. Breast cancer also can start in cells in the milk glands. These glands, called lobules, are designed to make breast milk. Cancer that happens in the lobules is called invasive lobular carcinoma. Other cells in the breast can become cancer cells, though this isn't common.

Risk factors

Factors that may increase the risk of breast cancer include:

A family history of breast cancer. If a parent, sibling or child had breast cancer, your risk of breast cancer is increased. The risk is higher if your family has a history of getting breast cancer at a young age. The risk also is higher if you have multiple family members with breast cancer. Still, most people diagnosed with breast cancer don't have a family history of the disease.
A personal history of breast cancer. If you've had cancer in one breast, you have an increased risk of getting cancer in the other breast.
A personal history of breast conditions. Certain breast conditions are markers for a higher risk of breast cancer. These conditions include lobular carcinoma in situ, also called LCIS, and atypical hyperplasia of the breast. If you've had a breast biopsy that found one of these conditions, you have an increased risk of breast cancer.
Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
Beginning menopause at an older age. Beginning menopause after age 55 increases the risk of breast cancer.
Being female. Women are much more likely than men are to get breast cancer. Everyone is born with some breast tissue, so anyone can get breast cancer.
Dense breast tissue. Breast tissue is made up of fatty tissue and dense tissue. Dense tissue is made of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in your breasts. Having dense breasts can make it harder to detect breast cancer on a mammogram. If a mammogram showed that you have dense breasts, your risk of breast cancer is increased. Talk with your healthcare team about other tests you might have in addition to mammograms to look for breast cancer.
Drinking alcohol. Drinking alcohol increases the risk of breast cancer.
Having your first child at an older age. Giving birth to your first child after age 30 may increase the risk of breast cancer.
Having never been pregnant. Having been pregnant one or more times lowers the risk of breast cancer. Never having been pregnant increases the risk.
Increasing age. The risk of breast cancer goes up as you get older.
Inherited DNA changes that increase cancer risk. Certain DNA changes that increase the risk of breast cancer can be passed from parents to children. The most well-known changes are called BRCA1 and BRCA2. These changes can greatly increase your risk of breast cancer and other cancers, but not everyone with these DNA changes gets cancer.
Menopausal hormone therapy. Taking certain hormone therapy medicines to control the symptoms of menopause may increase the risk of breast cancer. The risk is linked to hormone therapy medicines that combine estrogen and progesterone. The risk goes down when you stop taking these medicines.
Obesity. People with obesity have an increased risk of breast cancer.
Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is higher.

Things you can do to lower your risk of breast cancer

Breast self-exam

To perform a breast self-exam for breast awareness, follow a pattern that ensures you cover your entire breast. For instance, imagine that your breasts are divided into equal wedges, like pieces of a pie. Move your fingers along each piece in toward your nipple.

Making changes in your daily life may help lower your risk of breast cancer. Try to:

Ask about breast cancer screening. Talk with your doctor or other healthcare professional about when to begin breast cancer screening. Ask about the benefits and risks of screening. Together, you can decide what breast cancer screening tests are right for you.

Become familiar with your breasts through breast self-exam for breast awareness. You may choose to become familiar with your breasts by occasionally inspecting them during a breast self-exam for breast awareness. If there is a new change, a lump or something not typical in your breasts, report it to a healthcare professional right away.

Breast awareness can't prevent breast cancer. But it may help you to better understand the look and feel of your breasts. This might make it more likely that you'll notice if something changes.

Drink alcohol in moderation, if at all. Limit the amount of alcohol you drink to no more than one drink a day, if you choose to drink. For breast cancer prevention, there is no safe amount of alcohol. So if you're very concerned about your breast cancer risk, you may choose to not drink alcohol.
Exercise most days of the week. Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask a healthcare professional whether it's OK and start slowly.

Limit menopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with a healthcare professional about the benefits and risks of hormone therapy.

Some people have symptoms during menopause that cause discomfort. These people may decide that the risks of hormone therapy are acceptable in order to get relief. To reduce the risk of breast cancer, use the lowest dose of hormone therapy possible for the shortest amount of time.

Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. Eat fewer calories and slowly increase the amount of exercise.

Medicines and operations for those a high risk of breast cancer

If you have a high risk of breast cancer, you might consider other options to lower the risk. You might have a high risk if you have a family history of breast cancer. Your risk also might be higher if you have a history of precancerous cells in the breast tissue. Talk about your risk with your healthcare team. Your team might have options for lowering your risk, such as:

Preventive medicines. Using estrogen-blocking medicines can lower the risk of breast cancer in those who have a high risk. Options include medicines called selective estrogen receptor modulators and aromatase inhibitors. These medicines also are used as hormone therapy treatment for breast cancer.

These medicines carry a risk of side effects. For this reason, they're only used in those who have a very high risk of breast cancer. Discuss the benefits and risks with your healthcare team.

Preventive surgery. If you have a very high risk of breast cancer, you may consider having surgery to lower the risk of breast cancer. One option might be surgery to remove the breasts, called prophylactic mastectomy. Another option is surgery to remove the ovaries, called prophylactic oophorectomy. This operation lowers the risk of breast cancer and ovarian cancer.

More Information

Breast cancer chemoprevention
Genetic testing for breast cancer: Psychological and social impact
Cancer facts and figures 2023. American Cancer Society. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2023-cancer-facts-figures.html. Accessed Aug. 9, 2023.
Abraham J, et al., eds. Breast cancer. In: The Bethesda Handbook of Clinical Oncology. 6th ed. Kindle edition. Wolters Kluwer; 2023. Accessed March 30, 2023.
Breast cancer. Cancer.Net. https://www.cancer.net/cancer-types/breast-cancer/view-all. Accessed Aug. 2, 2023.
Mukwende M, et al. Erythema. In: Mind the Gap: A Handbook of Clinical Signs in Black and Brown Skin. St. George's University of London; 2020. https://www.blackandbrownskin.co.uk/mindthegap. Accessed Aug. 10, 2023.
Townsend CM Jr, et al. Diseases of the breast. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Aug. 2, 2023.
Breast cancer risk reduction. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1420. Accessed Aug. 2, 2023.
Breast cancer prevention (PDQ) – Patient version. National Cancer Institute. https://www.cancer.gov/types/breast/patient/breast-prevention-pdq. Accessed Aug. 2, 2023.
Breast cancer. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1419. Accessed Aug. 2, 2023.
Klimberg VS, et al., eds. Breast cancer diagnosis and techniques for biopsy. In: Bland and Copeland's The Breast: Comprehensive Management of Benign and Malignant Diseases. 6th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed Aug. 2, 2023.
Palliative care. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1454. Accessed Aug. 2, 2023.
Cancer-related fatigue. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1424. Accessed Aug. 2, 2023.
Breast SPOREs. National Cancer Institute. https://trp.cancer.gov/spores/breast.htm. Accessed Aug. 9, 2023.
Ami TR. Allscripts EPSi. Mayo Clinic. Jan. 31, 2023.
Ami TR. Allscripts EPSi. Mayo Clinic. April 5, 2023.
Member institutions. Alliance for Clinical Trials in Oncology. https://www.allianceforclinicaltrialsinoncology.org/main/public/standard.xhtml?path=%2FPublic%2FInstitutions. Accessed Aug. 9, 2023.
Giridhar KV (expert opinion). Mayo Clinic. Oct. 18, 2023.
Breast Cancer Education Tool
Breast cancer staging
Breast cancer types
Breast self-examination
Common questions about breast cancer treatment
Dragon Boats and Breast Cancer
Genetic Testing for Breast Cancer
HER2-positive breast cancer: What is it?
Infographic: Breast Cancer Risk
Modified radical mastectomy
Paulas story A team approach to battling breast cancer
Pink Sisters
Simple mastectomy and modified radical mastectomy
The Long Race Beating Cancer
Weight Loss After Breast Cancer
What is breast cancer? An expert explains

Associated Procedures

3D mammogram
Brachytherapy
BRCA gene test
Breast cancer risk assessment
Breast cancer supportive therapy and survivorship
Breast cancer surgery
Breast self-exam for breast awareness
Chemotherapy
Chemotherapy for breast cancer
Chest X-rays
Complete blood count (CBC)
Hormone therapy for breast cancer
Molecular breast imaging
Positron emission tomography scan
Precision medicine for breast cancer
Radiation therapy
Radiation therapy for breast cancer
Sentinel node biopsy

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How breast cancer goes hungry

image of PHGDH enzyme in metabolic pathway in breast cancer cells

The Takeaway

CSHL Assistant Professor Michael Lukey and postdoc Yijian Qiu have found a way to block breast cancer cells’ access to a critical nutrient and to their backup supply. The approach shrank tumors in mice. This discovery provides new insight into cancer metabolism. And it could lead to a new combination therapy for cancer treatments.

Cancer cells have voracious appetites. And there are certain nutrients they can’t live without. Scientists have long hoped they might stop tumors in their tracks by cutting off an essential part of cancer cells’ diet. But these cells are crafty and often find a new way to get what they need. How? By reprogramming their metabolism and switching to backup food supplies.

Now, Cold Spring Harbor Laboratory (CSHL) Assistant Professor Michael Lukey has found a way to deprive cancer cells of both a vital nutrient and their backup supply. In lab experiments with breast cancer cells, patient-derived tissue models, and mice, this strategy killed breast cancer cells and shrank tumors.

How does this work? Let’s go back to cancer metabolism . Aggressive cancer cells avidly consume an amino acid called glutamine. They use this vital nutrient to generate the energy and materials needed to grow and replicate.

Previous studies have shown that starving cancer cells of glutamine or preventing its conversion into metabolites can stop the cells’ growth in the lab. However, in recent clinical trials, breast cancer patients didn’t benefit from a drug taking this approach. This suggests that breast cancer cells can adapt and find a way to live without glutamine.

Lukey and postdoc Yijian Qiu saw the same thing in their lab. They noticed that breast cancer cells adapt to glutamine starvation by switching on a pathway that generates a critical metabolite called alpha-ketoglutarate, normally derived from glutamine. This enables cancer cells to continue producing the energy and building materials they would otherwise get from glutamine. It was a lightbulb moment for Lukey’s lab. He recalls:

“That made us think, could we exploit this for cancer therapy? Could we target glutamine metabolism? We know the cells adapt to that. So, could we simultaneously target their adaptive response by inhibiting the pathway?”

The approach was successful, killing breast cancer cells in lab dishes and effectively treating tumors in mice. Lukey’s team saw tumors stop growing and even shrink with the combination treatment. The animals remained healthy.

Inhibitors of both metabolic pathways are now under further investigation. Lukey notes that these pathways might be especially important for breast cancer metastasis to different tissues, including some that are very difficult to treat. He explains:

“Brain metastases in particular lack any effective therapies.”

Lukey hopes his lab’s combination therapy could ultimately improve the efficacy of glutamine metabolism inhibitors in the clinic. This could mean effective new treatments that target cancer’s metabolic addictions.

Written by : Jennifer Michalowski , Science Writer | [email protected] | 516-367-8455

National Institutes of Health, Department of Defense Breast Cancer Research Program, METAvivor, The Elsa U. Pardee Foundation

Qiu, Y., et al ., “The unique catalytic properties of PSAT1 mediate metabolic adaptation to glutamine blockade”, Nature Metabolism , August 27, 2024. DOI: 10.1038/s42255-024-01104-w

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Principal Investigator

Michael Lukey

Assistant Professor Cancer Center Assistant Director of Operations Ph.D., University of Oxford, U.K., 2010

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Nicole Eggert reveals what’s next for breast cancer treatment 8 months after diagnosis

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Actor Nicole Eggert opened up about the hardest part of her breast cancer journey since her diagnosis last year.

Eggert, 52, gave People an update on her health while attending the premiere of “After Baywatch: Moment in the Sun” in Los Angeles on Aug. 26.

“I am good,” she said. “I am in sort of a gray area and I finished my treatment, waiting for more imaging and hopefully maybe surgery.”

“There’s a lot of waiting in this and it’s sort of something I didn’t really realize and nobody really talks about,” she added. “But the gray area is the hardest because you don’t know what’s happening. When I’m doing treatment, I felt like I was doing something productive.”

The “Charles in Charge” actor continued: “So it felt positive and I was like, OK, I’m doing something positive. And now that it’s just like nothing, it’s like, well wait a minute. We got to get this out. So it’s just frustrating.”

Eggert said in an interview with People earlier this year she had been diagnosed with stage 2 cribriform carcinoma breast cancer in December 2023.

Cribriform breast cancer is a rare type of breast cancer that is slow growing, according to Breast Cancer Now . Surgery is one of the most common forms of treatment, along with radiotherapy and chemotherapy.

Eggert told People in January she had gained 25 pounds in three months and had "terrible pain" in her left breast, but dismissed them as signs of menopause until she felt a lump in her breast during a self-exam.

After a discovery mammogram and three biopsies, her pathology reports were positive for cancer, she said. Eggert said earlier this year she would need surgery to remove the cancer, and that she was working with an oncologist to determine if she would need radiation and chemotherapy.

“This journey’s been rough for me. This hasn’t been a breezy sale through life,” she said. “I always read inspirational quotes and corny stuff, but it gets me through.”

Eggert told People in August she meditates, does guided imagery and attends breath workshops to help keep herself occupied during her treatment.

“I do whatever I can, whatever I can ... going walk or if it’s doing a meditation ... I just do whatever I can to distract myself.”

She added that her two children, Dilyn, 25, and Keegan, 13, have been supportive since her diagnosis.

“I mean, they kept me on my toes,” she said. “My 13-year-old didn’t give me any special treatment. It was still like, ‘Mom, give me that, let’s go here, let’s do that.’"

“So she just kept me going and kept it lively,” Eggert added. “And I really loved that about both of them. And both treated it like nothing’s changing, just keep the days the way they are.”

Eggert said her children and working on "After Baywatch: Moment in the Sun" have given her a sense of purpose throughout her health journey.

“Having a young daughter and having this project has been a great motivation for me to not just sit and think about my health and my wellbeing. It’s giving me purpose,” Eggert said. “It’s keeping me driven every day. I think the timing of life is always for a reason.”

Anna Kaplan is a news and trending reporter for TODAY.com.

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