الفهرس 
?TumourogeneOnly 14 pages are availabe for public view
 |  | from | 220 |  |  |
| | | from | 220 | | |
Abstract
Breast cancer is the most common cancer in women. A history of breast cancer among relatives has been found, in epidemiological studies, to be an indication of breast cancer risk. Familial breast cancer is characterized by: a younger age at diagnosis than sporadic forms, increasing numbers of affected family members, an increased risk of bilateral breast cancer, and a strong association with ovarian cancer.
BRCA1 and BRCA2 are human genes that belong to a class of genes known as tumor suppressors. In normal cells, BRCA1 and BRCA2 help ensure the stability of the cell’s genetic material (DNA) and help prevent uncontrolled cell growth. Mutation of these genes has been linked to the development of hereditary breast and ovarian cancer. Mutations in several other genes, including TP53, PTEN and ATM, have been associated with hereditary breast and ovarian tumors. However, the majority of hereditary breast cancers can be accounted for by inherited mutations in BRCA1 and BRCA2.
In general, BRCA1-related breast cancers are frequently estrogen receptor/progesterone receptor (ER/PR) negative , with a greater proportion of medullary or atypical medullary-type tumors , while BRCA2-associated tumors are more frequently ER/PR positive.
Surveillance methods for breast cancer may include mammography and clinical breast exams. Studies are currently under way to test the effectiveness of other breast cancer screening methods, such as magnetic resonance imaging (MRI), in women with BRCA1 or BRCA2 mutations. With careful surveillance, many breast cancers will be diagnosed early enough to be successfully treated.
Also, Genetic testing can be offered for high risk groups. The test assesses woman’s risk of developing breast or ovarian cancer based on detection of mutations in the BRCA1 and BRCA2 genes. This test has become the standard of care in identification of individuals with hereditary breast and ovarian cancer in developed countries.
There is many strategies to decrease the risk of breast cancer include; prophylactic mastectomy, prophylactic salpingo-ophrectomy and chemo prevention.
Many women who choose to have prophylactic mastectomy also decide to have breast reconstruction to restore the shape of the breast.
Adjuvant therapy for breast cancer is any treatment given after primary therapy to increase the chance of long-term survival. Neoadjuvant therapy is treatment given before primary therapy.
Adjuvant therapy for breast cancer can include chemotherapy, hormonal therapy, the targeted drug Herceptin, radiation therapy, or a combination of treatments.
Patients who have a higher risk of breast cancer recurrence are more likely to need adjuvant therapy. Adjuvant and neoadjuvant therapies have side effects, but careful studies have shown that the risks of adjuvant therapy for breast cancer are outweighed by the benefit of treatment—that is, increasing the chance of long-term survival.
Optimally, patients require consultation with and collaboration among surgeons, medical oncologists, genetic counselors, and radiologists in a multidisciplinary clinical environment that provides clarification of risk, elucidation of management options, and elaboration of both the risks and benefits of various intervention strategies.