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Breast cancer Not a single disease. Type and stage. Grade/Lympho-vascular invasion

Breast cancer Not a single disease. Type and stage. Grade/Lympho-vascular invasion Molecular biology. ERPR Her-2-neu Other. Gene expression profiling. (Tumor and Patient). What causes cancer? DNA damage. WHY? Always! Radiation, random, metabolic, toxins.

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Breast cancer Not a single disease. Type and stage. Grade/Lympho-vascular invasion

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  1. Breast cancer • Not a single disease. • Type and stage. • Grade/Lympho-vascular invasion • Molecular biology. • ER\PR • Her-2-neu • Other. • Gene expression profiling. (Tumor and Patient)

  2. What causes cancer? • DNA damage. WHY? Always! • Radiation, random, metabolic, toxins. • Free radicals, adducts, breaks. • Incomplete DNA repair. • Error transmission. • Failure to recognize damage. • Failure to initiate programmed cell death. • Lack of immune response. • Suppression of normal genes • Promotion of cellular proliferation

  3. Genetic Issues • BRCA 1 and 2. • Other p53, AT. PTEN • Cancer susceptibility genes. • Polymorphisms. • Polygenic risk (the individual’s genetic fingerprint)

  4. Breast Cancer Types • Basal-like • Luminal A ER+ “good outcome” • Luminal B ER+ “bad outcome” • Normal breast-like • HER2+/ER-

  5. The Future • Microarrays • Proteomics • Positron Emission Mammography • ?Percutaneous Lesion Destruction • Personalized Therapy

  6. Microarrays • Amsterdam 70 • Oncotype Dx20 • Estrogen-regulated gene set 1E 2E

  7. The Butterfly Effect • Small initial changes can result in major variations in final conditions.

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