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Geonomics in Breast Cancer. Decoding Human Genome Luis Barreras , M.D., FACP. Breast Cancer Figures. 1 in 8 women will develop breast cancer in their lifetime 180,000 women and 2,000 men yearly will develop breast cancer Over 40,000 women and men will die from breast cancer in 2009
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Geonomics in Breast Cancer Decoding Human Genome Luis Barreras, M.D., FACP
Breast Cancer Figures • 1 in 8 women will develop breast cancer in their lifetime • 180,000 women and 2,000 men yearly will develop breast cancer • Over 40,000 women and men will die from breast cancer in 2009 • 77% of breast cancer cases occur in women over the age of 50 • Mortality rates have decreased by 3% annually since 1990
Stages of Breast Cancer • Tumor size • Nodal status • Metastasis
Genetics • While genetics influence breast cancer, only 5–10% of cancers are genetically recognized • Genomic tolls focus on the genetic makeup of cancer cells • These expressions of genes can be traced to specific cancers and their behaviors
BRCA 1 & 2(Breast Cancer tests for genes) • Studies reveal a 60% increase in breast and ovarian cancers, lifetime risks • Whereas in the general population, there is only 12% lifetime risk
Genomic Test • Gene expression testing • % of recurrence • Benefits of treatment
Marker in Breast Cancer • ER/PR • HER-2 • Proliferation • 21 – Gene Assay
Patient Case #1 • 39 year old with large tumor in breast, no lymph nodes, ER+, HER-2 neg. • Treatment prior to gene expression studies – Chemotherapy • 21 gene panel – low risk • Treatment after gene expression studies - Hormonal
Patient Case #2 • 60 year old with small tumor in breast, ER +, node negative, HER-2 neg. • Treatment prior to gene expression studies – Hormonal • 21 – gene panel – high risk • Treatment after gene expression studies – Chemotherapy and Hormonal