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Breast cancer

Breast cancer. 小组成员：程欢欢 高 帅 蒋陈君 辛 畅 杨晓伟 叶德湫 张鹏程 张庆雷. US Mortality, 2002. No. deaths. % of all deaths. Rank. Cause of Death. 1. Heart Diseases 696,947 28.5 2. Cancer 557,271 22.8 3. Cerebrovascular diseases 162,672 6.7

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Breast cancer

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  1. Breast cancer 小组成员：程欢欢 高 帅 蒋陈君 辛 畅 杨晓伟 叶德湫 张鹏程 张庆雷

  2. US Mortality, 2002 No. deaths % of all deaths Rank Cause of Death 1. Heart Diseases 696,947 28.5 2. Cancer 557,271 22.8 3. Cerebrovascular diseases 162,672 6.7 4. Chronic lower respiratory diseases 124,816 5.1 5. Accidents (Unintentional injuries) 106,742 4.4 6. Diabetes mellitus 73,249 3.0 7. Influenza and pneumonia 65,681 2.7 8. Alzheimer disease 58,866 2.4 9. Nephritis 40,974 1.7 10. Septicemia 33,865 1.4 Source: US Mortality Public Use Data Tape 2002, National Center for Health Statistics, CDCP, 2004.

  3. Cancer is more violent than the tiger ！！！

  4. What is the cancer process? Cancer begins in cells.Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place. Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor. Tumors can be benign or malignant.

  5. Spontaneous UV and ionizing radiation Chemical carcinogens Tumour induction Genetic abnormalities (XP) Virus-induced (HepC, EBV, HPV) Immunosuppression Causative agents

  6. How do cancer cells differ from normal? • Cytoskeletal change • Cell adhesion/motility • Nuclear changes • Enzyme production

  7. Cytoskeletal changes Distribution and activity of the microfilaments and microtubules change: 1.change the ways the cell interacts with neighboring cells 2.alter the appearance of the cells.

  8. Cell adhesion/motility Cell-cell and cell-extracellular matrix adhesion reducted: 1. allows large masses of cells to form. 2. impact on the ability of the cells to move.

  9. Nuclear changes The shape and organization of the nuclei changed -----useful in the diagnosis and staging of tumors Gene chip

  10. Enzyme production Secrete enzymes digest away the barriers to migration and spread of the tumor cells-----enable them to invade neighboring tissues.

  11. In English , the word “cancer” means “crab”. the change of the motality and enzymes makes cancer cells can move up and down in human body like the crabs in the river.

  12. What is breast cancer ? Definition of breast cancer: Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

  13. Prevalence of cancer in UK

  14. What are the symptoms of breast cancer? • A lump or a thickening in the breast or in the armpit • A change in size or shape of the mature breast • Fluid (not milk) leaking from the nipple • Change in size or shape of the nipple • Unusual pain in the breast or in the armpit

  15. What are risk factors for breast cancer? • Age • Personal history of breast cancer • Family history • Certain breast changes • Gene changes • Reproductive and menstrual history • Race

  16. The classification of breast cancer • Ductal Carcinoma in-situ • Infiltrating Ductal • Medullary Carcinoma • Infiltrating Lobular • Tubular Carcinoma • Mucinous Carcinoma • Inflammatory Breast Cancer

  17. Site 1974-1976 1983-1985 1995-2000 Relative Survival (%) during Three Time Periods All sites 50 53 64 Breast (female) 75 78 88 Colon 50 58 63 Leukemia 34 41 46 Lung and bronchus 13 14 15 Melanoma of the skin 80 85 91 Non-Hodgkin lymphoma 47 54 59 Ovary 37 41 44 Pancreas 3 3 4 Prostate 67 75 99 Rectum 49 55 64 Urinary bladder 73 78 82 *5-year relative survival rates based on follow up of patients through 2001. Source: SEER Program (1975-2001), NCI 2004.

  18. Treatment methods • Surgery • Chemotherapy • Radiotherapy • Hormone therapy • immunotherapy

  19. Surgery • Breast-sparing surgery: An operation to remove the cancer but not the breast is breast-sparing surgery. • Mastectomy: An operation to remove the breast (or as much of the breast tissue as possible) is a mastectomy. In most cases, the surgeon also removes lymph nodes under the arm

  20. 乳腺癌手术

  21. Chemotherapy To decrease a patient's risk of recurrence Use anticancer drugs : 1.a combination of drugs ---AC (doxorubicin and cycolphosphamide环磷酰胺) ---CMF (cyclophosphamide, methotrexate甲氨蝶呤 and fluorouracil氟尿嘧啶 ) 2.be given as a pill or by injection into a vein .

  22. Radiotherapy Radiation therapy uses high energy rays (similar to x-rays) to kill cancer cells. However , the rays can also kill normal cells besides the cancer cells . So this therapy may cause severe side effects .

  23. 钴-60放疗机

  24. Hormone therapy • 1. Breast tumors need hormones to grow----- estrogens, progesterone, prolactin, growth hormone, androgen, thyroxin etc. • 2.Hormone therapy keeps cancer cells from getting or using the hormones they need. It is directed mainly to correct the estrogenous impact on the breast • 3.Antiestrogens – tamoxifen他莫昔芬 toremifen托瑞米芬 , aromatase芳香化酶.

  25. Immunotherapy Nonspecific immunoregulatory substances : BCG LMS Nonspecific immunotheropy Cytokin : IFN IL-2 immunotheropy vaccine Specific immunotheropy Monoclonal antibody Bevacizumab (Avastin) Trastuzumab (Herceptin)

  26. Immunotherapy-----vaccine • A HER2/neu peptide (a small part of the protein made by the HER2/neu gene), used as the antigen in a vaccine, has been shown to cause an increased immune response against the HER2/neu receptor on cancer cells. • Other specific antigen vaccines have also shown promise. These vaccines are almost always used after primary therapy (lumpectomy and radiation therapy, or mastectomy) and sometimes together with hormonal therapy or chemotherapy, to try to prevent the cancer from coming back.

  27. Immunotherapy-----MAb The MAb trastuzumab曲妥珠单抗 (Herceptin赫赛汀 ) is used in women with breast cancer whose cancer cells have too many copies of the HER2/neu gene. These genes make extra receptors for growth-stimulating factors on the cells, which results in a more aggressive form of breast cancer. Trastuzumab attaches to the receptors, blocking the access of the growth factors to the cancer cells and slowing their growth.

  28. Immunotherapy-----MAb Bevacizumab (Avastin)贝伐单抗|阿瓦斯汀, a monoclonal antibody that slows blood vessel growth in tumors, has been shown to be helpful when used along with chemotherapy in some women with advanced breast cancer.

  29. thank you !

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