Breast Cancer Awareness Month 2020

Breast Cancer 

It’s October and breast cancer awareness month. Breast cancer can be traced right back to ancient Egypt, with the earliest recorded case described on the 1600 BC Edwin Smith Papyrus.

In 2020, an estimated 276,480 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 48,530 new cases of non-invasive (in situ) breast cancer [1].

About 2,620 new cases of invasive breast cancer are expected to be diagnosed in men in 2020. A man’s lifetime risk of breast cancer is about 1 in 883.

What is cancer?

  • Cancer is a broad term for a class of diseases characterized by abnormal cells that grow and invade healthy cells in the body. Cancer begins in the cells which are the basic building blocks that make up tissues. Sometimes, the process of cell growth goes wrong and new cells form when the body doesn’t need them and old or damaged cells do not die as they should.   
  • These cells can spread by breaking away from the original tumor and entering blood vessels or lymph vessels, which branch into tissues throughout the body. When cancer cells travel to other parts of the body and begin damaging other tissues and organs, the process is called metastasis.

What Is A Tumor? Benign vs. Malignant tumors

  • A tumor is a mass of abnormal tissue. There are two types of breast cancer tumors: those that are non-cancerous, or ‘benign’, and those that are cancerous, which are ‘malignant’.
  • Malignant tumors are cancerous and aggressive because they invade and damage surrounding tissue. When a tumor is suspected to be malignant, the doctor will perform a biopsy to determine the severity or aggressiveness of the tumor.

What Causes Breast Cancer Growth?

Cancer spreads in three important ways:

  1.  Damaged cells replicate, creating more damaged cells and tumor growth. When the cell’s DNA (the cell’s wiring) is damaged, mutated cells begin to rapidly reproduce without following the pre-wired plan.
  2. Our body’s hormones and chemicals can accelerate the growth of some tumors. Cancer cell growth is often fueled by normally healthy chemicals of the body, like estrogen, progesterone, and HER2/neu gene (a growth hormone).
  3. Lymph and blood vessels can carry cancer to other areas of the body, and lymph node examination can help pinpoint the progression of the disease. The lymph system, which is part of the immune system, is a network of lymph vessels and lymph nodes running throughout the entire body. Similar to how the blood circulatory system distributes elements throughout the body, the lymph system transports disease-fighting cells and fluids. 

What Grade is Breast Cancer?

Cancer cells are given a grade according to how different they are from normal breast cells and how quickly they are growing. Grade describes how different the cell is from the original.

There are three grades of invasive breast cancer:

  • Grade 1 – looks most like normal breast cells and is usually slow-growing
  • Grade 2 – looks less like normal cells and is growing faster
  • Grade 3 – looks different to normal breast cells and is usually fast-growing

What are the Breast Cancer Stages?

Stages 1-4. The stages take into account: the size of cancer, whether the lymph nodes are affected, and if cancer has spread to other parts of the body. 

Most Common Breast Cancer

Invasive ductal carcinoma (IDC), sometimes called infiltrating ductal carcinoma, is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas.

Invasive means that cancer has “invaded” or spread to the surrounding breast tissues. Ductal means that cancer began in the milk ducts, which are the “pipes” that carry milk from the milk-producing lobules to the nipple.

Although invasive ductal carcinoma can affect women at any age, it is more common as women grow older. According to the American Cancer Society, about two-thirds of women are 55 or older when they are diagnosed with invasive breast cancer. Invasive ductal carcinoma also affects men.

Breast Cancer Breakthroughs

  • atezolizumab (Tecentriq®)
    • In March 2019, the FDA approved the first checkpoint inhibitor immunotherapy drug, an anti-PD-L1 antibody called atezolizumab (Tecentriq®), in combination with chemotherapy, for the treatment of triple-negative, metastatic breast cancer in patients whose tumors express the PD-L1 protein.
    • Triple-negative breast cancer (TNBC) accounts for about 10-15%  of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells don’t have estrogen or progesterone receptors and also don’t make too much of the protein called HER2. (The cells test “negative” on all 3 tests.) These cancers tend to be more common in women younger than age 40, who are African-American, or who have a BRCA1 mutation.
    • Triple-negative breast cancer differs from other types of invasive breast cancer in that they grow and spread faster, have limited treatment options, and have a worse prognosis (outcome)
  • A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. Less than 15% of women who get breast cancer have a family member diagnosed with it.
  • Mutations in the BRCA1 and BRCA2 genes are the most common. On average, women with a BRCA1 mutation have up to a 72% lifetime risk of developing breast cancer. For women with a BRCA2 mutation, the risk is 69%. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women. Increased ovarian cancer risk is also associated with these genetic mutations.

A study found two cosmetics chemicals damage DNA of breast cells at low doses

  • A new approach to studying the effects of two common chemicals used in cosmetics and sunscreens found they can cause DNA damage in breast cells at surprisingly low concentrations, while the same dose did not harm cells without estrogen receptors.
  • The two compounds — examined in cells grown in the lab and in the mammary glands of mice were the ultraviolet filter benzophenone-3 (BP-3), also known as oxybenzone, and propylparaben (PP), an antimicrobial preservative found in cosmetics and other personal care products [2].

Clinical Trial: Evaluating Bioactivity in Breast Cancer Tumor Tissue After Intratumoral Administration of PVSRIPO

Researchers are conducting a pilot study to examine PVSRIPO bioactivity in tumor tissue after intratumoral administration of PVSRIPO in women with invasive breast cancer. PVSRIPO is the live attenuated, oral (Sabin) serotype 1 poliovirus vaccine containing a heterologous internal ribosomal entry site (IRES) derived from the human rhinovirus type 2 (HRV2).

The researchers hypothesize that the administration of PVSRIPO in the tumor causes inflammation, which will stimulate innate and adaptive immune activation in women with invasive breast cancer. Researchers are seeking to enroll 6 women with invasive breast cancer.

 

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