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The A-Z of Breast Cancer

The A-Z of Breast Cancer

BY Sunil Vats 4th November 2019

Breast Cancer can occur in women and rarely in men. Symptoms of breast cancer include a lump in the breast, bloody discharge from the nipple and changes in the shape or texture of the nipple or breast. Its treatment depends on the stage of cancer. It may consist of chemotherapy, radiation, hormone therapy and surgery.

Doctors know that breast cancer occurs when some breast cells begin to grow abnormally. Cells may spread (metastasize) through your breast to the lymph nodes or to other parts of your body. Breast Cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma).

The results are combined to determine the stage of cancer for each person. There are 5 stages: stage 0 (zero), which is noninvasive ductal carcinoma in situ (DCIS), and stages I through IV (1 through 4), which are used for invasive Breast Cancer.

Breast Cancer Types:

  • Ductal Carcinoma in Situ (DCIS): is a non-invasive Breast Cancer where abnormal cells have been contained in the lining of the breast milk duct. …
  • Invasive Ductal Carcinoma
  • Triple-Negative Breast Cancer
  • Inflammatory Breast Cancer
  • Metastatic Breast Cancer
  • Breast Cancer during Pregnancy
  • Other

Breast Cancer Symptoms & Signs

Breast Cancer does not always produce symptoms; women may have cancers that are so small they do not produce masses that can be felt or other recognizable changes in the breast. When symptoms do occur, a lump or mass in the breast is the most common symptom.

Other possible symptoms include

  • nipple discharge or redness,
  • changes in the skin such as puckering or dimpling,
  • and swelling of part of the breast.

What tests do physicians use to Diagnose Breast Cancer?

Although the above signs and symptoms can diagnose breast cancer, the use of screening mammography has made it possible to detect many of the cancers early before they cause any symptoms.

The American Cancer Society (ACS) has the following recommendations for breast cancer screenings:

Women should have the choice to begin annual screening between 40-44 years of age. Women age 45 and older should have a screening mammogram every year until age 54. Women 55 years of age and older should have biennial screening or have the opportunity to continue screening annually. Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.

Mammograms are a very good tool for breast cancer screening test; mammograms have limitations and will miss some cancers. Patients should discuss their family history and mammogram and breast exam results with their health care provider.

Role of DSS Imagetech in Breast Cancer

BRCA Gene analysis: MRC-Holland provide BRCA kit for the analysis of copy number variation and Entrogen provide kit for the study of BRCA gene in family on NGS. Both kits are promoted by DSS Imagetech in India.

The BRCA gene test analyses DNA to look for harmful mutations in two breast cancer genes (BRCA1 or BRCA2). This test is performed as a routine blood test. The test should only be performed on patients who have specific types of breast cancers or have a family history suggesting the possibility of having an inherited mutation. These mutations are uncommon and inherited BRCA gene mutations are responsible for about 10% of breast cancers.

Who is a candidate for BRCA gene testing?

This should be discussed with your health care provider or treatment team as this information is frequently updated. Guidelines for testing may include:

  • a personal history of breast cancer diagnosis at a young age, bilateral breast cancer, breast and ovarian cancer diagnosis, or a personal history of ovarian cancer;
  • family history of breast cancer at a young age (under 50) or ovarian cancer and a personal history of breast cancer;
  • family member with bilateral breast cancer, ovarian cancer, or both breast and ovarian cancer;
  • relative with a known BRCA1 or BRCA2 mutation; and
  • a male relative with breast cancer.

What is HER2-positive breast cancer?

For about 20% of women with breast cancer, the cancer cells test positive for HER2. HER2 is a growth-promoting protein located on the surface of some cancer cells. HER2-positive breast cancers tend to grow more rapidly and spread more aggressively.

What tests detect HER2?

All patients with invasive breast cancer should have their tumor cells tested for HER2.

There are four tests for HER2. Discuss the interpretation of the tests with your health care team. Health care professionals may use either immunohistochemistry (IHC) to identify the HER2 protein or in-situ hybridization (ISH) testing to look for the gene.

IHC test: This test shows if there is too much HER2 protein in the cancer cells and is graded 0 to 3. Reagent for IHC is provided by Agilent and DSS Imagetech is their exclusive distributor in India. 

FISH test: This test evaluates if there are too many copies of the HER2 gene in the cancer cells. This test is either positive or negative. Only Abbott molecular provide FDA approved HER-2 test (Pathvysion) kit for the FISH test in the world. Abbott Molecular product distributed in India via only DSS Imagetech.

SPoT-Light HER2 CISH test: This test also evaluates if there are too many copies of the HER2 gene in the cancer cells and is reported as positive or negative.

Inform HER2 Dual ISH test: This test also evaluates if there are too many copies of the HER2 gene in the cancer cells and is reported as positive or negative.

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