Breast Cancer

Lesson 7: Breast Cancer & You - It's Not Just Physical

Back To Basics

If you've hung in this long with me, I thank you for your tenacity. Whether you've concluded your breast cancer journey, or are just beginning, or have vowed to be the support person for a loved one or friend, you need a little more detail. I have tried to give you my personal take on most of the treatments, diagnostic tests and emotional upheavals. You will be reading and trying to absorb lots of medical jargon. In an effort to refresh your memory, or just as something you can use to help someone else digest their medical reports, I am going to "go back to basics" and include some terminology that you might find useful.

Cancer is the name given over 100 forms of this disease. Almost all tissue in our bodies can develop malignancies (cancerous growths). When our body is healthy, the over 30 trillion cells work together for growth and reproduction with the surrounding cells. When cells become cancerous, they pay no attention to the rules. They follow their own time frame for reproduction and sometimes can even migrate to other parts of the body, through the blood or lymph fluid.

Scientists have discovered that cells transform to their malignant state through a series of mutations (changes) to specific genes. Two classes of genes are known as cancer-triggering genes. These are proto-oncogenes, which encourage growth and tumor suppressor genes, which retard growth. When a proto-oncogene mutates, it encourages cell multiplication beyond the norm. On the reverse side, when a tumor suppressor gene mutates, it loses its ability to prevent cell growth.

For a cancerous tumor to form, several of the genes in a cell have to mutate. A normal cell population sustains a genetic mutation and continues to grow when it should be resting. This is known as a genetically altered cell. This cell looks normal, but reproduces too much. This is known as hyperplasia. Once these cells start to look abnormal in shape and location, the tissue now takes on the characterisic of dysplasia. When the cells continue to appear more abnormal in growth and appearance, but stay within the boundaries of the tissues where they began, this is known as in situ cancer. When the cells invade the surrounding tissue, break through the original boundaries, and perhaps break off and migrate through the blood or lymph fluid, this is known as invasive cancer.

About 20% of breast cancers are the result of a family-inherited gene mutation. All breast cancers involve some type of gene mutation. Here are some of the genes involved in breast cancer:

Oncogenes - erb-B - codes for the epidermal growth factor receptor erb-B2 - also known as HER-2 or HER-2-neu - also related to growth factor Bcl-1 - codes for cyclin D1, a stimulator of the cell cycle clock

Tumor Suppressor genes - RB - genes for proteins in the nucleus of the cell - Think of it as a brake in the cell cycle p53- codes for the p53 protein which can stop cell division and induce abnormal cells to commit suicide BRCA1 - unsure of cell location - breast and ovarian cancer BRCA2 - unsure of cell location - breast cancer

Now if this all sounds like a foreign language to you, don't worry. Most of the scientific research into breast cancer is beyond the comprehension of the average lay person. But if you find this fascinating, as I do, you can get more information. There is a great book produced by Scientific American, called "What You Need To Know About Cancer". It is published by W.H. Freeman and Company in New York. I have paraphrased much of the information above from what I gathered in this book. Any errors in terminology or explanation are mine alone. I do not profess to be a scientist, merely trying to be an informed consumer.

Terminology can be one of the stumbling blocks in your quest for information about breast cancer. Whether you are newly diagnosed and want general information, are deciding between different therapies, or just want to keep up with the latest in breast cancer, you need to know the "lingo" to stay on top of the situation. A definition of every word that you could possibly need to know is not possible. I will attempt to give short, easy to understand definitions, for the most basic of breast cancer terms.

Adenocarcinoma - cancer in gland forming tissue. (Breast cancer is a form of adenocarcinoma)

Adjuvant therapy - drugs used in combination with either surgery and/or radiation to treat cancer

Alopecia - hair loss

Amenorrhea - absence of menstrual period

Angiogenesis - growth of new blood vessels

Apoptosis - cell death

Atypical cell - abnormal cell

Axilla - armpit

Axillary lymph node dissection - (AND) removal of lymph nodes in the armpit

Benign - non-cancerous

Bilateral - both sides

Biopsy - removing tissue

CA# - Blood substance used as a tumor marker (generally referred to as a blood test to detect presence of cancer; is not a diagnostic test (usually used as follow-up for breast cancer patients) Elevated numbers may be present in women with benign disease.

Calcification - samll calcium deposit, which can be seen on mammogram

Cancer - Term for a lot of diseases which are characterized by abnormal/uncontrollable cell growth, which may infiltrate/destroy surrounding tissue. Can spread to other body parts via the blood or lymph system.

Carcinoma - cancer in the epithelial tissue (primarily glands and skin). Includes most cancers

Cellulitis - soft tissue infection

Chemotherapy - treating a disease with chemicals

Clinical Trial - Research study when new treatment is tried out in human subjects. It is your decision to participate/not participate in a clinical trial

DCIS (ductal carcinoma in situ) - cancer cells which have not spread outside the duct (sometimes called pre-cancerous)

Edema - swelling (fluid in the tissues)

Epithelial cells - Cells that line an organ

Estrogen receptor - Protein, in some cells, that will bind with estrogen (some tumors are estrogen positive)

Fibroadenoma - benign fibrous breast tissue

Hematoma - blood in the tissues (can occur after breast surgery)

Her2neu - oncogene which leads to extensive cell growth when overexpressed

Hormone - Chemicals produced by our glands, which travel through bloodstream and affect other tissues

Hot flash - Quick surge of heat/swelling/perspiration associated with menopause

HRT - Hormone replacement therapy

Hyperplasia - Excessive cell growth

Hysterectomy - Removal of uterus and cervix

Infiltrating cancer - cancer which has grown beyond site of origin to nearby tissue (also known as invasive)

Ipsilateral - On the same side Latissimus flap - Section of skin/muscle from the bacak used for breast reconstruction

Lobule - Breast part which can produce milk

Lumpectomy - Surgical removal of lump with small circle of tissue surrounding it

Lymphedema - Swelling of arm/armpit/chestwall due to additional fluid in the tissues post-surgical treatment

Malignant - cancerous

Mastectomy - Removal of a breast

Menarche - Your first menstrual period

Metastasis - Spread of cancer to another body organ

Mitosis - cell division

Mutation - Change in the genetic code

Necrosis - dead tissue

Neutropenia - Abnormally small number of white blood cells (neutrophils) in the blood. White blood cells help body fight infection

Node status - Lymph nodes can be classified as positive (cancer detected in the lymph nodes) or negative (no cancer detected in the lymph nodes)

Oncogene - Tumor gene in the body

Oophorectomy - Removal of the ovaries

Palliation - Relieves the symptom, but does not cause a cure

Palpable - Can be felt during manual examination

Phlebitis - Irritation of a vein

Primary tumor - Malignant tumor in the organ of origin (where the cancer started) Prognosis - Estimated/expected outcome

Prosthesis - Artificial body part (such as a breast prosthesis)

Quadrantectomy - removing one quarter of the breast

Quality of Life - How you live on a day to day basis (Self-care, social activities, work ability, emotional stability, family relationships)

Radiation therapy - Treatment with high-energy X-ray rdiation, linear accelerators. Radiation kills cancerous cells and also healthy cells Reconstruction - Rebuilding a breast after a mastectomy

Recurrrence - When cancer returns

Remission - When cancer can't be seen/felt/detected anymore

Sentintel Node Biopsy (SNB) - Removal of the "main" lymph node in the axilla, to determine if the cancer has spread through the lymphatic system.

SERM (selective estrogen receptor modulator) - Compound which is anti-estrogenic in some organs and estrogenic in other organs

Seroma - Collection of fluid in the tissues

S phase fraction - Measurement of how many cells divide at one time. (The higher the S phase, usually the more aggressive the tumor)

Staging - Tests/exams/measurements to figure out where the cancer is, if it has spread, and how it compares to other cancers. (eg. Stage I is the least serious "stage" of breast cancer; Stage IV, the most serious)

Systemic treatment - Treatment of the whole body (usually some type of drug therapy)

Tamoxifen - Breast cancer estrogen blocking hormone

Tumor - Abnormal tissue mass (Tumors can be benign or malignant)

Veg-F (vascular epidermal growth factor) - Protein which encourages new growth of blood vessels

This is by no means a complete list and does not venture into new research or complementary alternatives. It is hopefully a jumping off point for future research.

Keep surfing and reading - knowledge is the key to being an informed consumer. Be your own best advocate.

http://www.cancerhelp.com/ed/glossary.htm http://www.jsonline.com/alive/news/cance...

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