3 Methods To Cure Breast Cancer!

We all know breast cancer is a big problem. This year alone there have been 266, 120 new cases of invasive breast cancer in which the survival rate is under 35% and last year 72 Canadian women were diagnosed with breast cancer every day!

This devastating disease needs to be stopped and a cure needs to be found. Here in my second article about cancer we will be talking about what it is, the different types of breast cancer and how they work, inefficiencies in current treatments and some new innovative methods that could potentially end this devastating sickness.

Spoiler, this article goes fairly in-depth and I suggest you read my previous article on cancer so that this article is an easy read! You can find my other article here: https://www.dhirubhai.net/pulse/worlds-biggest-enemy-cancer-ayaan-esmail/

Breast cancer is a sickness in which cells in the breast area grow out of control and harm other cells in the body.

Breast cancer is a genetic disease in which cells in the breast gain detrimental variation in their genome which allows them to spread and harm other cells in the body. There are many factors as to why one might have breast cancer and I have decided to split them up into two sections; non-modifiable and modifiable.

Modifiable risk factors of breast cancer include:

• Not taking hormones, as some hormones encourage the growth of breast cancer and can increase the risk of you developing it.
• Decreasing the amount that you breastfeed, as your breasts need this milk.
• Try to take the least amount of alcohol as possible, as it can affect your health and help create detrimental variation in the genome of cells.
• Exercising as much as possible as this keeps your body active and healthy therefore reducing the risk of developing cancer in general.

Non modifiable risk factors of breast cancer include:

• Gender, if you are a woman you are more likely to gain breast cancer compared to men.
• Aging, because you grow older your cells are just more likely to detrimental genetic variation.
• Genetics, based on your genetic information and mutations just by luck out of all mutations that are expressed the one which causes cells to become cancerous is expressed.
• Family history, if your mother or father had breast cancer your risk is over 40% more than someone whose family that did not have breast cancer.

Now that we understand the different factors of breast cancer and what it is, let’s dive into the different types of it!

There are many different types of breast cancer and they can range from not harmful at all to very very harmful.

There are many different types of breast cancer, with the first being:

Ductal carcinoma in situ (DCIS)

This is breast cancer in it’s very early stages and deals with cells that line the milk ducts of the breast. It is usually non-invasive and does not spread into surrounding tissue but instead only lays in the ducts of the breast. These glands are responsible for delivering the milk to the surface of the skin and out of the mother through tiny pores in the nipple. They also form a tree-branch-like network that converges at the nipple. Below is a picture showing where the ducts are located in the breast and how cancer in the ducts is different from normal duct cells.

One of the main methods to treat this type of breast cancer is through hormone therapy. Since, some hormones encourage the growth of some cancers, such as breast and prostate by removing these from the body we will lower the risk of DCIS occurring in the first place. Adding on, this process involves taking medications that prevent cancer cells from getting the hormones they need to grow so that they die inside the body are able to no longer outgo metastasis and can no longer infect other cells and spread to different parts of the body.

Lobular carcinoma in situ (LCIS)

This is when cells that look like cancer cells start growing in the milk producing glands of the breast, called the lobules, however they do not grow through the walls of lobules. Women who have this have a 7 to 12 times higher risk of developing invasive cancer in either breast, and have an over 50% survival rate. This type of breast cancer is also an indication that a person is at higher than average for getting breast cancer at some point in the future. Below is a picture showing what happens to the lobules during LCIS, as you can tell it is completely blocked by cancer cells however they do not go past the walls of the lobules.

The main method of treatment for LCIS is through surgical breast biopsy. This is a surgery in which the doctor will remove all or part of a lump in the breast so it can be checked to see if there are cancer cells in it. The skin of the breast is cut to allow the doctor to remove the suspicious area. You often need stitches after a surgical biopsy, and pressure may be applied for a short time to help limit bleeding. The area is then covered with a sterile dressing.

There are two main types of this biopsy incisional and excisional. The incisional biopsy removes only part of the abnormal area to make a diagnosis, whereas the excisional biopsy removes the entire tumor or abnormal area. An edge of normal breast tissue around the tumor may be taken, too but this is depending on the reason for the biopsy.

Invasive Breast Cancer

This is the type of breast cancer that spreads past the walls of the lobules. There are two main types of this cancer, IDC and ILC. IDC is most common type of breast cancer and starts in the cells that line a milk duct in the breast, then breaks through the wall of the duct, and grows into the nearby breast tissues. It also may be able to metastasize to other parts of the body through the lymph system and bloodstream. On the other hand, ILC starts in the milk producing glands lobules and expands from there on out. The milk producing glands empty out into the ducts that carry milk to the nipple. This type of cancer is more common as women grow older and about 1 in 5 women who have ILC have cancer in both breasts.

One of the main detection and treatment methods for this type of cancer is through mammograms. This is an X-ray of the breast that uses low doses of radiation and compressed the breast is compressed using two metal compression plates. The breast tissue is compressed to make the mammogram clearer so the tissues inside the breast can be seen and flattening the breast also allows less radiation to be used. Views of each breast are taken from different angles and from there on out a pathologist will look at the images and diagnose the patient accordingly.

Inflammatory breast cancer

This is a rare type of cancer in which malignant tumor cells block the lymph vessels in the skin of the breast therefore blocking certain vessels the breast needs to give milk, and survive. It is different from other forms of breast cancer because it commonly does not cause a lump or mass because it is internal. This cancer accounts for only 1 to 5 percent of all cases of breast cancer but has a five-year survival rate of only 40 percent.

The main method of treatment for this type of cancer is simple, removing of the breasts. With surgery one is able to get rid on their breasts and this allows for the tumor to no longer metastasize to other parts of the body and instead just immediately fail and all cells will just die.

Now that we understand the different types of breast cancer lets move into how genetics affects the risk of one developing this sickness.

Since cancer is a genetic disease and is caused by detrimental variation in the genome, genetics does plays a humongous factor in one's risk of developing cancer. in breast cancer we look at something called penetrance, in which the extent to which a particular gene or set of genes is expressed in the phenotypes of individuals carrying it, is measured by the proportion of carriers showing the characteristic phenotype.

Adding on genetics is also determined by your family history, this is called autosomal dominant fashion. In which, you get half of your genes from your mother, half of your genes from your father, and in autosomal dominant patterns you are going to pass on one set of those genes to your progeny.

For example, if you have the BRCA 1 & 2 mutations which are you are more likely to get cancer because these mutations produce tumor suppressor proteins. These tumor suppressor proteins actually suppress tumors and try to stop them from growing, however if the BRCA 1 & 2 mutations are found, which is a very rare case, these mutations surpass the overall function of the protein and instead promote breast cancer cells.

Adding on, below is a table showing how those who have the BRCA 1 & 2 mutation are more likely to develop breast and other types cancer compared to those who do not have this mutation.

Now that we understand what breast cancer is, the different types of it, and how genetics affects one’s risk of getting cancer, let’s look into some current methods of treating this deadly sickness and inefficiencies in them.

Problem: right now we are trying to cure and detect breast cancer through panel testing, mammography and radiation therapy

As of now our main method of killing breast cancer cells, other than chemotherapy, is through radiation therapy. Radiation therapy is a technique that uses high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells. Since cancer cells grow and divide faster than most normal cells radiation therapy works by making small breaks in the DNA inside cells that keeps cancer cells from growing and dividing and causes them to die instead.

Unlike chemotherapy, which usually exposes the whole body to cancer-fighting drugs, radiation therapy is a targeted alternative treatment. In most cases, it’s aimed at and affects only the part of the body being treated. The problem with radiation therapy is that although it is aimed at only targeting cancer cells, neighboring cells are also affected and this can cause even more complications than before, which is not what we want. Below is a picture of radiation therapy occurring on a patient.

Secondly, right now doctors use a method called multi-gene panel testing to detect if there are cancer cells in the breast. Multi-gene panel testing simultaneously examines a number of different genes to look for potentially cancer-causing mutations, which can provide information to help people take action to prevent or stop cancer. However, by only looking at mutations in genes this gives us less clinical data and the fact that we are not looking at the whole genome allows us to not be able to properly diagnose the patient. Adding on, not only do genetics play a humongous factor in seeing if a patient has cancer, environmental carcinogens also do, by only looking at genetics we will not be able to properly diagnose the patient as we are not looking at the full picture.

Lastly, mammograms are used to look at cancer cells in the breast. This is the process of using low-energy X-rays to examine the human breast with the goal of early detection of breast cancer. Two metal plates will compress a breast and views of each breast are taken from different angles. From there on out a pathologist will look at the images and diagnose the patient accordingly. However the problem is that a pathologist has an accuracy of under 70% and when dealing with someone's life the accuracy should be much higher, also by compressing the breast we might cause even more disruption in the cells as well.

Solution: using immunotherapy, organoids, and artificial intelligence we can possibly detect and cure cancer in patients.

1.) The first innovative method of killing cancer is immunotherapy.

This is the use of the immune system to treat cancer. This approach explores the fact that cancer cells often have molecules on their surface that can be detected by the immune system, known as tumor antigens. By directing the immune system to attack tumor cells by targeting tumor associated antigens or by enhancing existing anti-tumor responses and including the use of monoclonal antibodies, lymphocytes and cytokines we could potentially kill cancer cells in the body and allow for them to not grow or expand. The below image shows how immunotherapy uses the immune system to create tumor homeostasis and tumor clearance to allow for T-cells to kill cancer cells.

2.) We can also use organoids to test cancer drugs and understand how tumors harm you

Doctors can now use fleshy 3-D, miniature models of human organs called organoids that simulate how well a cancer drug works and how one of your organs, like your breasts, may react to it. They can also show how tumors grow in the organ and reveal genetic clues that cells will turn into cancer.

In the future, doctors may be able to use research on organoids to make a treatment plan that's just for you and is personalized to your specific situation and genetics. Organoids can also help doctors learn what happens in your body before tumor cells turn into cancer and are currently used for research of colorectal, pancreatic, breast and other types of cancer.

The traditional way to do these tests is to breed a mouse with the right set of genes. But organoids are a much cheaper, accurate and faster option. 

3.) We can use artificial intelligence to detect tumors much better than a pathologist.

More specifically we can train machine learning models to detect whether a patient’s tumor is malignant or benign and the best way to treat it based on past data of how other patients were treated successfully and/or in-successfully. This type of treatment is being used as we speak. For example, just a few months back Google was able to create a machine learning model that detected breast cancer in the slide images of a patient's tissues which had a 89% accuracy compared to the 73% accuracy of a trained human pathologist! Shown below researchers were able to tell wether tumors were malignant or benign based on certain factors such as cell shape, size, quantity of cells in the area etc.

Key Takeaways

• Breast cancer is caused by detrimental variation to cells in the lobules or ducts of the breasts and if it starts spreading it will usually go to the lymph system, bloodstream or surrounding breast tissue.
• One’s risk of getting breast cancer can be heavily affected by their genetics and if they have the BRCA1 and/or 2 mutation.
• New innovative treatments such as immunotherapy, organoids and artificial intelligence could better detect and cure cancer.

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