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Breast Cancer

Comprehensive Management

• © 2022
• Shashanka Mohan Bose (Editor-in-Chief) 0 ,
• Suresh Chander Sharma 1 ,
• Alok Mazumdar 2 ,
• Robin Kaushik 3

Former Senior Professor & HOD of Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

You can also search for this editor in PubMed   Google Scholar

Department of Radiotherapy, MM IMSR, Mullana, Ambala, Haryana, India

Department of general surgery, seven hills hospital, visakhapatnam, india, department of general surgery, government medical college and hospital, chandigarh, india.

• Comprehensive book covering all aspects of breast cancer
• Serves as a complete practical guide for practitioners involved in the management of breast cancer
• Presents some of the less discussed features of breast cancer

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About this book

The book provides detailed information on breast cancer and covers all the aspects of this rapidly spreading disease, such as applied anatomy and physiology, causative factors, various Investigations to reach a concise, definitive and complete diagnosis. The management of breast cancer involves multi-modality treatment and the book describes all the modalities in a very clear manner. It also discusses in a very lucid and practical way. the multi-prong treatment that the patient requires .

The book serves as a useful resource for surgeons, medical oncologists, radiotherapists, pathologists, radiologists and many other specialists interested in the field of breast cancer and actively working in this area.  It is useful for practitioners and residents as well as for those who want to learn the different aspects of this disease.

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Breast Cancer: Overview of Decision Making by the Medical Oncologist

Introduction to Breast Cancer

• Aetio-pathogenesis of breast cancer
• Diagnostic modalities for breast cancer
• Multi modality treatment of breast cancer
• Rehabitilation and follow-up of breast cancer patients
• Management of breast cancer

Table of contents (30 chapters)

Front matter, breast cancer scenario in india.

• Shashanka Mohan Bose, Robin Kaushik

Applied Anatomy of Breast Cancer

• Madhur Gupta, Neeru Goyal

Applied Physiology of Breast Cancer

• R. Muralidharan

Etiopathogenesis of Breast Cancer and Prevention

• Farheen Khan, Anjali Mishra, Saroj Kanta Mishra

Classification of Breast Cancer

• Aditi Chaturvedi, Bhawna Sirohi

Approach to a Suspected Case of Breast Cancer

Cytopathology of breast cancer.

• Manish Rohilla, Radhika Srinivasan

Pathology of Breast Cancer

• Amanjit Bal, Kusum Joshi

Imaging in Breast Cancer

• Ekta Dhamija, Niranjan Khandelwal

MRI in Breast Cancer

• Jyoti Arora, Jeevanjot Matharoo

Radiological Interventions for Breast Cancer

• Ekta Dhamija, Smriti Hari

Role of Nuclear Medicine in Breast Cancer

• Ashwin Singh Parihar, Anish Bhattacharya

Tumour Markers, Prognostic and Predictive Factors in Breast Cancer

• Dhritiman Maitra, Anurag Srivastava

Management of Early Breast Cancer – Surgical Aspects

• Alok Mazumdar, Sumeet Jain, Satish Jain, Shashanka Mohan Bose

Breast Cancer Surgery Under Local Anaesthesia

Shashanka Mohan Bose

Management of Locally Advanced Breast Cancer

• Dinesh Yadav, N. K. Shukla, Mahesh C. Mishra

Recurrent Breast Cancer (Local and Metastatic): Surgical Aspects

• Sunil Saini, Manisa Pattanayak, Anshika Arora

Management of Hereditary Breast Cancer: An Overview

• Abhay K. Kattepur, K. S. Gopinath

Role of Radiotherapy in Breast Cancer

• Suresh Chander Sharma, Rakesh Kapoor

Editors and Affiliations

Former senior professor & hod of surgery, post graduate institute of medical education and research (pgimer), chandigarh, india.

Suresh Chander Sharma

Alok Mazumdar

Robin Kaushik

About the editors

Dr. Shashanka Mohan Bose  did his medical graduation from G R Medical College, Gwalior, India in 1963, and postgraduation in surgery from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India in 1966. He joined PGIMER as registrar in surgery in 1967, continued his ascent and superannuated as senior professor and head of surgery department in 2002. He had also worked as professor in surgery at A.I.I.M.S., New Delhi. In addition, he had done training in some of the best surgical units of the world - Royal Postgraduate Medical School and Hammesmith Hospital, London; Kings College, London; Memorial Sloan Kettering Cancer Centre, New York, etc. Following his superannuation, he continues to practice as senior consultant oncosurgeon.   

Dr. Bose has been taking active part in professional organizations, held a number of positions in various societies, such as national president of Association of Surgeons of India, Indian Association of Surgical Gastroenterology, and president of Chandigarh Surgical Society.

Dr Bose is a recipient of three national awards; Dr. B.C. Roy National Award as eminent medical teacher, MCI National Award for outstanding research, Department of Science & Technology Award for outstanding communication skills. He is recipient of multiple international and national fellowships including that of WHO, UICC etc. He is also a recipient of more than 25 prestigious oration awards.

His autobiography book “Memoirs of a Surgeon beyond Incisions, Blood, & Sweat” has been recently published. He is very much interested in health education of people and has written a number of books, and a large number of articles in lay press. 

Dr Suresh C Sharma is a former professor and head, department of radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. He was former professor and head; and presently is professor emeritus, department of radiotherapy, MM Institute of Medical Sciences and Research, Mulana, Ambala, where he established most modern department of radiotherapy and also started M.D. Radiotherapy course.

Dr Sharma has special interest in the management of breast cancer, lymphomas and brachytherapy. He has published nearly 240 scientific papers in national and international journals of repute. He has contributed 6 chapters in different books.

Dr. Sharma is recipient of prestigious orations of Association of Radiation Oncologist of India (AROI). He was chairman of Indian College of Radiation Oncology from 1998 to 2002 and president of AROI from 2002 to 2004.

Dr. Alok Mazumdar (M.S, D.N.B, F.I.C.S) graduated from Christian Medical College, Ludhiana and did M.S in general surgery from Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. He worked in the department of general surgery at PGIMER Chandigarh as senior resident for 3 years.  Later got DNB in general surgeryand also F.I.C.S. Dr Mazumdar is presently working as head of the department of surgery, Seven Hills Hospital, Visakhapatnam. He is interested in teaching and training postgraduate students as a part of D.N.B (Diplomate of National Board, New Delhi). He is a member of a number of professional associations, such as ASI, AMASI, NASA, IASO, IMA and others.

Dr. Robin Kaushik  graduated from Armed Forces Medical College, Pune and later qualified MS in general surgery from Dayanand Medical College and Hospital, Ludhiana. He joined GMCH Chandigarh soon after, where, among other things, he developed keen interest in the management of breast cancer. He is an avid reader and writer, and has authored books on surgery and even ventured into fiction. He served as associate editor for the Indian Journal of Surgery for nearly 14 years, and is currently working on another book project.

Bibliographic Information

Book Title : Breast Cancer

Book Subtitle : Comprehensive Management

Editors : Shashanka Mohan Bose, Suresh Chander Sharma, Alok Mazumdar, Robin Kaushik

DOI : https://doi.org/10.1007/978-981-16-4546-4

Publisher : Springer Singapore

eBook Packages : Medicine , Medicine (R0)

Copyright Information : The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022

Hardcover ISBN : 978-981-16-4545-7 Published: 01 February 2022

Softcover ISBN : 978-981-16-4548-8 Published: 02 February 2023

eBook ISBN : 978-981-16-4546-4 Published: 31 January 2022

Edition Number : 1

Number of Pages : XXII, 605

Number of Illustrations : 31 b/w illustrations, 155 illustrations in colour

Topics : Surgery , Oncology , Pathology , Imaging / Radiology , Medical and Radiation Physics , Gynecology

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Breast cancer articles within Nature

Article 08 April 2024 | Open Access

The PARTNER trial of neoadjuvant olaparib with chemotherapy in triple-negative breast cancer

A study details the results of the PARTNER trial, a prospective, randomized controlled trial of the use of neoadjuvant olaparib with carboplatin–paclitaxel chemotherapy in patients with triple-negative breast cancer who were germline BRCA1 and BRCA2  wild type.

• Jean E. Abraham
• , Karen Pinilla
•  &  Helena M. Earl

Article 10 January 2024 | Open Access

MRE11 liberates cGAS from nucleosome sequestration during tumorigenesis

The double-strand break sensor MRE11 is identified as a pivotal mediator of cGAS activation in response to multiple types of DNA damage.

• Min-Guk Cho
• , Rashmi J. Kumar
•  &  Gaorav P. Gupta

Article | 13 December 2023

Tumour circular RNAs elicit anti-tumour immunity by encoding cryptic peptides

The tumour-specific circular RNA FAM53B is highly immunogenic and can induce anti-tumour responses in mouse models of breast cancer and melanoma, expanding the repertoire of anticancer targets for development.

• , Xiaofeng Zhu
•  &  Erwei Song

Article | 15 November 2023

Stepwise requirements for polymerases δ and θ in theta-mediated end joining

Polymerase delta is required for multiple steps in polymerase theta-dependent repair of chromosome breaks, a pathway targeted in cancer therapy.

• Susanna Stroik
• , Juan Carvajal-Garcia
•  &  Dale A. Ramsden

Article 06 September 2023 | Open Access

Polθ is phosphorylated by PLK1 to repair double-strand breaks in mitosis

In mitosis, genome integrity is maintained by DNA polymerase theta-dependent repair of DNA double-strand breaks, which is regulated by Polo-like kinase 1 activity.

• Camille Gelot
• , Marton Tibor Kovacs
•  &  Raphael Ceccaldi

Spatial predictors of immunotherapy response in triple-negative breast cancer

Imaging mass cytometry is used to map the multicellular dynamics of immune checkpoint blockade-treated triple-negative breast cancer, finding that key proliferative fractions and cell–cell interactions drive response, and immunotherapy distinctively remodels tumour structure.

• Xiao Qian Wang
• , Esther Danenberg
•  &  H. Raza Ali

Article 16 August 2023 | Open Access

Long-molecule scars of backup DNA repair in BRCA1- and BRCA2-deficient cancers

Linked-read whole-genome sequencing reveals patterns of structural DNA variants that are specific to homologous recombination deficiency and can be used to distinguish between BRCA1- and BRCA2-deficient phenotypes.

• Jeremy Setton
• , Kevin Hadi
•  &  Marcin Imieliński

Article 26 July 2023 | Open Access

Evolutionary histories of breast cancer and related clones

By using phylogenetic analyses of multiple microdissected samples from both cancer and non-cancer lesions, unique evolutionary histories of breast cancers harbouring a common driver alteration are shown, providing new insight into how breast cancer evolves.

• Tomomi Nishimura
• , Nobuyuki Kakiuchi
•  &  Seishi Ogawa

Article | 21 June 2023

Structure and function of the RAD51B–RAD51C–RAD51D–XRCC2 tumour suppressor

Structural and biochemical studies of the RAD51B–RAD51C–RAD51D–XRCC2 complex reveal that it uses coupled RAD51B and RAD51C ATPase activities to promote the nucleation and extension of RAD51 nucleoprotein filaments.

• Luke A. Greenhough
• , Chih-Chao Liang
•  &  Stephen C. West

Article 17 May 2023 | Open Access

ERα-associated translocations underlie oncogene amplifications in breast cancer

An analysis of 780 breast cancer genomes shows that focal amplifications are frequently preceded by dicentric chromosome formation from inter-chromosomal translocations associated with oestrogen receptor binding, which leads to chromosome bridge formation and breakage, initiating the amplification process.

• Jake June-Koo Lee
• , Youngsook Lucy Jung
•  &  Peter J. Park

Article | 19 April 2023

PI3Kβ controls immune evasion in PTEN-deficient breast tumours

A mouse model of invasive breast cancer in which Pten and Trp53 are simultaneously inactivated links PTEN loss with STAT3 activation and indicates that immune escape in PTEN-null tumours is mediated by PI3Kβ.

• Johann S. Bergholz
• , Qiwei Wang
•  &  Jean J. Zhao

Article 09 November 2022 | Open Access

Spatial genomics maps the structure, nature and evolution of cancer clones

A workflow centred around base-specific in situ sequencing generates detailed maps of, and can phenotypically characterize, the unique set of subclones of cancers.

• Artem Lomakin
• , Jessica Svedlund
•  &  Lucy R. Yates

Article 26 October 2022 | Open Access

Single-cell genomic variation induced by mutational processes in cancer

Single-cell whole-genome sequencing shows that 'foreground' cell-to-cell structural variation and alterations in copy number are associated with genomic diversity and evolution in triple-negative breast and high-grade serous ovarian cancers.

• Tyler Funnell
• , Ciara H. O’Flanagan
•  &  Samuel Aparicio

Article | 07 September 2022

Genomics to select treatment for patients with metastatic breast cancer

Targeted therapies matched to genomics improved progression-free survival when genomic alterations were classified as level I/II (according to ESCAT), and genomics should thus be driven by target actionability in patients with metastatic breast cancer.

• Fabrice Andre
• , Thomas Filleron
•  &  Ivan Bieche

Article 10 August 2022 | Open Access

Truncated FGFR2 is a clinically actionable oncogene in multiple cancers

Truncation of exon 18 of FGFR2 ( FGFR2 ΔE18 ) is a potent driver mutation in mice and humans, and FGFR-targeted therapy should be considered for patients with cancer expressing stable FGFR2 ΔE18 variants.

• Daniel Zingg
• , Jinhyuk Bhin
•  &  Jos Jonkers

Article | 22 June 2022

The metastatic spread of breast cancer accelerates during sleep

A study of patients with breast cancer and mouse models demonstrates that most circulating tumour cells are generated during the rest phase of the circadian rhythm, and that these cells are highly prone to metastasize.

• Zoi Diamantopoulou
• , Francesc Castro-Giner
•  &  Nicola Aceto

Article | 15 June 2022

cGAS–STING drives the IL-6-dependent survival of chromosomally instable cancers

The survival of cells with chromosomal instability (CIN) depends on the cGAS–STING pathway, in which IL-6 and its receptor have a key role; this vulnerability can be exploited to treat tumours that display CIN.

• Christy Hong
• , Michael Schubert
•  &  Floris Foijer

Article | 18 May 2022

PHGDH heterogeneity potentiates cancer cell dissemination and metastasis

PHDGH heterogeneity in primary tumours could be a sign of tumour aggressiveness.

• Matteo Rossi
• , Patricia Altea-Manzano
•  &  Sarah-Maria Fendt

Article 23 February 2022 | Open Access

Effective drug combinations in breast, colon and pancreatic cancer cells

A survey of potency and efficacy of 2,025 clinically relevant two-drug combinations against 125 molecularly characterized breast, colorectal and pancreatic cancer cell lines identifies rare synergistic effects of anticancer drugs, informing rational combination treatments for specific cancer subtypes.

• Patricia Jaaks
• , Elizabeth A. Coker
•  &  Mathew J. Garnett

Article 07 December 2021 | Open Access

Multi-omic machine learning predictor of breast cancer therapy response

Integration of pre-treatment tumour features in predictive models using machine learning could inform on response to therapy.

• Stephen-John Sammut
• , Mireia Crispin-Ortuzar
•  &  Carlos Caldas

Article | 10 November 2021

Structures of the HER2–HER3–NRG1β complex reveal a dynamic dimer interface

Cryo-electron microscopy structures of the HER2–HER3–NRG1β complex reveal a dynamic HER2–HER3 interface and explain the mechanism for the activating HER2 cancer mutations.

• Devan Diwanji
• , Raphael Trenker
•  &  Natalia Jura

Article | 03 November 2021

Tumour DDR1 promotes collagen fibre alignment to instigate immune exclusion

In mouse models of triple-negative breast cancer, the extracellular domain of the collagen receptor DDR1 has a role in tumour defence against the immune system, by aligning collagen fibres to obstruct immune infiltration.

• , Bogang Wu
•  &  Rong Li

Article | 02 June 2021

Hepatic stellate cells suppress NK cell-sustained breast cancer dormancy

Liver-resident natural killer (NK) cells sustain the dormancy of disseminated breast cancer cells, and a decrease in NK cells and increase in activated hepatic stellate cells is associated with the formation of liver metastases.

• Ana Luísa Correia
• , Joao C. Guimaraes
•  &  Mohamed Bentires-Alj

Article | 24 March 2021

Breast tumours maintain a reservoir of subclonal diversity during expansion

Single-cell analysis of genomes from primary human breast tumours and cell lines shows that chromosomal aberrations continue to evolve during primary tumour expansion, resulting in a milieu of subclones within the tumour.

• Darlan C. Minussi
• , Michael D. Nicholson
•  &  Nicholas E. Navin

Matters Arising | 03 March 2021

Reply to: Hippo signalling maintains ER expression and ER + breast cancer growth

• Adrian Britschgi
• , Joana Pinto Couto

Hippo signalling maintains ER expression and ER + breast cancer growth

• Shenghong Ma
• , Zhengming Wu
•  &  Kun-Liang Guan

Article | 03 February 2021

BRCA1 and RNAi factors promote repair mediated by small RNAs and PALB2–RAD52

Single-stranded, DNA-damage-associated small RNAs generated by a BRCA1–RNA-interference complex promote PALB2–RAD52-mediated DNA repair at transcriptional termination pause sites that contain R-loops and are rich in single-stranded DNA breaks in both quiescent and proliferating cells.

• Elodie Hatchi
• , Liana Goehring
•  &  David M. Livingston

Article 09 December 2020 | Open Access

A metastasis map of human cancer cell lines

A method in which pooled barcoded human cancer cell lines are injected into a mouse xenograft model enables simultaneous mapping of the metastatic potential of multiple cell lines, and shows that breast cancer cells that metastasize to the brain have altered lipid metabolism.

• , Zelalem Demere
•  &  Todd R. Golub

Article | 09 September 2020

Targeting TRIM37-driven centrosome dysfunction in 17q23-amplified breast cancer

TRIM37 overexpression promotes centrosome dysfunction that drives genomic instability in breast cancer cell lines containing the recurrent 17q23 amplicon, revealing a vulnerability that can be targeted to eliminate cancer cells.

• Zhong Y. Yeow
• , Bramwell G. Lambrus
•  &  Andrew J. Holland

Article | 15 July 2020

Fasting-mimicking diet and hormone therapy induce breast cancer regression

In mice, periodic fasting or a fasting-mimicking diet enhances the efficacy of endocrine therapy for breast cancer and delays acquired resistance to it; in patients with breast cancer, a fasting-mimicking diet recreates the metabolic changes observed in mice.

• Irene Caffa
• , Vanessa Spagnolo
•  &  Alessio Nencioni

Article | 11 June 2020

DNA of neutrophil extracellular traps promotes cancer metastasis via CCDC25

DNA from neutrophil extracellular traps interacts with the transmembrane receptor CCDC25 on cancer cells, activating the ILK-β-parvin pathway to enhance cell motility and promote distant metastases.

• Linbin Yang
• , Qiang Liu

Article | 20 January 2020

The single-cell pathology landscape of breast cancer

A single-cell, spatially resolved analysis of breast cancer demonstrates the heterogeneity of tumour and stroma tissue and provides a more-detailed method of patient classification than the current histology-based system.

• Hartland W. Jackson
• , Jana R. Fischer
•  &  Bernd Bodenmiller

Article | 01 January 2020

International evaluation of an AI system for breast cancer screening

An artificial intelligence (AI) system performs as well as or better than radiologists at detecting breast cancer from mammograms, and using a combination of AI and human inputs could help to improve screening efficiency.

• Scott Mayer McKinney
• , Marcin Sieniek
•  &  Shravya Shetty

Article | 18 September 2019

Synaptic proximity enables NMDAR signalling to promote brain metastasis

Breast-to-brain metastasis is enabled by activation of an N -methyl- d -aspartate receptor, which is achieved via the formation of pseudo-tripartite synapses between cancer cells and glutamatergic neurons.

• , Iacovos P. Michael
•  &  Douglas Hanahan

Letter | 04 September 2019

E-cadherin is required for metastasis in multiple models of breast cancer

Although E-cadherin loss promotes tumour-cell invasion in mouse and human models of invasive ductal carcinoma, E-cadherin expression prevents oxidative-stress-mediated apoptosis during detachment and is essential for metastasis.

• Veena Padmanaban
• , Ilona Krol
•  &  Andrew J. Ewald

Letter | 31 July 2019

Loss of p53 triggers WNT-dependent systemic inflammation to drive breast cancer metastasis

Loss of p53 in mouse models of breast cancer leads to activation of WNT signalling, which promotes metastatic spread by inducing systemic neutrophilic inflammation.

• Max D. Wellenstein
• , Seth B. Coffelt
•  &  Karin E. de Visser

Article | 03 July 2019

Isomerization of BRCA1–BARD1 promotes replication fork protection

BRCA1–BARD1 has a role in replication fork protection that is mediated by a mechanism of phosphorylation-targeted isomerization of BRCA1 and is independent of the canonical interaction between BRCA1 and PALB2.

• Manuel Daza-Martin
• , Katarzyna Starowicz
•  &  Joanna R. Morris

Letter | 22 May 2019

Genomic characterization of metastatic breast cancers

Patient data from six clinical trials are used to compare the genomic landscapes of breast cancer metastases with those of primary tumours, revealing an increase in mutational burden and clonal diversity.

• François Bertucci
• , Charlotte K. Y. Ng
•  &  Fabrice André

Letter | 17 April 2019

LLGL2 rescues nutrient stress by promoting leucine uptake in ER + breast cancer

The polarity protein LLGL2 supports tumour growth in breast cancer by promoting leucine uptake and adaptation to nutrient stress.

• Yasuhiro Saito
•  &  Senthil K. Muthuswamy

Letter | 13 March 2019

Glucocorticoids promote breast cancer metastasis

In patient-derived xenograft models of breast cancer in mice, an increase in stress hormones during progression or treatment with their synthetic derivatives activates the glucocorticoid receptor, and results in increased metastatic colonization and reduced survival.

• Milan M. S. Obradović
• , Baptiste Hamelin

Dynamics of breast-cancer relapse reveal late-recurring ER-positive genomic subgroups

A statistical framework for breast-cancer recurrence uses long-term follow-up data and a knowledge of molecular subcategories to model distinct disease stages and to predict the risk of relapse.

• Oscar M. Rueda
• , Stephen-John Sammut
•  &  Christina Curtis

Letter | 06 March 2019

Effective breast cancer combination therapy targeting BACH1 and mitochondrial metabolism

The transcription factor BACH1, which targets mitochondrial metabolism, is expressed at high levels in several types of cancer; reducing its expression in tumours makes them more susceptible to treatment with mitochondrial inhibitors.

• Jiyoung Lee
• , Ali E. Yesilkanal
•  &  Marsha Rich Rosner

Letter | 27 February 2019

Breast cancer cells rely on environmental pyruvate to shape the metastatic niche

Exogenous pyruvate is needed for breast cancer cells to form metastases, and the inhibition of pyruvate metabolism impairs collagen hydroxylation and the growth of lung metastases in different mouse models.

• Ilaria Elia
• , Matteo Rossi

Letter | 06 February 2019

Neutrophils escort circulating tumour cells to enable cell cycle progression

The authors show that circulating tumour cells can be found in association with neutrophils, an interaction which supports their proliferation and their ability to seed metastasis.

• Barbara Maria Szczerba

Article | 12 September 2018

Accurate classification of BRCA1 variants with saturation genome editing

Germline BRCA1 loss-of-function variants are associated with predisposition to early-onset breast and ovarian cancer; here the authors use CRISPR/Cas9 genome editing to functionally assess thousands of BRCA1 variants in order to facilitate the clinical interpretation of these variants.

• Gregory M. Findlay
• , Riza M. Daza
•  &  Jay Shendure

Article | 22 November 2017

Mechanism of tandem duplication formation in BRCA1 -mutant cells

BRCA1, but not BRCA2, suppresses the formation of tandem duplications at stalled replication forks in primary mammalian cells.

• Nicholas A. Willis
• , Richard L. Frock
•  &  Ralph Scully

Letter | 16 August 2017

CDK4/6 inhibition triggers anti-tumour immunity

Mouse models of breast carcinoma and other solid tumours show that selective cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors not only induce tumour cell cycle arrest but also promote anti-tumour immunity.

• , Molly J. DeCristo

Brief Communications Arising | 06 July 2017

Fischer et al . reply

• Kari R. Fischer
• , Nasser K. Altorki
•  &  Dingcheng Gao

Upholding a role for EMT in breast cancer metastasis

• , Thomas Brabletz
•  &  Robert A. Weinberg

Article | 28 June 2017

Recurrent and functional regulatory mutations in breast cancer

High-depth sequencing of targeted regions in primary breast cancer identifies mutated promoter elements with recurrent mutations at specific and/or nearby bases, suggesting selection of certain non-coding events.

• Esther Rheinbay
• , Prasanna Parasuraman
•  &  Gad Getz

Browse broader subjects

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• Feature Stories
• What Is Breast Cancer?
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• Overview of Breast Cancer Types
• HER2-Positive and HER2-Negative Breast Cancer
• Your Breast Cancer Care Team
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• Radiation and Chemotherapy
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• View Full Guide

Best Breast Cancer Books

Breast cance r is the most common cancer for women living in the United States, second only to skin cancers.

If you were recently diagnosed with breast cancer , or you know someone who was, books can be a great way to answer your questions and learn more about breast cancer. Here are some great breast cancer reads, as recommended by doctors and people living with breast cancer .

Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health by Gayle Sulik

Nancy Stordahl was diagnosed with stage IIB breast cancer in 2010. Since then, she’s been sharing her breast cancer experience candidly through her blog, Nancy’s Point, and several books including, Facing Your Mastectomy & Making Reconstruction Decisions and Getting Past the Fear .

Stordahl says “ Pink Ribbon Blues was an eye-opener. Sulik, a medical sociologist and research associate, explores the “pink ribbon” breast cancer-related industry through historical and cultural research, campaign and advertisement analysis, and hundreds of interviews.

“Book preferences vary. I’ve read a lot of cancer books and I get something out of each one,” Stordahl says. “There are a lot of terrific reads about cancer out there. Memoirs are always my favorite because I love reading about personal experiences.”

My Parent Has Cancer and It Really Sucks by Maya and Marc Silver

Barbara Jacoby, a two-time breast cancer survivor who runs the award-winning blog Let Life Happen, recommends this book.

“I have found that most people have neither the time nor the disposition to read a book these days, especially if they are in the middle of treatments at any level while trying to manage the rest of their lives,” she says. “However, I would like to think about our family members who are also affected by our cancer and suggest books for them.”

This book in particular uses “real-life advice from real-life teens,” Jacoby says. Maya was 15 when her mother was diagnosed with breast cancer. She and her father, Marc, draw from their own experiences and a range of experts to offer practical guidance for living with cancer.

Dear Friend: Letters of Encouragement, Humor, and Love for Women with Breast Cancer by Gina Mulligan

Jane Meisel, MD, a medical oncologist at the Winship Cancer Institute and an associate professor at Emory University School of Medicine in Atlanta, calls this book fantastic. It’s a series of letters written by women to other women who have been diagnosed with breast cancer.

When Mulligan was diagnosed with cancer she received many letters of encouragement. The experience led her to found a nonprofit, Girls Love Mail, to support others. The book features a collection of handwritten letters from women who have with breast cancer. The messages run the gamut, from empathetic to inspiring and even humorous.

The Cancer-Fighting Kitchen: Nourishing, Big-Flavor Recipes for Cancer Treatment and Recovery by Mat Edelson and Rebecca Katz

Anna Crollman, who was diagnosed with breast cancer at 27 and founded the blog My Cancer Chic, suggests this book. In it you’ll find more than a hundred easy-to-prepare dishes designed to boost the appetite and help with treatment side effects like fatigue , nausea, and weight loss. Recipes range from soups to veggie-based meals, as well as savory and sweet snacks.

Crollman adds that Brené Brown’s Rising Strong also spoke to her “in a self-improvement, self-reflective space.”

Cancer Was Not A Gift & It Didn’t Make Me A Better Person by Nancy Stordahl

Susan Rahn, an advocate, public speaker, and writer who has stage IV metastatic breast cancer , is a fan and personal friend of Nancy Stordahl.

“She’s very real about it,” Rahn says. “She gets real with people. And then she also has kind of like a guide to get you ready for chemotherapy and kind of get you past the fear of it so that you know what to expect, which is super helpful for a lot of people.”

Stordahl’s memoir builds on her recollection as a caregiver for her mother, who had metastatic breast cancer, and Stordahl’s personal experience as someone diagnosed with breast cancer. Her candid writing paints a straightforward portrait of cancer and helps unravel unrealistic society expectations.

Everybody’s Got Something by Robin Roberts

Meisel also recommends Good Morning America anchor Robin Roberts’ memoir.

Roberts breathes life into her experience with breast cancer and a rare blood disorder , Meisel says. She details her medical leave and the outpouring of support from friends and family alike as she made her way through uncharted waters.

Roberts explains that “we’ve all got something,” to deal with, whether it’s facing grief and heartbreak or a medical crisis. But she adds that we also all have something to offer -- namely hope and encouragement.

Dodging Dandelions: A Memoir of Love, Loss, and Acceptance by Ron Richards

This book, Jacoby says, is “a memoir of love, loss and acceptance by Ron Richards, describing the journey that he and his wife took while she was diagnosed multiple times with cancer.”

Richards presents a husband’s perspective on his wife Sara’s breast cancer experience. He also discusses other challenges the couple faced together.

Persevere: A Life with Cancer ( Reflections on Love and Loss, Family and Friendship, Compassion and Courage) by Lisa Adams

Rahn says Adams was the first person she connected with after her cancer diagnosis.

“She was just amazing,” Rahn says. “She really chronicled everything … and she had this saying, people still say it all the time: ‘Find a bit of beauty in the world today, share it and if you can’t find it, create it. Some days this may be hard to do but persevere.’”

Persevere: A Life with Cancer is a compilation of Adams’ most popular writings. It includes journal entries and poetry. Her book helps people who have cancer feel understood and helps those without cancer understanding the experience.

The Middle Place by Kelly Corrigan

Corrigan’s “middle place” is the overlap of parenthood and childhood. She found herself there when she was acting as a caretaker for her father while living with her own breast cancer diagnosis .

Corrigan shares her experiences with humor and candor, Meisel says.

In-Between Days: A Memoir About Living with Cancer by Teva Harrison

Rahn says this book stands out because it’s in a graphic novel format. “It’s very easy to read.”

Harrison, who was diagnosed with metastatic breast cancer in her 30s, uses short personal essays and illustrations to detail what it’s like living with breast cancer. She tackles everything from identity crises to uncertainty as she considers both long-term goals and her new normal. She also addresses the emotional aspects of balancing cancer and her relationships with friends and family.

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Breast Cancer: Current Trends in Molecular Research

Introduction.

Breast cancer is one of the most common cancer types worldwide, and is a leading cause of cancer related deaths in women. In this book, medical experts review our current understanding of the molecular biology and characteristics of breast cancer. The topics covered in this book provide comprehensive knowledge of mechanisms underlying breast carcinogenesis, and are intended for a wide audience including scientists, teachers, and students.

11 chapters present information about several topics on breast cancer, including the role of cell growth and proliferation pathways, androgen and cytokine signaling, germline mutations in breast cancer susceptibility genes, and molecular factors causing invasive and metastatic breast cancer. In addition, the editors discuss the recent advancements in multi-omics data analysis based on inter-and intra-tumor molecular profiles.

The reference highlights how the knowledge and understanding of the biological behavior of breast neoplasms have facilitated ongoing investigations into dietary polyphenolic compounds with antioxidant properties, making them function as cancer chemopreventive agents. Along with this, the current development of treatment strategies such as targeted molecular therapy, and radiation therapy is brought to the fore to update readers.

• Contributors

List of Contributors

Cellular and molecular mechanisms of breast cancer progression.

PDF Price: $30

Immune-Endocrine Perspectives of Breast Cancer

Dna damage response: a therapeutic landscape for breast cancer treatment, emerging trends in bioinformatics for breast cancer molecular research, role of nitric oxide in breast cancer, autoantibodies as clinical biomarkers in breast cancer, epigenetics of breast cancer, nanoparticles targeting and uptake: current advances in breast cancer research, dietary polyphenols and its molecular mechanism in the management of breast cancer, radiotherapy in carcinoma breast, an overview of breast cancer therapy, subject index.

Current Advances in Breast Cancer Research: A Molecular Approach

Editor(s) : shankar suman, garima suman, sanjay mishra.

DOI: 10.2174/97898114514471200101 eISBN: 978-981-14-5144-7, 2020 ISBN: 978-981-14-5142-3

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For Books Shankar Suman, Garima Suman, Sanjay Mishra , " Current Advances in Breast Cancer Research: A Molecular Approach ", Bentham Science Publishers (2020). https://doi.org/10.2174/97898114514471200101

Page: i-i (1) Author: Smita Misra DOI: 10.2174/9789811451447120010001

Page: ii-ii (1) Author: Shankar Suman, Garima Suman and Sanjay Mishra DOI: 10.2174/9789811451447120010002

List of Contributors

Page: iii-iv (2) Author: Shankar Suman, Garima Suman and Sanjay Mishra DOI: 10.2174/9789811451447120010003

Breast Cancer: A Global Burden

Page: 1-29 (29) Author: Brij Nath Tewari and Sanjay Mishra DOI: 10.2174/9789811451447120010004 PDF Price: $30

The burden of breast cancer incidence and related mortality is a major health problem worldwide. In the last few years, the incidence and mortality rate of breast cancer have grown very rapidly in many developing countries and also slowly in developed nations. According to GLOBOCAN 2018 status report, the global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. The etiology of breast cancer depends upon several factors and includes age, genetic, environmental, radiation, breastfeeding, diet, and lifestyle factors, etc. The reasons behind the high breast cancer-related mortality are due to the lack of basic knowledge and awareness about breast cancer, less efficient diagnosis, late screening, poor health facilities, and limited access to treatment in developing countries. In this chapter, we summarize key studies on breast cancer epidemiology, types of breast cancer, risk factors, diagnosis, screening tools, predictive marker, surgery, chemotherapy, radiotherapy, hormonal therapy, targeted therapy, and preventative methods on breast cancer over the past years. These integrated findings may help protect and fight against breast cancer.

Current Imaging Techniques in Breast Cancer: An Overview

Page: 30-60 (31) Author: Garima Suman and Anurima Patra DOI: 10.2174/9789811451447120010005 PDF Price: $30

Tissue diagnosis has been recognized as the gold standard method of diagnosing breast cancer; however, over the last few decades, radiologic imaging has taken the center-stage in pre-operative diagnosis of breast cancer. Radiological imaging tools play a crucial role in not only early detection of breast cancer and staging but also help the surgeons in chalking out the surgical plan and later also in surveillance of the patients. While the advancements in imaging have improved the rate of early detection of breast cancer, ‘false alarms’ raised due to limitations of existing imaging methods are an important area of concern. The purpose of this chapter is to provide an overview of the capabilities and limitations of the current imaging techniques in breast cancer.

An Overview of Genetic, Proteomic and Metabolomic Biomarkers in Breast Cancer

Page: 61-103 (43) Author: Tarjani Agrawal DOI: 10.2174/9789811451447120010006 PDF Price: $30

The molecular techniques play an important role in the diagnosis and treatment of breast cancer. Recent advances in molecular techniques have contributed significantly to understanding tumor biology, tumor heterogeneity, identification of different biomarkers, and discovery of new therapeutic measures and improvement in overall survival, especially in specific subsets of breast cancer. There are other challenging areas in breast cancer research, such as the development of treatments for the highly aggressive triple-negative breast cancer subtype, chemotherapy-resistant cancer stem cell subpopulation, and male breast cancer. New knowledge emerging from researches in genetics, proteomics, and metabolomics offers a promising opportunity for the identification of new biomarkers, and to find novel targets that could facilitate future therapeutic interventions.

Recent Proteomics Development for Biomarker Detection in Breast Cancer

Page: 104-122 (19) Author: Gatha Thacker DOI: 10.2174/9789811451447120010007 PDF Price: $30

Breast cancer accounts for a massive and very frequently occurring disease among females throughout the world. In spite of several approaches for the detection of cancer at an early stage and diverse curative strategies that are coming out, the discovery of a potent, efficacious, and unique biomarker is requisite for precise diagnosis at an early stage, as prognostic predictors and as a marker of the development of therapeutic resistance. In the current scenario, the availability of validated breast cancer biomarkers is almost nil. Barely a handful of biomarkers that have a practical advantage in terms of prognosis and diagnosis include estrogen receptor (ER), progesterone receptor (PR), and HER-2 with limitations. Therefore, the urge of precise biomarkers for the detection of breast cancer stands in need. The progress and utilization of proteomic techniques for the discovery of new protein biomarkers have revolutionized the way of understanding the biology and the associated pathways involved in the progression of the disease. With the help of proteomics, now plenty of prospective protein and peptide biomarkers can be identified from the samples using high-throughput analysis. In this chapter, we covered the techniques, which are routinely employed for treatment, diagnosis, and prognosis of breast cancer with all their benefits and drawbacks. It also includes recent advancements in the field of proteomics and their utility in search of new cancer biomarkers.

Deregulation of Enzymatic Post-Translational Modifications in Breast Cancer

Page: 123-138 (16) Author: Lokesh Baweja, Neha Rajoria and Shankar Suman DOI: 10.2174/9789811451447120010008 PDF Price: $30

Post-translational modifications (PTMs) regulate vital cellular processes such as signaling, proteasomal mediated degradation of proteins, and transcription. Deregulation of post-translational modifications (PTMs) has been proven to have a strong association with breast cancer development. Aberrant PTMs can promote carcinogenesis by perturbing normal cellular homeostasis. The current literature review showed that breast cancer cells displayed abnormal ubiquitination, glycosylation, phosphorylation, and SUMOylation patterns. Breast cancer cells also exhibited stable modifications in histone proteins and DNA. These epigenetic modifications can directly affect the expression of cell cycle regulators by disrupting the transcriptional state of the genome. The current chapter summarizes the involvement of PTMs in carcinogenesis and the mechanism by which PTMs promote abnormal cell growth. Enzymes responsible for aberrant PTMs could be targeted to reduce the severity of the disease and may improve the prognosis of breast cancer.

Genomic Fingerprint of Molecular Mechanisms of Breast Carcinogenesis

Page: 139-177 (39) Author: Akanksha Nigam and Shivam Priya DOI: 10.2174/9789811451447120010009 PDF Price: $30

Breast cancer in women is the most frequent cancer with the highest mortality worldwide. The risk factor includes aging, family history, genetic predisposition, and hormone factor. In recent years, many new gene signatures have been identified, which have a profound effect on breast cancer initiation and progression. Extensive research has been done in the past five decades in understanding breast cancer biology through genomics and proteomics. All these comprehensive studies from breast cancer patients elucidate heterogeneity of disease as one of the complex problems in its treatment and management. The outburst of molecular information has led to an understanding of the biological diversity of breast cancer. The involvement of various genes at different steps of cancer progression, such as proliferation, evading apoptosis, migration, immunosuppression, and chemoresistance, have been described in this chapter. With the advent of miRNA and splicing factors, new differential regulators of genes have been identified in breast cancer. The breast cancer therapeutic approach can be accomplished by identifying the oncogene and tumor suppressor genes at an early stage of the disease. Elucidation of novel genes in breast cancer will lead to identifying new molecular pathways that may be targeted for its treatment. For the prognostic and diagnostic treatment of breast cancer it is very important to identify newer genomic fingerprints and to develop novel therapeutic targets against them. Our main goal is to make available inclusive understanding of molecular mechanisms and hallmarks of breast carcinogenesis.

Perspectives of Deregulated Metabolism in Breast Cancer

Page: 178-207 (30) Author: Shankar Suman DOI: 10.2174/9789811451447120010010 PDF Price: $30

Cancer cells devise different mechanisms to undergo aberrant cell division. Dysregulated signaling pathways and metabolic reprogramming are the two key mechanisms leading to cancer development. The role of metabolic dysregulation has been well known in cell proliferation, metastasis, and resistance to therapy, eventually leading to tumor progression. The dysregulation of enzyme activity and biochemical pathways have emerged as major factors in the metabolic reprogramming of breast cancer. The abnormal changes in the level of metabolites are mechanistically associated with the metabolism of cancer. Quantitative research studies have provided a list of metabolic biomarkers, which have a promising role in the early detection of breast cancer as well as in its therapy. Many of the current research studies are directed towards understanding the intricacies of metabolism in cancer cell proliferation. This chapter gives an overview of breast cancer metabolism with updated information and describes how deregulated metabolism plays a key role in the oncogenic cascade leading to the neoplastic transformation of cells.

Oxidative Stress and Lifestyle-based Changes in Breast Cancer Progression

Page: 208-235 (28) Author: Vipendra K. Singh and Pradeep K. Sharma DOI: 10.2174/9789811451447120010011 PDF Price: $30

Lifestyle-based changes such as diet, physical inactivity, smoking, and alcohol consumption are some key risk factors of breast cancer among women. Changes in the lifestyle disrupt redox homeostasis, particularly decreasing the ability of the body to detoxify harmful free radicals. Therefore, an imbalance between these finely tuned mechanisms results in the formation of excessive reactive oxygen species (ROS). These elevated levels of ROS may promote breast cancer development and progression. Over the centuries, the way of living has changed drastically worldwide, and several lifestyle factors have evolved as a threat and risk factor for cancer in humans. Most of these lifestyle factors, e.g., smoking, alcohol consumption, physical inactivity, poor nutrition, etc., have been associated with the rise in breast cancer incidences globally. A large number of accumulating evidence from clinical and epidemiological studies strongly suggest the link between lifestyle factors and the incidence of breast cancer in women. Some changes in lifestyles increase the risk of breast cancer in both premenopausal and postmenopausal women. However, the period between menarche to the birth of the first child is the most vulnerable phase in women's lives. Lifestyle factors drive carcinogenesis through various mechanisms. Among them, ROS-mediated oxidative damage plays a significant role in breast cancer development. Here, in this chapter, we have discussed the most relevant lifestyle factors associated with breast carcinogenesis in women. Also, we have discussed how these lifestyle factors modulate redox homeostasis to elicit oxidative damage-induced carcinogenesis. A better understanding of the association between lifestyle factors and breast cancer may enable us to identify critical factors that can play a significant role in breast carcinogenesis.

Epithelial-Mesenchymal Transition (EMT) in Breast Cancer: An Overview

Page: 236-253 (18) Author: Manish Charan, Bhavana Kushwaha, Sanjay Mishra and Ramesh K Ganju DOI: 10.2174/9789811451447120010012 PDF Price: $30

The epithelial to mesenchymal transition (EMT) is a key cellular event that plays a pivotal role in promoting metastatic disease and tumor recurrence among solid malignancies. EMT is involved not only in essential cellular processes, including embryonic development and tissue remodeling, but also in inducing tumorigenesis. Breast cancer (BC) is the most prevalent cancer in women globally, and the main causes of breast cancer mortality are metastasis and recurrence. EMT plays an imperative role in enhancing invasion, following metastasis. Integrated changes in several cell signaling events lead to an epithelial to mesenchymal phenotypic shift and provide cells with more migratory and invasive properties that eventually results in metastatic colonization at a secondary site. However, the present knowledge about the cross-talk of multi-faceted signaling pathways and associated crucial transcription factors is yet to be understood. Understanding the cellular complexities of EMT will provide valuable insights for the therapeutic targeting of aggressive breast cancers, and in the development of novel biomarkers to delimit malignancies with greater chances of metastasis and recurrence.

miRNA Biology in Breast Cancer Progression

Page: 254-277 (24) Author: Sanjay Mishra, Manish Charan, Swati Misri, Dinesh Ahirwar and Ramesh K. Ganju DOI: 10.2174/9789811451447120010013 PDF Price: $30

Among the plethora of human malignancies, breast cancer is one of the most prevalent cancers diagnosed in women worldwide. The early detection of breast cancer with current techniques has significantly reduced the mortality rate in the last decade. Nonetheless, various drawbacks presented by these techniques remain as one of the foremost hurdles in the proper clinical management of the condition. The discovery and utilization of highly specific, minimally invasive unique biomarkers would greatly aid an efficient diagnosis and prognosis of breast cancer. The differential expressions of miRNAs also play well-studied roles in the progression and metastasis of the condition. The chapter outlines the clinical importance of miRNAs-based biomarkers in the early detection and prognosis of breast cancer and reviews the different subtypes involved. The role of miRNAs in modulating various cellular processes during the progression and metastasis of breast cancer has been discussed. Finally, the importance of an integrated omics approach in identifying novel targets of miRNAs is also elaborated upon.

Calcium Signaling in Breast Cancer: Current Perspective

Page: 278-304 (27) Author: Manuraj Pandey, Akanksha Nigam and Rajendra Mehta DOI: 10.2174/9789811451447120010014 PDF Price: $30

Calcium (Ca2+) signaling plays an important role in every aspect of cellular physiology, including cell proliferation, cell death, and cell motility. In the cellular environment, calcium signaling is tightly regulated to achieve a specific cellular response. Dysregulation in cell proliferation and cell death are crucial events in cancer evolution. There are several reports which have established the central role of calcium signaling in acquiring the hallmarks of cancer. Calcium signaling has been shown to be linked with several proteins and pathways, which are involved in the progression and advancement of breast cancer, including RANK/RANKL signaling pathway, EGFR and CAMK signaling, Rap2B, ERK1/2 signaling, Ca2+ influx pathways, MCU proteins, PTHrP, calmodulin, PARP1, NFAT, calpain, mitogen-activated protein kinase (MAPK), calmodulin-dependent protein kinase II (CaMKII), epithelial-mesenchymal transition (EMT), phospholipase C (PLC), inositol 1,4,5-trisphosphate (IP3), vascular endothelial growth factor (VEGF), estrogen, and estrogen receptor. In the recent past, several studies presented good enough pieces of evidence suggesting Ca2+ channels and transporters as a potential therapeutic target of breast cancer treatment. Therefore, in light of previous knowledge, in this chapter, we will discuss the role of Ca2+ signaling in breast cancer and its therapeutic implication as to the current perspective of breast cancer treatment.

Role of Mitochondrial-mediated Pathways in Breast Cancer: An Overview

Page: 305-327 (23) Author: Nabanita Chatterjee, Debangshi Das, Ashna Jha and Sraddhya Roy DOI: 10.2174/9789811451447120010015 PDF Price: $30

The powerhouse of the cell, mitochondria play several cellular functions, and it also regulates the physiological adjustment of the body. The deregulation of any of the key factors in the regulation pathway of energy production or cellular metabolism leads to disease conditions and, sometimes even cancer. Several studies emphasize the fact that the alteration in metabolic pathways, generate or evoke cancer susceptibility including breast cancer. Among the several cancers, breast cancer is a major concern in the female population. Thus, the alteration of any mitochondrial factors or metabolites associated with the mitochondrial energy cycle, the changes in breast cancer development or progression of metastasis is high. Mitochondrial regulation could be a promising therapeutic approach in the treatment of breast cancer.

Advances of the Current Therapeutic Approach for the Management of Breast Cancer

Page: 328-345 (18) Author: Saroj Kumar Amar, Ajeet Kumar Srivastav and Swayam Prakash Srivastava DOI: 10.2174/9789811451447120010016 PDF Price: $30

Breast cancer is the most common type of malignancy in women worldwide. There are several factors associated with breast cancer for manifesting a heterogeneous disease in nature. Chemotherapeutic drugs significantly reduce the mortality rate of breast cancer. The recent development of chemotherapeutic drugs is targeting heterogeneity by including hormone receptors, expression of genes, epidermal growth factors, etc. The therapeutic response is dependent on a variety of factors, including stages, subtypes, metastasis, etc. For example,- endocrine therapy is preferred for positive hormone response in luminal breast cancer. In the recent therapeutic regimens, CDK4/6 quenchers are emerged, which regulate cell cycle by interacting with cyclin D1. It is also because, in the case of resistant hormonal therapy, tumors still showed its dependency on CDK4/6- cyclin D1 for proliferation. Apart from chemotherapy, immunotherapy is one of the emerging therapeutical regimens for breast cancer. There are also a number of vaccination approaches against breast cancer, including Nelipepimut–S, derived from the extracellular domain of the human epidermal factor receptor, which is used as a vaccine to prevent the reoccurrence of refractory breast cancer. Epithelial-to-mesenchymal transition (EMT) is a crucial mechanism for breast cancer progression. Currently, EMT inhibitor is used for preclinical testing to further used as a drug molecule to treat breast cancer. Thus, the advancement of chemo- or immunotherapy can substitute over invasive treatment strategies such as the surgical method for the treatment of breast cancer.

Micro and Nano-scale Technologies for Breast Cancer Detection and Destruction

Page: 346-368 (23) Author: Pranay Agarwal DOI: 10.2174/9789811451447120010017 PDF Price: $30

In this chapter, we thoroughly review the current developments and challenges in the field of tissue engineering of normal and breast cancer cells. We also briefly describe the current advances in cell culture techniques and common biomaterials, which are useful in the field of tissue engineering. Further, the need for a new microencapsulation technology of cells utilizing the microfluidic method is illustrated. Moreover, the most recent applications of cell-laden microcapsules in tissue engineering are summarized. Lastly, the chapter is concluded with an outline of the future prospective.

Subject Index

Page: 369-382 (14) Author: Shankar Suman, Garima Suman and Sanjay Mishra DOI: 10.2174/9789811451447120010018

Introduction

Breast cancer is a recognized disease around the world with varying patient outcomes based on the type of breast cancer, access to healthcare and other factors. Survival rates for breast cancer are significantly lower in metastatic cases than localized cases. Early diagnosis and effective treatments for the efficient management of breast cancer are now in demand , as they help to prolong patient life. There have been many breakthrough developments in the molecular biology of breast cancer research in recent times. Advancements in diagnostic techniques (imaging and biomarker detection) for breast cancer have improved the screening of the disease and have improved patient outcomes. Despite these enhancements, the disease is still lethal for patients and the search for a cure requires a complete understanding of the disease. Current Advances in Breast Cancer Research: A Molecular Approach presents a comprehensive overview of current basic and translational research on the subject. The 14 chapters of the book give emphasis to current knowledge about breast cancer, ongoing challenges, and innovative research findings by different research groups. Readers will find detailed information about breast cancer biology, genetics, clinical diagnostics and treatments. Additional information for advanced readers in life sciences, such as techniques relevant to genomics (including genetic fingerprinting), proteomics, metabolomics and medicine (such as imaging and molecular diagnostics) is also provided. The combination of both basic and advanced information makes this book a useful reference to the student and researcher, alike, seeking an understanding about breast cancer at a molecular level.

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12 Books About Breast Cancer That Will Change How You View This Disease

Sam manzella.

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All products and services featured are independently chosen by editors. However, Flow Space may receive a commission on orders placed through its retail links, and the retailer may receive certain auditable data for accounting purposes.

Beat Breast Cancer Like a Boss

Beat Breast Cancer Like a Boss is a compilation of 30 interviews about breast cancer  conducted and condensed by Ali Rogin, an award-winning journalist of PBS Newshour fame. With poignant stories of pain and triumph from prominent survivors like Edie Falco, Sheryl Crow, and Athena Jones, this book is perfect for anyone seeking inspiration in their breast cancer journey. It’s also a deeply personal endeavor for Rogin, who faced life-altering uncertainty herself when she learned that she has the BRCA1 genetic mutation at age 20.

Not the Breast Year of My Life

Cara Sapida, an award-winning broadcast journalist, chronicles her breast cancer journey with frankness and humor in her debut memoir Not the Breast Year of My Life . She tackles everything from going through chemotherapy to navigating a divorce. Although the tale she unfolds is full of challenges, Sapida reminds readers of the power of hope and resilience. It’s no wonder this candid memoir became the number-one bestseller in Amazon’s breast cancer category soon after it was published. 

Breasts: The Owner's Manual

A board-certified breast cancer surgeon, Dr. Kristi Funk is best known for treating A-list celebrities like Angelina Jolie and Sheryl Crow. Breasts: The Owner’s Manual  distills the practical knowledge she’s amassed regarding breast cancer prevention, treatment options, and outcomes. As Dr. Funk notes, “Many women believe that family history and genetics determine who gets breast cancer, but that’s not true for most people.” Her book offers accessible, evidence-based strategies for cancer prevention and recovery, including lifestyle swaps and nutritional guides.

Breasts: The Owner’s Manual

The breast cancer survival manual.

Dr. John Link is the founder of Breastlink Medical Group and a leading oncologist who specializes in breast cancer treatment. The seventh edition of The Breast Cancer Survival Manual , which was released just this year, draws upon his decades of experience helping patients fight this disease. Dr. Link clearly and thoroughly covers the latest research in the field, including the value of genomic testing, individually tailored treatment plans, and hormone therapy after cancer. It’s an ideal resource for anyone in search of practical, up-to-date information as they navigate treatment or recovery.

Living with Breast Cancer

The physical effects of breast cancer treatment are well-charted territory. However, fewer resources explore the emotional and psychological dimensions of this disease. In Living with Breast Cancer , Drs. Jennifer A. Shin, David P. Ryan, and Vicki A. Jackson — three active providers at renowned hospital systems who treat cancer patients — tackle the topic from all angles. They clearly and empathetically explain how to grapple with your diagnosis, navigate treatment and possible side effects, and cope with advanced or progressive cancer.

The Middle Place

Acclaimed writer Kelly Corrigan is host of the podcast Kelly Corrigan Wonders and the PBS Show Tell Me More . The Middle Place , her New York Times -bestselling memoir, recounts her journey battling breast cancer while caring for her ailing family patriarch, George Corrigan. She occupies the roles of both patient and caregiver, ushering in a two-fold journey of coming into her adult self and revisiting her roots. As sad as some of her personal struggles are, Corrigan chronicles them with humor and grace. It’s a meaningful read for anyone who needs a boost of comfort and hope.

Off Our Chests

Off Our Chests: A Candid Tour Through the World of Cancer was coauthored by Dr. John Marshall and Liza Marshall. John is a renowned oncologist at Medstar Georgetown University Hospital; Liza is his wife — and later, a stage-III triple-negative breast cancer patient. Their tell-all memoir explores what it’s like to grapple with a cancer diagnosis and treat the disease from the dual perspectives of caregiver and patient, husband and wife. It was published in 2021 and won the 2022 Living Now Book Award for Health/Wellness.

There aren’t many books out there that discuss breast cancer from a cultural or historical perspective. With Radical: The Science, Culture, and History of Breast Cancer in America , New York Times healthcare journalist Kate Pickert fills that gap. The book pulls from Pickert’s research, reporting, and personal experience battling breast cancer in her 30s. It’s full of fascinating insights into oncological medicine and our nation’s healthcare system that will contextualize anyone’s journey navigating treatment — and shed light on why scientists still haven’t cured this notoriously common and deadly disease.

The Undying

In this Pultizer Prize-winning hybrid memoir, poet and essayist Anne Boyer chronicles her harrowing diagnosis with triple-negative breast cancer in her 40s. With its use of illness as metaphor, The Undying: A Meditation on Modern Illness   harkens back to the works of other women writers like Audre Lorde and Kathy Acker, who used their craft to make sense of their sickness. It’s an unflinching but comforting read for literary types grappling with the existential questions that surround cancer and mortality.

The Breast Cancer Book

Dr. Kenneth D. Miller is an oncologist at the University of Maryland; Dr. Melissa Camp is a breast cancer surgeon with Johns Hopkins. The Breast Cancer Book: A Trusted Guide for You and Your Loved Ones , which they coauthored with the help of Kathy Steligo, is a practical, comprehensive resource geared toward people who’ve just been diagnosed with breast cancer. It presents a wide range of treatment options with insights from noted experts in complementary fields, including genetics and radiology. Visual learners, rejoice: This book is chock-full of helpful diagrams, photographs, and illustrations.

Let Me Get This Off My Chest

Like many women, Margaret Lesh’s life was turned upside down when she got her breast cancer diagnosis. In Let Me Get This Off My Chest…: A Breast Cancer Survivor Over-Shares , the freelance court reporter and novelist gets real about her experience navigating cancer treatment — not once, but twice. Her heartfelt, humorous takes on everything from drug-induced hot flashes to mortality crises will resonate with anyone on a similar journey. Per reviewers, it’s perfect for folks who prefer a more intimate, conversational read.

There’s no such thing as a universal breast cancer experience. In Flat: Reclaiming My Body From Breast Cancer , memoirist Catherine Guthrie reminds us of this important truth. Guthrie is a queer woman, and she’d spent years of her life trying to feel at home in her skin. Her two bouts of breast cancer upended this progress — and introduced new issues in her relationship with her life partner, Mary. Flat tackles all of this and more, challenging the hyper-gendered, pink ribbon-laden messaging around breast cancer. (Remember, this disease doesn’t just affect cisgender women.)

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Beyond Breast Cancer

by Tufia C. Haddad, M.D., Kathryn J. Ruddy, M.D., M.P.H.

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Proceeds are invested into furthering medical research and education at Mayo Clinic.

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A Mayo Clinic Guide to Healing and Wellness

Tufia C. Haddad, M.D., Kathryn J. Ruddy, M.D.

A supportive, practical guide to navigating life after breast cancer diagnosis and initial treatment.

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Description

Beyond Breast Cancer: A Mayo Clinic Guide to Healing and Wellness  is a supportive, practical guide to life after diagnosis and initial treatment for breast cancer. In this short, accessible book, Mayo Clinic breast cancer specialists Tufia C. Haddad, M.D., and Kathryn J. Ruddy, M.D., and colleagues offer their insights on how to navigate this new phase of the journey, including monitoring for signs of recurrence; optimizing diet, sleep and exercise habits; coping with lingering treatment effects; improving sexual health; managing money and insurance issues; and much more.

Use this book to help you through those months after treatment is over and when treatment is ongoing. Return to it as needed. Life after a diagnosis of breast cancer is rarely the same as it was before. But that doesn’t mean it can’t be richer, more meaningful and perhaps even healthier. It’s about more than just surviving. It’s about living the life you were meant to live.

Softcover • 5 x 8 Inches • 224 Pages • Mayo Clinic Press • 2023 • ISBN 798887700267

About the author

Tufia C. Haddad, M.D.

Tufia C. Haddad, M.D., is a medical oncologist specializing in breast cancer. She sees patients with all types and stages of breast cancer, striving to promote their understanding of their cancer and empowering them to become partners in managing their health. She has a special interest in survivorship care and works together with clinicians from many different specialties -- including integrative medicine, women's health, cancer psychology, primary care and others -- to provide holistic care for complex problems. Her research focuses on identifying novel strategies to transform cancer care with an emphasis on using telehealth tools and artificial intelligence. Dr. Haddad is the Medical…

Kathryn J. Ruddy, M.D., M.P.H.

Kathryn J. Ruddy, M.D., M.P.H., is a medical oncologist specializing in breast cancer. She has particular expertise in treating younger women with breast cancer, helping them navigate the side effects of cancer treatment and address survivorship issues such as fertility preservation and future pregnancy. Dr. Ruddy also has expertise in male breast cancer and survivorship concerns unique to men. She is active in research focused on prediction and prevention of toxicity in patients with cancer. Dr. Ruddy is the Director of Cancer Survivorship for the Department of Oncology at Mayo Clinic.

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Breast Cancer Research and Treatment: Innovative Concepts (Cancer Treatment and Research, 188) 1st ed. 2023 Edition

• ISBN-10 3031336011
• ISBN-13 978-3031336010
• Edition 1st ed. 2023
• Publisher Springer
• Publication date January 5, 2024
• Language English
• Dimensions 6 x 1 x 9.25 inches
• Print length 376 pages
• See all details

Editorial Reviews

From the back cover.

This book focuses on innovative treatment options for breast cancer, including surgery, radiotherapy, systemic therapy and of course immunotherapy that is changing outcomes in some aggressive breast cancer histotypes. Subsequent chapters also address the ongoing emerging research in the screening, diagnostics, and management of all subtypes of breast cancers. All current landscapes and future perspectives in each molecular subtype: luminal, HER2-positive, and triple-negative breast cancers are discussed within the different chapters.

Breast cancer is still the most common cancer and cause of cancer deaths among women worldwide. The improvement of breast cancer outcome appears to be strictly related to the validation of precise biomarkers that enable us to better select personalized approaches in breast cancer management.

The closing chapters deal with the challenges of low income countries of conducting research in the era of precision medicine forcancer. The book is edited and authored by leading experts in this field and will be of interest for clinicians and scientists alike.

About the Author

Dr. Ouissam Al Jarroudi, MD, is a distinguished medical oncologist practicing in the medical oncology department at Mohammed VI University Hospital in Oujda, Morocco. She holds a position as a professor at the Faculty of Medicine and Pharmacy, affiliated with Mohammed Ist University. Dr. Al Jarroudi has pursued various fellowships at renowned institutions such as the Department of Medical Oncology at Paul Brousse Hospital, Assistance Publique - Hopitaux de Paris, and Léon Bérard Center in France.

Dr. Al Jarroudi's research is primarily focused on prognostic and predictive biomarkers in breast cancer and she is currently a member of the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology (ASCO).

Khalid El Bairi is a clinical research fellow and an investigator in OVANORDEST studies. He is currently pursuing clinical and translational research in medical oncology. He has published many peer-reviewedarticles in the field of predictive and prognostic cancer biomarkers to improve survival outcomes in several WoS and Medline-indexed journals. His research focuses particularly on biomarkers for digestive and gynecological cancers such as ovarian and colorectal malignancies. He is currently a member of various international scientific societies such as the European Society for Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), the European Society of Gynaecological Oncology (ESGO), and the American Association for Cancer Research (AACR). He is also an editor and reviewer for various journals and a guest editor for several special issues on emerging topics in gynecological cancers such as platinum-resistant ovarian cancer. He is also highly interested in teaching evidence-based medicine, clinical research methods, and publishing ethics to medical and PhD students and was selected for the 70th Lindau Nobel Laureate Meeting as a young scientist. He is also involved in “global oncology” initiatives through providing free training to young researchers across LMICs. He joined the ASCO Trainee & Early Career Advisory Group as a member for the 2022-2024 term and NCODA (National Community Oncology Dispensing Association, Inc.) as an advisory member of its International Executive Council in 2023.

Giuseppe Curigliano, MD PhD, is Associate Professor of Medical Oncology at the University of Milano and the Head of the Division of Early Drug Development at the European Institute of Oncology, IRCCS, Italy. He is a clinician and researcher specializing in early drug development for patients with solid tumors with a special commitment to breast cancer. He has been a member of the Italian National Health Council since 2018 and, in 2019, he served as Chair of the Scientific Committee of The Lega Nazionale Lotta ai Tumori. He has served as a Member of the ESMO Breast Cancer Faculty since 2001 and he is currently the Faculty Coordinator. He has alsoserved on the Scientific Committee for the St Gallen Conference since 2011 and was the Scientific Co-Chair in St Gallen 2017 and 2019. He has been an Editorial Board Member for Annals of Oncology since 2014, and serves as Co-Editor in Chief of The Breast, Co-Editor in Chief of Cancer Treatment Reviews, Associate Editor of the European Journal of Cancer, Editor of the Journal of Clinical Oncology. He also serves on the European School of Oncology (ESO) faculty committee.

Product details

• Publisher ‏ : ‎ Springer; 1st ed. 2023 edition (January 5, 2024)
• Language ‏ : ‎ English
• Hardcover ‏ : ‎ 376 pages
• ISBN-10 ‏ : ‎ 3031336011
• ISBN-13 ‏ : ‎ 978-3031336010
• Item Weight ‏ : ‎ 1.81 pounds
• Dimensions ‏ : ‎ 6 x 1 x 9.25 inches
• #1,175 in Obstetrics & Gynecology (Books)
• #1,603 in Oncology (Books)

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Breast cancer resources and support organisations

There are many organisations, support groups, books, videos and other resources to help you cope with breast cancer and its treatment. There is also information about mastectomy wear and prosthesis suppliers.

Cancer Research UK information and support

Cancer Research UK is the largest cancer research organisation in the world outside the USA. We fund research on all aspects of cancer from its causes to prevention and treatment.

We are committed to producing high quality information for people affected by cancer. As well as looking at the information on this website you can call our nurse freephone helpline on 0808 800 4040. They are available from Monday to Friday, 9am to 5pm. Or you can send them a question online.

• Contact our cancer information nurses

Cancer Chat is our online forum where you can share experiences.

• Cancer Chat discussion forum

Breast cancer support organisations

Against breast cancer.

Leathem House 13 Napier Court Barton Lane Abingdon, Oxfordshire, OX14 3YT

Against Breast Cancer is a charity based in Oxford. It funds breast cancer research into new treatments, earlier diagnosis and long term survival. 

Tel: 01235 534211 Email:  [email protected]

• Find out about Against Breast Cancer

Breast Cancer Now

Breast Cancer Now is a charity dedicated to funding breast cancer research. They also provide breast cancer information and support across the UK. Services are free and include a helpline, website, publications, and practical and emotional support. It was formed by the merger of The Breast Cancer Campaign and Breakthrough Breast Cancer in 2015. 

5th Floor Ibex House 42 - 47 Minories London EC3N 1DY

Tel: 0808 800 6000 Ask a nurse:  Contact form   

• Find out about Breast Cancer Now

CoppaFeel is a UK charity that provides information, advice and creates awareness of breast cancer especially in young people. They also have resources for teachers and educators.

You can contact them on their general enquires contact form .

• Go to CoppaFeel website

Flat Friends UK

Flat Friends UK is a charity that supports women who choose to go flat. So for those ladies living without reconstruction after a mastectomy. You can get in touch with people who have had similar experiences via their online forum, Instagram, Facebook, Twitter, or face to face. The website also has information about research, fashion ideas, and personal stories.

• Find out about Flat Friends UK

Hereditary Breast Cancer Helpline

Provides support and information if you are concerned about hereditary breast cancer. There is an email address and a telephone number for enquires. Outside office hours, there is a 24 hour answerphone to leave your message. 

Tel: 01629 813000 (available 8am-10pm) Email:  [email protected]

• Find out about the Hereditary Breast Cancer Helpline
• The Inflammatory Breast Cancer Network UK

The Inflammatory Breast Cancer Network UK offers support and advice during treatment and beyond. They have an online support group for people diagnosed with inflammatory breast cancer. This is a closed group. You need to apply online to join.

General support organisations

Macmillan cancer support.

Macmillan Cancer Support is a charity that gives practical, medical and financial support to people with cancer in the UK. Its helpline gives guidance on cancer and advice on benefits. It also publishes booklets about cancer and treatments. Information is available in other languages.

Freephone: 0808 808 00 00 (7 days a week, 8am to 8pm) Contact email form

• Visit the Macmillan Cancer Support website

Cancer Card

Cancer Card is a national charity based in Scotland. They aim to provide support to everyone affected by cancer. Their website has a support directory where you can search for national and local cancer support charities and services. You can also find stories of people affected by cancer. They have a cancer support helpline and a digital helpline, which can help you with your online needs. For example helping you gain digital skills so you can access online services, such as banking.

Cancer Card 109/11 Swanston Road Edinburgh EH10 7DS

Email:  [email protected]

• Visit Cancer Card's website

Look Good Feel Better

This charity aims to help with the physical and emotional wellbeing of people going through cancer treatment. They provide confidence boosting workshops, which gives a chance for people to meet others going through a similar experience and to learn skills to manage some of the side effects of treatment, such as skincare and make up techniques. 

Workshops take place in hospitals and support centres across the UK. You can find your nearest workshop and read more about the work of the charity on their website.

West Hill House 32 West Hill Epsom Surrey KT19 8JD

Phone: 01372 747500 Email:  [email protected]

• Find out about Look Good Feel Better
• The Daisy Network

The Daisy Network provides help, support and information for women who have early menopause.

PO Box 71432 London SW6 9HJ

Email:  [email protected]

Lymphoedema Support Network (LSN)

A national charity offering information and support to anyone affected by lymphoedema. It has local support groups, a helpline and a website. It also produces a range of information including factsheets about lymphoedema and its treatment, videos about self management techniques for lymphoedema, and a newsletter.

Telephone: 020 7351 4480 Email: [email protected]

• Visit the Lymphoedema Support Network website

Maggie's Centres

Maggie’s is a national charity with centres across the UK. They offer care and support to people affected by cancer. Each centre is beside an NHS cancer hospital and is run by specialist staff.

You can join a support group, take part in weekly sessions like relaxation and stress management, or learn about nutrition and health. You can also visit just to have a cup of tea and a friendly chat.

Phone: 0300 123 1801 Email:  [email protected]

• Visit the Maggie’s website

Switchboard LGBT+ helpline

Switchboard provides an information, support and referral service for lesbians, gay men and bisexual and trans people - and anyone considering issues around their sexuality or gender identity. Their helpline is open every day between 10am and 10pm. They also offer a chat and email service. 

PO Box 7324 London N1 9QS

Phone number: 0800 0119 100 open from 10 am to 10 pm every day Email: [email protected]  

• Switchboard LGBT+ helpline website

Suppliers for women who have had breast surgery

Amoena (uk) ltd.

Amoena makes and retails breast forms (prostheses), prosthetic nipples, mastectomy lingerie, nightwear and mastectomy swim wear. They also sell sports wear (active wear). They have stockists across the UK and you can also make online orders.

Order line: 0345 434 7334 (Monday to Friday from 9am to 4pm)

Enquiry line: 023 80 270 345 (Monday to Friday from 9am to 4pm)

Email:  [email protected]

Fill out a contact form .

• Find out about Amoena

Betty and Belle Ltd

Betty and Belle is a lingerie shop where you can get expert bra fitting. They sell mastectomy lingerie, breast prostheses and swimwear, including non wired support bras and front fastening bras for after breast surgery. Their collection is also available online. The shop is usually open Tuesday to Friday 10am to 5pm and Saturday 10am to 4pm.

35 Oxford Road Altrincham Cheshire WA14 2ED

Tel: 0161 929 1472 Email:  [email protected]

• Find out about Betty and Belle

Bare Necessities

A lingerie and swim wear boutique specialising in quality brands, plus size lingerie, swim wear, and mastectomy wear.

4 High Street Uttoxeter Staffordshire ST14 7HT

Tel: 01332 865554

Email: [email protected]

• Find out about Bare Necessities

An online supplier of breast prostheses,mastectomy bras and swim wear. It also sells front fastening bras for after surgery.

23 Shirwell Crescent Milton Keynes MK4 1GA

Tel: 01908 340 094

• Find out about Eloise

Nicola Jane

Sells mastectomy bras, swim wear, night wear and breast prostheses by mail order, online or by phone. Free returns service in UK. 

Tel: 01243 537 300 (Monday to Friday 9am to 5pm, Saturday 9.30am to 1pm) Email:  [email protected]

• Find out about Nicola Jane

Makes breast forms and protheses. Also sells mastectomy bras, swim wear and tops. They offer a pocketing service for your own bras and swimsuits.

Email:  [email protected]

• Find out about Silima

Books or leaflets about breast cancer

Breast cancer: answers at your fingertips.

E Pennery, V Speechley and M Rosenfield Class Publishing, 2008 ISBN 978-1859591987

Contains information about the signs and symptoms of breast cancer. It offers guidance on the various forms of treatment and care, including surgery, radiotherapy and chemotherapy. It also gives information about complementary therapies, practical advice about managing life with and after cancer (diet, exercise, work and finances). And answers questions about relationships and family.

Coping with breast cancer

Terry Priestman Sheldon Press 2006 ISBN 978-0859699686

Coming to terms with a diagnosis of breast cancer isn't easy. This book gives reassurance and practical advice about getting on with life as normally as possible. It is helpful for friends and family as well as people with breast cancer.

The Breast Cancer Survival Manual, Sixth Edition: A Step-By-Step Guide for Women with Newly Diagnosed Breast Cancer

John Link St. Martin’s Griffin, 2017 ISBN 978-1250144522

It is a book written by an American breast cancer specialist. It includes information on recent treatment developments. It is mainly for people with primary breast cancer.

Living Well Beyond Breast Cancer: A Survivor's Guide for When Treatment Ends and the Rest of Your Life Begins

M Weiss and E Weiss Three Rivers Press, 2010 ISBN 978-0307460226

This American book discusses all the physical and emotional issues that you may have after finishing cancer treatment.

Breast Cancer: The Essential Guide

Katherine Locke Need-2-Know, 2013 ISBN 1861440960

A book for women who have just been diagnosed with breast cancer. Written by a woman who has been through treatment for breast cancer. Provides information about what breast cancer is, how it is diagnosed and the treatment options available. It also talks about the emotional effects after a cancer diagnosis.

How To Cope With Breast Cancer When You Have Children: Parenting for Breast Cancer Mums

Briony Jenkins BCM Publishing, 2014 ISBN-10: 0993070310

A personal story and guide to talking about cancer to children. Written by a woman diagnosed with breast cancer aged 43 when her son was 7 and her daughter was 3. The book has information about coping with treatment and coping emotionally when you have children.

Be a survivor – your guide to breast cancer treatment (7th edition)

Vladimir Lange Lange Productions, 2019 ISBN 978-0692177242

A complete guide to breast cancer diagnosis, treatment, breast reconstruction, complementary therapies, research trials and coping with cancer. It is an American book, so some aspects are not relevant to UK readers.

Breast Reconstruction – Your Choice

D Rainsbury and G Straker Class Publishing, 2008 ISBN 1859591973

Written by a breast surgeon and breast care nurse. Gives information about breast reconstruction that aims to help women to make decisions about this type of surgery. It describes the surgical process, the possible benefits and problems. It also talks about psychological aspects of breast reconstruction, gives options for women who decide not to have reconstructive surgery, and explains how other treatments may affect or be affected by reconstruction.

Breast screening

Breast screening: helping women decide This leaflet is sent to all women invited for breast screening.

An easy guide to breast screening A booklet about breast screening for women with learning disabilities.

Breast screening: breast implant guidelines This leaflet tells women how breast implants may affect screening.

Breast screening: high risk women This factsheet explains breast screening for women at higher risk of developing breast cancer.

• See all these leaflets by the NHS Breast Screening Programme on the GOV.UK website

NHS population screening: information for transgender and non binary people This leaflet includes information about breast cancer screening.

• Read the leaflet about screening for transgender people

Books about lymphoedema and menopause

Let's talk lymphoedema: the essential guide to everything you need to know.

Dr P Mortimer and‎ G Levine Elliott & Thompson, 2017 ISBN 1783962852

Explains the causes and symptoms of lymphoedema. Describes treatments, including massage, exercise, and compression garments. It also has information about coping day-to-day with lymphoedema.

Before Your Time: The Early Menopause Survival Guide

E W Sterling and A Best-Boss Fireside Books, 2010 ISBN 9781439108451

An American book that has information on treatments and other ways of managing early menopause. As it is American, some of the options and resources may not be available in the UK.

The premature menopause book – when the change of life comes too early

Kathryn Petras Avon books, 2000 ISBN 0380805413

Discusses the physical and emotional effects of early menopause and how to cope with them.

A Young Woman's Guide to the Menopause After Treatment for Cancer

This booklet is written by Dr Louise Newson and Ellie Waters. Ellie was 15 when she had the menopause after cancer treatment. Dr Newson is a GP and menopause expert. She founded The Menopause Charity and created the Menopause Doctor website, now called Balance, which provides a wealth of information about the menopause.

This booklet provides information about what the menopause is, what the possible symptoms are and what you can do to help, and about how menopause might affect future health.

• Go to the Menopause Library section of the Balance website

Biographies

The secret history of a woman patient.

Janet Rhys Dent Radcliffe Publishing, 2007 ISBN 1 84619 150 5

This is an easy to read book of one woman’s experience of breast cancer. As she considers the dilemmas and discoveries of the diagnosis, both inside and outside hospital, she reflects on what being a patient means, where she gets information and support and how her attitude to life and living changes.

Courage Brave Amazon – one woman's spiritual journey through breast cancer

Christine Rayner Lucas Books, 2002 ISBN 1903797179

This is 1 woman's story of having breast cancer. It's easy to read and gives good explanations of tests and treatment. It explains the more unpleasant aspects of treatment in a non-frightening way. It has a strong spiritual focus and may not suit everyone but others may find it a useful source of support.

Worms on Parachutes

Sarah Jane Phillips CreateSpace Independent Publishing Platform, 2013 ISBN 978-1482058116

This is a warm and easy to read book about a 36 years old woman’s experience of breast cancer (some 20 years after treatment for Hodgkin lymphoma). The author gives an honest and open account of her feelings and experiences during her diagnosis, treatment, and the early years following treatment. She describes what the tests and treatments involve, and offers insight into what it really feels like and how she coped at each stage. The author is very positive about the support she receives from her family and friends, and the health professionals involved in her care. Proceeds from the book will go towards the NHS trust where she had treatment.

Information for children and people with a learning disability

Looking after my breasts (books beyond words).

S Hollins and W Perez Beyond words, 2017 ISBN: 9781784580957

This book tells a simple story about a women going for a mammogram and getting her result. It also explains what happens if you are called for further tests and how to look out for any changes in your breasts – being breast aware.

An easy guide to breast screening

National Health Service (NHS) Cancer Screening Programmes

This is a picture leaflet for women with a learning disability to tell them about breast screening. You can read or download this leaflet in PDF format on the NHS website. 

• Find out about an easy guide to breast screening

My parent has cancer and it really sucks

Maya Silva and Marc Silva  Sourcebooks Fire, 2013 ISBN 978-1402273070

Maya was 16 when her mother was diagnosed with breast cancer. She has written this book with her father in order to help other teenagers in a similar position.

Videos of people's stories

Provides free, reliable information about health issues including mental health, by sharing people's real-life experiences.

• Visit the Healthtalk.org website

Find local cancer support and information services

NHS website has a service that tells you about local information and support.

• Go to NHS website 

Related links

Breast cancer main page.

Find out about breast cancer, including symptoms, diagnosis, treatment, survival, and how to cope with the effects on your life and relationships. 

Treatment for breast cancer

Treatment for breast cancer depends on a number of factors. Find out about breast cancer treatments, where and how you have them, and how to cope with possible side effects.

Living with breast cancer

Get practical, physical and emotional support to help you cope with a diagnosis of breast cancer, and life during and after treatment.

Cancer Research UK online shop

Home of the original Cancer Care Collection, discover our range of products that help people going through cancer feel like themselves again.

It’s a worrying time for many people and we want to be there for you whenever - and wherever - you need us. Cancer Chat is our fully moderated forum where you can talk to others affected by cancer, share experiences, and get support. Cancer Chat is free to join and available 24 hours a day.

Visit the Cancer Chat forum

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Find a clinical trial

Search our clinical trials database for all cancer trials and studies recruiting in the UK

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Talk to other people affected by cancer

Nurse helpline 0808 800 4040

Questions about cancer? Call freephone 9 to 5 Monday to Friday or email us

Living with Breast Cancer

Jennifer A. Shin, MD, MPH, David P. Ryan, MD, and Vicki A. Jackson, MD, MPH with Michelle D. Seaton

Your complete resource for handling the physical and emotional effects of breast cancer treatments. At the time of diagnosis, breast cancer patients are faced with many overwhelming decisions about possible treatments. Living with Breast Cancer provides you with an overview of what to expect from testing and treatment, which cancer specialists you may need to see, and common terms to use to help communicate your needs to your team. This empathetic resource full of relatable stories teaches patients and caregivers how to ask the right questions to get the best possible care. The authors explain...

Your complete resource for handling the physical and emotional effects of breast cancer treatments. At the time of diagnosis, breast cancer patients are faced with many overwhelming decisions about possible treatments. Living with Breast Cancer provides you with an overview of what to expect from testing and treatment, which cancer specialists you may need to see, and common terms to use to help communicate your needs to your team. This empathetic resource full of relatable stories teaches patients and caregivers how to ask the right questions to get the best possible care. The authors explain how to minimize the symptoms and side effects of treatment and outline coping strategies to deal with the stress of breast cancer treatment, including the changes in your body from cancer and its therapies. The book helps readers

• make sense of their diagnosis • set goals and prepare for treatment • understand the different types of therapies, tests, and scans • manage the symptoms and side effects of treatment, such as nausea, fatigue, shortness of breath, weight fluctuations, and depression • learn what medications and lifestyle modifications can help with symptoms • live and cope with progressive cancer

Living with Breast Cancer is your definitive resource for handling the physical and emotional effects of breast cancer and treatment.

Related Books

edited by Kenneth D. Miller, M.D.

Vicki A. Jackson, MD, MPH, and David P. Ryan, MD, with Michelle D. Seaton

Peter V. Rabins, MD, MPH

Carly Sygrove, Andrea Simonson, and Caroline Norman

Mark J. Russ, MD

The authors provide a soup-to-nuts guide for breast cancer patients, whether readers are newly diagnosed or farther along in their breast cancer journey. This book hits all the right notes from understanding a diagnosis, knowing what to expect, and making what are sometimes difficult treatment decisions. While other books cover these same issues, this book's section on symptoms and side effects is what truly sets it apart. The palliative perspective is especially noteworthy.

Book Details

Preface Acknowledgments Part One. Making Sense of Your Diagnosis Chapter One. How Am I Going to Get Through This? Chapter Two. Setting the Goals for Treatment Chapter Three. Local Therapies in Breast

Preface Acknowledgments Part One. Making Sense of Your Diagnosis Chapter One. How Am I Going to Get Through This? Chapter Two. Setting the Goals for Treatment Chapter Three. Local Therapies in Breast Cancer Chapter Four. How to Prepare for Systemic Treatment Chapter Five. Tests and Scans in Treatment Chapter Six. How Am I Supposed to Cope Emotionally? Chapter Seven. How Do I Cope with Changes in My Body? Part Two. Managing Symptoms and Side Effects Chapter Eight. Managing the Side Effects of Hormonal Therapy Chapter Nine. Controlling Nausea Chapter Ten. Managing Constipation and Diarrhea Chapter Eleven. Minimizing Pain Chapter Twelve. Should I Worry about Shortness of Breath? Chapter Thirteen. What If I'm Gaining or Losing Weight? Chapter Fourteen. What If I Have a Sudden Fever? Chapter Fifteen. Clotting and Bleeding Issues Chapter Sixteen. Why Am I So Exhausted? When Will I Have Energy Again? Chapter Seventeen. Why Do People Keep Asking Whether I Am Depressed or Anxious? Chapter Eighteen. How Does Cancer Affect My Brain? Part Three. Dealing with Progressing Cancer Chapter Nineteen. They Tell Me the Cancer Is Progressing Chapter Twenty. Living and Hoping with Advancing Cancer Chapter Twenty-One. What about Practical Concerns? Chapter Twenty-Two. My Doctor Says Cancer Treatment Is No Longer Effective Chapter Twenty-Three. My Body Feels Like It's Shutting Down Chapter Twenty-Four. What Is a Good Death? A Final Note Index

Jennifer A. Shin, MD, MPH

David p. ryan, md, vicki a. jackson, md, mph, michelle d. seaton.

with Hopkins Press Books

How Breast Cancer Risk Assessment Tools Work: Cancer Currents

July 3, 2024 , by Elise Tookmanian, Ph.D.

Credit: iStock

In March 2024, when the actress Olivia Munn announced that she had been diagnosed with breast cancer, she highlighted a breast cancer risk assessment tool she used on her path to diagnosis. In the latest  Cancer Currents: An NCI Cancer Research Blog   post,  Ruth Pfeiffer, Ph.D. , senior investigator in the Biostatistics Branch , and Peter Kraft, Ph.D. , director of the Trans-Divisional Research Program , discuss how breast cancer risk assessment tools are created and how people can use them to understand and manage their risk. 

Drs. Pfeiffer and Kraft stressed that while these risk assessments are informative, they cannot predict the future for any one individual. Dr. Kraft said, "It’s really important that [people] talk with a health care provider about what the risk estimates mean for them."

Our researchers are involved in the creation and improvement of  risk assessment tools  for several different types of cancer, including  breast ,  colon ,  lung ,  thyroid , and  melanoma . One way to improve the models is to acquire more data. Dr. Pfeiffer said, "The more data we have, and the more representative those data are of the populations in which we would use a model, the better that model will perform."

Read the  Cancer Currents: An NCI Cancer Research Blog  post titled, "How Breast Cancer Risk Assessment Tools Work."

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• Eur J Breast Health
• v.18(3); 2022 Jul

Update of the 100 Most Cited Articles on Breast Cancer: A Bibliometric Analysis

Ahmet necati Şanlı.

1 Department of General Surgery, Abdulkadir Yuksel State Hospital, Gaziantep, Turkey

The aim of this study was to perform a bibliometric analysis of the 100 most cited articles related to breast cancer.

Materials and Methods:

The research was done on the Web of Science (WOS) database. Only research articles were included in the study. Results were obtained by typing the term “breast cancer” in the WOS Search box. The results were sorted according to the number of WOS core citations and all database citations, the first author of the article, the institution of the first author, publication year, article category, and countries.

The most cited article had 10236 citations. Nearly three-quarters (70%) of the articles were from the USA and most articles were published by Harvard University. Thirty-seven percent of the articles were in the medicine, general and internal medicine categories.

Conclusion:

This bibliometric analysis identified the 100 most cited research articles about breast cancer and provided a record of historical developments and trends in breast cancer research.

• The result of this research about the 100 most cited articles on breast cancer may help to understand important studies on breast cancer and shed light on future studies.

Introduction

Breast cancer is the most prevalent cancer globally, as well as a leading cause of cancer-related death among women ( 1 ).  Substantial support for breast cancer awareness and research funding has helped created advances in the diagnosis and treatment of breast cancer ( 2 ). Early detection, a novel personalized approach to treatment, and a better knowledge of the disease have all contributed to an improvement in breast cancer survival rates and a steady decline in the number of deaths related with the disease ( 3 ). Current guidance on preventing and treating breast cancer, as well as what might cause it, has come mainly from information discovered from research studies ( 4 ). The most significant component of the methodological qualities of studies is associated with an increase in citations and a high impact factor of the journal in which it was published ( 5 ). To the best of our knowledge, there is only one early study that has performed a bibliometric analysis of the attributes of the 100 most cited articles about studies concerning breast cancer ( 6 ). The aim of this study was to evaluate the current status of the 100 most frequently cited articles.

Materials and Methods

A Web of Science (WOS) (Clarivate Analytics, Philadelphia, PA, United States) search was used to collect the information for this investigation. The journals indexed in the Science Citation Index Expanded (SCI-E) were included. There were no restrictions on the journals. Over 9200 of the world’s most influential publications from 178 scientific areas are now indexed in the Science Citation Index Expanded™. More than 53 million records and 1.18 billion cited references date from 1900 to the present ( 7 ).

Inclusion Criteria

The term “breast cancer” was typed into the search box of WOS basic research with the selection of all the years and the search was performed on 11.02.2022. The search produced 621,351 published articles between 1978 and 2022. As filters, English language, SCI-E scope and research article type were selected, resulting in a reduction to 376,105 articles. These were then ranked in order of citation frequency, from highest to lowest. The study was conducted by generating a shortlist of the top 100 cited publications from this search list, which were classified by journal, study category, country and location where the research was published, authors, and publication date.

Exclusion Criteria

Articles in indexes other than SCI-E, published in languages other than English, and other types of articles, such as reviews, meeting abstracts, letters, book chapters, etc., were excluded. Also, cancer statistics articles were excluded, despite receiving more citations than the included research articles.

Written informed consent was not necessary because no patient data was included in the study. The study complied with the Declaration of Helsinki.

Statistical Analysis

No inferential statistical analysis was undertaken. All the data is given in percentages, numbers and charts.

The articles included in the study are listed according to the total number of citations in the WOS database and in the all databases (WOS database, Arabic Citation Index, BIOSIS Citation Index, Chinese Science Citation Database, Data Citation Index, Russian Science Citation Index and SciELO Citation Index). According to our results, the most cited article was by Charles M. Perou and his colleagues, with 10,236 citations in the WOS database, and the least cited article was by Lisa A Carey and her colleagues, with 1,403 citations. Considering the number of publications, the most cited author was D.J. Slamon with 25,000 citations, followed by B. Fisher with 11,809 citations, T. Sorlie with 11,343 citations, Charles M. Perou with 10,236 citations, and N.K. Aaronson with 9247 citations ( Table 1 ). It was evident that all articles received more than 1000 citations and all were published between 1985 and 2021. Twelve of the most cited articles were published in 2007, and there was one publication each for 1987, 1992, 1993, 1995, 2000, 2018, and 2021 among the most cited articles ( Figure 1 ).

Distribution of the most cited articles by publication year

These most cited articles were published in 20, high-impact factor journals, with 24 articles published in the New England Journal of Medicine, 13 in Nature, 11 in the Journal of Clinical Oncology, and 11 in Science ( Table 2 ). Seventy of the studies originated from the United States of America (USA), 13 publications from the United Kingdom (UK), six from Italy and three from Canada ( Figure 2 ).

Countries from which publications originate

The articles were sourced from 51 different centers. The institution with the most publications was Harvard University with eight articles, followed by the University of Pittsburgh with six articles, the IRCCS European Institute of Oncology (IEO) with five articles, and the University of North Carolina with five articles, while 32 institutions had only one publication each ( Table 3 ).

According to WOS publication categories, 37% of the articles were in the field of medicine, general and internal medicine, medicine, research & experimental, cell biology; pathology and surgery were the least published categories in this list. In addition, when the categories we created according to the content of the articles were examined, most articles were on genetics and drug research (47% and 24%, respectively) ( Table 4 ).

Discussion and Conclusion

Citation analysis is used to find important papers on a certain subject. It aids in the analysis of scientific influence while also acknowledging substantial/pioneering contributions made by predecessors and noteworthy research advancement. There are numerous bibliometric article analyses conducted in various areas of medicine ( 8 , 9 , 10 , 11 ).  To the best of our knowledge, there is only one previous article about the 100 most cited articles concerning breast cancer, and it was published in 2017 ( 6 ). Since research areas can change due to advances in science and technology, we found that the total number of citations in this study, which we aimed to evaluate the current status of the 100 most frequently cited articles, reached 280,906, an increase of approximately 1.6 times compared to 2017. This result suggests that interest in quality publications on breast cancer has increased. Also, 41 of the articles in the list were found to have changed. The vast majority of articles on the list were on chemotherapy and genetic studies.

The number of citations may be related to the time since publication. As the publication time increases, the number of citations also increases. In our study, we observed that 12 articles from 2007 and 9 articles from 2005 entered the list ( Figure 1 ). However, many factors, such as the content of the article, its quality and the journal in which it was published, can affect the number of citations. Therefore, although it was published in 2021, the study by Xi Wang and his colleagues was the fourth most cited article ( 6 ).

As expected, the most cited articles were published in the medical journals with the highest impact factors. In the present study, most articles were published in the New England Journal of Medicine, followed by articles in Nature, the Journal of Clinical Oncology, and Science, respectively. The first three articles on the list were published in Nature, Science and the Journal of the National Cancer Institute, respectively. It is feasible to hypothesize that the audience of a general medical journal is particularly interested in the topic of breast cancer, or that authors of breast cancer research choose popular medical journals to reach more researchers and readers. One of the important points in the study was that 70% of the articles originated from the USA. Similar to our study, in the bibliographic studies in the literature, 70%–93% of the research articles were USA based ( 8 , 9 , 10 , 11 ). The fact that these quality studies originate from the USA can be explained by the large patient population and the presence of many well-funded cancer centers.

The first most cited article was “Molecular portraits of human breast tumours” written by Perou et al. ( 12 ) in 2000. In this study, in which they made a molecular portrait of breast cancer, they created a molecular subtype classification of breast cancer ( 12 ). Today, this molecular classification is still in use and therefore the topic of this article remains relevant.

The second most cited article was “Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene” written by  Slamon et al. ( 13 )  in 1987. In this study, they showed that the HER-2/neu oncogene may play a role in the biological behavior and pathogenesis of human breast cancer. Also, they found that amplification of the HER-2/neu gene is an important predictor of both overall survival and time to relapse in patients with breast cancer, and that the HER-2/neu oncogene plays a role in the biological behavior and pathogenesis of human breast cancer.

The third most cited article was “The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology” written by Aaronson et al. ( 14 ) in 1993. The EORTC QLQ-C30 questionnaire was developed as a reliable and valid measure of cancer patients’ quality of life in multicultural clinical research settings in this multicenter survey performed by the European Organization for Research and Treatment of Cancer.

The other most cited articles are in the fields of chemotherapy, gene expression, tumor genetics, pathology, and surgery. Research in these areas has made important contributions to the understanding of breast cancer. According to WOS categories, 91% of the articles were in the field of general internal medicine, multidisciplinary sciences was the second most common category, and cancer research came third. Surgery was one of the least-published fields. As the biological behavior and pathogenesis of breast cancer are better understood, studies on chemotherapy drugs have come to the fore. A possible reason for the increase in these types of studies is the increase in funding for drug research in the treatment of breast cancer. For this reason, research on surgery may have lagged behind.

Although citation analysis is a useful method that can provide insight into trends in the literature, it is not without flaws. Only the WOS database was used in this study. Thus, publications that may be indexed in other databases, such as Scopus and Google Scholar, were not included in the list of this study. Also, self-citations, lectures and textbooks were not evaluated. A search was made by typing only the term “breast cancer” in the WOS search box. Other terms that may be related to breast cancer, such as “breast, breast neoplasm, breast surgery, etc.,” were not searched. Another limitation was that the research area was examined according to the research categories determined by WOS. A more detailed investigation could not be made.

In conclusion, in this study, in which a bibliographic analysis of the 100 most cited articles in WOS on breast cancer was performed, it was observed that the number of citations increased by 1.6 times in the last 5 years. It was found that the most cited articles were published in high impact factor journals, especially the New England Journal of Medicine, most publications were from 2007, and the most cited articles were from the USA and Harvard University. Most studies focused on gene expression and chemotherapy. The result of this research may help to understand important studies on breast cancer and shed light on future studies.

Ethics Committee Approval: No ethical approval was obtained because this study did not involve a prospective evaluation, did not involve laboratory animals and only involved non-invasive procedures (e.g. faecal samples, voided urine etc).

Informed Consent: N/A

Peer-review: Externally peer-reviewed.

Financial Disclosure: The authors declared that this study received no financial support.

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Breast cancer patient’s outcomes after neoadjuvant chemotherapy and surgery at 5 and 10 years for stage ii–iii disease.

Simple Summary

1. introduction, 2. materials and methods, 3.1. patient and tumor characteristics, 3.2. neoadjuvant chemotherapy outcomes, 3.3. survival outcomes, 3.4. prognostic factors for patient survival, 3.5. discussion, 4. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest, abbreviations.

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Falo, C.; Azcarate, J.; Fernandez-Gonzalez, S.; Perez, X.; Petit, A.; Perez, H.; Vethencourt, A.; Vazquez, S.; Laplana, M.; Ales, M.; et al. Breast Cancer Patient’s Outcomes after Neoadjuvant Chemotherapy and Surgery at 5 and 10 Years for Stage II–III Disease. Cancers 2024 , 16 , 2421. https://doi.org/10.3390/cancers16132421

Falo C, Azcarate J, Fernandez-Gonzalez S, Perez X, Petit A, Perez H, Vethencourt A, Vazquez S, Laplana M, Ales M, et al. Breast Cancer Patient’s Outcomes after Neoadjuvant Chemotherapy and Surgery at 5 and 10 Years for Stage II–III Disease. Cancers . 2024; 16(13):2421. https://doi.org/10.3390/cancers16132421

Falo, Catalina, Juan Azcarate, Sergi Fernandez-Gonzalez, Xavier Perez, Ana Petit, Héctor Perez, Andrea Vethencourt, Silvia Vazquez, Maria Laplana, Miriam Ales, and et al. 2024. "Breast Cancer Patient’s Outcomes after Neoadjuvant Chemotherapy and Surgery at 5 and 10 Years for Stage II–III Disease" Cancers 16, no. 13: 2421. https://doi.org/10.3390/cancers16132421

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Novel Approaches in Metronomic Chemotherapy for Breast Cancer Treatment

Publisher description.

This book provides the latest research and developments in the field of metronomic chemotherapy for breast cancer. It presents the principles and mechanisms of metronomic chemotherapy, preclinical and clinical studies, and the latest developments in drug delivery systems and nanoformulations. The clinical pharmacology of metronomic chemotherapy, including pharmacokinetics, pharmacogenetics, pharmacoeconomics, and adverse drug reactions, are also examined. Key Features: Introduces metronomics therapy in the neoadjuvant and adjuvant treatment of breast cancer Explores the potential of metronomics in terms of personalized chemotherapy Present pharmacological bases of metronomic chemotherapy Covers the latest developments in drug delivery systems, nanotechnology, and nanoformulations Discusses antiangiogenic effects and the impact of metronomics on immunity This book is useful for students, researchers, oncologists, pharmacologists, and healthcare experts interested in understanding the clinical potential of metronomic chemotherapy in breast cancer.

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How Breast Cancer Risk Assessment Tools Work

June 27, 2024 , by Sharon Reynolds

After using a breast cancer risk assessment tool, people should talk with their doctor about what the risk estimates mean for them, NCI experts advised. 

In March 2024, the actress Olivia Munn announced that she had been diagnosed with breast cancer. Ms. Munn also highlighted the role a cancer risk assessment tool played in the process that led to her diagnosis. In this Q&A, Ruth Pfeiffer, Ph.D., and Peter Kraft, Ph.D., of NCI’s Division of Cancer Epidemiology and Genetics discuss how these tools are created and how people can use them to understand and manage their risk.

Can cancer risk assessment models predict whether an individual woman will develop breast cancer?

Dr. Pfeiffer: Women want to know: Will I get breast cancer? Unfortunately, these models cannot predict the future with certainty for any one individual. They present population averages.

For example, if a woman’s risk estimate over a predefined time period is 5%, that means that out of 100 women who have the same risk factors as her, such as age and family history of breast cancer, 5 will develop breast cancer over that period. But we can’t identify the exact 5 women out of that 100 who will develop breast cancer.

Dr. Kraft: And it’s important to remember that these estimates of risk do not guarantee a specific outcome . So, you could have a relatively high-risk value on a given tool, but that doesn’t necessarily mean you will get breast cancer. And just because you have a low value doesn’t mean you won’t get breast cancer.

Dr. Pfeiffer: No woman should think, “I don’t need to get screened because my breast cancer risk is low.” On the flip side, there is no need to panic if her risk is high. 

There are multiple breast cancer risk models out there. How are they different? 

Dr. Pfeiffer: One big difference is the [risk] factors the models consider. In addition, some take into account that a woman might die from causes other than breast cancer. NCI’s risk assessment models for breast cancer, colorectal cancer, and melanoma do this. Other models estimate what we call pure risk: the probability that a woman will get breast cancer if she couldn’t die from anything else. These models produce higher estimates of risk.

Ruth Pfeiffer, Ph.D.

DCEG Biostatistics Branch

All models use slightly different information, but all models use information on factors that have been shown to be associated with breast cancer risk. They consider things like a woman’s family history of cancer, number of childbirths and her age at those births, and whether she has had a  benign breast disease . Benign breast diseases are conditions that may show up on a mammogram and lead a woman to have a biopsy, but they are not breast cancer.

These factors do not necessarily cause breast cancer, but, for whatever reason, they predict one’s risk of breast cancer.

What can people do with the information from a risk assessment tool?

Dr. Kraft: It’s really important that they talk with a health care provider about what the risk estimates mean for them. That’s the opportunity to discuss: Am I at high risk? If so, what can I do about it? What are the recommendations for me?

Dr. Pfeiffer: There are also breast cancer risk prediction models out there that include potentially modifiable risk factors, like body mass index , alcohol consumption, and hormone replacement therapy use. So someone could play around with these factors and ask: What would be my risk if I did not drink alcohol? Or if my body mass index was in the normal range ? That could help someone make personal decisions about certain lifestyle changes.

Other decisions, like those about screening or taking medications that can reduce your cancer risk, which can come with side effects, need to be made together with a health care provider. But that shouldn’t deter anybody from going online and just seeing what their risk is.

Knowledge is power. And that knowledge could encourage women to reach out to their [health care provider] for help putting such information in context. 

What is NCI doing to make risk models more useful or accurate?

Peter Kraft, Ph.D.

Director, DCEG Trans-Divisional Research Program

Dr. Kraft: The NCI Breast Cancer Risk Assessment Tool and others like it use factors that people know about themselves. They don’t include the risk that you may have from your genetic makeup. 

Unfortunately, most studies of the inherited risk of breast cancer have been done in people of European ancestry. These genetic studies have not had large numbers of Black Americans, Latinos, Asian Americans, or Pacific Islanders, for example. Models that incorporate genetic information, such as whether someone has certain gene changes, may not perform as well in these population groups.

At NCI we’ve launched the Confluence Project , which is looking at the genetics of breast cancer across diverse populations. 

One of Confluence’s main tasks is to increase the sample size from diverse groups. This can improve model performance for everybody, but especially for people who have been historically excluded from genetic studies.

Then, the Breast Cancer Risk Prediction Project is bringing together the new genetic results from Confluence with some of the existing models.

Dr. Pfeiffer: The more data we have, and the more representative those data are of the populations in which we would use a model, the better that model will perform. 

For example, NCI researchers developed a breast cancer risk model for Hispanic women . That model distinguishes between Hispanic women born in the United States and those born in other countries, because the data we have tell us that their risks are different.

Learn more about breast cancer risk .

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