Breast cancer is one of the most common kinds of cancer. It is called as second leading reason of deaths among women across the globe. In spite of high incidence rate, the survival rate in 5 years diagnosed women with cancer is around 90% in Asian countries. 

Young Age Breast Cancer Diagnostic approaches and management

Breast cancer is one of the most common kinds of cancer and called as second leading reason of deaths among women across the globe. Although screening mammography used for diagnosis, is accountable for significant decrease in morality of breast cancer. But there is limitations of mammography for several women especially those having this cancer with pre-menopause issue.  In spite of high incidence rate, the survival rate in 5 years diagnosed women with cancer is around 90% in Asian countries (developed) and Western countries respectively.

Improvements in treatments and earlier identification of breast cancer have decreased the morality in all women of different age groups although there is risk factor for poor survival of young age women. Unique characters seen in young women who have rare presence of breast cancer and these characters are not observed in older women having cancer of breast.

Young age breast cancer (YABC) has observed biological features include aggressiveness and could be analysed at early stage. If not diagnosed at time then this could lead to bad outcome in contrast to older women suffering from pre and post- menopause conditions.  Similarly different approaches for treatment are needed to achieve good therapeutic results for YABC. These young women need special considerations concerning to fertility and psychological factors.

Diagnosis of breast cancer

In order to facilitate early stage of diagnosis and better disease prognosis biomarkers are used. For overall survival rate biomarker helps to improve among patients with breast cancer.

Evaluation of human tissue kallikrenin 7 (hK7) has been done to find better prognostic/diagnostic marker as breast cancer biomarker. hK7 has activity like chymotrypsin and is secreted as serine protease.

Kallikrein-related peptidase 7 (KLK 7) is protease family and this hK7 belongs to this family. KLK7 mRNA expression level in tissues of breast cancer women indicates as better marker of prognosis. This is for unfavourable breast carcinoma prognosis. hK7 down regulation shows possible role of breast cancer and other benign diseases of breast in natural course. Therefore this gene could be use as a biomarker for identification of breast cancer.

Another approach explains that a process of apoptosis considered as a hallmark of cancer. It is a cellular pathway engaged in carcinogenesis of cancer. Cells that do not express apoptosis can survive and start development of tumor. This may also have clonal expansion inside tumor or other tissues could be invaded. In apoptosis pathway an originator protease Caspase 8 (CASP8) is found to be a crucial gene for susceptibility of breast cancer.

Diagnosis of cancer in breast is postponed in younger female leads to their before time presentation with fatal diseases. This is due to deficiency of awareness and less concerned about this type of cancer.

Real-time PCR quantification is done to evaluate CASP8 expression between tissues of cancer and adjacent normal tissues. Results illuminates reduce CASP8 gene expression in tissues of breast cancer than adjacent normal tissues. These tissues possess high expression of gene. Which glorifies its seminal role to sensitize cells of tumor to stimulus of apoptosis.

Accessory breast tissue (ABT) appears from partial embryologic mammary ridge’s involution called milk line. In ABT primary breast cancer is present which is rarely find in females. Study conducted to estimate the inflammatory breast cancer which is present in upper abdominal ABT in women with cancer in breast history. This tissue has carcinoma presence when evaluated on patients with this cancer and possess the invasive ductal carcinoma (IDC). This will consequently shows challenges for ABT breast cancer diagnosis and treatment. This could also helps to determine the early stage of development of this cancer.

YABC expresses unfavourable prognosis like negativity of estrogen receptor ET, grade 3 and 4 diseases, high rate of proliferation and other biological characteristics like engage in more BRAC 1 /2 mutations in age <35 years. Diagnosis is tough in young women owing to various physiological changes and parenchyma development episode in lactation and pregnancy.

Diagnosis of cancer in breast is postponed in younger female leads to their before time presentation with fatal diseases. This is due to deficiency of awareness and less concerned about this type of cancer.

YABC have found to have poor prognosis even after adjusting for diagnosis delay. Patients of age <35 years have ET positive, are predicted to have more morality risk i.e. up to 1.5% high fold on adjuvant and risk of death increased as well.

Therapy

By local therapy young women show high ipsilateral breast tumor recurrence. Women suffers more psychological and physical impacts after surgery of breast than older women. This include chemotherapies, adjuvant chemotherapy and biopsy.

Younger women with breast cancer are Tamoxifen resistant when adjuvant hormonal therapy is applied to them, this hormone reduce death rate in older women >45 years till 39%. Ovarian cysts occur often in small age women who receive Tamoxifen. These women suffer poor quality of life and emotional distress during treatment and diagnosis.

Women with YABC require accurate counselling, therapies and measures regarding awareness and support like possible pregnancy and fertility preservation. New technologies could better diagnose and predict at early stage of development of cancer. Different biomarker could also be used in this aspect.

BRCA 1/ 2 mutations should be tested to identifies the heredity of breast cancer. Though incidental rate is low, but all clinical features of YABC patients need to consider during treatment to save life.

 

 

https://i0.wp.com/www.technologytimes.pk/wp-content/uploads/2018/10/Young-Age-Breast-Cancer-Diagnostic-approaches-and-management.jpg?fit=765%2C350&ssl=1https://i0.wp.com/www.technologytimes.pk/wp-content/uploads/2018/10/Young-Age-Breast-Cancer-Diagnostic-approaches-and-management.jpg?fit=150%2C69&ssl=1Beenish William SardarArticlesBreast cancer is one of the most common kinds of cancer. It is called as second leading reason of deaths among women across the globe. In spite of high incidence rate, the survival rate in 5 years diagnosed women with cancer is around 90% in Asian countries.  Breast cancer is one...Pakistan's Only Newspaper on Science and Technology