The problem of breast cancer must be faced with information and with hope.

You have to individualize "YOU" cancer. Do not get carried away by stories lived by other people, because they lived  "YES" cancer, which probably has nothing to do with yours.

The first thing you have to know is that there are two large groups of cancers:

1. ""in situ"" cancers.

2. ""Infiltrating"" cancers.

So that you understand it better, I am going to give you the simile of a bird and its nest. On  cancers "in situ", the chick is still inside the egg that  there is inside the nest, it has not yet flown out. The "infiltrating" cancer, the chick has broken the shell of the egg and has already left the nest. What we do not know is whether or not it has flown far from it. Hence the importance of early diagnosis to catch him near the nest. The time it takes for the tumor/bird to fly depends on two factors: its aggressiveness and our defense capacity.

Also the treatment of these two types of tumors are completely different. The first (in situ) we must limit ourselves to preventing it from developing, and the second (infiltrating)

we must attack it directly (tumorectomy/mastectomy/) and assess whether we should act on the possible flight that it may have had to prevent it from laying other nests in the different parts of our body (RT/QT).

When at the beginning I told you about individualizing "YOU" cancer, it is because  All infiltrating tumors have  the same aggressiveness.

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Malignant cells have their own characteristics  that make their aggressiveness different :

•   Degree of differentiation :

Grade 1 (Well differentiated)

Grade 2 (Moderately differentiated)

Grade 3 (Poorly differentiated)

The less differentiated, the more aggressive the tumor.

• Cell ploidy (amount of DNA)

diploid; regular quantity

Aneuploid : Abnormal amount.

The more quantity, the more aggressive.

• Hormone receptors :

Breast cancer cells obtained during a biopsy or surgery will be tested for certain proteins that are receptors for estrogen or progesterone. When the hormones estrogen and progesterone bind to these receptors, they stimulate cancer growth. Cancers are identified as hormone receptor-positive cancers or hormone receptor-negative cancers depending on whether they have hormone receptors (proteins) or not. Knowing hormone receptor status is important in deciding treatment options.  

• HER2 receptor:

HER2 is a protein on the outside of all breast cells that promotes growth. Breast cancer cells with higher than normal levels of HER2 are called HER2-positive. These cancers tend to grow and spread faster than other types of breast cancer, but they respond to treatment with drugs that target the HER2 protein.

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With all this information, supplied by the Pathological Anatomy Laboratory

The Oncologist will consider the best option for "YOU" treatment, NEVER forget that each case is different from the others.

Currently, with a view to personalizing YOUR treatment, what is called is being done:

• Gene expression testing for breast cancer.

Tests for the genetic study of breast Ca  They aim to check the chances of recurrence of the tumor and the chances of success of chemotherapy  in YOU cancer  . They are usually done in cancers in early stages

There are several options:

The Oncotype DX, MammaPrint, and Prosigna tests are examples of tests that look at different sets of breast cancer genes. More tests are currently being developed.

Based on these studies, 4 subtypes of breast cancer have been defined:

Luminal A : Hormone receptors + and Her2 negative

Luminal B : Hormone receptors and Her2 positive

Basal type : Hormone receptor negative, Her2 negative

With excess Her2 receptors : negative hormone receptors and positive Her2.

The researchers conclude that patients with Luminal A have the best prognosis and usually only require hormone therapy. Patients with  Luminal B has a worse prognosis than luminal A and better than the other two following, and usually benefits from hormone therapy and chemotherapy. The last two varieties have a worse prognosis and their treatment goes hand in hand with the treatment of

ovarian tumors.

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