Breast cancer / Mamma carcinoma
Breast cancer is the most frequently occurring form of cancer amongst women in Germany, at around 32% of cases. Statistically speaking, one in eight women will suffer from breast cancer over their lifetime, with risk increasing with age. Breast cancer can normally be traced back to glandular tissue and can be categorized into ductal and lobular types, as well as a few other types of carcinoma.
The majority of breast carcinomas occur at random, i.e. sporadically, but they may also have a genetic cause. Risk factors for breast cancer include a person’s hormonal status, age, thickness of breast tissue and lifestyle.
Whilst there are often no symptoms during the earlier stages of the disease, complaints such as bone pain, difficulty breathing and weight loss can be present in advanced breast cancer cases. In general, women should take care to watch out for certain signs, e.g. lumps in the breast, changes to nipples, or swellings in the area of the armpit, as these all require consultation by a specialist.
maintrac® for breast cancer
An important objective of the medical treatment of breast cancer is to preserve the breast affected in addition to curing the cancer itself. A number of different therapeutic approaches are available. Treatment usually starts with the surgical removal of the primary tumor. In many cases, this procedure also involves removal of nearby lymph nodes. After the surgery, a radiotherapy and subsequently a chemotherapy may follow, depending on the specific case. The purpose of chemotherapy is to reduce any possible residues of the tumor. Chemotherapy can also be used to shrink the size of the tumor before surgery (neoadjuvant therapy). Both during adjuvant therapy as well as in neoadjuvant therapy , maintrac® can be of use for monitoring of treatment progress and for treatment optimization.
After a five-year treatment with tamoxifen, breast-cancer patients often ask the question of whether further treatment is necessary. Statistically, a ten-year hormone therapy is associated with a 15% increase in survival rates, where no predictions can be made on an individual basis regarding which patients will benefit from the continued therapy. maintrac® can help when trying to make the right treatment decision regarding hormone/ maintenance therapy for breast cancer.
Additionally, it can be helpful to determine the hormone receptor status and HER2/neu status of CETCs with maintrac® when considering further hormone/maintenance therapy.
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Therapy-relevant characteristics in breast cancer
Breast cancer cells have certain properties, which are specific to these cancer cells and may be important for making therapy decisions. That is why the determination of estrogen receptors (ER), progesterone receptors (PR) or HER2/neu-amplification can be useful.
- ER and PR belong to the group of steroid hormone receptors, responsible for the effects of the female sex hormones, estrogen and progesterone. In cases of hormone-receptor-positive breast cancer, it is common for healthy as well as for malignant cells in the tumor and also the circulating tumor cells to carry estrogen and/or progesterone receptors. Differences between the circulating tumor cells and the cells remaining in the tumor mass may occur.
Around 70-80% of all breast cancer patients have a hormone receptor-positive tumor, which can be treated with medicines having anti-hormonal effects. Examples of how these medicines work include: either inhibiting hormone production (aromatase inhibitors); having an effect on the receptor (selective estrogen receptor modulators (SERM)); or completely blocking the receptor.
maintrac® can be useful during any decision-making regarding whether to continue with anti-hormonal therapy or starting with therapy once again if stopped.
- HER2/neu is an example of a growth factor receptor. In approximately 20-25 % cases of breast carcinoma, a multiplication of the HER2/neu gene (amplification) can be found in the DNA of the cancer cells, associated with an overexpression of the HER2/neu receptor (10- to 100-fold increase compared to normal cells is possible). By looking for evidence of HER2/neu gene amplification in the circulating tumor cells, the HER2/neu status can be determined. If it can be determined whether a patient with breast cancer is presenting gene amplification and an associated overexpression of the HER2/neu receptor, then this is a good indicator that the patient will respond to an anti HER2/neu therapy (e.g. Trastuzumab). With this therapeutic approach, HER2/neu receptors are prevented from giving further growth signals to cells.