Breast Cancer in the Era of Precision Medicine
Introduction: Precision medicine is concerned in diagnosis of patients according to their biological, genetic and molecular status B As cancer is a genetic disease, its treatment comes among the first medical disciplines as an application of precision medicine .A Breast cancer is a highly complex, heterogeneous and multifactorial disease as well as it is one of the most common diseases among women in the world .Usually, it has no clearly symptoms, so gradual screening is important for early detection. Scientists recently resorted to use modern techniques which help in its accurate diagnosis at the genetic level and its treatment. C D Entering the era of precision medicine and leaving behind traditional treatment approaches may provide data-driven treatments suitable to the genetic, environmental, and lifestyle factors that contribute to the uniqueness of each individual. I Keywords: breast cancer, precision medicine, genetic disease, Literature Review: Unlike most breast cancer treatments (including surgical treatment, radiation therapy, hormone therapy, chemotherapy, and targeted therapy)that showed risks and side effects, precision medicine has been proven to be the most effective treatment for each patient.
Most breast cancers start either in the breast tissue made up of mammary glands’ lobules, or in the ducts attached to the nipple. The remainder of the breast is made up of fatty, connective, and lymphatic tissues. DE Breast cancers was also reported in rare men cases in the US, accounting for less than 1%. Breast Cancer Risk Factors: Family characteristics: Family history, genetic predisposition, breast density, bone mineral density, height, menstrual cycles and endogenous hormone levels. F Reproductive factors: Pregnancy, fertility drugs, postmenopausal hormones, breastfeeding, hormonal birth control, alcohol, tobacco, diet, physical activity, obesity and weight gain Environmental and other risk factors: Radiation exposure, diethylstilbestrol exposure, environmental pollutants, bras .breast implants, night shift work, hair dyes, relaxers, and antiperspirants. D In a randomized clinical trial of an earlier study for breast irradiation, it was shown to reduce cancer recurrence in the breast, but there was no statistically significant reduction in mortality.H In a 2005 study, an evidence based method is used to calculate a general estimation of optimum radiotherapy utilization of 52.3% for all notifiable cancer in Australia.
The advantage of radiotherapy over other treatment options that’s why it has a better survival, local control, and toxicity profiles. The whole estimate provides a useful instrument for assisting in planning adequate radiotherapy resources .k In a 2012 study by Yamamoto et al, it was reported that the applications of genome-wide expression profiling technologies, such as DNA microarrays, are important for better characterize the molecular features of breast cancers The study showed that it is possible to integrate noninvasive magnetic resonance imaging (MRI) data with more involved and greatly dimensional microarray genomic studies for breast cancer. The results also showed some potential ways of associating breast tumor biology to imaging descriptors recognized through routine studies and provide a palette of copy traits for future radiogenomic studies to leverage. J. In a study at 2017, authors suggested new approaches that may help in improving the efficiency of the currently available cancer therapies. Of these, the optimization of drug dosage and the recognizing genetic changes that are related to cancer symptom occurrence and severity.
Besides, gene profiling studies would also help in identifying the genetic biomarkers. This can predict the risk of individuals to develop common symptoms related to cancer treatment, thereby achieving a better quality of life for patients undergoing cancer treatment. G More recently in a 2018 study, the ecoomics technologies, genomics, transcriptomics, proteomics, metabolomics and radiogenomics have been favorite in breast cancer research, aiming to assimilating several layers of data for an integrative portrait of breast cancer and recognizing precision medicine in breast cancer Radiogenomics represents not only the progress of radiology-pathology correlation from the anatomic histologic level to the genetic level, but also describes the interface of biologic systems methodologies and imaging .I More research is needed to study the importance of follow-up to patient survivorship. Immunotherapy with immune checkpoint inhibitors is a promising and rapidly growing field of interest in many solid tumors, including breast cancer. TILs are mononuclear immune cells that are found in and around tumor tissue. The prognostic value of TILs in primary breast cancer has been substantially evaluated using tumor samples in thousands of patients from prospective trials of adjuvant chemotherapy. Advanced response rates and longer survival have been detected in patients with advanced TIL levels,25 L