Breast cancer is something that many women fear, especially if it runs in their family. This is because the kids who born from mothers with breast cancer inherit a mutant gene from their mother or father, referred to as “hereditary cancer”. This group has higher risk for breast cancer than most people because the mutation genes are passed down from generation to generation. Basically, most people are born with two normal copies of each gene, one from each parent. But, hereditary cancer happens when a child is born with mutations in a gene that gets damaged and isn’t able to protect against cancer. According to the National Cancer Institute, breast cancer is the main cause of cancer deaths among women ages 15-54 and estimates around 450,000 deaths annually worldwide, although it is very rare for women under age 40 to develop it.
Each year in Thailand the number of women who have contracted breast cancer has risen rapidly, caused from the expansion of a mutant gene passed from parents to their children, family and relatives. About 1 in 8 women will develop breast cancer in her lifetime, caused by a combination of factors. It may include lifestyle, environmental factors, hormonal factors as mentioned already, hereditary factor is one of the main reasons as well as unknown factors sometimes. The Queen Sirikit Center for Breast Cancer has opened in 2005 by Her Majesty the Queen, aiming to spread awareness and educate women about breast cancer along with treatments. The center is the base of teaching hospital and giving lecture on breast examination and breast health to community, universities, slums and outreach provinces. “An increasing number of women are getting breast cancer each year. Statistics taken in 2008 showed that there were 500 new breast cancer patients at the center. The center was established in 2005 with a current number of 1,200 breast cancer patients. This disease might not be preventable but it is better to discover it early on in the stage,” said Dr. Kris Chatamr, the Director of the Queen Sirikit Centre for Breast Cancer.
There are two types of mutations. First one is called oncogenes, or gene that causes a cell to become cancer. These genes produce a protein that can stimulate cells to grow out of control and develop into a cancer. The second is the most common inherited breast cancer genes called BRCA1 (Breast Cancer gene one) and BRCA2 (Breast Cancer gene two). BRCA1 and BRCA2 are tumor suppressor genes because they build proteins that help prevent the cells from multiplying out of control, slow down cell division and repair DNA mistakes. It contains high densities of repetitive elements. The cancer starts when one of these genes has changed during a mutation when the proteins are not built, making a tumor to develop easier. Even though everyone has BRCA1 and BRCA2 genes but, when these genes contain abnormalities, it provides the wrong set of instructions and leads to faulty cell growth. Women with a mutation in BRCA1 have a 50% risk of developing breast cancer while the risk of BRCA2 is 60%. Not only women are affected by BRCA mutations. Men also have breast tissues and can receive mutations causing breast cancer too but it rarely happens.
Other than this, there are many other genes that can cause breast cancer. For example, CHEK2 gene provides instructions for making a protein called checkpoint kinase 2. When mutated CHEK2 genes fail to do their job, the scientists confirmed it as a risk factor for breast cancer. The researchers found that if normal women have 14% of getting breast cancer, women who carried the CHEK2 mutation are at double the risk to 28% suddenly. p53, also known as TP53 or tumor protein, is a gene responding to DNA damage and preventing cancer. It is the most common mutation found in cancer cells, shown in over 50% of cancers. If the gene is not working due to a mutation, damaged cells are unchecked which can cause the spread of cancer.
Generally, the risk of getting hereditary breast cancer may come from closely-related family members in one family from different generations who have developed cancer such as first-degree relatives like mothers and sisters or many close relatives like grandmothers, aunts, nieces and granddaughters have been diagnosed with breast cancer, especially before age 50. In this case, DNA tests for hereditary breast cancer is recommended when there is a strong family history of breast cancer; to see if you carry one or more of the faulty genes from the first degree relatives like mother or father or not. For women who don’t have family history of breast cancer, the possibilities of carrying a BRCA mutation are very low.
Genetic testing is able to see if you carry one or more of the faulty genes, while some women are required to do regular mammography screening from an early age. The test result cannot tell when cancer might develop, but it provides the risk of one will develop breast cancer or not.
When women with breast cancer are pregnant, unusual cancer can happened to their children and is believed that it comes from hereditary condition A child with family history of cancer genes may carry BRCA1 or BRCA2 mutated genes. When a girl under 20 years old has a breast cancer, the doctor found it very difficult because the breast tissue in young girl is generally denser than the breast tissue in adults. So when younger woman can feel a lump in their breast, the cancer usually become advanced. Many young women assumed they are too young to get breast cancer and rarely respond to treatment concerning to their beauty. Dr. Chatamra said, “The treatment process at our center does not always mean removing your breast because our center uses a new treatment procedure called ‘Tomosynthesis’ that uses a special pin injected into the breast and sucks the tumor out but a tumor has to be smaller than one centimeter. There are only five ‘Tomosynthesis’ machine in the world and we are lucky to have one at our center.”
Hereditary is the major concern among scientist and doctors because it is an abnormal gene that is being passed along family tree and hardly prevented. Even though it occurs in only 5% of breast cancer patient but doctors believe that hereditary cause a long term effect and could become harmful factor of breast cancer widespread in the future. However, there are many other factors that can increase a woman’s risk of developing breast cancer such as age at time of reproductive events, pregnancy, alcohol and etc.
By : Saruta Chaochavanil
Chutimon Skulthai
Khanatsawan Phoowattanadilokkoon