Academic literature on the topic 'Breast cancer treatment][Cancer'

The core project in this thesis is the translational study PGSNPS, which aimed to investigate the pharmacogenetics of breast cancer chemotherapy in the adjuvant setting. Blood or saliva samples were collected from over 2300 patients, who were recruited during a 4 year period. The trial design was adapted to a GWAS approach. The combination of high quality genotype data and detailed clinical information allows this collection to be a useful resource not only for pharmacogenetic analysis but for investigation of prognosis and susceptibility in future analyses. I also examined the role of candidate gene analysis in the identification of variants associated with survival and susceptibility analysis. Candidate gene analysis of the prostaglandin pathway investigated the potential role of key genes in this pathway and their association with breast cancer susceptibility and survival. There was little evidence that common variants are associated with modest risks of breast cancers and no evidence for association with overall survival (OS) for any tagSNP studied. The metabolic enzyme cytochrome P450 2D6, (CYP2D6), is involved in the metabolism of tamoxifen to its active metabolites. I examined the role of the <i>CYP2D6</i> gene in breast cancer specific survival (BCSS) and OS in tamoxifen treated breast cancer patients. One putative poor metaboliser (PM) <i>CYP2D6*6</i> may be associated with decreased BCSS and OS, but the prior probability of such an association is low. All other putative functional variants showed no association. The evidence from this study does not support implementation of routine <i>CYP2D6</i> testing pre-treatment to guide choice of hormone therapy.

This thesis concentrates on the treatment of women with breast cancer in the 19th and 20th century. It analyses written published patient narratives linking them with clinical developments. Medical history holds a rich source of information providing the view of the clinician. This includes case reports and case series from one surgeon or one hospital for the earlier period of the study and has progressed to the double blind randomised controlled trial that dominates comparative research today. There is an imbalance in the material available for the analysis of patients’ perceptions of their treatment. The patient view is not represented well in the history of medicine. This thesis attempts to provide a more complete assessment of the developments in breast cancer treatment by including the patient’s view. Three narratives provide an insight into the perception of women who were treated with breast cancer prior to the introduction of anaesthesia and infection control. The novelist, Fanny Burney (1752-1840), underwent a mastectomy in 1811. In a letter to her sister she wrote about her experience providing details of her diagnosis and treatment. In comparison, Emily Gosse (1806-1857) refused a mastectomy for her breast cancer and sought alternative treatment with caustics. Her husband, Phillip Gosse and friend, Anna Shipton, wrote narratives about Emily’s suffering. A third narrative provides the view of a woman with breast cancer who received no treatment and died of metastatic breast cancer; Zelie Martin died in 1877. These narratives were linked to a case report by Lorenz Heister (1683-1758). Heister described the procedure for amputation of the breast in detail. His method prevailed until new scientific developments in surgery such as anaesthesia and infection control improved the short-term survival of patients and enabled surgeons to operate sooner with a greater attention to detail.

When breast tumor cells encounter stress due to cancer therapies, they may enter a dormant state, escaping from treatment-induced apoptosis. Dormant cells may eventually regain proliferative capabilities and cause recurrent metastatic disease, which is the leading cause of mortality in breast cancer patients. We sought to determine if a high dose of radiation therapy (RT) or combined chemo-immunotherapy, with and without the blockade of autophagy by chloroquine (CQ), could overcome treatment-induced tumor dormancy or relapse. We found that autophagy contributes in part to treatment-induced tumor dormancy. We also found that three therapeutic strategies were successful in inhibiting or preventing tumor relapse. These include: 18Gy/day RT, chemotherapy combined with the blockade of autophagy, and combined chemo-immunotherapy. Follow-up studies are needed to determine the feasibility of preventing tumor relapse by prolonging tumor dormancy versus eliminating dormant tumor cells.

Le cancer du sein est le cancer le plus fréquent chez les femmes. Il y a une multitude de solutions proposées concernant une éventuelle intervention médicale pour le cancer du sein ‐ une en particulier est la chirurgie mammaire conservatrice (tumoréctomie). Le but de la tumoréctomie est de parvenir à un contrôle local du cancer, ainsi que de préserver une forme du sein qui satisfait les besoins esthétiques de la femme. Bien que ces objectifs sont généralement atteint, il reste encore parfois des résultats inattendus,tels qu'une tumeur récurrence locale, ou des résultats cosmétiques insuffisants.L'objectif de cette thèse est de proposer une plateforme de calcul, qui contribue à la tumoréctomie. Cela comprend:1) Une étude de la dynamique de croissance des tumeurs du sein.2) Une étude sur la prédiction du contour du sein grâce a la chirurgie virtuelle.3) Un modèle de calcul de la forme finale du sein après cicatrisation<br>Breast cancer is the most common cancer among women in the developed as well as the developing countries. There are a plethora of proposed solutions regarding possible medical interventions for breast cancer–one in particular is Breast Conserving Therapy (BCT). BCT comprises of complete surgical excision of the tumor (partialmastectomy), and post-operative radiotherapy for the remaining breast tissue. This is a feasible treatment for most women with breast cancer. The goal of BCT is toachieve local control of the cancer, as well as to preserve breast shape that appeases awoman’s cosmetic concerns. Although these goals are usually achieved, there are still occasional unexpected results, such as reexcision of the tumor due to a positive margin assessment, tumor local recurrence, unsatisfactory cosmetic results, and breastpain. Other than surgical experience and judgment, there are currently no toolswhich can predict the outcome of partial mastectomy on the contour and deformity of the treated breast. The objective of this dissertation is to propose computational framework, which contributes to BCT operations, this was achieve by exploring two areas.On the one hand we developed a multiscale model adapted for breast cancer tumor growth, ductal carcinoma in situ (DCIS). The model features included: nutrients growth limitation, wall degradation enzyme and HER2 chemical expression tumor phenotype. Our model successfully simulate some pattern of DCIS carcinoma.Among the interesting result we showed that the enzyme contributed to a greater tumor size and that when HER2 was over expressed, the growth limiting factor wasthe EGFR. On the other hand, we developed a virtual surgery box to simulate BCT surgery. The box will input MRI patient data and will output cosmetic and functional indicator to rate the impact of the surgery. It appears that stiffness of the tissue, resection radius as well as the lump quadrant location are the most sensitive parameters to the indicators. A healing model was also embedded to simulate the wound closure after resection, this model was stress dependent and illustrate anasymmetric wound closure progression.The tools developed in this research allows a new type of field convergence between the surgery and computation field. At the local level it will allow surgeons and patient to be able to communicate on the pertinence and necessity of performing alumpectomy surgery, enabling to anticipate the possible outcome of the operation.On the global aspect this type of tool gives birth to a new type of field: computational surgery, where computer scientist and surgeons work hand in hand to provide the best and the most reliable service to the patients

In the treatment of early stage breast cancer, both mastectomy and lumpectomy followed by radiation therapy have been recognized as having similar survival rates. Increasingly, women are being given the opportunity to choose which of these surgical treatment options they wish to pursue. Decisions tend to be made rather quickly, and some women may later regret their treatment choice. In this study, an instrument (Breast Cancer Treatment Inventory (BCTI)) was developed that identified five primary sources of influence that affect women's breast cancer treatment decisions: cosmetic outcome, preparedness, physician's choice, short-term effects, and long-term effects. Items were generated and refined by oncology professionals and breast cancer survivors, followed by a pilot study conducted with members of a breast cancer support group. The resulting 28-item scale was completed by 139 early stage breast cancer patients. A series of oblique factor analyses yielded a five-factor solution with reliabilities ranging from .66 - .87. Content validity was enhanced by involving oncology experts and women with breast cancer in the item generation procedures. Use of the BCTI may assist women through a methodical and effective decision-making process. The BCTI may also be appropriate for research studiesinvolving the process and prediction of treatment selection since it meets requirements for ease of administration, brevity, reliability, and validity.<br>Department of Counseling Psychology and Guidance Services

The aim of this study is to describe breast cancer survivors' experiences and the associated meanings participating in their important activities during and after breast cancer treatment and the relationship among the survivor, environment, occupation, and performance, using a concurrent mixed method design. Ten survivors between the ages of 45 and 64 with Stage I, II, or III breast cancer who had been treated consecutively with surgery, chemotherapy, and radiation therapy were recruited for the study. Each survivor completed the Activity Card Sort-modified scoring system (ACSm) during the first and last week of radiation therapy and 3 and 6 months post radiation therapy. Additionally, each survivor participated in a semi-structured interview at the end of radiation therapy and 6 months afterwards. Qualitative data was analyzed using interpretative phenomenological analysis (IPA) to understand the survivors' experiences participating in their most important activities. The means and standard deviations of the proportion of activities resumed for the participants' global and category activities were calculated at each time point. A desire to resume participation in meaningful activities emerged from the data and demonstrated the interrelationship between environment, person, and occupation. Themes from the last week of radiation were (a) individual outlook influences how activities are approached, (b) social support reduces the stress of life, (c) side effects influence how activities are completed, and (d) personal and treatment stresses and struggles influenced their perspectives on life. At 6 months post radiation therapy, the themes were (a) emotional effect on activities, (b) life after cancer has changed due to cancer diagnosis and treatment, and (c) side effects continue to influence daily activities. Using the seven stages of analyzing mixed method data developed by Onwuegbuzie and Teddlie (2003), the qualitative and quantitative data were integrated. The results illustrated that the participants resumed a greater proportion of instrumental activities, which were reported consistently as one of their five most important activities. Additionally, supportive extrinsic factors appeared to be more influential in resuming participation important activities than intrinsic factors. Findings from this study support using the Person-Environment-Occupational-Performance (PEOP) model to develop treatment plans for women undergoing or recovering from breast cancer treatment.