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Breast Cancer Biology. Jo Anne Zujewski, MD Cancer Therapy Evaluation Program Division of Cancer Diagnosis and Treatment National Cancer Institute May 2011. Breast Cancer Theory: Halsted. Operative breast cancer is a local-regional disease - PowerPoint PPT Presentation
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Jo Anne Zujewski, MDJo Anne Zujewski, MDCancer Therapy Evaluation ProgramCancer Therapy Evaluation Program
Division of Cancer Diagnosis and TreatmentDivision of Cancer Diagnosis and TreatmentNational Cancer InstituteNational Cancer Institute
May 2011May 2011
Breast Cancer Biology
Breast Cancer Theory: Halsted
• Operative breast cancer is a local-regional disease• The positive lymph node is the source of distant
metastases
Breast Cancer Theory: Systemic
• Operative breast cancer is a systemic disease• Positive lymph node is an indicator of host-tumor
relationship that permits metastases
Breast Cancer Theory: Spectrum
• Operative breast cancer is a systemic disease in many but not all cases
• Positive lymph node is correlated with the subsequent appearance of distant metastases
Seminal observations that have Seminal observations that have led to the current understanding led to the current understanding
of breast cancer as a family of of breast cancer as a family of related diseases, not a single related diseases, not a single
monolithic process.”monolithic process.”
Molecular Portrait of Breast Cancers
HER-2Basal-like Luminal ALuminal B“Normal”
Sorlie T et al, PNAS 2001Slide courtesy of L. Carey
Subtypes and Prognosis
Sorlie T et al, PNAS 2001
Genetic FactorsGenetic Factors
Oncogenes
Tumor suppressor genes
DNA repair genes
Carcinogen activating/deactivating genes
Cell cycle genes
Cell cycle checkpoint genes
Cell death genes
Cell signaling genes
Cellular senescence genes
Cellular differentiation genes
Metastasis/invasion genes
Hormones Growth factors Small interfering RNAs Post-translational modifications
methylation protein ubiquination phosphorylation
Epigenetic Factors
Breast Cancer
a multi-step process
genetic changes
epigenetic changes
mutagenic/nonmutagenic
risk factors
gene signatures
In pathways, messages are sent from the outside of the cell to the inside of the cell through messengers.
SIGNAL
TRANSDUCTION
Cells respond to external signals through pathways.
Breast Cancer Development, Growth, Survival Breast Cancer Development, Growth, Survival and Metastasis Involves Multiple Interrelated and Metastasis Involves Multiple Interrelated
Pathways Pathways
Concurrent Concurrent targeting of targeting of
multiple multiple pathways pathways
will likely be will likely be optimal!!optimal!!