Breast Cancer: Pathophysiology and Impact on Patient's Life

Breast cancer is a disease that may appear in men and women, there are millions of women affected in the world, and it is one of the main causes of death among women between 40 to 44 years of age. The incidence of this disease has been increasing particularly in the past half century. Many risk factors have been identified such as black race, family history of breast cancer, estrogen exposure, number of pregnancies and age of the first one, radiation past history, obesity, alcohol consumption, smoking history and environmental history. It is also known that genetics plays a role in the development of breast cancer. The presence of BRCA1 and BRCA2 gene mutation is correlated with the formation of this disease (McCance, Huether, Brashers & Rote, 2010). Breast cancer is an illness conditioned to hormones, especially estrogen. Women, who do not have functioning ovaries and have never received hormone therapy replacement, do not develop this disease. The most frequent form of breast cancer originates from cells of the ductal tissue which metastasizes early, although they do not grow too large. This disease presents with pathological variant differing morphological, molecular, and structural fetures. There are several types of breast cancer: cancer originated in the ducts tissue, infiltrating carcinoma, invasive carcinoma, cancer originated in the lobular tissue, and sarcoma of the breast. The less common form it begins in the stromal cells. This pathology has some biological associations known as Ductal Carcinoma In Situ, that is, a cell multiplication in the ducts and lobules. It is more frequent in women but it also can be diagnosed in men too. This type of breast cancer is correlated with invasion in the place of clinical diagnosis, where exists a progressive division from ductal carcinoma in situ to invasive carcinoma and it is the base for the medical treatment of this disease. The proliferation of uncommon cells, however, is not related with the diagnostic of invasive cancer at the place of the tumor. According to the histology it is classified in five different classes: papillary, micropapillary, cribriform, solid, and comedo. Another class of breast cancer is the Invasive Breast Carcinoma, which is originated in the end duct of lobular cells and it is considered a malignant invasive tumor. It is formed from any place in the parenchymatous or adjunct breast tissue, however it is more frequently seems in the upper outer portion of the breast. Studies demonstrate that lump related stroma suffers broad gene process alterations as does the malignant epithelial cells. Fibroblast cells have a very important role in keeping epithelial cell functions, advancing cancer process, and exactly begin carcinogenesis in the epithelial cells. Recent methods have shown that there are many alterations in DNA, RNA, and proteins of carcinomas, which lead to the presence of a diversity of invasive breast carcinomas (McCance et al., 2010). Lobar Carcinoma in situ is formed from the end duct lobular cells. It is differenced with the ductal carcinoma in situ, because this tumor has a steady aspect in which the cells appear in groups and are not adhered principally in lobules. This type of breast cancer is rare, seen only about 3.8% of the breast cancer diagnosed people, and the greatest numbers of cases are seen prior to menopause (McCance et al., 2010). The classification of the disease depends on the location of the tumor, the size of itself, the compromise with lymph nodes and the spread beyond the original tumor to other parts of the body. At the same time, the treatment will be influenced by the stage of the tumor and the compromise with nearby or distance tissues. The more the tumor is advanced, the more aggressive the treatment will be. This could be a single modality or a combination of many treatment options such as chemotherapy, radiation therapy, hormone therapy, biological therapy, immunotherapy, and/or surgery (partial or total mastectomy) with or without breast reconstructive surgery (Pronzato et al., 2011). This is a disease with great impact in the patient's life, patient's family and close friends as well. The entire patient's environment is affected due to this pathology. Starting with the psychological component and the implications of the disease. The body image in this kind of patients is more affected than in any other type of cancer because of their risk of breast amputation (Mechthild, 2008). The negative connotation that the word "cancer" contains for all the patients, has its first impact in the psychological aspect when starting to accept the disease. They have to pass through