Breast cancer: epidemiology, molecular classification, diagnostic and therapeutic management

Abstract

Breast cancer is one of the most common types of cancer occurring in the female population. It is estimated that it causes up to 15% of deaths related to oncological diseases. Despite the development of medicine, there are still no effective methods of treating breast cancer, especially in the advanced stage of the disease. Selected, up-to-date details in the field of epidemiology, etiology, and diagnosis of breast cancer are presented in this article. Moreover, the molecular classification and available therapeutic strategies used in patients with breast cancer are described. The most important step in breast cancer prevention is to increase patients' awareness of self-examination and diagnosis. However, in the case of breast cancer therapy, there is a wide range of solutions, but much depends on the molecular subtype of the cancer and the stage of disease advancement. The basic choice if early changes are detected is breast-conserving surgery or mastectomy. To complement the main therapy (i.e. surgery and radiotherapy), adjuvant therapies are used, which include chemotherapy, hormone therapy, and molecularly targeted therapies. Additionally, in the case of triple-negative breast cancer, immunotherapy is used using monoclonal antibodies, which are programmed death receptor 1 inhibitors or blockers of antigen 4 associated with cytotoxic T lymphocytes. Other immunotherapy methods, such as therapy using chimeric T cells and anticancer vaccines, are also of interest in the treatment of patients with triple-negative breast cancer. The worst-prognosis form of breast cancer is a lesion that metastasizes to tissues. In such cases, the recommended systemic treatment includes various methods (molecularly targeted therapy, chemotherapy, hormone therapy) used alone or in combination. A relatively rare situation is the occurrence of breast cancer in the male population. Nevertheless, all disturbing changes should be monitored, as late diagnosis prevents effective therapy, which is based on methods used to treat breast disease in women. Despite many therapeutic strategies currently used in treatment, the death rate among patients with advanced breast cancer is still alarmingly high. The problem is the lack of response to treatment, side effects, and the occurrence of metastases and relapses of the disease.

Keywords

• breast cancer
• immunotherapy
• adjuvant therapy