Current Methods of Prognosis:
Breast cancer prognosis depends on a combination of factors including the location of the tumor, extent of metastasis, tumor markers, tumor size and shape, and the rate of cell division. However, accurate methods for quantitatively determining the location and assessing the severity of the primary tumor have not been implemented in clinical practice yet.
Immunohistochemistry (IHC) & Fluorescence in-situ hybridization (FISH) – Two tests used to detect the presence of HER2, a growth-promoting protein that is indicative of aggressive forms of breast cancer. The problem with this is that HER2 is not cancer-specific and may be indicative of other unrelated diseases.
Mitotic Index (MI) – This test uses the rate of cell division to produce a numerical measurement that predicts how aggressive the cancer is. The problem with this is that it offers some degree of vagueness since it does not take into account which phase of the cell cycle the division is occurring in.
Tumor Grade – This traditionally used method is a numerical score assigned by pathologists as to the apparent abnormality of the tissue cells under a microscope. The problem with this is that it uses qualitative assessment and will differ depending on which pathologist is assigning the score.
Current Methods of Treatment:
Breast cancer treatment depends on several factors such as the size, stage, locale of the tumor, and the number of mutations in inherited breast cancer genes such as BRCA1 and BRCA2. However, the available treatment options result in many negative side effects and do not have very high specificity or precision.
Radiation Therapy – This treatment uses high-energy X-rays to ablate cancer cells. While the lowest probabilities of cancer relapse are correlated with the use of radiation therapy, side effects include chest pain, fatigue, swelling of the breast, lowered white blood cell counts, and skin reactions.
Chemotherapy – This treatment eradicates cancer cells using an explicit treatment plan of drugs given at recurring interims for a set number of times. Side effects include anemia, fertility issues, neuropathy, and memory loss.
Hormonal Therapy – This treatment is useful in managing a tumor that assays positive for either estrogen or progesterone receptors. Obstructing these hormones restricts the development of the tumor. Side effects include osteoporosis, fatigue, insomnia, and joint pains.