geonomics in breast cancer decoding human genome luis barreras, m.d., facp
TRANSCRIPT
Geonomics in Breast CancerDecoding Human Genome
Luis Barreras, M.D., FACP
Breast Cancer Figures
1 in 8 women will develop breast cancer in their lifetime
180,000 women and 2,000 men yearly will develop breast cancer
Over 40,000 women and men will die from breast cancer in 2009
77% of breast cancer cases occur in women over the age of 50
Mortality rates have decreased by 3% annually since 1990
Stages of Breast Cancer
Tumor size
Nodal status
Metastasis
Genetics
While genetics influence breast cancer, only 5–10% of cancers are genetically recognized
Genomic tolls focus on the genetic makeup of cancer cells
These expressions of genes can be traced to specific cancers and their behaviors
BRCA 1 & 2(Breast Cancer tests for genes)
Studies reveal a 60% increase in breast and ovarian cancers, lifetime risks
Whereas in the general population, there is only 12% lifetime risk
Genomic Test
Gene expression testing
% of recurrence
Benefits of treatment
Marker in Breast Cancer
ER/PR
HER-2
Proliferation
21 – Gene Assay
Response to Therapy by Gene Expression Testing
Category 1 Category 2 Category 3 Category 40
1
2
3
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5
6
Series 1Series 2Series 3
Patient Case #1
39 year old with large tumor in breast, no lymph nodes, ER+, HER-2 neg.
Treatment prior to gene expression studies – Chemotherapy
21 gene panel – low risk
Treatment after gene expression studies - Hormonal
Patient Case #2
60 year old with small tumor in breast, ER +, node negative, HER-2 neg.
Treatment prior to gene expression studies – Hormonal
21 – gene panel – high risk
Treatment after gene expression studies – Chemotherapy and Hormonal