Word: breast
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...last summer, at 47, Maria decided to have both breasts removed. Her own graceful curves were replaced with silicone implants that harbored no trace of her family's lethal legacy. A short time later, Maria received a report that vindicated her decision. A postoperative examination of her breast tissue had found precancerous lesions. "I just broke down and cried," she recalls. "I'd done this knowing I might never know if I'd made the right choice...
Families like Maria Burkhardt's are rare, accounting for a tiny fraction of breast-cancer cases. But the malevolent genes they pass down through the generations are beginning to yield important clues to all breast malignancies. "Cancer," declares celebrated molecular biologist James D. Watson, "is a disease of the DNA," the master molecule that encodes the genetic blueprint for every living cell. Tumors develop as the result of rearrangements in DNA, specifically in the genes that govern cell growth...
...most cases, the changes that lead to breast cancer begin accumulating after birth, perhaps triggered by some set of environmental stresses, whether random cosmic rays or a dietary factor. Some women, however, start out with the genetic deck stacked against them. Like Burkhardt and her sisters, they stand a greater risk of developing breast cancer, in both breasts and at an earlier age, than other women...
Recent months have brought a series of discoveries about the genetic mutations involved in breast cancer. "Information is accumulating at an astounding rate," says University of Utah geneticist Mark Skolnick. Changes in at least two types of genes play a role: those that direct cells to grow and divide; and those that issue commands to halt growth. Much of the research has focused on a growth-enhancing gene on chromosome 17, often referred to as the HER-2/neu oncogene. An estimated 30% of breast-cancer patients have somehow acquired abnormal quantities of this gene -- as many...
...extra copies are a bad omen. Patients that have them suffer three times the rate of cancer recurrence of other patients, says UCLA oncologist Dr. $ Dennis Slamon. Such patients, he says, should "absolutely" get further treatment. But one genetic abnormality is not enough to transform healthy, law-abiding breast cells into anarchic tumors. "The genes responsible for this disease are like pieces of a patchwork quilt," says geneticist Mary- Claire King of the University of California, Berkeley. The patchwork pattern may vary from one woman to the next, but each case probably involves five or six separate mutations occurring over...