-- Current coverage of diagnosis and treatment on a wide spectrum of active cancer research.

The current volume represents the fourth over a period of five years in our series on Advances in the Cellular and Molecular Biology of Breast Cancer. The first three volumes were entitled Breast Cancer: Cellular and Molecular Biology, Regulatory Mechanisms in Breast Cancer, and Genes, Oncogenes, and Hormones, respectively. Throughout this series, we have tried to take a broad look at cutting-edge topics in basic science research into breast cancer. This attempt has resulted in a wide range of subject material, including rodent and human model systems, oncogenes, suppressor genes, growth factors, hormones, tumor-host interactions, and determinants of metastases. Since our last volume, research in breast cancer has continued to proceed at an explosive rate. We hope the current volume will provide the reader with some of the excitement felt by the editors and authors as we begin to understand this all-too-common disease. The first section of this book is devoted to the basic processes of proli feration, differentiation, and malignant progression of breast cancer. T.l. Anderson and W.R. Miller lead off with a detailed description of controls on proliferation in the normal human breast and in breast cancer. This chapter strongly emphasizes pathological aspects. The second chapter, by M.R. Stampfer and P. Yaswen, presents a corresponding viewpoint through a presentation of experiments with human mammary epithelial cells in culture. The second section of the book emphasizes the genetic basis for breast cancer onset and malignant progression. Chapter 3, by M.-C. King and S.

This book by a scientist whose background is in cellular and molecular biology examines the fearsome disease that strikes one in eight women in the United States. Although women are more likely to die of heart disease or of lung cancer, a diagnosis of breast cancer is the medical pronouncement that a woman is most likely to fear. It kills more than 40,000 Americans annually. Why are some women more vulnerable than others? The interplay between genetics and environment is suspected. Thus this book for general readers will help them understand the genetic basis of both sporadic and inherited breast cancers. Although only five to ten percent of breast cancer patients have inherited mutations in these genes, all women need to understand the genetic implications of the disease. In clear, concise language Barbara T. Zimmerman guides the reader through the complexities, discussing in detail the genes that are known to increase susceptibility and the ways they are passed on. Examining the general biology of breast cancer, Zimmerman describes how sporadic and inherited forms of the disease arise and how the location of the tumors can affect the body. She discusses genetic mutations and their roles in the development of tumors and tells how these potentially cancer-inducing genes were discovered. Covered too are the issues of risk, prevention, screening, diagnosis, therapy, and genetic testing and counseling. Zimmerman concludes with a comprehensive analysis of current research and with an emphasis on how a woman's understanding of inherited breast cancer can help doctors seeking to design better methods for prevention and therapy. A useful list of resources for further information about the genetic causes of breast cancer is included.

Breast cancer remains the second-leading cause of cancer related mortality in women. We are using the ACI rat model of 17[beta]-estradiol (E2)-induced mammary cancer, which is highly relevant to human luminal breast cancer, to define how genetic variants and hormonal factors contribute to breast cancer etiology. ACI rat is uniquely susceptible to E2-induced mammary cancer, whereas BN rat is highly resistant. This dissertation presented that the luminal epithelium of ACI rats exhibited a rapid and sustained proliferative response to E2. By contrast, the epithelium of BN rats exhibited luminal ectasia and associated changes in the extracellular matrix in response to E2. Marked differences in expression of genes that encode proteins with well-defined roles in mammary gland development were observed. We hypothesize that variation in a subset of the cellular and molecular phenotypes is heritable and underlies the differing susceptibilities of the ACI and BN rats to E2-induced mammary cancer. This hypothesis was tested by evaluating mammary phenotypes, luminal epithelial density, luminal ectasia and mammary cell composition in a panel of unique congenic rat strains that were developed to characterize genetic determinants of susceptibility to E2-induced mammary cancer in intercrosses between susceptible ACI and resistant BN rats. Luminal epithelial density is a marker associated with susceptibility and was shown to be regulated by Emca8. Luminal ectasia is a marker associated with resistance and was shown to be regulated by Emca4, Emca5 and Emca8, and cosegregates with reduced mammary cancer susceptibility at Emca4.2 and Emca8.1. The number of CD45-CD31-CD24+CD29high basal epithelial cells, which harbor mammary stem cells, differ dramatically between susceptible ACI and resistant BN rats and was regulated by Emca4.1, which is orthologous to 8q24 breast cancer risk locus in human. We propose that variation in the different mammary phenotypes is representative of variation that would exist within the genetically heterogeneous human population and a subset of these phenotypes may serve as biomarkers for breast cancer early diagnosis and prevention.

Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.