Dr Joseph Kamugisha Breast cancer is one of the most prevalent diseases in our society. It is therefore a big concern to the physicians involved and the community at large. It is important to mention that challenges and impact of breast cancer diseases have not only been felt in our societies but it is also a worldwide concern. Various studies have been conducted on a wide scale and suggest that birth control pills increase the risk of breast cancer. While this is proven information, many birth control users have directed their focus to the formulation of pills. There are two types of birth control pills or oral contraceptives that are widely used. The most common birth control pills are man-made manipulation of female hormones; estrogen and progesterone. This is the combined oral contraceptive and most effective. The other oral contraceptive is usually termed as the mini-pill and only contains progesterone. This is also a man-made version of the progesterone hormone only. Hormonal imbalance has been highly implicated in the occurrence of some cancers. Physiological imbalance in estrogen and progesterone that occur naturally in the body can increase the risk of some cancers. This is why man-made hormones found in oral contraceptives can have the same effect when it comes to breast cancer. Family planning has been at the center stage for social and economic development. Oral contraceptives play a big role in birth control measures within families. Due to their high demand and longstanding effect on health, manufactures have resorted to formulations or quantity of these hormones in a given brand. For example, in some clinical trials, Some oral contraceptives where found to contain high-dose estrogen and increased breast cancer risk by almost 3 times where as those with moderate dose estrogen present with 1.5 increased risk. Oral contraceptives containing low-dose estrogen were found to have no effect on breast cancer risk. The occurrence of hormone receptors in breast cancer is an important clinical and pathological indicator. In our clinical practice, we, therefore, give great focus on the presence or absence of the hormonal receptors to Estrogen and progesterone. Hormone receptors work like other cell receptors and these are special proteins found within and on the surface of certain cells throughout the body. The breast cells also contains receptors among which are hormonal receptors. These receptors are very sensitive to what is taking place in the body or blood stream. Receptors act like our senses such as ears and eyes. Now, normal breast cells contain hormone receptors that can attach to estrogen and progesterone. Both hormones contribute to the growth and function of the normal breast cells. Estrogen and progesterone are sometimes termed as female hormones because they play an important role in women’s menstrual cycle, sexual development, pregnancy, and childbirth. Men have them too but exist in much smaller quantities than in women. Even after menopause, women continue to have these hormones in their bodies. Like healthy breast cells, most breast cancer cells have hormone receptors and respond to the signals that can come from these hormones. It is, therefore, important to know whether or not breast cancer cells have hormone receptors so as to make treatment decisions. For hormone-receptor-positive breast cancer cells, hormonal therapy can be used to interrupt the influence of hormones on the cells’ growth and its overall function. In medical oncology management, we prescribe medications that inhibit or block the action of the hormone and the the cancer cells are less likely to survive. People will respond well or feel better after medications as the hormone-receptor-positive can lose their receptors over time. The opposite can be true as hormone-receptor-negative cancers can gain receptors. If there is recurrence in breast cancer especially as an advanced disease, doctors can order another biopsy and retest the cancer for hormone receptors. If the cancer cells no longer have receptors, hormonal therapy is unlikely to help treat the cancer. If the cells have gained hormone receptors, however, then hormonal therapy may be helpful. A cancer is estrogen-receptor-positive (or ER+) if it has receptors for estrogen. The cancer is progesterone-receptor-positive (PR+) if it has progesterone receptors. Most of the breast cancer patients are hormonal receptor positive, with two in three patients falling in this category. Dr Joseph Kamugisha is a resident oncologist at Jerusalem Hospital, Israel
