Rakovina prsníka a nebezpečné mutácie BRCA1 a BRCA2

Pravdepodobne každý z nás má v svojom okolí niekoho, kto s rakovinou musel alebo stále musí bojovať. Ako však rakovina vzniká? Dá sa jej predísť? Rakovina začína v bunkách, ktoré sú základnými stavebnými kameňmi. Bunky tvoria všetky tkanivá a orgány v tele, vrátane prsníka.

rak1

Rakovina prsníka

Normálne bunky v prsníku a v iných častiach tela rastú a delia sa. Takýmto spôsobom vytvárajú nové bunky, vtedy, keď sú nové bunky potrebné. Keď normálna bunka zostarne, alebo príde k jej  poškodeniu, táto bunka odumrie a nová bunka nahradí jej miesto.
Niekedy však tento proces zlyhá. Nové bunky sa tvoria,  aj keď ich telo nepotrebuje. Staré alebo poškodené bunky neumierajú, ako by mali. Nahromadenie týchto buniek často vytvorí zhluk tkaniva, ktorý sa nazýva nádor.

Nádory v prsníku môžu byť benígne (nezhubné nádory) alebo malígne (rakovinové).

Benígne nádory:

- Nie sú zvyčajne škodlivé

- Zriedka napádajú tkaniva okolo nich

- Nešíria sa do iných častí tela

- Môže byť odstránené a zvyčajne sa znovu neobjavia

Zhubné (malígne) nádory:

- Môžu znamenať ohrozenie života

- Môžu napadnúť blízke orgány a tkanivá (napr. hrudné steny)

- Môžu sa šíriť do ďalších častí tela

- Často môžu byť odstránené, ale niekedy môžu dorásť


Bunky pochádzajúce z rakoviny prsníkasa môžu šíriť po tele
. Môžu cestovať cievami alebo lymfatickými cievami a tak dosiahnuť aj iné časti tela. Takýmto spôsobom sa môžu rakovinové bunky pochádzajúce z prsníka pripojiť k ďalším tkanivám a môžu začať rásť. Takto vytvoria nové nádory, ktoré môžu poškodiť tieto tkanivá.

Bunky rakoviny prsníka sa napríklad môžu rozšíriť najprv do okolitých lymfatických uzlín. Skupiny lymfatických uzlín sú v blízkosti prsníka pod ramenom (podpazušie), nad kľúčnou kosťou a v hrudníku za hrudnou kosťou.

Keď sa rakovina prsníka šíri z pôvodného miesta do iných častí tela,nový nádor má rovnaký druh abnormálnych buniek a rovnaký názov ako primárny (pôvodný) nádor.Ak sa napríklad rakovina prsníka šíri do pľúc, rakovinové bunky v pľúcach sú vlastne bunky rakoviny prsníka. Choroba je metastatický karcinóm prsníka, nie rakovina pľúc. Z tohto dôvodu, bude táto rakovina liečená ako rakovina prsníka a nie ako rakovina pľúc.

Najčastejším typom rakoviny prsníka jeduktálny karcinóm. Tento typ rakoviny prsníka začne v bunkách, ktoré lemujú mliekovody prsníka . Približne 7 z každých 10 žien s rakovinou prsníka má práve duktálny karcinóm. Tento typ rakoviny prsníka zvykne metastazovať do kostí, pľúc, pečene a mozgu. Taktiež metastazuje do lymfatických uzlín.

Druhým najčastejším typom rakoviny prsníka je lobulárny karcinóm. Postihuje intralobulárne duktuly mliečnej žľazy. Približne 1 z každých 10 žien s rakovinou prsníka má lobulárny karcinóm.

Iné ženy majú kombináciu duktálneho a lobulárneho typu, alebo majú menej zvyčajný druh rakoviny prsníka (Tubulárny karcinóm, Medulárny karcinóm, Mucinózny karcinóm, Morbus Paget).

Karcinómu prsníka patrí medzi zhubné ochorenia ako aj medzi civilizačné choroby. Je najčastejším zhubným nádorom u žien a má stále vzrastajúci výskyt.  Najvyššia incidencia je u žien okolo veku 65 rokov. Veľmi dôležitou prevenciou pri rakovine prsníka je samo vyšetrenie prsníka a taktiež preventívne prehliadky u doktora.

Nebezpečné mutácie BRCA1 a BRCA2

Zhubné nádory prsníka vzniknú u prevažnej väčšiny žien súhrou náhody a rizikových faktorov. Avšak jeden z 300 – 800 prípadov je spôsobený mutáciou v géne BRCA 1 alebo BRCA 2. Pokiaľ tieto gény fungujú správne, opravujú chyby v DNA a pomáhajú predchádzať vzniku rakoviny. Pokiaľ sa u nich ale objavia mutácie, táto schopnosť sa naruší, čo výrazne zvyšuje riziko vzniku rakoviny prsníka a vaječníkov.

Zatiaľ čo v bežnej zdravej populácii je riziko rozvoja rakoviny prsníka približne deväť percent, v prípade mutácie BRCA génov ide až o 86 percent. Tieto invazívne nádory sa môžu vyskytnúť aj o 15 – 20 rokov skôr ako u populácie bez BRCA mutácie. To je tiež dôvodom, prečo zhubné nádory u nositeľov BRCA mutácie vznikajú v oveľa nižšom veku.

Mutácie génov BRCA 1 a BRCA 2 sú dedičné, dedia sa tzv. autozomálne dominantným spôsobom, čo znamená, že ak jeden z rodičov má mutáciu v jednom z týchto génov, existuje päťdesiatpercentná pravdepodobnosť, že ju odovzdá svojim deťom. Mutácia sa tak odovzdáva z generácie na generáciu. Pokiaľ teda nenesú mutáciu rodičia, nemôžu ju odovzdať ani svojim potomkom.

Táto dedičná dispozícia sa nevyhýba ani mužom. U nich je potom riziko rakoviny prostaty, hrubého čreva a prsníka zhruba 2-krát až 5-krát vyššie ako v normálnej populácii. A tiež muži môžu preniesť túto mutáciu na svojich potomkov.

Mutáciu BRCA génov je možné zistiť genetickým vyšetrením z krvi.

Podozrenie, že by sa v rodine mohla táto predispozícia vyskytovať, by mal človek pojať predovšetkým v prípade, že má dvoch príbuzných, u ktorých sa vyskytla rakovina prsníka a aspoň u jedného z nich pred päťdesiatym rokom veku, alebo ak má troch alebo viac príbuzných s rakovinou prsníka v akomkoľvek veku. Pokiaľ má žena podozrenie, že by mohla byť nositeľkou BRCA mutácie, mala by osloviť svojho praktického lekára alebo gynekológa, ktorí jej môžu vystaviť žiadanku na genetické testovanie.

41 komentárov

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    Many users get baseline checks before beginning an Anavar cycle, followed by mid-cycle and post-cycle exams.
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    PCT often consists of the use of specific drugs and cycling off
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    Throughout the initial section of incorporating Oxandrolone into their regimen, most customers experience noticeable modifications in their strength and endurance levels.
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    Anavar’s optimistic effects on muscle achieve, fats loss, and power aren’t without price.
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    (17) Malhotra, A., Poon, E., Tse, W. Y., Pringle, P.
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    I don’t use them all the time, however they're within the toolbox when needed.
    The deficit doesn’t automatically mean you’ll get an additional advantage.
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