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By Karen Hassey Dow

Collage of significant Florida, Orlando.Text on breast melanoma for nurses and wellbeing and fitness care execs. Discusses clinical administration, nursing help, and family members matters touching on breast melanoma. 26 U.S. participants.

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Extra info for Contemporary Issues in Breast Cancer (Jones and Bartlett Series in Oncology)

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Mismatched nucleotides signal a genetic error. In their normal roles, DNA mismatch repair genes, like genetic proofreaders, seem able to spot mismatches and orchestrate the necessary repairs (Cleaver, 1994). If these repair genes don't work, errors accumulate in the course of many generations of cell division and eventually a cancerous mutation occurs. These genes have been described as being like the spell-check in a word processing computer program (Service, 1994). One gene, hMSH2, is said to be primarily a replication editor and the other gene, hMLH1, a recombination editor (Radman & Wagner, 1993).

Loss or inactivation of the same gene may contribute to the development of several different common cancers. It must be emphasized that most common cancers, even when showing familial aggregations, are not inherited. A large number of genes may be involved in tumorigenesis. Several different cancer genes may be involved in the same tumor. The same genes may be lost Page 11 Table 1-3 Familial Cancers Associated with Breast CancerSyndromeClinical ManifestationGenetic MutationMode of Inheritance Breast/ovarian cancer syndromea Breast cancer, ovarian cancer prostate cancer, colon cancerBRCA1Autosomal dominant Site-specific breast cancera,by Breast cancer (male and female), ovarian cancerBRCA2Autosomal dominant Li-Fraumeni syndromea Breast cancer, sarcoma, brain tumors, leukemia, adrenocortical carcinomaP53Autosomal dominant Muir-Torre syndromec GI and GU cancers, skin cancer, breast cancer, benign breast tumors, uterine and ovarian cancerMSH2, MLH1Autosomal dominant Cowden's diseasec Multiple mucocutaneous lesions, vitiligo, angiomas, benign proliferative disease of multiple organ systems, breast cancer, thyroid cancer, GI neoplasms, GU lesionsUnknownAutosomal dominant Peutz-Jeghers syndromec Abnormal melanin deposits, GI polyposis, GI cancer, breast cancer, cancer of uterus, ovarian cancer, cancer of testisUnkownAutosomal dominant Ataxia-telangiectasiac Cerebral ataxia, oculocutaneous telangiectasias, radiation hypersensitivity, leukemia, lymphoma, breast cancer and other solid tumorsLinked to chromosome 11q21Autosomal recessivea Inherited cancer syndrome.

Peters, 1994, Journal of Oncology Management, November/December, 18-26. Most of the studies performed on chromosomal mutations in breast cancer have been either from relatively small heterogeneous populations or with short follow-up times (van de Vijver, 1993). It will be important to validate study results using prospective study design and homogenous groups, allowing enough time for sufficient follow-up before clinical standards can be established. No genetic markers are used clinically at this time.

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