What does cancer look like
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Summary
6 papers analyzed
These studies suggest cancer is characterized by uncontrolled cell proliferation, genetic and epigenetic changes, and physical traits like increased stiffness and altered tissue structure, with specific types showing distinct morphological features.
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Understanding the Appearance of Cancer: Key Insights
Ductal Carcinoma In Situ (DCIS) Imaging Characteristics
Ductal carcinoma in situ (DCIS) is a noninvasive form of breast cancer that represents about 25% of all breast cancer diagnoses in the United States. DCIS is known for its heterogeneous nature, presenting a wide range of clinical manifestations and imaging findings. Advances in ultrasonography (US) have significantly improved the detection of early-stage cancers. When calcifications are identified through mammography, US can be used to evaluate for invasive components and guide biopsies. High-frequency transducers, spectral compounding, and speckle reduction algorithms enhance the detection of calcifications. Calcified DCIS typically appears as echogenic foci within a mass or duct, often associated with internal microlobulations or a branch pattern. Noncalcified DCIS, more common in symptomatic patients, may present as a hypoechoic mass with microlobulated margins and no posterior acoustic features, or it may have a "pseudomicrocystic" appearance. Harmonic imaging and coronal reconstruction can improve the detection of noncalcified DCIS. The presence of internal vascularity can increase the positive predictive value of US in detecting DCIS.
Defining Cancer: Uncontrolled Proliferation and Evolution
Cancer is broadly defined as a disease characterized by the uncontrolled proliferation of cells that can spread to other parts of the body. This definition has evolved to include the concept of cancer cells being transformed and subject to evolution by natural selection. This modernized definition captures the genetic and epigenetic changes that accumulate within cancer cells, leading to their lethal phenotype. Essentially, cancer is a disease of uncontrolled proliferation by transformed cells that evolve through natural selection.
Physical Traits of Cancer: Biomechanical Abnormalities
The physical properties of tumors significantly contribute to their growth and treatment outcomes. Four distinct physical traits are commonly observed in tumors: elevated solid stress, increased interstitial fluid pressure, increased stiffness, and altered tissue microarchitecture. Elevated solid stress results from proliferating and migrating cells pushing and stretching the surrounding tissue, which can compress blood and lymphatic vessels, impairing blood flow and the delivery of oxygen and drugs. Elevated interstitial fluid pressure is caused by plasma leakage from abnormally permeable tumor blood vessels and insufficient lymphatic drainage, leading to edema and facilitating invasion and metastasis. Increased stiffness, due to matrix deposition and remodeling, promotes proliferation, invasiveness, and metastasis of cancer cells. Altered tissue microarchitecture disrupts normal tissue structure, affecting cell interactions and signaling pathways associated with invasion and metastasis. Understanding these physical traits is crucial for developing new therapeutic strategies.
Basal-like and Triple-negative Breast Cancers: Morphological and Clinical Features
Breast cancer is a heterogeneous disease with various entities exhibiting distinct morphological features and clinical behaviors. Basal-like breast cancer, identified through gene expression analysis, shares transcriptomic characteristics with tumors arising in BRCA1 germline mutation carriers. These tumors are aggressive, have a poor prognosis, and typically do not express hormone receptors or HER-2, classifying them as "triple-negative." This phenotype makes them less likely to benefit from current targeted systemic therapies. Despite their distinctive features, there is no consensus on the routine clinical identification and classification of basal-like breast cancers, which complicates consistent identification and treatment development .
The Tumor Microenvironment: A Complex Ecosystem
Cancers are not merely masses of malignant cells but complex "rogue" organs that recruit and corrupt other cells, creating the tumor microenvironment (TME). The interactions between malignant and non-transformed cells within the TME play a crucial role in tumor development, progression, immune evasion, and treatment resistance. Understanding the TME is essential for developing new therapeutic strategies that target these interactions.
Conclusion
Cancer manifests in various forms, each with unique imaging characteristics, physical traits, and microenvironmental interactions. Advances in imaging technologies and a deeper understanding of the physical and biological properties of tumors are crucial for early detection, accurate diagnosis, and effective treatment. Recognizing the diverse appearances and behaviors of different cancer types is essential for improving patient outcomes and developing targeted therapies.
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