Author/Editor		Lanišnik-Rižner, Tea; Kristan, Katja; Stojan, Jure; Adamski, Jerzy
Title		Site directed mutagenesis of 17beta-hydroxysteroid dehydrogenase from fungus Cochliobolus lunatus
Type		članek
Source		In: Dolinar M, Jerala R, Komelj R, editors. Book of abstracts of the 4th meeting of the Slovenian biochemical society with international participation; 2001 Sep 13-15; Kranjska Gora. Ljubljana: Slovenian biochemical society,
Publication year		2001
Volume		str. 33
Language		eng
Abstract		Breast cancer (BC) is the commonest cancer in women in affluent countries and so is in Slovenia. It is expected that the incidence is going to increase in the comming decade. The lenght of survival in the patients with BC has improved due to increase in early detection and advances in treatment. Despite that BC remains the leading cause of cancer deaths among women. Therefore huge efforts are undertaken, not only in search for methods for early detection, but also in looking for ways for BC prevention. After a decade of laboratory and clinical research there are following options for prevention of BC: - chemoprevention with Tamoxifen (there is further research underway testing other substances) - prophylactic mastectomy in women with strong genetic predisposition -prophylactic oophorectomy. Prevention of BC with chemoprevention and prophylactic mastectomy and oophorectomy carries with it multiple side effects and its own morbidity. Therefore prior to decision for such treatment careful objective evaluation of level of risk (Gail index) and general health status of each potential candidate is paramount. Prevention, detection and treatment of BC requires cooperation of experts of different specialities and can only be performed in the institutions where such cooperation exists. Team work is crucial in efforts to further reduce mortality from BC. Multiprofessional and multidisciplinary approach to the problem is the only waranty for success and progress.
Summary		Rak na dojki (RD) je v razvitem svefu in Sloveniji najpogostnejši rak pri ženskah. Pričakujemo pa, da se bo v prihodnjih 10 letih incidenca še večala. Zaradi deleža rakov, odkritih v omejenem stadiju (zgodnje odkrivanje) in napredka v zdravljenju RD, se je preživetje bolnic izboljšalo. Kljub temu pa RD pri ženskah ostaja na proem mestu med vzroki smrti zaradi raka. Zaradi vse večjega bremena RD intenzivno iščemo ne le nove in učinkovite načine zgodnjega odkrivanja, ampak tudi možnosti njegovega preprečevanja. Po 10 letih strokovnih laboratorijskih in kliničnih raziskav razpolagamo danes z naslednjimi možnostmi preprečevanja raka na dojki: - kemopreventiva s tamoksifenom in nadaljnje klinične raziskave s številnimi, različnimi učinkovinami z večjo selektivnostjo in manjšimi neželenimi učinki, - profilaktična mastektomija pri genski obremenitvi (družinski rak) in - profilaktična odstranitev jajčnikov. Zaradi neželenih učinkov ob kemopreventivi in/a1i zbolevnosti, ki nastane ob profilaktični mastektomiji in odstranitvni jajčnikov, so v program preventive RD vkljucene samo ženske, ki imajo objektivno potrjeno dovolj visoko tveganje za razvoj raka (Gailov indeks) in opravljeno presojo splošnega zdravja. Preprečevanje, odkrivanje in zdravljenja RD zahteva sodelovanje izkušenih specialistov različnih strokovnih usposobljenosti. Obravnava RD lahko poteka v ustanovah, kjer takšno sodelovanje obstaja. Samo s takim načinom dela je možno še nadalje vplivati na zmanjševanje umrljivosti zaradi RD. Multidisciplinarna in multiprofesionalna obravnava je edini porok za uspeh in napredek.