Biological writing for Breast Cancer:

Breast cancer is caused by a homeostatic imbalance of cell division Healthcare practitioners need to understand cellular activities to appreciate the physiological basis of health (homeostasis), the pathophysiological basis of illness and the physiological rationale of healthcare. Cells are the basic unit of life (Clancy and McVicar, 2011a). This article describes normal cell division and the anatomy and physiology of the breast and, using a case study, will show how breast cancer is a homeostatic imbalance of cell division. There are analogies between the components of homeostasis and the components of the nursing (healthcare) process (Clancy and McVicar, 2011b) in the condition of breast cancer. After reading this article, nurses should be able to: understand that breast cancer is a cellular hence chemical imbalance that causes uncontrollable mitotic division of breast cells; understand how the cell cycle of cancer cells differs from that of normal cells; identify nature-nurture interactions involved in the aetiology of breast cancer; understand that when caring for people with breast cancer, health professionals including oncology nurses are acting as external agents of homeostatic control as the patient recovers from breast cancer, and also to some extent when reducing signs and symptoms, hence quality of life, by providing palliative care. Genes, as homeostatic controllers, maintain intracellular homeostasis generally by directing chemical reactions (metabolism). Specific genes are expressed and produce enzymes that ensure that the chemicals inside the cell are within their homeostatic ranges. In addition, since all components outside the cell in tissue fluid and blood are of cellular origin, genes also regulate these components within their homeostatic ranges. There are two types of cell division: somatic cell division, which is called mitosis; and reproductive cell division, which is called meiosis. In both cases, the dividing or parent cell produces offspring or daughter cells. Mitosis will be considered in this article. Mitosis ensures that the daughter cells have the same number of chromosomes, hence genes, and DNA that is identical to that of the parent cell. For this to occur, the parent cells DNA must first be duplicated so that one copy can be passed to each daughter cell. Mitosis is therefore sometimes referred to as duplication division. Mitosis completes one cell cycle and initiates the next one. Tumours are classified as benign or malignant. Benign (non-cancerous) tumour cells are localized and encapsulated. These cells develop singly or occasionally expand in small groups. They usually pose no threat as long as the tumour does not produce symptoms through pressure on tissues or become unsightly. An extremely small percentage of benign tumours lead to secondary growths, called metastases. These tumours are referred to as innocent tumours and do not always need to be removed. If the size or position of the tumour, however, impairs tissue or organ function, or are cosmetically displeasing for the person, then surgical removal is required. The presence of a capsule around a benign tumour makes this procedure straightforward. Postsurgery, there is no danger of secondary tumours and little chance of recurrence. Malignant (cancerous) breast tumour cellseither singularly or as cords/sheets of cellsleave the original tumour site and invade other tissues and organs. This spread, called metastasis, is dangerous and difficult to control. This is because, at their new sites, metastatic cells divide mitotically and produce secondary tumours that will affect the functional capacity of the newly affected tissues or organs. Ordinarily, dividing cells must maintain an adequate rate of tissue growth and replacement conducive to health and wellbeing. According to homeostatic theory, the rate of division is controlled genetically (i.e. by nature) in response to local environmental tissue biochemical conditions (i.e. nurture) (Clancy and McVicar, 2011b).

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