breast_cancer_pts_1_2_FA22

NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Using Precision Medicine to Target Breast Cancer and the Cell Cycle Know Your Enemy, Know Yourself: d{" If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but Kelsie M. Bernot, Telah A. Wingate, & Kiara D. Whitaker not the enemy, for every victory gained you will also su ff er a Department of Biology defeat. If you know neither the enemy nor yourself, you will North Carolina A&T State University, Greensboro, NC succumb in every battle. —Sun Tzu, Th e Art of War Introduction Learning Objectives After completing this case study, you should be able to: • Read and interpret breast cancer pathology results. • Draw the phases of mitosis. • Connect cell signaling to cell cycle regulation, and explain how dysregulation of those events can lead to cancer. • Discuss how physicians use precision medicine to obtain genetic information about the individual’s tumor tissue to target treatment speci fi c to that individual’s cancer. • Discuss how physicians use precision medicine to obtain genetic information about the individual’s somatic, non-cancerous cells to make decisions about treatment. • De fi ne incidence and mortality . • Compare how health disparities impact patients’ and physicians’ abilities to know the enemy and know themselves in the United States and the world. • Discuss the impact of ethnicity, age, geographic location and healthcare infrastructure on health disparities. YOU ARE WELCOME TO ACCESS THESE, BUT THE MATERIAL IS PART OF THIS WEEK Please prepare for our class meeting by watching the following videos and taking notes on the phases of mitosis. Video 1: Hasudungan, A. 2013. Cell cycle (mitosis). Running time: 9:52 min. <https://youtu.be/DePnK9TwU6w>. Video 2: BiologySpotTutors. 2012. Cell cycle checkpoints. Running time: 3:44 min. <https://youtu.be/ eljbYQihxXw>. After watching these two videos you should be able to: • Describe the cell cycle and what happens at each phase: G 0 , G 1 , S, G 2 , M, and cytokinesis. • Describe the three cell cycle checkpoints, what is being detected at each checkpoint, and what happens to the cell if it does not meet the requirements of the checkpoint. Next, watch the following: Video 3: Bozeman Science. 2014. Phases of mitosis. Running time: 10:41 min. <https://youtu.be/mXVoTj06zwg>. You should now also be able to: • List the phases of mitosis in the order in which they occur and describe what happens in each phase. Case copyright held by the National Center for Case Study Teaching in Science , University at Bu ff alo, State University of New York. Originally published October 15 , 2018 . Please see our usage guidelines , which outline our policy concerning permissible reproduction of this work. Photo © Richard FIsher, cc by 2 . 0 , <https://www. fl ickr.com/photos/richard fi sher/3415115671>.

NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Part I – Uh-oh Kelly and her husband Jack were fooling around in bed one evening, when Jack felt a lump on Kelly’s breast. “What’s this?” he asked. Kelly replied, “Oh, I don’t know, it’s probably a cyst or something to do with my menstrual cycle.” At 33 years of age, Kelly wasn’t concerned about the lump and was certain it would go away; however, her gynocolo- gist wasn’t so sure. After a mammogram showed a suspicious mass, the radiologist ordered a biopsy , telling Kelly “It’s possible that this is a benign tumor; however we need to make certain that it is not malignant .” During the next two days while Kelly was waiting to hear the results of the biopsy, she felt anxious. She periodically felt adrenaline coursing through her body as she fi nally considered the possibility that she might have cancer . Questions 1. Explain the relationship between the following words: benign, malignant, biopsy, and cancer. If you have studied epinephrine (adrenalin) signaling previously (and you most certainly have) , consider why Kelly felt the effects of the hormone, adrenaline. What signals was this molecule sending to various parts of her body? (You may need to consult a reliable online source to fully understand the concept of how the hormone adrenalin acts on different tissues in the body.) “Know Your Enemy, Know Yourself” by Bernot, Wingate, & Whitaker Page 2 uncontrolled rate of cell proliferation that leads to benign doesn't spread into other tissues non cancerous destruction of neighboring mass of cells w no functional purpose tissue malignant cancerous can spread to other parts of the body uncontrolled division of cellsinvading other tissues biopsy a tissue removed to be analyzed to see if the cells are cancerous Kelly was worried that she had a malignant tumor so adrenaline can cause her heart rate to increase eyes to dilate etc increase temp inc respiration Of blood sugar level I glucose available to in cellular respirator glucose is stored as glycogen so you breakdown glycogen

NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE present during all active phases of the cell cycle (G 1 , S, G 2 , and mitosis/cytokinesis), but is absent from resting cells (G 0 ). Ki-67 is an excellent marker to determine the growth fraction of a given cell population. Th e fraction of Ki-67-positive tumor cells (the Ki-67 labeling index) is often correlated with the clinical course of cancer.” <http://en.wikipedia.org/wiki/Ki-67_(protein)>. Based on the Wikipedia description, does a high Ki-67 score mean that the cancer is more aggressive (growing faster) or less aggressive (growing slower)? 3. Estrogen receptor, progesterone receptor, and Her2/Neu (also known as epidermal growth factor receptor) are all signal transduction receptor proteins that transmit signals to the cell to divide. Predict the name of the ligand for each receptor. How could having too many growth factor receptors on the surface of the cell make a more aggressive cancer? 4. Some cells divide constantly, whereas other cells rarely divide if at all. Rank the following cell types by their frequency of cell division from never to constantly. a. Hair cells ________ b. Liver cells ________ c. Muscle cells ________ d. Sensory Neurons ________ 5. Review the phases of the cell cycle by placing the abbreviated phase name (G 1 , S, G 2 , or M/C) next to the event(s) that occur during that phase of the cell cycle. a. _____ Errors in DNA replication are repaired. b. _____ DNA is replicated. c. _____ Th e cell grows by producing more proteins and organelles. d. _____ Th e cell physically divides into two cells, with identical copies of DNA going into each new cell. 6. Review the three regulatory checkpoints that determine whether a cell progresses through the cell cycle, rests in G 0 , or undergoes programmed cell death (apoptosis). Checkpoint Name: What is the cell checking for at each checkpoint? What happens to cell if it can’t pass checkpoint? G 1 G /M 2 Metaphase (part of mitosis) “Know Your Enemy, Know Yourself” by Bernot, Wingate, & Whitaker Page 4 weare trying to see if cancerous cells are replicating too much there are any temporary in Go but the majority of µ cellsare held in Go ble mature cells in Go don't express ki 67 more aggressor theratio of Ki67 expressing cells ki 67 non expressing all should be low If your Ki62 here are highermore cells are reprinting when they shouldn't be of ligand estrogen for estrogen receptor ligand progesterone for progesterone receptor I 2 3 Jeff ed liver cells constantly never will grow back if you remove Yffety sensory neuronsc liver cells chair cells G Me If the cell wants to commit to cell division cell makes sure that the cell is equipped v1 necessary