The Bigger Picture
In Egypt, there are over 22,000 new cases diagnosed with cancer annually, accounting for 33% of all female cancer cases. Given the growing population, shifting population pyramid, and adoption of a more Westernized lifestyle, this is predicted to increase exponentially over the coming years. Breast cancer (BC) is one of the most important cancers in Egyptian women (Abdelaziz et al. 2021). According to the last global cancer statistics, it was the second-leading cause of cancer-related deaths in 2018. In 2018, more than two million women were affected by this disease, with a mortality rate of 6.6%, resulting in more than 500 thousand deaths of women (Bray et al. 2020).
Chemotherapy resistance is defined as a medication's low ability to generate a positive response during treatment and is one of the primary causes of chemotherapy failure (Vasan et al. 2019). Chemotherapy resistance affects the choice of chemotherapy in recurrence cases and presents a challenge to the treatment of neoplasms. Multidrug resistance is a characteristic of cells that can endure chemotherapy treatment and decrease drug absorption, which encourages the efflux of anticancer medications from tumor cells. Membrane transporter protein activity is dependent on MDR, which can explain why some cancer cells are resistant to chemotherapy (Nedeljkovic and Damjanovic 2019).
Results
In terms of genetic and biochemical processes, cancer has several characteristics that may cause the deregulation of signaling pathways like p53 and nuclear factor-B (NF-B), accelerating cancer development (Aunan et al. 2017). The immune system's primary building block is inflammation, where chronic inflammation is thought to be a sign of cancer development and has the potential to cause a variety of complex changes at the molecular, cellular, and hampered healing processes. Also, the ROS/RNS random production causes mutations, decreases DNA repair efficiency, and significantly increases cytokine/chemokine release, as well as pathophysiologic protein synthesis and signaling pathways (Kubatka et al. 2021).
The pleiotropic proinflammatory cytokine that is encoded by tumor necrosis factor (TNF) is important for controlling immune cells. The cytokine was implicated in the perception of a broad range of biological processes, such as cell division, proliferation, death, lipid metabolism, and coagulation. TNF was discovered to be an endotoxin-induced serum factor that contributes to several malignancies, including necrosis. TNF-α has been associated with breast cancer developmental stages and metastasis (Rana et al. 2021).
A highly complex process is involved when tumor tissue transforms regularly over the course of years or even decades of life. Strong stresses that have the potential to damage DNA, persistent inflammation, extensive interaction between relevant molecular pathways, and cellular cross talk between adjacent tissues all play a role in this process. Based on modifiable risk factors, which are essential in cancer prevention, the majority of cancer cases are naturally sporadic (Kapinova et al. 2018).
The discovery of chemopreventive agents from efficient natural sources has received a lot of scientific attention in recent years. Through various cellular and molecular methods, a wide range of phytoconstituents have been investigated for their potential to inhibit the development of carcinogenesis both in vitro and in vivo (Kaur et al. 2018).
