On the Mechanism of Cellular Toxicity in Breast Cancer by Ionizing Radiation and Chemotherapeutic Drugs

Breast cancer is the second leading cause of cancer mortality and the most frequent cancer found in women around the globe. The development of breast cancer is a multistep and complicated process that includes the development of ductal and lobular cells into atypical hyperplasia, carcinoma in situ, and invasive carcinoma, with an ability to metastasize. The efficacy of radiotherapy in breast cancer seems to be reduced because of a frequently observed lack of cellular sensitivity to apoptosis. Both Bcl-2 and p53 are linked to apoptosis pathways and are known to play a role in the outcome of radiotherapy. Resistance of tumor cells to therapeutic drugs and the undesirable cytotoxicity of normal cells are frequently observed in treatment outcomes in clinics. Research is, therefore, needed to develop strategies for improving the protocols of chemotherapy and radiotherapy in patients with breast cancer. This review focuses on understanding the molecular mechanisms of enhanced tumor cell killing by the combined action of certain anticancer drugs together with gamma radiation in vitro, with possible implications for practical applications in clinics.