الفهرس 
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Abstract
Breast cancer is a public health problem increased markedly among women especially in developing countries reaching to 22.9% of all female cancers. In Egypt, breast cancer is estimated to be the most common cancer among females reaching to 37.7% of their total with 12,621 new cases in 2008. It is also the leading cause of cancer related mortality accounting for 29.1% of their total with 6546 deaths. There is a correlation between aging ad development of breast cancer in females. Different opinion suggests higher susceptibility of daughters and sisters of breast cancer patients to the development of the disease. The present work was carried out to observe the correlation of the disease with different conditions of patients such as married or not, estrogen and progesterone level, pre-& post-menstrual cycle as well as in diabetic and hypertensive patients through biochemical and assessment of gene expression of HER 2/neu. Also, the main work is to make a correlations between breast cancer patients and their sister and daughter.Breast cancer patients (44 mothers and 35 daughter and 24 sister) were investigated in 2014-2015 during admission in Mansoura University Hospital, Department of surgery. The ages ranged from 40-60 years old. The mother patients were categorized as follows:26 normal patient, diabetic 6, hypertensive 8. They were subjected for serum biochemical analysis for transaminases (ALT & AST) and lactic dehydrogenase (LDH), HER2/neu. DNA extraction was carried out from blood of patient and determined HER 2/neu gene by first PCR with forward ATA TCC AGG AGG TGC AGG G and reverse PCR CTT CGA AGC TGC AGC TCC C and then assayed HER 2/neu gene using nest PCR for determining the low average of circulating breast cancer cells with forward CTC ACA ACC AAG TGA GGC AG and reverse CAG GGG TGG TAT TCT TCA.The present findings are summarized as follows:Biochemical Observations:Breast cancer patients exhibited marked increased of the assayed serum enzyme activities alanine amino transferase (ALT) activity and lactic dehydrogenase and a significant increase of aspartate amino transferase. The breast cancer patients showed marked increase of serum HER 2/neu and Cancer antigen marker 15-3(CA15-3). Histopathology of breast cancer:Biopsies of human Breast cancer patient characterized by widespread of intra-epithelial spaces of varying sizes and invasive cancer cells in glandular duct and stromal desmoplasia.Immunohistochemistry of HER 2/neu:Biopsies from human breast cancer patients characterized by mutation of the oncogene HER 2/neu as immune reacted dark- brown membrane staining of the breast cancer cells of invasive ductal carcinoma comparing with missing expression of the HER2 / neu in other area of breast cancer. Image analysis illustrated the marked increase of the polymorphism HER 2/neu gene in breast cancer cells. ER &PR receptors by IHC nuclear staining and Image analysis illustrated the marked increase of ER &PR receptors.HER 2/neu gene expression in mothers and their daughters and sisters: Investigating the HER 2/ neu gene polymorphism of both first PCR at 205bp and nested PCR at 126bp among breast cancer patients revealed increased average of nested PCR mutation. On the other hand, daughters and sister possessed increased percentages of mutation HER2/neu gene. The frequency of HER2/neu gene among daughter reached 2.1% meanwhile in sisters reached to 0.96%. HER 2/neu gene is less expressed in married compared with non-married. However, there was a detected mutation of the HER 2/ neu gene correlated with the menstrual cycle, estrogen and progesterone level. Also, polymorfism of HER 2/neu gene was remarked in diabetic and hypertensive patient.