The regulation of cell proliferation and cell survival in breast cancer is a complex interplay between steroid hormones, growth factors and their receptors. The understanding of the signalling pathways involved in these processes may help us find predictive factors for tumour aggressiveness and therapy resistance. Already recognised is the importance of the oestrogen receptor (ER) status of the tumour for predicting the benefit from endocrine treatment [1].Although it has not yet been fully established from clinical materials, experimental studies suggest that overexpression of different growth factor receptors in breast cancer makes cells less sensitive to tamoxifen and other cytotoxic drugs. These receptors include insulin-like growth factor CI = confidence interval; CMF = cyclophosphamide-methotrexate-5-fluorouracil; ER = oestrogen receptor; FITC = fluorescein isothiocyanate; pAkt = phosphorylated Akt; PI3-K = phosphatidylinositol 3-kinase; RR = rate ratio. Stål et al., licensee BioMed Central Ltd (Print ISSN 1465-5411; Online ISSN 1465-542X). This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any non-commercial purpose, provided this notice is preserved along with the article's original URL. AbstractBackground: The serine/threonine kinase Akt, or protein kinase B, has recently been a focus of interest because of its activity to inhibit apoptosis. It mediates cell survival by acting as a transducer of signals from growth factor receptors that activate phosphatidylinositol 3-kinase.

While advances in science and technology have increased options for treating breast cancer, current social trends have changed the way people deal with this disease. Women in the United States are no longer simply passive patients, but rather they are survivors, advocates and activists who are speaking up for themselves and speaking out for issues relevant to the treatment and prevention of breast cancer. As the discoveries of basic science have been translated to better clinical treatment, a new sense of hope has emerged. Quality of life now shares the spotlight with quantity of life as breast cancer has shifted from an acute to a chronic condition and as the numbers of long-term survivors increase. While this new population tends to have more optimistic expectations for survival, they are also expressing concerns about issues affecting their lives through and beyond treatment. These issues include, but are not limited to, such concerns as efficient and accurate diagnosis, the complexity of treatment decisions, access to quality cancer care, informed consent, privacy issues, availability of supportive care treatments, and effective communication skills, especially with their physicians. Survivors are also concerned about the impact of their disease on spouses and family, on fertility and sexuality issues, on their employment and (in the USA) insurability, and on their long-term survival. The identification of these increasing issues has given rise to a consumer movement that encourages a shift away from powerless victim to empowered survivor.