Category: Breast Cancer

Tumours are diseases that can be characterized with little percentage of preventive measures taken to forecast the condition of a patient or analyze the possibility of inherited genomes to provoke development of cancer tumours. In this respect, preventive measures should be taken in order to decrease the mortality rates all over the world in terms of cancer illness and breast cancer in particular.

The changes should be made in the area of preventive approaching the breast cancer as a chronic illness in institutions addressing the healthcare providers’ professional competencies and the way patients, families, and communities perceive this illness and prevent its appearance.

Breast cancer as a chronic disease

Breast cancer is a chronic illness because it is a recurring one and, as a rule, it progresses slowly. Mammary neoplasms are treated as a chronic illness if neoplasms occur constantly even after the use of invasive method and chemotherapy sessions and demonstrate a low progress.

In this respect, it needs a completely different approach than a single instance of breast cancer tumour that can be extracted and a tumour can happen to occur no more. Another case that can be considered in breast cancer treatment is the fast or inoperative instance of mammal neoplasm. Inherited propensity and different external factors (smoking, eating carcinogenic products, and others) can accelerate the risk of cancer occurrence.

However, sometimes, people live with cancer tumours all life long and undergo a number of chemotherapy sessions that slow down the development and spreading of infected cells. So, a patient should be screened for a breast cancer and appropriate measures should be taken if a patient has an inherited propensity of breast cancer. As reported by Perry et al. (2007),

in June 2003, the European Parliament called for establishment of a programme by 2008 which should lead to a future 25% reduction in breast cancer mortality rates in the EU and also a reduction to 5% in the disparity in the survival rates between member states” (p.615).

So, this can be considered the first set of measures to be taken for improving the treatment incorporation of preventive measures into practice as an alternative for supportive measures. Though supportive measures are necessary for patents that have been diagnosed advanced breast cancer tumour, it is necessary to think about alternative ways to decrease the rate of mortality caused by breast cancer and various complications.

Thus, Blamey et al. (2007) have studied the survival of invasive breast cancer which presupposes supportive taken for patients that were diagnosed advanced breast cancer tumour and have to perceive some treatment in the form of surgical invasion followed by chemotherapy sessions. In this respect, breast cancer can be characterised as a chronic illness that needs preventive measures to be introduced for healthcare providers and for patients and their families as an alternative to supportive measures.

Supportive care contrasted to preventive measures

As supportive measures were taken for breast cancer patients in the late 20^th century, it is necessary to implement some preventive measures. Perry et al. (2007) suggests that even the supportive invasive measures were well-coordinated in case of advanced tumours diagnosis (p.619).

In other words, supportive measures are contrasted to timely screening of breast cancer and preventive measures taken for breast cancer patients. When preventive treatment does not work, it is necessary to implement healthcare education for patients and their families. In addition, all types of health care institutions should incorporate preventive measures for patients that have inherited predisposition to breast cancer.

Counselling sessions and other ways to inform people that may potentially be diagnosed breast cancer would be primary steps to prevent breast cancer and reduce the mortality rate. As a rule, the reports inform about increase in the spreading rates and the mortality rates.

However, the study by Ravdin et al. (2007) offers some evidence of the decrease in breast cancer incidence in breast cancer in the United States in 2003. Perhaps, it is necessary to analyze the measures taken by healthcare providers that year to achieve this result and continue in the same manner.

One of the possible ways to increase the awareness of patents in their possible illnesses is to inform the population of the measures to be taken to decrease the effect of various factors on their organism and undergo a set of procedures. Thus, Robson, & Offit (2007) report of certain risk assessment and genetic testing to be taken in case a patient can potentially be diagnosed breast cancer.

Besides, there are measures that can be taken to inform the patient and her family members about the risk and risk that exists in this case. A set of preventive measures can be taken if a person is of definite age and can be potentially diagnosed breast cancer due to certain external factors.

In addition, it is necessary to take some measures such as mammography to prevent the slightest possible percent of being diagnosed breast cancer. However, even if you are diagnosed breast cancer, it woud be more productive to remove the tumour and take non-invasive measures while fighting against the disease.

Another study that analyzes management measures that should be taken to prevent occurrence of a disease is the one by Narod & Offit (2005). Hereditary illnesses should be opposed to chronic ones.

In addition, there should be definite measures taken for patients that have already been diagnosed breast cancer and those who may potentially have it in future. As a rule, it is a matter of time if all female relatives of a patient were diagnosed breast cancer.

In this case, preventive therapy is the most appropriate measure that consist in risk assessment, genetic testing, counseling sessions, and other steps including breast examination, mammography, magnetic resonance imaging, ultrasonography, and screening for other cancers, as well as chemoprevention and surgery as parts of strategies for reducing risks.

Moreover, the preventive measures for breast cancer include prophylactic mastectomy, analysis of reproductive factors, and oophorectomy for breast cancer risk reduction.

As you can see, there are many steps that can be taken but the most appropriate way to fight against the cancer in the earliest stages is to take a combination of those steps and prevent the occurrence of the disease before the patient is diagnosed breast cancer.

Conclusion

It appears to be more productive to take preventive measures instead f taking invasive measures while dealing with such problem as breast cancer and inherited breast cancer.

When women face such problem, they should receive constructive counselling. Moreover, most women with a possibility to have breast cancer can undergo a set of preventive measures including mammography that would help to screen the tumour when non-invasive measures would be enough.

The patents as well as health care providers should be aware of the alternative measures to be taken in every separate case and certain complications and individual peculiarities that should be taken into account while considering preventive measures and certain complications, age, family health history, and other numerous factors.

Preventive measures can be introduced on the regular basis to help women with different stages of breast cancer to fight their disease int he most productive way.

Reference List

Blamey, R.W., Ellisa, I.O., Pindera, S.E., Leea, A.H.S., Macmillana, R.D., Morgana, D.A.L.,… Elstona, C.W. (2007). Survival of invasive breast cancer according to the Nottingham Prognostic Index in cases diagnosed in 1990–1999. European Journal Of Cancer, 4 3, 1548-1555.

Narod, S. A., & Offit, K. (2005) Prevention and management of hereditary breast cancer. Journal of Clinical Oncology, 23 (8), 1656-1663.

Perry, N., Broeders, M., de Wolf, C., Törnberg, S., Holland, R., & von Karsa, L. (2007). European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition – summary document. Annals of Oncology, 19 (4), 614-622.

Ravdin, P. M., Cronin, K. A., Howlader, N., Berg, C. D., Chlebowski, R. T., Feuer, E. J., … Berry, D. A. (2007) The decrease in breast-cancer incidence in 2003 in the United States. The New England Journal of Medicine, 356 (16), 1670-1674.

Robson, M., & Offit, K. (2007). Management of an inherited predisposition to breast cancer. The New England Journal of Medicine, 357 (2), 154-162.

Introduction

Breast cancer is a serious health issue associated with a significant mortality rate of the affected population. It is noteworthy that women are often unaware of all of the major signs and features of this disease, as well as the various treatment opportunities available to them (Sulik, 2012). Therefore, a focus on breast cancer awareness as a part of a company’s corporate social responsibility (CSR) strategy can be beneficial.

Version 1

CSR campaigns aimed at raising breast cancer awareness often focus on females, who make up much of the affected population. However, at the same time, making males aware of the issue can also be helpful as they can encourage women to learn more about the disease and its treatment. Therefore, the campaign for employees as internal stakeholders will target all employees, regardless of gender, age, or ethnicity. This campaign may involve the use of posters and leaflets with relevant images and information. The information provided will be designed to address such areas as facts about the disease, statistics, personal stories, support options, available treatments, and so on. The campaign will also involve a number of discussions with breast cancer survivors. Finally, the campaign will include free screening for all female employees and the wives of employees.

Version 2

The second campaign will target the company’s customers. Amazeen (2012) notes that such campaigns can be beneficial for the company’s image and profitable as well. It is necessary to note that the corporation’s customers are mainly Emirati males between 30 and 50 years old. Therefore, it is advisable to focus on this population. The breast cancer awareness campaign may involve the development of new advertisements (e.g., videos and visuals) that focus on the health issue in question rather than the company’s products. Benetton Corporation started using this strategy in the 1980s, and it has proved to be effective (Sulik, 2012). The advertisement may address many similar topics, but the focus should be on the male’s role as one who cares, supports, and encourages the women in their lives to have check-ups, receive treatment, and so on. The visuals will primarily be used in online communication (e.g., on the company’s website, social networks, and so on). It is also possible to invite some celebrities to take part in the campaign. They can be featured in the advertisements or the visuals. The company’s official website should contain a section devoted to this health issue and the campaign. It can also be effective to note that all company employees have been given the opportunity to check their health or the health conditions of their loved ones.

Recommendations

It is necessary to note that Version 2 requires a larger investment. It may also need more time to be implemented as the development of the advertisement, and all visuals will take time. At the same time, this version is also associated with a larger impact. It will raise the breast cancer awareness of customers and their families as well as the entire country; moreover, the company may develop a favorable image while simultaneously promoting its products. However, the Version 1 campaign will be easier to implement and beneficial for the development of the company, as employee motivation levels might increase as a result. Therefore, it is recommended to start with the implementation of the Version 1 campaign. The campaign can be developed by the company’s employees, which would reduce costs. When recommending healthcare facilities, it is necessary to negotiate significant discounts or even free services as the facility will be publicized through the company’s official website and social networks.

References

Amazeen, M. (2012). Just window dressing? The gap (RED) campaign. In S. May (Ed.), Case studies in organizational communication: Ethical perspectives and practices (pp. 73-85). Thousand Oaks, CA: SAGE Publications.

Sulik, G. A. (2012). Pink ribbon blues. New York, NY: OUP USA.

“Cancer is the uncontrolled growth of abnormal cells in the body” (Carlson et al., 2009). Cancerous cells are also referred to as malignant cells. “Cells act as the building blocks of organisms” (Carlson et al., 2009). Under normal circumstances, cells will undergo cell division depending on the body’s needs, and then die once their function ends.

In addition, malignant cells divide very fast and sometimes fail to die. Cancer develops in different tissues and organs of the body. Cancerous cells have the characteristic of spreading from their source to other parts of the body (invasive). Cancerous cells that remain at their source are said to be noninvasive. The breast is one common organ that cancer affects. Breast cancer occurs in two main categories (Carlson, et al., 2009). Ductal malignancy: this is the most common type of cancer.

This type of breast cancer manifests itself in the tubes/ducts which form the channel for transporting milk from the breast to the nipple. “Lobular carcinoma: this type of cancer usually begins in the milk producing regions of the breast (lobules)” (Breast cancer, 2011). Rarely does cancer develop from other parts of the breast. “Breast cancer is known to occur in invasive or noninvasive form” (Breast cancer 2011). Thus, cancerous cells in the breast may metastasize to other parts of the breast from their source.

The prevalence and causes of cancer vary. “Cancer biologists have discovered that most breast carcinomas are sensitive to the hormone estrogen” (Breast cancer, 2011). The hormone causes the cancerous cells to grow. The breast cancer cells that respond to estrogen have estrogen receptors on their surfaces (Breast cancer, 2011).

Cancer biologists refer to these estrogen receptor possessing breast cancer cells as receptor-positive/EP-positive cancer cells. Scientists have discovered a certain gene called HER2 that helps breast cancer cells to multiply and repair themselves. It has also been noted that women with this type of gene have a severe breast cancer than their female counterparts who lack it.

In addition, HER2 bearers have a higher risk of breast cancer reoccurrence. Generally, chances of developing cancer increase with age. The older one becomes, the higher the risk. Women above 50 years have advanced breast cancer cases. Women are twice more likely to develop breast cancer than men. Family history plays a central role in dictating the chances of someone developing breast cancer.

Persons whose close relatives had ovarian, uterine, breast or colon cancer are at a high-risk of developing breast cancer. Scientists have also discovered that women who experience very early periods (before the age of 12), and those who continue to experience periods through menopause (after age 55) have a higher risk of developing breast cancer. Moreover, excessive alcohol (for adults) and radiation therapy around the chest area in children present a risk of developing breast cancer.

Women who have received hormone replacement therapy with estrogen and those that used diethylstilbestrol (DES) are at a higher risk. Child birth has also been found to have an effect on breast cancer. Bearing several children and at an early age, reduces the risk. On the other hand, women who bear children after the age of 30 or those who do not bear children at all poses a great risk of developing breast cancer (Giuliano et al. 2011).

Breast cancer at an early stage does not present any symptoms (Hayes, 2007). That is why experts encourage women to go for regular checkups. However, after it has progressed it may present the following symptoms. A hard lump in the breast or armpit that does not induce pain is an indicator of breast cancer.

The lump has uneven edges. Change in the appearance (size and shape) of the nipple may be another indicator. The nipple may show some reddening, dimpling or puckering. The nipple may also produce a discharge. The fluid could be bloody, clear, and yellow or appear like pus. “Symptoms of advanced breast cancer are bone pain, breast pain and discomfort, skin ulcers, weight loss and swelling of one arm next to the breast with cancer” (Breast cancer, 2011).

The treatment of cancer depends on the type, stage, sensitivity to certain hormones or whether the cancer over expresses HER2/neu gene (Carlson et al., 2009). Doctors usually conduct certain tests before deciding the type of treatment to give. Such tests include breast MRI, biopsy, ultrasound, mammography, sentinel lymph node biopsy or CT/PET scans. Three options may be employed. Chemotherapy or radiation therapy (to kill cancer cells) and surgery to remove the cancerous tissue (could be lumpectomy or mastectomy).

Hormone therapy may be prescribed to women with ER positive breast cancer to inhibit certain hormones that cause uncontrolled cell division. Newer strategies include biologic/targeted therapy and immunotherapy (Carlson et al., 2009). “In targeted therapy, anticancer drugs are used to recognize and inhibit certain changes in cells that may lead to cancer” (Breast cancer, 2009). Immunotherapy utilizes activated immune system cells to treat cancer cells. More research is being carried out to shade more light on the use of immunotherapy.

References

Breast Cancer (2009). Breast Cancer. Web.

Breast Cancer (2011). Breast Cancer. Web.

Carlson, R. et al. (2009). Breast Cancer: Clinical Practice Guidelines in Oncology. Journal of Comprehensive Cancer Network, 7(2), 122-92.

Giuliano, A. et al. (2011). Axillary Dissection vs no Axillary Dissection in Women with Invasive Breast Cancer and Sentinel Node Metastasis: A Randomized Controll Trial. Journal of the American Association (JAMA), 305(6), 569-75.

Hayes, D. (2007). Clinical Practice: Folow-up of Patients with Early Breast Cancer. The New England Journal of Medicine, 356(24), 2505-13.

Introduction

Breast cancer cases have shown an increasing trend over the last few decades. It is a disease that is common to women. However, some men have developed breast cancer but the rates of incidence of the disease are very low compared with that exhibited in women. In the US, breast cancer has been one of the fatal diseases that have affected a significant proportion of the female population. Breast cancer affect women from all races, ethnic groups, ages, geographic locales as well as socioeconomic strata.

Over the past several decades, epidemiological research has shown that there have been widespread ethnic disparities as far as the disease is concerned. It has been well documented that different ethnic groups have different rates of the incidence of breast cancer. This paper explores the different rates of breast cancer incidence as far as the different ethnic groups in the US are concerned as well as the most probable way of reducing the rates of incidence across all the groups.

The Incidence of breast cancer among different ethnic groups

One of the tools used in monitoring the incidence of breast cancer in the United States is the ‘report card’. The card was developed by key bodies in the American health care system. They include the American Cancer Society, National Center for Health Statistics, the National Cancer Institute and the Center for Disease Control and Prevention.

The initial release of the ‘report card’ was in 1998. It showed that there had been a continual decline in the incidence of breast cancer in the American population. However, the report card also showed that there was disproportionate incidence of breast cancer as well as mortality rates of African American Women compared with their white counterparts.

The report noted that among the African women, there was an increasing trend of both the incidence of breast cancer and the mortality rates associated with the disease. According to the report, “African American women also tended to present with a later stage at diagnosis” (Jones, and Chilton 341). The African American women have not been successful in their fight against breast cancer since study has shown that they have the highest breast cancer death rates.

From 2000-2003, the white non-Hispanic Americans recorded the highest rates of breast cancer incidence i.e. 141 women in every 100,000 had developed cancer. The second highest rate was exhibited by the African Americans with 118 breast cancer patients per every 100, 000.

The third and fourth positions were taken by the Asian American and the Hispanics respectively. In 2008, the CDC released the latest data showing the incidence of the disease among different ethnic groups. American white women still had the highest incidence rate followed by the African Americans.

The third group that had significantly a high incidence rate was the Hispanic followed by Asian/Pacific Islanders and the Asian Americans. However, the mortality rates due to the disease differed significantly. Research has shown that the African American women exhibited the highest mortality rates followed by the White women.

Following the report issued in 1998 via the ‘report card’, the American Cancer Society embarked on a more detailed research to unveil the cancer problems specific to each of the ethnic groups with much emphasis on the African American women since the breast cancer mortality rates were highest in this group. The National Cancer Institute has played a pivotal role in the reduction of the effects of cancer across all the ethnic groups in the US.

Its sole responsibility is to conduct research on the detection, treatment and control of the disease. Additionally, it conducts research on the prevention of cancer. To achieve its goal, it has sponsored several research agencies an aspect that has led to the discovery of many aspects as far as breast cancer is concerned. The research has led to the discovery of more breast cancer detection and diagnosis techniques.

It has also led to the development of better programs as far as better supportive care and improved treatment for patients is concerned. The development of the new technologies assisted in the reduction of the severity of the disease among the different ethnic groups. According to Jones and Chilton, the discoveries have not equally benefitted the various ethnic groups since the African American women are still endangered by the disease (539).

For instance, between the African American women and white women, there has been a great disparity in the rate of breast cancer survival for decades. With the exception of the African American women, the other groups had a positive response to the new mode of technology. African American women have continued to be disproportionately affected by the fatal disease.

The incidence and effect of breast cancer among some specific groups

As aforementioned African American women are disproportionately affected by the disease. Research has shown that it has been one of the leading causes of death among the women in this particular ethnic group.

Besides the impact of the disease in the society, women and their immediate family members have to endure the deep emotional effect imposed by not only the disease but also its treatment. Families also dread the recurrence of breast cancer. The incidence of the disease has been increasing over the last several decades (Cunningham et al 4).

For instance, from 1973 to 1998, the incidence of breast cancer among black women increased by over 40%. Despite all the efforts that the health system has made in the fight against breast cancer, African American women still continue to suffer from the effects of the disease. Research has shown that breast cancer is the second leading cause of cancer related death Among the African American women-the first cause is lung cancer (Jones, and Chilton 540).

Different ethnic groups consist of several sub-groups. Research has shown that, these subgroups exhibit different rates of breast cancer. As aforementioned, the Asian Americans have a relatively low rate of the breast cancer incidence as far as the ethnic groups in the US are concerned. Within the Asian ethnic group, the rates of breast cancer incidence vary by specific ethnicity with the Japanese women recording the highest rates while the Laotian women have the lowest rate.

Additionally, the place of birth of the members of a given ethnic group also determines their risk of developing breast cancer. For instance, during the period between 1988 and 2004, the breast cancer rates were higher for the US-born Filipina and Chinese women than their foreign-born counterparts (Gomez et al. 126). This trend was also true for the US borne and Foreign-born Japanese. However, the US-born Filipina recorded the highest rates of breast cancer incidence during that period-80%.

Factors that cause the differences in breast cancer incidence among ethnic groups

Socioeconomic factors vary among the various ethnic groups. This includes aspects such as the average income level of the members of a given ethnic group, lack of proper infrastructure e.g. poor means of transportation as well as lack of proper healthcare facilities.

This also includes the availability of screening programs within the available healthcare facilities. For instance, African American women have poorer socioeconomic status among the African Americans than the whites. African American women also have reduced access to health care services.

As compared to White women, African American women have a lower frequency of mammography with delayed diagnosis. Additionally, they tend to have reduced chemotherapy dosage which is associated with underlying neutropenia. For both White and African American women who have access to the same health care facilities and programs, other factors contribute to the high mortality rates among the African Americans due to the disease (Chen et al. 440).

Furthermore, the African Americans tend to have a much higher rate of high-grade cancers than the white women. In most cases, the breast cancer among the African American women tends to be ER negative posing a great danger to the victims. Several socioeconomic factors hinder the ability of the ethnic groups to access routine preventive health care programs.

Different ethnic groups differ in their ability to access routine preventive health care programs. A relatively high percentage of African Americans and Hispanics do not have access to proper health care. In some cases, they do not have a primary care provider.

The importance of a primary care provider is to enhance proper preventive care through the provision of routine check-ups and breast cancer screenings. Preventive care enables the detection of breast cancer at an early stage, which can be easily treated as opposed to the advanced stage-less treatable.

One of the factors that contribute to such is a strong belief, cultural or religious, related to their health and their health care. Some of the ethnic groups have strong beliefs in some supernatural healing and miracles. Religious/cultural beliefs impair individuals from participating in the routine preventive programs offered in the health care sector.

Women who hold such strong beliefs in healing and miracles do not have faith or rather do not trust the health care system. In most cases, they end up as breast cancer patients since they will only turn to the health care system probably at the advanced cancer stages. Generally such women in the group or sub-group do not participate in any form of routine preventive health care increasing the rate of breast cancer incidence in the ethnic group.

Communication barrier, the inability to understand another person’s language, impairs an individual’s ability to seek medical assistance. Consequently, women may fail to discuss their health concerns with medical practitioners impairing the preventive program since. In some cases, the interpreter may not be able to enhance comprehensive communication between the two parties in question. This might lead to lack of proper health care for the patient.

Most people lack the knowledge or rather the understanding of not only the symptoms but also the health care risks associated with breast cancer. Research has shown that most of the women who seek medical attention only during the advanced cases of breast cancer lack the knowledge of the symptoms of breast cancer in the early stages. Most American Hispanic Women are less aware of the risks of breast cancer. This prevents them from seeking medical attention in advance.

Some of the ethnic groups are deeply rooted in cultural practices. Such practices include traditional medicine that they believe are capable of addressing all their healthcare needs. In such groups, women who experience abnormalities in their breasts give first priority to the cultural practices rather than doctors. Owing to this, the fail to get proper medical assistance in time an aspect that puts their life at a great danger.

Reduction of the rates breast cancer incidence in all the ethnic groups

The rates of breast cancer can be reduced by the reduction of the main causative of the disease. Research has shown that the high prevalence of obesity is associated with breast cancer across all the ethnic groups. America has recorded the highest rates of obesity in the world.

According to Blackburn and Walker, 74.6% of Americans are obese with obesity being one of the leading causes of death in the nation (207). Obesity is one of the diseases that have led to the current crisis in the American healthcare system especially by causing other diseases among which is breast cancer. The medical expenditures associated with obesity in the nation are approximately $70 billion, which translates to more than a quarter of the American healthcare system’s expenditure.

Wolf and Colditz argue that America has suffered a loss of 40 million productive workdays and an additional 63 million days due to the frequent visits that obese individuals make to the doctor(s) (100). In an attempt to curb breast cancer and other forms of cancer associated with obesity, the American healthcare system has developed the ‘CARE’ policy whereby ‘CARE’ stands for Communication, Action, Research and Evaluation.

The policy aims to increase life expectancy by increasing both the quality and the years of healthy living of the Americans. Some of the key issues that the policy seeks to attain are improvement of the nutritional value of foods in major educational institutions; ensure the availability of physical education facilities not only in schools but also in public recreation centers; ensure more intensified research on the causes of the disease and bringing the findings to public attention.

The policy also advocates for education of healthcare professionals and students on the prevention, management and the treatment of the disease together with its related conditions such as breast cancer. Moreover, the policy incorporates the need for more research on the prevention and the treatment of obesity.

This paves way for new methods of dealing with the epidemic in the nation. It also calls for the promotion of health and nutrition related curriculums in high schools besides raising awareness of the two diseases and preventive screening of all individuals in America. The policy addresses the special needs of the elderly obese individuals in the nation in one of its initiatives-Healthy ageing initiative: Eating better and moving more.

Conclusion

Different ethnic groups have different rates of breast cancer incidence. As aforementioned, the white women have the highest incidence rates followed by the African American women. The Hispanics and Asian Americans have relatively low rates of breast cancer incidence.

However, African American women have the highest mortality rates associated with breast cancer. As discussed above, the specific groups within a given ethnic group also have different breast cancer incidence rates. Additionally, the place of birth of an individual also determines his/her ability to develop breast cancer. For instance, among the Asian American women during the period between 1988 and 2004, the breast cancer rates were higher for the US-born Filipina and Chinese women than their foreign-born counterparts.

There are many causes of the variation of breast cancer incidences across different ethnic groups. However, research is yet to establish the exact cause of the variation. Most researchers have attributed the variation to diet and lifestyle, genetic make-up and socioeconomic status. The American healthcare system has embarked on addressing obesity, which cuts across all the ethnic groups, in an attempt to curb the disease.

Annotated Bibliography

Cunningham, Ruth, et al. “Ethnic and Socioeconomic Trends in Breast Cancer Incidence in New Zealand.” BMC Cancer, 10. 694(2010): 1-10. Print.

The article includes a study of the incidence of breast cancer in New Zealand. It utilizes data from the New Zealand cancer registry for the period between 1981 and 2004.

The authors also compare the trend of the rates of the breast cancer incidence of the groups in New Zealand with those of the same groups in other parts of the world with a bias on the U.S. It also explains some of the socioeconomic factors that influence the breast cancer incidences in the different ethnic groups.

Gomez, Scarlet et al. “Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Immigrant Status.” American Journal of Public Health, 100.1 (2010): 125-131. Print.

It focuses on the breast cancer incidences for specific Asian Populations in California. The data employed in this study was obtained from the Californian Cancer Registry for the period between 1998 and 2004. The information also included the immigration details of the sample group. The data was used to determine the rates of breast cancer incidences within the specific groups of the Asian Americans. It is a good source of information since California is the home of the largest number of Asian Americans in the U.S.

Jones, Lovel, and Chilton, Janice. “Effect of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade.” American Journal of Public Health, 92. 4(2002): 539-542. Print.

It compares the rates of incidence of breast cancer incidence between the African American women and white women. It utilizes data for the Center of Disease Control and the National cancer Institute in giving the trend of the rates among the two groups of women. It also gives some of the causes of the disparities obtained from a research conducted by the National Cancer Institute.

Works Cited

Blackburn, Lawrence, and Walker, Williams. “Science-based Solutions to Obesity: What Are The Roles of Academia, Government, Industry and Healthcare?” The American Journal of Clinical Nutrition, 82.1. (2005): 207-210. Print.

Chen, Zao et al. “Ethnicity and Breast Cancer: Factors Influencing Differences In Incidence and outcome.” Journal of the National Cancer Institute, 97. 6 (2011): 439-448. Print.

Cunningham, Ruth, et al. “Ethnic and Socioeconomic Trends in Breast Cancer Incidence in New Zealand.” BMC Cancer, 10. 694(2010): 1-10. Print.

Gomez, Scarlet et al. “Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Immigrant Status.” American Journal of Public Health, 100.1 (2010): 125-131. Print.

Jones, Lovel, and Chilton, Janice. “Effect of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade.” American Journal of Public Health, 92. 4(2002): 539-542. Print.

Wolf, Arnold., and Colditz, Gregory. “Current Estimates of the Economic Cost of Obesity In the US.” Progress in Obesity Research, 6 (1998): 97-106. Print.

Definition of the Breasts

Both men and women have breasts. Considering the case of females, the breasts consist of the milk glands. A milk gland is made up of lobules in which milk is formed and it also consists of ducts which are tubes that facilitate the movement of milk to the breast nipples. On the other hand, considering the case in men, suppressing of lobule development by testosterone during the puberty stage can be observed.

The breasts in both men and women have “supportive fibrous tissues and fatty tissues” (Cancer Council, 2011, p.6). Some of the breast tissues go up to the armpit. Armpits have a set of the lymph nodes that make up a part of the “lymphatic system” (Cancer Council, 2011, p.6).”The lymphatic system forms a part of the body’s immune system and serves to offer protection to the body against diseases and infections” (Cancer Council, 2011, p.6).

Definition of Breast Cancer

Breast cancer comes about at the time the breast ducts’ or lobules’ cells grow in an abnormal way. “There can be formation of a tumour within the breast lobules or ducts. The breast tissue is made up mainly of fat, glandular tissue, milk ducts and connective tissue” (Garvan Institute of Medical Research, 2010, p.1). In most of the “invasive breast cancers”, development of the tumour starts within the milk ducts lining (Cancer Council, 2011).

If it is not detected, these affected cells may also move to the rest of the parts of the breast and to the lymph nodes in the armpit and to other body parts as well. It is important to point out that breast cancer can develop not only in women but in men as well, though its occurrence is very rare among men. However, the breast cancer symptoms in both men and women are quite common (Cancer Council, 2011).

It has also been noted that breast cancer “is not just one single disease” (Garvan Institute of Medical Research, 2010, p.1) but takes a large number of different forms marked as “differences in disease aggression and response to treatment” (Garvan Institute of Medical Research, 2010, p.1).

There are various types of breast cancers. In the case where “the cells which appear like breast cancer are still confined to the ducts or lobules of the breast, it is called pre-invasive breast cancer” (Cancer Council, 2011, p.8). “The most widespread pre-invasive type of breast cancer is ductal carcinoma in-situ” (Cancer Council, 2011, p.8).

A large number of the breast cancer types are identified at the point they are found to be invasive. This implies that there is spreading of the breast cancer into the tissue around from the breast lobules or ducts. The types that are commonly found include invasive ductal cancer and invasive lobular cancer (Cancer Council, 2011, p.8).

Facts about Breast Cancer

Considering the case in Australia, breast cancer is found to be the most widespread form of cancer among women. It is also found to be the second most widespread cause of death that is related to cancer; the most common cause being lung cancer (Watson, et al.,1998).

It has also been found out that one Australian woman in every nine of them will be found to have breast cancer and one woman in every thirty eight of them will end up being killed by this disease by the age of eighty five years. Every year, more than twelve thousand of Australian women are diagnosed with the disease (Garvan Institute of Medical Research, 2010, p.1).

Due to the presence of the ageing population in Australia, breast cancer cases in this region remain to be on the increase. But on the other hand, at the present, breast cancer survival rate among the Australian women is increasing more than it has ever been in the past.

It has been found out that “the 1 year survival rate is 97% and 88% of women diagnosed with breast cancer can expect to be still alive 5 years after diagnosis” (Garvan Institute of Medical Research, 2010, p.1). Remarkable advances realized in the early detection as well as treatment of this disease imply that a larger number of women “are surviving the disease than ever before” (Garvan Institute of Medical Research, 2010, p.1).

The Risks of Developing Breast Cancer

According to Queensland Government, breast cancer has been found to be the most commonly reported form of cancer for women in Australia. It is also reported that among the greatest risk factors is the increasing age (Queensland Government, 2011). The risk is found to be approximately one in two hundred and fifty for a woman in Australia who is in her 30s.

But on the other hand, an Australian woman who is about 70 years or above, the risk is about one woman in every thirty. Diagnosis of a larger number of the breast cancers is made after menopause, having approximately three quarters of the total number of cases taking place among those women who are fifty and above (Cancer Australia, 2013).

However, it is imperative to bear in mind that all females are at risk of developing breast cancer, regardless of the risk category to which one may belong (Donegan, 2002). Among women who are at a higher risk, there are those who never end up developing breast cancer.

On the other hand, among the women who may be classified as being at a low risk, there are those who end up developing this disease. Other than an increase in age, there are also other factors that may increase the risk of this disease (Miller, Boyer & Dunn, 1995). These factors are “family history, specific genetic profile, breast diseases such as ductal carcinoma in situ and lobular carcinoma in situ, hormonal factors and body weight and size” (Queensland Government, 2011, p.1).

Moreover, the lifestyle factors may also increase the risk and such factors include; taking of alcohol, lack of physical activity, and getting exposed to the ionization radiation. It is pointed out that a large number of risk factors like breast cancer family history, ageing, and genetic condition are factors that are “not readily modifiable” (Queensland Government, 201, p.1).

Symptoms of Breast Cancer

Every woman may become aware of a change in her breast or her doctor may detect an extraordinary change in the course of carrying out an examination. There are a number of signs which may indicate the presence breast cancer. Some of them include;

1. Lumpiness or thickening in the breast.
2. Changes occurring on the nipple.
3. Changes in the breast skin like dimpling and strange redness of the skin among other changes.
4. An enlargement or reduction in the breast size.
5. An alteration in the breast shape.
6. A swell in the armpit.
7. Continual, strange pain which is not related to a woman’s menstrual cycle, stays after the period and happens in just one breast.

It is important to point out that the changes that may occur in one’s breast do not essentially imply that one has developed breast cancer. But on the other hand, if a person has developed any of the symptoms linked to this disease, she needs to have these symptoms examined by a medical expert in the soonest time possible. It is has also been found out that there are women who might not be having any symptoms and the breast cancer is detected by a “screening mammogram” (Cancer Council Australia, 2013).

Detecting Breast Cancer

In the case where detection of breast cancer is made early, women have higher chances of receiving effective treatment and for a larger number of them, the disease will not return after receiving treatment. At the present, screening mammograms are found to be the most excellent method that is available and can be used to detect breast cancer at an early stage.

The mammograms may detect a breast cancer that is too minute to be felt. Mammograms refer to “low dose x-rays of a woman’s breasts” (Cancer Council Australia, 2013, p.1). The performance of screening mammograms is carried out on those women who do not have any symptoms of this disease. They are offered at no cost based on the “BreastScreen Australia program” (Cancer Council Australia, 2013). For the women who are more than fifty years old, recommendations have been made. (National Breast Cancer Center, 2001).

A biopsy can also be used to detect breast cancer. A medical expert may recommend a biopsy in a situation where a strange or abnormal tissue area is identified in one’s breast. When a biopsy is carried out, a small quantity of tissue from one’s breast is to be removed. The removed tissue is carefully checked by a pathologist to see whether there are any cancer cells. In order to check it, a microscope can be used. A person may be required to go through more than just one biopsy (Cancer Council, 2011).

Breast Self-Examination

As it has already been found out, the survival rate for breast cancer is higher if its detection is carried out earlier. One of the most excellent and effective ways of identifying breast lumps is to undertake a breast examination on a monthly basis (Sterrett, et al., 1994). In spite of this, it is reported that around thirty three percent of women in Australia carry out regular breast self-examinations (Women’s & Breast Imaging, 2013).

After surveying women in Western Australia on breast cancer self-examination, it was found out that just about seventeen percent of the women in the region performed the self-exams on a monthly basis (Women’s & Breast Imaging, 2013). The findings from the survey also indicated that only about thirty percent of the respondents had never performed “breast cancer self-examination” (Women’s & Breast Imaging, 2013).

A “breast self-examination” comprises of the manual exam either lying down or standing and “a visual examination in the mirror” (Women’s & Breast Imaging, 2013, p.1). This should be performed on a monthly basis. A female person has to be aware of what is supposed to be normal for her breast and carrying out a breast self-exam will assist her in detecting any changes that may have occurred in her breast (Women’s & Breast Imaging, 2013).

Breast Cancer History

Human beings have known the breast cancer disease since the ancient times (De Moulin, 1983; Papac, 2002). Due to the symptoms that can be clearly seen, particularly during the later stages “the lumps that progress to tumours have been recorded by physicians from early times” (Mandal, 2013, p.1).

However, during the early times, this was regarded as a taboo and a cause of shame and this implied that diagnosis and detection of this disease was very rare (Yalom, 1997). Having more women involved in revealing the breast cancer in an open way is an occurrence that came up about forty years ago. In the course of the last decade of the 20^th century, the “pink ribbon”, which is a breast cancer symbol, introduced a revolution against this form of cancer (Mandal, 2013).

By the mid 1990s, following the introduction of modern medicine, the number of women who had a mastectomy had gone below ten percent. At this point, new therapies for the disease “including hormone treatments, surgeries and biological therapies” have been set up (Mandal, 2013, p.1). There was also development of mammography and since that time, the early detection of breast cancer has become possible (Mandal, 2013).

Treatment of Breast Cancer

Breast cancer treatment may include surgery, radiotherapy, chemotherapy, hormone therapy and targeted therapies (Cancer Council, 2011, p.24). In most cases, more than one treatment for breast cancer can be used at a time. The doctor’s advice are required regarding the best breast cancer treatment that any particular person may require.

The kind of treatment to be given will depend on a number of factors and these include the patient’s test results, where the cancer is located, the patient’s general health and age, the patient’s preferences, and the extent to which the cancer has moved among other factors.

Looking at surgery, it can be of two kinds: mastectomy and breast conserving surgery. The ‘breast conserving’ surgery involves removing some portion of the breast that has the cancer cells. This type of surgery is carried out when the size of cancer is smaller than the breast’s size. The doctor undertakes the removal of the most minimal amount of breast tissues possible. On the other hand, mastectomy involves the removal of the entire breast (Hartmann, 1999).

However the chest muscles are not removed. Some of the lymph nodes or even all of them, found under the arm, which are very close to the breast having the cancer, may be removed as well (Lee et al. 1992). This kind of surgery may be performed if the size of cancer is bigger than that of the breast or if the cancer is found in multiple areas (Hartmann, 1999).

Another breast cancer treatment method is radiotherapy. This one makes use of “high-energy x-rays” in killing the cancer cells or stopping the growth of these cells (Cancer Council, 2011).

Recommendation for radiotherapy is made by the doctor for a patient after she has gone through “breast conserving surgery” in order to assist in destroying any remaining cancer cells and to bring down the level of chance of having the cancer returning. Sometimes, this kind of treatment is also given to patients who have gone through a mastectomy. Some of the side effects of radiotherapy include tiredness, dry and red skin, and blistering and inflammation of skin.

Chemotherapy is another method of breast cancer treatment. It involves the use of drugs to either kill or slow down the rate of growth of the cancer cells (Bonadonna, et al., 1976). This method may be used when the chances of the cancer coming back are high, when the cancer is back after performing surgery or even radiotherapy and the method may also be used in case the cancer does not show any response to the hormone therapy (Pierce, 1993).

There is a number of drugs that are used in this treatment of the cancer and some of them include carboplatic, docetaxel and fluorouracil drugs among many others (Harris &Swain, 1996).

The drug gives a specific drug combination to the patient depending on the kind of breast cancer she is having and the kind of treatment she has already gone through. In most cases, chemotherapy is administered via a vein and the patient will have approximately four to six sessions of chemotherapy in the course of every two to three weeks over a period of several months.

The side effects associated with this treatment are dependent on the kind of drugs that have been used but some of these effects include nausea and vomiting, changes in weight, loss of hair and tiredness among other effects.

Hormone therapy is also used for breast cancer treatment. This method of treatment is applied to the patients that have “ER+ hormone receptors on their breast cancer cells” (Cancer Council, 2011, p.36). The main objective of this method is to slow down or put a halt to “the growth of hormone receptor positive cancer cells” (Cancer Council, 2011, p.36).

References

Bonadonna G., Brusamolino E., Valagussa P., Rossi A., et al. (1976). Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med, 294(1),405–10.

Cancer Australia, (2013) Breast cancer risk factors – a review of the evidence. Web.

Cancer Council, (2011). Understanding breast cancer. Web.

Cancer Council Australia, (2013). Early detection of breast cancer. Web.

De Moulin, D. (1983). A short history of breast cancer. New York, N.Y: Oxford University Press.

Donegan, W. L. “Staging and prognosis”. In: Donegan W. L, Spratt J. S, eds. Cancer of the breast, 5th ed. Philadelphia: W.B. Saunders Co; 2002. p. 478.

Garvan Institute of Medical Research, ( 2010). Breast Cancer. Web.

Harris, L. & Swain S. M. (1996). The role of primary chemotherapy in early breast cancer. Semin Oncol, 23(1), 31–42.

Hartmann, L. C, et al. (1999). Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med 340(1), 77–84.

Lee, M. S, et al., (1992). Mastectomy or conservation for early breast cancer: psychological morbidity. Eur J Cancer, 28(1), 1340–4.

Mandal, A. (2013). History of breast cancer. Web.

Miller, M. J, Boyer.J, & Dunn, S. M. (1995). Why do Australian cancer patients use unproven treatments? Proceedings of the American Society of Clinical Oncology 22(1), 76.

National Breast Cancer Center, (2001). Management of early breast cancer. Adelaide, Australia: Commonwealth of Australia.

Papac, R. J. (2002). Origins of cancer therapy. Yale J Biol and Med, 74(2), 391–8.

Pierce, P. F. (1993). Deciding on breast cancer treatment: a description of decision behavior. Nurs Res 42(1),22–8.

Queensland Government, (2011). Risk of breast cancer in Australian women. Web.

Sterrett G, et al. (1994) Breast cancer in Western Australia in 1989 III. Accuracy of FNA cytology in diagnosis. Aust N Z J Surg, 64(1)745–9.

The Free Dictionary, (2013). Breast. Web.

Watson, M., et al. (1998). Counselling breast cancer patients: a specialist nurse service. Counselling Psychology Quarterly 1(1),1 -9.

Women’s & Breast Imaging, (2013). Breast Self-examination. Web.

Yalom, M. (1997). A history of the breast. New York, N.Y: Alfred A. Knopf.

Introduction

Today, most women experience unique health issues. Although both men and women have almost similar health issues, women react differently to diverse health issues. Due to this disparity, scholars do their research to find solutions to the most prevalent health issues affecting women. The women’s health problem on breast cancer is the most researched as it affects countless women worldwide.

Women Health Research Article

New research suggests that it is possible to reduce the spread of breast cancer by turning off a gene (Ohio State University, 2014). This strategy provides a breakthrough for medical practitioners in their attempt to find a cure for breast cancer. The study from Ohio University reveals that a myoferlin, a protein linked to cancer, can significantly reduce the metastasis of breast cancer. It suggests that lowering the protein’s level makes the genes that enable the cells to spread remain huddled together in the primary tumor. The lowering of myoferlin affects breast cancer cells in two major ways. Reducing the levels of myoferlin alters the breast cancer cells’ mechanical properties, as it is evident from the fact that the shape and ability of breast cancer cells to spread is low with reduced production of myoferlin. Thus, metastasis does not occur because the cells cannot change the mechanical properties that would fuel them to invade. Also, low levels of myoferlin cause a change to the activation of many genes, making them have normal cell behavior.

The new research on the breast cancer issue draws my attention as many women lose their lives due to the metastasis of cancer. The breakthrough occurs at a time when many young women are screened positive for breast cancer. My main interest in the topic is the fact that it is possible to reduce the spread of breast cancer. How the reduction of myoferlin prevents the metastasis of breast cancer cells is fascinating with the recent tests on mice. Scholars, through their mouse experiments, confirm that silencing the gene lowers the metastasis of breast cancer cells, limiting it to the initial tumor (Ohio State University, 2014).

The research shows the possibility of healing breast cancer because the tumor can be surgically removed once the cells accumulate at the initial tumor. This intervention is like a dream come true for the many women fighting breast cancer. In my opinion, the topic in the article provides hope in the war against the most common type of cancer in women. Due to the lifestyle changes and eating habits of many women, the risk of breast cancer has rapidly increased. Women, especially those at the reproductive stages, are at the highest risk of diagnosing positively with breast cancer. Due to this situation, the issue on how to lower the metastasis of breast cancer cells is of interest since breast cancer is real in society today. With continuous research, scholars will eventually invent a way of preventing and destroying the initial cancerous cells that result in breast cancer.

Conclusion

An understanding of the functioning of the female body is vital in the study of the unique health issues affecting women. Breakthroughs like the silencing of a gene to prevent the spread of breast cancer are essential in solving the unique health problems relating to women. Breast cancer, being a prevalent issue among many women today, should capture the attention of researchers in determining its control. Research indicates that most women related health issues are chronic and deserve early detection, prevention as well as the correct treatment. It is only through research and creating awareness that women health concerns can be resolved.

Reference

Ohio State University. (2014). Breast cancer cells less likely to spread when one gene turned off.Science Daily, Para. 1-16. Web.

Introduction

Breast cancer is a tumor that affects lobules and milk ducts, which form part of the breast tissue. Depending on the site of occurrence, breast cancer can form ductal carcinomas and lobular carcinomas if they occur in the ducts and lobules of the breast, respectively. Breast cancer is prevalent among women, and it is the major cause of death in the United States. The prevalence rates and epidemiology of breast cancer indicate that it is a challenging disease, which the health care systems across the world are struggling to diagnose, treat, manage, and prevent. According to Lin and Pan (2012), “breast cancer is the most common malignancy in women, with approximately 1.38 million new patients, and 459,000 deaths per year worldwide,” (p. 1). The malignancy and treatment of breast cancer disable patients, as it causes great pain, shoulder dysfunction, lymphedema, hormone disorder, neuropathy, and psychological disorders. To enhance understanding of breast cancer, this paper assesses a literature review to determine treatment and rehabilitation options, performs a functional assessment, and establishes residual functional capacity of patients.

Literature Review

Breast cancer is dominant cancer among women, and it contributes to the high mortality rates. The health care system utilizes chemotherapy, radiotherapy, and surgery in the treatment of breast cancer. Since breast cancer has disabling effects, it requires effective treatment and rehabilitative interventions. According to Silver (2007), pain-relieving, fatigue reduction, physical exercise, and psychotherapy are some of the rehabilitation methods applicable to the management of cancer. However, a few numbers of patients usually undergo the process of rehabilitation; hence, increasing their risk of disabling effects of cancer (Lin, & Pan, 2012). Therefore, many women are grappling with the impacts of breast cancer and the adverse effects of therapies.

Breast cancer and treatment methods have significant effects on the health of patients. Studies show that breast cancer and its treatment methods cause motor, sensory, cognitive, emotional/behavioral, and adaptive dysfunctions (Perry, Kowalski, & Chang, 2007). Motor and sensory dysfunctions occur due to chronic pain that has a paralyzing effect. Chemotherapy and radiotherapy cause fatigue and increase physical disability among patients with breast cancer. In the emotional/behavioral aspect, breast cancer and its treatment reduce libido, thus causing sexual dysfunction (Melisko, Goldman, & Rugo, 2010). Functional analysis shows that breast cancer and its treatment methods have significant disabling effects that require effective treatment and rehabilitative interventions.

Treatment and Rehabilitation Options

Depending on the nature and stage of breast cancer, surgery, chemotherapy, and radiotherapy are available treatment options. Surgery involves the excision of the benign or malignant cells that are present in the breast. If surgery entails the excision of benign cells, the patient experience minimal disability. However, cases of malignancy always lead to mastectomy, which involves complete removal of the whole breast. Usually, patients who undergo mastectomy require breast reconstruction to replace their breasts. The use of chemotherapy and reconstruction procedure determines the disabling nature of mastectomy. Chemotherapy is an effective treatment that therapists apply in both long-term and short-term treatment of breast cancer.

It entails the destruction of cancerous cells using drugs, hormones, and antibodies (Silver, 2007). Chemotherapy is applicable in reducing the growth of cancer and preventing breast cancer cells from metastasizing into other tissues in the body. Radiotherapy is also an effective therapy that aids in the destruction of cancerous cells after surgery. A combination of surgery, chemotherapy, and radiotherapy provides enhanced treatment of breast cancer.

Breast cancer malignancy and treatment cause great disability, which influences the ability of patients to perform their daily activities. One of the rehabilitation options for people with breast cancer is physical therapy. Physiotherapy enhances the treatment of breast cancer because it promotes the normal functioning of the physiological processes in the body. “Physical and occupational therapy can help increase shoulder range of motion, promote upper extremity strengths, decrease pain, and reduce swelling” (Silver, 2007, p. 529). Hence, physical therapy has cascading effects that aid in the treatment and management of disabilities associated with breast cancer. Relieving pain is another method of rehabilitating patients with breast cancer. The malignancy and adverse effects of treatment cause great pain, which has disabling effects on the patients. Silver (2007) states that acupuncture, massage, analgesics, and occupational therapy are some of the ways that patients can use in relieving pain. With reduced pain, patients are able to perform their duties without undue interference by breast cancer.

Reducing fatigue is a rehabilitation option that people with breast cancer can use in overcoming disabling effects of breast cancer. “Studies examining the prevalence of fatigue among breast cancer patients have found that up 99% experience some level of fatigue during the course of radiation and/or chemotherapy” (Bower, Ganz, Desmond, Rowland, Meyetrowitz, & Belin, 2011, p. 743). Moreover, patients experience higher fatigue than healthy individuals do. This means that breast cancer and treatment method determine the extent of fatigue that individual experiences. Since fatigue occurs due to physical or emotional impacts of breast cancer, exercise, pain-relieving, and psychotherapy can help in reducing its impact.

Functional Assessment

Breast cancer and treatment have some disabling effects on patients. The functional assessment indicates that breast cancer affects motor functions, sensory functions, emotional/behavioral functions, cognitive functions, and adaptive functions of patients. Breast cancer and its treatment have significant impacts on the ability of patients to function effectively because they cause chronic pain, shoulder dysfunction, hormone disorder, psychological problems, and neuropathy (Lin, & Pan, 2012, p. 1). Each of these impacts has disabling effects on patients. Pain associated with breast cancer is chronic and emanates from the malignancy of cancer and adverse impacts of therapies such as chemotherapy, radiotherapy, and surgery.

According to Silver (2007), pain causes musculoskeletal disorders such as arthritis, cellulitis, edema, neuroma, brachial plexopathy, deep vein thrombosis, epicondylitis, and tendinitis, amongst other complications that contribute to physical disability. Additionally, breast cancer causes shoulder dysfunction, which prevents patients from lifting objects or performing heavy tasks using their hands. Thus, chronic pain and shoulder dysfunctions comprise a motor and sensory dysfunctions that patients of breast cancer exhibit.

Breast cancer also causes hormonal imbalance among patients and leads to serious emotional/behavioral dysfunctions. A combination of radiotherapy, surgery, and chemotherapy causes hormonal imbalance and consequent sexual dysfunction. “Sexual issues identified in breast cancer survivors include changes in body image associated with the loss of a breast or weight gain, decreased libido, vaginal dryness, and dyspareunia, difficulty with arousal and orgasm, and concern over fertility” (Melisko, Goldman, & Rugo, 2010, p. 248). Thus, sexual dysfunction is an emotional/behavioral dysfunction, which contributes to sexual disorders that patients with breast cancer are struggling to overcome.

In the aspect of cognitive function, breast cancer causes depression. According to Perry, Kowalski, and Chang (2007), breast cancer causes psychosocial distress, which affects cognitive functions and results in depression. Breast cancer threatens patients and causes a lot of anxiety because it leads to loss of breast and eventually death in some instances. However, despite enduring numerous disabling effects of breast cancer, patients exhibit adaptive functions such as adhering to therapeutic and rehabilitative interventions and thus improving their quality of life.

Residual Functional Capacity and Job Options

Since breast cancer affects sensory and motor functions, patients with breast cancer can perform light duties and walk short distances. Patients with breast cancer are unable to perform heavy duties and walk long distances because they experience fatigue. “There is growing evidence to suggest that fatigue may persist for months or even years after completion of breast cancer treatment, particularly among patients who have received adjuvant chemotherapy” (Bower, Ganz, Desmond, Rowland, Meyetrowitz, & Belin, 2011, p. 743). This shows that adjuvant therapy is responsible for fatigue that breast cancer patients experience during therapy and even years after the therapy. Moreover, sexual dysfunction due to loss of libido is a long-term effect of breast cancer. After undergoing therapy, some patients usually lose their sexual ability. Concerning cognitive and adaptive functions, patients with breast cancer portray normal cognitive abilities and adaptive functions. Hence, breast cancer and treatment have no significant impact on the cognitive and adaptive capacities of patients.

Conclusion

Breast cancer is a tumor that is dominant among women. Chemotherapy, radiotherapy, and surgery are common treatment options for breast cancer. Additionally, rehabilitation options for breast cancer are pain-relieving, reduction of fatigue, exercise, and psychotherapy. Analysis of functional assessment and residual functional capacity indicates that breast cancer affects motor, sensory, cognitive, emotional/behavioral, and adaptive functions of patients.

References

Bower, J., Ganz, P., Desmond, K., Rowland, J., Meyetrowitz, B., & Belin, T. (2011).

Fatigue in breast cancer survivors: Occurrence, correlates, and impact on quality of life. Journal of Oncology, 18(4), 743-753.

Lin, Y., & Pan, P. (2012). The use of rehabilitation among patients with breast cancer: A retrospective longitudinal cohort study. Health Services Research, 12(282), 1-7.

Melisko, M., Goldman, M., & Rugo, H. (2010). Amelioration of sexual adverse affects in early breast cancer patient. Journal of Cancer Survival, 4(3), 247-255.

Perry, S., Kowalski, T., & Chang, C. (2007). Quality of life assessment in women with breast cancer: Benefits, acceptability, and utilization. Health and Quality of Life Outcomes, 5(24), 1-14.

Silver, J. (2007). Rehabilitation in women with breast cancer. Physical Medicine and Rehabilitation Clinics of North America, 18(3), 521-537.

The treatment of breast CA has developed over the past 20 years, and many treatment centers offer a variety of modalities and holistic treatment options in addition to medical management.

Nowadays, there are different treatment options that are used for improving the condition of patients with breast cancer. Even though medical management remains the most commonly used method of treatment, many women resort to complementary and alternative therapies. For instance, a lot of patients start using natural products. They take various herbs and vitamins because believe that they help the body to heal itself. Moreover, women use relaxation techniques, such as meditation and breathing exercises. These activities are expected to make it easier for patients to cope with stress and other unpleasant emotions that are associated with their health condition. In addition to that, they are often claimed to reduce pain and discomfort. However, it is vital to take into consideration the fact that the effectiveness of these approaches is questionable, because of the lack of sufficient research (Vidal, Carvalho, & Bispo, 2013). Thus, medical management of breast cancer is not the only treatment option that can benefit patients.

Can you describe a center in your geographic area that offers this type of management for these patients, and can you describe in detail the type of care that women are offered at this center?

The University of Maryland Medical Center (UMMC) offers women with breast cancer an opportunity to be treated with the help of naturopathy. In this way, the emphasis is made on the healing power of nature. Those techniques that were described previously are also used in the UMMC. For example, during the visit, a naturopath offers a patient several treatment options that are appropriate for them. They include nutrition based on natural products, herbal and homeopathic medicine, psychological counseling. In addition to that this professional uses acupuncture, physical medicine, and hydrotherapy. Detoxication and spirituality, vitamins, and relaxation techniques can also be addressed (UMMC, 2017). Thus, numerous holistic treatment options are available for patients in Maryland.

References

UMMC. (2017). Naturopathy. Web.

Vidal, M., Carvalho, C., & Bispo, R. (2013). Use of complementary and alternative medicine in a sample of women with breast cancer. SAGE Open, 2013, 1-4.

Introduction

Breast cancer is a widespread disease that usually affects women in their 50’s and 60’s. The article “Screening for Breast Cancer” presents guidelines for the females who are concerned about this problem. Biennial mammography might either benefit or harm patients. Therefore, it is necessary to be aware of possible outcomes of this procedure. The main goal of this paper is to describe the specific set of clinical circumstances under which the application of screening is the most beneficial for women aged 40 to 74 years.

Biennial Mammography

Mammography is a procedure that involves the application of low-energy X-rays in order to diagnose breast cancer. The article by Siu (2016) provides recommendations on biennial mammography for women between the ages of 50 and 74. The author suggests that women under the age of 50 should decide on undergoing mammography individually. Females who feel the necessity for such tests might begin biennial screening at the age of 40.

Also, the U.S. Preventive Services Task Force (USPSTF) states that there is not enough evidence to analyze the advantages and drawbacks of screening mammography for women over the age of 74. In addition, the USPSTF claims that there is not enough evidence that supports the application of digital breast tomosynthesis as a preventive approach to breast cancer. Breast ultrasonography, magnetic resonance imaging, or other procedures cannot contribute to better outcomes for patients with negative screening mammograms.

However, mammography screening is considered to be a measure that reduces breast cancer mortality among patients between the ages of 40 and 74. Breast cancer death rates are higher in women aged 60 to 69 years (Siu, 2016). Except for age, there are other risk factors for breast cancer. Women between the ages of 40 and 49 whose relatives suffer breast cancer are at the same risk group as women aged 50 to 59 years who do not have such a family history.

However, there are certain harms caused by screening for females between the ages of 40 and 74. The main negative factor is the treatment of non-invasive and invasive cancer that is not life-threatening. Another problem is false-negative test results. Such incidents delay necessary treatment and often result in deaths. Also, it is worth mentioning that deaths caused by radiation-induced breast cancer rarely take place.

The USPSTF provided the meta-analysis of various clinical tests. This research includes the analysis of the screening of 10,000 women between the ages of 60 and 69 (Siu, 2016). The results show that this procedure reduces the number of breast cancer deaths by more than 50 percent. This research includes cases that took place 30 years ago. Therefore, it does not reflect the current correlation between screening mammography and breast cancer deaths. However, this technology has been significantly improved since then, and the ways of the treatment for breast cancer have been positively changed as well.

The research also revealed that harms of mammography outweigh its benefits for women under the age of 50. However, for females in their 60’s, screening is highly beneficial. The main risk factors for younger patients are overdiagnosis, overtreatment, and invasive testing. The CISNET model describes favorable clinical circumstances for screening (Siu, 2016). It demonstrates that this procedure reduces the number of breast cancer deaths in women aged 40 to 74 years. However, it reveals a large number of unnecessary breast biopsies and overdiagnosed breast tumors. Although the mostly recommended age to start biennial screening is around 50, this procedure might be crucial for younger females in specific cases.

Conclusion

The main problems relating to breast cancer screening are false diagnoses and unnecessary invasive procedures. However, it was proved that this method helps to identify the disease at an early stage and consequently reduce the number of deaths. Therefore, it is highly recommended to follow the described above guideline to prevent the development of this dangerous disorder.

References

Siu, A. L. (2016). Screening for breast cancer: US preventive services task force recommendation Statement. Annals of Internal Medicine, 164(4), 279-296.

Introduction

Cancer of the breast occurs in women of all races and appears to have happened throughout history. It is slowly increasing in frequency all over the western world. Those factors influenced in the development of breast cancer that can be avoided are obesity and ionizing radiation. Of the remaining risk factors, age is inevitable. According to the statistical results: “Breast cancer is the second leading cause of cancer deaths in American women today, claiming more than 40,000 lives annually” (Claudo 92).

Pathology

Breast cancer is a term which covers a very wide variety of disease patterns (Olivier 4). Some patients’ cancers remain confined to the breast for years, while others have no lump to feel in the breast, becoming ill with severe metastatic disease elsewhere in the body. The cells lining the breast ducts and forming the secretory groups are normally orderly both in content and arrangement. Incipient cancer is recognizable by characteristic calcification on X-ray of the breast, or by microscopic examination of tissue taken for diagnosis, or as part of an operation to remove a true cancer (BreastCancer.org, 2007). The condition is fully curable by surgery but may affect both breasts. According to Iversen et al (2000) this situation is comparable to the finding of abnormal cells on the surface of the cervix, curable by excision or vaporization of the tissue. Since it has no manifestation, this phase of breast cancer has only been noticed incidentally in the past, but its ability to produce X-ray signs means it is being found more frequently now. This produces new dilemmas for doctors and patients (Parmigiani 445). It is not known how many breast cancers may start in this way or how long this phase of the disease may last. The cells of an active cancer are demonstrably malignant by their ability to travel to unusual sites. Thus they grow outward into the breast tissue, entering the blood and lymphatic vessels where loose cells travel with the stream of fluid to distant sites (BreastCancer.org 2007).

Metastasis

Metastasis is the appearance of a mass of cancer in another part of the body at a distance from the original cancer. Thus the original lump is the primary and all the metastases are secondaries (Iversen et al 445). Loose cells in the lymph vessels of the breast are trapped in the armpit lymph nodes and form secondaries there. As these secondaries enlarge, they either release cells themselves or cause cells from the primary to by-pass them in new lymphatic channels. Hence nodes further from the tumor become involved, such as those in the root of the neck (2007).

Diagnosis and Treatment

The mainstay of investigation is needle aspiration cytology. In some districts it may be necessary to perform a biopsy, that is remove a piece of the lump either by operation or with a special thick-cutting needle (Breast Cancer 2007). Either test is backed up by a mammogram: an X-ray of both breasts to characterize the known lump and discover any other suspicious areas. Most surgeons know that the choice of initial treatment for the affected breast does not influence outcome in terms of survival. They also know that many women hope to keep their breast and be treated by lumpectomy and radiotherapy (Olivier 45). Unfortunately, 30 to 50 per cent of lumps are unsuitable for this treatment by virtue of their size or proximity to the nipple. The surgeons know that putting more people in this treatment group can lead to future trouble. As it is, about 15 per cent of patients having lumpectomy with radiotherapy will have further cancer at the site of the first lump, and undergo mastectomy up to three years later (Locker et al. 1989). Performing more lumpectomies in the fringe group seems certain to increase the risk of local recurrence. The lumpectomy patients in the large American trial had fewer late mastectomies, probably because the microscopist were not happy with the initial excision in some cases, and the surgeon did an immediate mastectomy at the time of the lumpectomy in 10 per cent of cases (Breast Cancer 2007). Surgeons who are happy to discuss the options with their patients also know that about 30 per cent of those suitable for either operation will choose a mastectomy. The number will vary depending on the way in which the information is presented to the patient. Mastectomy, of course, gives a chance of avoiding radiotherapy, which patients find as debilitating as surgery (Breast Cancer 2007).

Psychological Problems

In those women for whom breast loss creates psychological distress breast reconstruction is available. The breast tissue can be substituted by a plastic sac. It is often appropriate to start with an empty sac which can be progressively filled with fluid through an injection port under the nearby skin. Once the correct size is reached, a small operation removes the first sac and substitutes a permanent and more natural one. Problems include migration of the sac to the wrong place, hardening of the scar round the sac, lack of nipple, and difficulty in diagnosing local recurrence of the breast cancer (Breast Cancer 2007). The ingenuity of plastic surgeons has produced an array of choices in re-forming the lost breast tissue and skin. Detailed descriptions are not appropriate here, but the principles are easy to describe.

After the initial cancer operation, the microscopist’s report is reviewed and decisions on future care made according to the unit’s policy. Most lumpectomy patients and some mastectomy patients will be recommended to have radiotherapy, normally on an outpatient basis. Sessions are painless, happening every weekday for three to six weeks. Extra treatment is given to the lumpectomy area itself, either by more external beam therapy, or occasionally with implants. Under anaesthetic the surgeon or radiotherapist places plastic tubes in the breast tissue, and subsequently radioactive material is placed in the tubes for a suitable time, usually a few hours (BreastCancer.org.2007). Afterwards the tubes are withdrawn and the remainder of the treatment given by external beam, using gamma-rays from a cobalt source, or X-rays from a generator.

The primary aim in counseling patients with breast cancer is to help women find their own means of coping with the emotional stresses of having a life-threatening illness. The outcome of good coping in this sense means successfully adapting to the difficult and changing physical and emotional demands placed on a woman with breast cancer. At different times women may be beset and bemused by feelings of anger, guilt, fear, uncertainty, depression, and confusion about what to do and what the future holds (BreastCancer.org 2007). Effective counseling and psychotherapy should permit appropriate expression and ventilation of these negative emotions and then help the woman develop some more positive means of dealing with them by, for example, restructuring, channeling, or changing the way in which they perceive their current situation and perceive their future.

Preventive Measures

Regular attendance and examination are required of, or requested by, most cancer patients. “Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered” (Breast Cancer 2007). Hopefully, this will lower the number of deaths caused by cancer. The interviews and examinations are conducted by surgeons or radiotherapists at intervals ranging from twelve weeks at first to a year later. The traditional visit and examination have been shown to be oddly ineffective, as only one in three recurrences are found by examination or enquiry at that time (Olivier 45). Patients often find their own recurrences, perhaps through knowing where to look. In addition, much of the depression and anxiety catalogued later in this book is not recognized by surgeons or seen as their problem (Breast Cancer 2007). In general, ways to prevent cancer include: “Changing lifestyle or eating habits, avoiding things known to cause cancer, taking medicines to treat a precancerous condition or to keep cancer from starting” (Breast Cancer 2007). The visit seems to provide reassurance for both patient and doctor, but this may only be as a consequence of the anxiety generated in the lead-up to it. Perhaps the most significant part of follow-up is regular mammography of the other breast to discover any small new cancer there. In future it may be possible to do this through the general breast screening program. Following Iversen et al (2000) “Incorporating family history as a predictor in statistical models is often done by selecting suitable summaries of a pedigree and using them as right-side variables” (445). For some patients, then, confidence in survival grows as the shock of mutilation and threat of death recede. Visits are less frequent, more of a reunion and a secret celebration of success. Others demonstrate their anxiety by repeated attendances to discuss various bodily symptoms which need reassurance and sometimes investigation.

Works Cited

BreastCancer.org .2007.

Breast Cancer. Medical Center Institute. 2007. Web.

Claudio, L. Breast Cancer Takes Center Stage. Environmental Health Perspectives 112, (2004): 92.

Iversen Jr., E.S. Parmigiani, G., Berry, D.A., Schildkraut, J.M. Genetic Susceptibility and Survival: Application to Breast Cancer. Journal of the American Statistical Association 95, (2000): 445.

Olivier, S. The Breast Cancer Prevention and Recovery Diet. nguin Books Ltd; New Ed edition. 2000.

Bibliography Cards.

BreastCancer.org . Online Internet. 2007. Web.

Breast Cancer. Medical Center Institute. Online Internet. 2007. Web.

Claudio, L. Breast Cancer Takes Center Stage. Environmental Health Perspectives 112, (2004): 92.

Iversen Jr., E.S. Parmigiani, G., Berry, D.A., Schildkraut, J.M. Genetic Susceptibility and Survival: Application to Breast Cancer. Journal of the American Statistical Association 95, (2000): 445.

Olivier, S. The Breast Cancer Prevention and Recovery Diet. nguin Books Ltd; New Ed edition. 2000.

Personal Collection.