Breast Cancer Disease - Coursework Example

Breast Cancer Introduction When cancerous cells are discovered in the breast of a man or more commonly a woman, the person is said to have developed breast cancer. Across the world, it is the most common type of cancer which affects women since one in forty women will experience it in their lifetimes on average. For women who reach the age of ninety or more the chances rise to one in three. After lung cancer, it is second most fatal form of cancer for women but unlike lung cancer, the numbers of cases have risen quite sharply since the 70s (Laurance, 2006). The disease itself is classified as C50: Malignant neoplasm of breast by the WHO (2006) and it has caused serious concerns in the public as well as private arenas. Risk Factors and Causes Being the most common form of cancer in the UK, a lot of research and study has been done into the risk factors and causes of breast cancer. With more than 40,000 cases being reported each year, scientists are continually trying to find what links these individuals together in terms of diet, lifestyle, environment and genetics. While the cancer can come up in men, it is still relatively rare with only 300 reported cases in a year (Macnair and Hicks, 2005). Clearly, women are more at risk than any other segment of the population. Despite all the information that we have, the exact causes and influences on the disease remain largely unknown to us (Madigan et. al. 1995). Age of the Patient We do know that the risk of breast cancer increase as a woman gets older (ACS, 2007). The majority of women are diagnosed with it when they are over fifty years old and half of the reported cases are from women who are sixty years or older (Macnair and Hicks, 2005). For younger women, the risk is lower because the cancer is very uncommon for women who have not crossed 35 years of age. It is further suggested by Lee (2007) that Caucasian women may have a greater incidence of breast cancer than women of African or Asian origins. Family History A woman who has had a personal history of breast cancer in one breast faces an increased risk of getting breast cancer in their other and if any other member of her family has had breast cancer then her own risks are also increased. These women also have an increased risk of developing ovarian cancer, and may have an increased risk of developing other cancers. Certain other diseases of the breast such as atypical hyperplasia or lobular carcinoma in situ can also increase a womans risk for developing breast cancer. Similarly, genetic influences may also account for some risks since hereditary breast cancer accounts for 5% to 10% of all breast cancer cases. In fact, some altered genes related to breast cancer are more common in certain ethnic groups than others (Lee, 2007). Macnair and Hicks (2005) suggest that using the oral contraceptive pill increases the risk by a small margin but the risk returns to normal after the use of the pill has been discontinued. Similarly, biochemical and growth changes in the body such as an early set on of periods or a late menopause may be seen as risk factors since they increase the amount of time the body remains exposed to the naturally occurring chemical known as Estrogen (Lee, 2007). Breast Density An individual’s breast density also has an effect on the risks for breast cancer since women who have a high proportion of lobular and ductal tissue in their breasts may find early detection to be difficult. A high content of lobular and ductal tissue is also dangerous since cancers quite often develop in such tissue of the body and not fatty tissue. Additionally, as a diagnostic issue, it is more difficult for doctors to see abnormal areas on a mammogram when a person’s breasts are dense (Lee, 2007). Lifestyle Choices When and how many children a woman decides to have can also affect the likelihood for the development of breast cancer. For example, if a woman has children at a younger age, it is less likely that she will get breast cancer as she gets older. Additionally, the more children she has the less likely it is for her to develop breast cancer. Late childbearing (after the age of 30) or having no children at all are both elements which increase the chances of getting breast cancer (Macnair and Hicks, 2005). There are things which reduce the chances of the development of breast cancer and these include breastfeeding, eating low fat high fibre diet, the consumption of fruits and vegetables, maintaining an ideal weight after menopause consuming alcohol within recommended limits (Macnair and Hicks, 2005). Women who tend to consume more than the permissible levels of alcohol can find themselves with an increased risk of breast cancer (Schatzkin et. al., 1989). However, as reported by Lee (2007) as well as Macnair and Hicks (2005), doctors are still not sure about the exact causes of Breast cancer since some women develop it without displaying any of the risk factors listed above. As research continues on the topic our understanding of the risk factors as well as causes is likely to improve and so will the survival and recovery rates for individuals suffering from the disease (Madigan et. al. 1995). Symptoms Recognition of the symptoms of breast cancer can help in early detection and with early detection comes the chance of a full recovery. NBCF (2007) reports that if breast cancer is found early the five year survival rate is more than 95%. Early detection, knowing the symptoms and the availability of treatment options has allowed America to have more than two million survivors of the disease. Although the symptoms may be caused by different reasons, they are often grouped together when cancer is present (NBCF, 2007). The List of Symptoms There are several symptoms which have been given by the NBCF (2007), the CDCP (2006) as well as Macnair and Hicks (2005). These symptoms include things such as: A lump in the breast or armpit which is usually felt as a firm single lump and is almost always without pain. A swelling of a portion of the breast or underarm with or without an unusual appearance. Dimpling, discolouration, or other such changes on the breast. Unusual discharge from the nipple with or without the release of blood. A change in the direction of the nipple. Veins on the skin surface of a breast could become more prominent. The most important symptom remains the presence of a lump which is felt within the breast. However, the NBCF (2007) suggests that this is no reason to panic because only a small minority of lumps are cancerous. Even then, an appointment with a doctor for a mammogram and further examination is necessary if the symptoms described above are present since only a doctor or a professional medical examiner could truly confirm the presence or absence of breast cancer. Investigation On the presence or detection of symptoms, a medical examination by a health care professional becomes necessary but before that situation comes up, it is highly recommended that women should conduct self exams for breast cancer. The process for that is relatively simple and the basics can be done in the privacy of one’s home. The shower is an ideal place for doing this exam since mirrors are within easy reach (NBCF, 2007). The Self Exam The self exam begins with the woman standing up with straight with the left hand placed at the back of the head. The right hand should then be used to examine every part of the left breast with the fingers of the hand held flat. The same process should be repeated for the right breast which should be examined with the left hand. The person making the examination should be looking for any lumps, hard knots or unusual thickening of the breast region (NBCF, 2007). The second step has to be conducted before a mirror where the person should keep their arms at their sides and then raise them high above their head. While doing this motion, they should observe any changes in breast shape or the contours of the breast. Any swelling, discolouration, or dimpling of the skin should be marked. Still in front of the mirror, the person should bring their hands to rest on their thighs and flex the muscles of the chest. Again, any changes in the breast should be noted with caution (NBCF, 2007). Breast Self Examination Process (NBCF, 2007) The third step of the examination asks for the person conducting the test to lie down with a pillow under their shoulder with the head resting on their right arm. They should then use their left hand to press the breast in small circular movements to cover the entire breast. Pressure on the breast should be varied from light and medium to firm to check for discharge or any unusual lumps. The nipple should be squeezed to check for discharge as well. Finally, the same steps should be repeated for the left breast to complete the self examination for breast cancer (NBCF, 2007). While self examinations can be conducted on a monthly basis, early detection requires clinical examinations to be done every three years between the ages of 20-40 and then on a yearly basis. Women should look into getting a baseline mammogram at the age of 40 and then continued mammograms every year or two between the ages of 40-49. After the age of 50 a mammogram should be conducted every year (NBCF, 2007). Medical Diagnosis The medical diagnosis of breast cancer requires a few more steps before breast cancer can be confirmed in a patient. These include a mammography, an ultrasonography and then a biopsy. The mammography is an x-ray of the breast which gives the doctor a closer look at the lump within the breast while an ultrasonography uses high frequency sound waves to detect if the lump is a fluid filled cyst or something else altogether. A cyst is not cancerous while a solid lump may be cancerous (White, 2007). Based on the results of the mammography and the ultrasonography, the doctors may ask for further tests including a biopsy in which fluid or tissue matter has to be extracted from the breast. This procedure can be a fine needle aspiration which uses a thin needle to remove fluid or solid cells from the breast to examine in a lab. The doctors may also conduct a surgical biopsy which removes a section of a lump or all of a lump or suspicious area as well as an area of tissue which is seen as healthy around the edges of the lump. It is then examined under a microscope to detect cancerous cells (White, 2007). These experiences can certainly be traumatic for the patient especially if s/he does not know what the results are going to be. However, there are support groups and hospital consulting personnel who help patients through these difficult periods before their results arrive, during their treatment and after they have survived the disease. The psychological impact of the disease is often as great as the physical impact therefore care must be taken to get the right treatment for the mind, body and soul. Therefore, emotional support for the individual as well as their family becomes very important in the treatment of the disease (Macnair and Hicks, 2005). Treatment Depending on the nature of the cancer, age of the patient and several other factors which include the previous medical history of the patient, doctors can recommend several treatments for breast cancer. These can include things such as surgery, radiotherapy, chemotherapy, biological therapy and hormone therapy (Macnair and Hicks, 2005). The most common treatment for breast cancer remains surgery followed by radiation therapy which is used to destroy the remaining cancer cells (White, 2007). Surgery and radiation therapy are both considered local treatments but if the cancer spreads to other parts of the body more systemic treatments may be considered as viable options by the doctors. For example, if the cancer has spread to the bone or to the lungs, a doctor can recommend chemotherapy for the whole body or hormonal therapy to combat the cancer. Systemic therapy is used primarily to ensure that the cancer does not spread further or that the patient does not relapse into the disease (White, 2007). The surgery and the further treatment required for the cure of breast cancer can be disfiguring and breast reconstruction can help in recovering the patient’s self esteem as well as a positive image for their body. If the patient wishes to have reconstructive surgery, it is recommended that they consult with a plastic surgeon before they go into surgery for the removal of the cancer (White, 2007). At the same time, the patient as well as their family may need continual psychological counselling to help them deal with the disease as well as the side effects of it. Conclusion Breast cancer is indeed a very important issue for women across the world today because of the rising number of cases which show that the cancer has an increasing trend. However, it is one of the cancers which are easily treatable and curable if early detection is made of the presence. The only weapon which doctors can provide to the population at large against this disease is awareness as well as knowledge and it seems that they are doing their best to do the same. However, there is still a lot of room for improvement since scientific discoveries with regard to breast cancer are being made on a daily basis. As we learn more about the disease, its causes and its cure, we might one day be able to eradicate it completely from amongst us. Works Cited ACS (American Cancer Society). 2007, ‘What are the Risk Factors for Breast Cancer’, Cancer.org, [Online] Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp CDCP (Centre for Disease Control and Prevention). 2006, ‘Breast Cancer: Symptoms’, CDCP, [Online] Available at: http://www.cdc.gov/cancer/breast/basic_info/symptoms.htm Laurance, J. 2006, ‘Breast cancer cases rise 80% since Seventies’, The Independent, [Online] Available at: http://news.independent.co.uk/uk/health_medical/article1771835.ece Lee, D. 2007, ‘Breast Cancer’, MedicineNet.com, [Online] Available at: http://www.medicinenet.com/breast_cancer/article.htm Macnair, T, and Hicks, R. 2005, ‘Breast cancer’, BBC.co.uk, [Online] Available at: http://www.bbc.co.uk/health/conditions/breastcancer1.shtml Madigan, M. et. al. 1995, ‘Proportion of breast cancer cases in the United States explained by well-established risk factors’, Journal of the National Cancer Institute, vol. 87, no. 1, pp. 1681-1685. NBCF (National Breast Cancer Foundation). 2007, ‘Early Detection’, NBCF, [Online] Available at: http://www.nationalbreastcancer.org/early_detection/index.html Schatzkin, A. et. al. 1989, ‘Alcohol consumption and breast cancer: A cross-national correlation study’, International Journal of Epidemiology, vol. 18, no. 1, pp. 28-31. White, E. 2007, ‘How is breast cancer diagnosed?’, MedicineNet.com, [Online] Available at: http://www.medicinenet.com/breast_cancer/page5.htm#toch WHO (World Health Organisation). 2006, ‘Malignant neoplasms’ WHO.org, [Online] Available at: http://www.who.int/classifications/apps/icd/icd10online/?gc50.htm+c50 Read More