essay on breast cancer

BreastCancerEssayexamples

IntheUnitedStatesin1999alone,anestimated43,700peoplewilldiefrombreastcancer.Itisthe numbertwocancerkilleramongfemalesages15to54.Onaverageifawomangetsthisdisease, theirlifeexpectancydropsdrasticallyThiscanceriswithinthetopthreecancersofallwomen abovetheageof15,andcomprisesagreatamountofallhealthcarecostsintheU.S.totalingan astounding37billiondollarsayearindirectmedicalcosts.Anaveragewomanissaidtohaveaone inninechanceofgettingthecancer,butifthatpersonhadfamilyhistoryofthedisease,hisorher chanceshavebeenmeasureduptoaoneinsixchance.Sixty–ninepercentofAfrican–American womensurvivefromit,andtherearepredictedtobeshowmorecontent

Thisaccountsforapproximately13%ofallbreastcancerpatientsobserved.Jewishwomenin specificwereused,asearlyontherewasadefinitepatternofbreastcancerthroughtheJewish communityespeciallythatwhichlivedintheUnitedStatesThespecificmutation,185delAG,was, "stronglyassociatedwiththeonsetofbreastcancerinJewishwomenbeforetheageof30."

Scientistsadvanceduponthisnewinformationofgenealogicalinterplay,sothe"NewEngland JournalofMedicine"(NEJM)setoutdeterminedtostudytheoveralleffectsofthesegenes.Inan articleprintedonJanuary18,1996,germ–linealterationsinBRCA1werediscoveredinsixofthe 80womensurveyedwhohadbreastcancerbuthadnoapparentfamilialhistoryofitThusthe scientistsconcludedthatmutationwasnotlimitedtowomenwithahistoryofcancer.Genesare thoughttocausefivetotwentypercentofallbreastcancers.Ageneknownasp53supposedlystalls reproductionofcells,andcanevencauseacellto"commitsuicide".Othergenesthatseemto accelerategrowthtoovertakeandsticktoproteinsincludeHER2,neu,anderB2(Fitzgeraldetal, 1996)Therelationbetweenserumestrogenlevelsatasingletimeislinkedtobreastcancer,butno evidencelinksestrogenlevelsoveranextendedtimetotheriskofbreast

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BreastCancerTreatment

OnlylungcancerkillsmorewomeneachyearintheUnitedStatesthanbreastcancerdoes.The AmericanCancerSociety(ACS)estimatesthatover

184,000newcasesofbreastcancerwerediagnosedinwomenin1996(ACSBreast)

Althoughthesestatisticsarealarming,thereareanumberoftreatmentoptionsavailableforthose thatarediagnosedwithbreastcancer.

ThebestwaytotreatanydiseaseistopreventitSincelittleisknownaboutbreastcancer,thereare noestablishedrulesforprevention.The ACSrecommendsthatwomenagetwentyandolderperformmonthlybreastself–exams,anditalso suggestsclinicalexaminationseverythreeyears(ACSshowmorecontent

Radiationtherapyisanothercommontreatmentforbreastcancer.

Radiationinvolvestheuseofhigh–energyx–raystodamagecancercellsandretardfurthergrowth Theradiationmaycomefromaradioactivesourceoutsidethebody,oritcancomefromradioactive pelletsplaceddirectlyinthebreasts.

Itisnotuncommonforapatienttoreceivebothinternalandexternalradiation.Forexternal radiation,patientsmustvisitthehospitalorcliniceachday.Whenthisregimenfollowsbreast–sparingsurgery,thetreatmentsaregivenfivedaysaweekforfivetosixweeksAttheendofthat time,anextra

"boost"ofradiationisoftengiventotheplacewherethetumorwasremoved.

HospitalstaysarerequiredforimplantradiationSomecommonsideeffectsofradiationtherapy includeswellingofthebreastanddryskinattheradiationsite.Chemotherapyisoneofthesystemic therapiesdoctorsusetofightbreastcancer.Chemotherapyusesdrugstokillcancercells,andit usuallyinvolvesacombinationofthosedrugs.Traditionalchemotherapyisadministeredincycles;a treatmentperiodfollowedbyarecoveryperiod,thenanothertreatment,andsoon(NIH23).Like radiationtherapy,chemotherapycanbeadministeredonanoutpatientbasisAlthoughchemotherapy workstokillcancercells,someofthesideeffectsalmostmaketreatment

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BreastCancer

Chromosome17andBRCA1

Amongthemostcommondiseasesaffectingthefemalepopulation,breastcancerdevelopsinoneof everyeightAmericanwomen.Thismeansthatalmost200,000womensufferfromthediseaseeach year.Doctorswouldadvisewomentotakenecessaryprecautions,suchasroutinesurveillance,in ordertoensurealifewithoutobtainingthisdiseasepriortounderstandinganygeneticlinkageof breastcancer.Althoughmanyexternalfactorscontributetobreastcancer,currentinvestigations revealthatfivetotenpercentofthesecasesmaybeattributedtogeneticinheritance(Lynch,1999). Thisknowledge,aningeniousfindingbyMary–ClaireKingin1990,linkedbreastcancertothe long–armof...showmorecontent...

al,1999)VariousmethodsofpositionalcloninghavebeenusedtodetectmutationsofBRCA1,but originallythegenewasisolatedusingsingle–strandconformationpolymorphism(SSCP)anddirect sequencing.During1994,whenthegenewasfirstdiscovered,SSCPwasdoneusingbothgenomic DNAandcDNAfromlymphoblastRNA(Friedman,et.al,1994).SSCPanalysisdetectedeach variantandsequenceditonseveraltemplates.Resultsfromthisexperimenthelpedprovethe involvementofBRCA1tobreastcancerdevelopmentOtherstudieshaveusedSouthernBlotting techniquesandotherPolymeraseChainReaction(PCR)methodsinordertofurtheranalyze BRCA1.

BRCA1encodesaproteinthatisapproximately1865aminoacidsinlength,whichis"atumor suppressor,aproteinthatactsasanegativeregulatoroftumorgrowth"(Mikiet.al.,1994).Lossof functionisduetoprematureterminationofproteinsynthesis.Becausepredispositionisadominant genetictrait,asinglecopyofthemutantalleleisenoughtoincreaserisksofbreasttumorsproving thatafunctionalBRCA1isneededinorderfornormalbreasttissue(Mikietal,1994)Thisprotein isexpressedintheepithelialcellsofmammaryglandsandothertissues,andtheproteinactsto inhibitcelldivision.BecauseBRCA1isatumorsuppressorgene,anymutationleadstobreasttumor formation

Oncethetwogenes,BRCA1andBrCA2

BreastCancer

In2016,breastcancerwasthecommonestdiagnosedcancerinwomenwith17millioncases diagnosedandaresultant5milliondeaths.IntheWesternworld,improvedtreatmentsandscreening programmeshaveresultedina5–yearsurvivalof80–90%(WHO,2016)However,athirdofbreast cancerpatientsarefoundtohavedistantmetastasesatdiagnosis,bringingtheir5–yearsurvivalrate downby25%(Siegeletal.,2004).Metastasisoccurswhentumourcellstravelthroughthevascular orlymphaticsystemandgrowindistantorgans,commonlybone,lung,liverandbrain Currenttreatmentinvolvessurgicalremovalofthevisibletumourbulkfollowedbychemo–and radio–therapytargetingdistantspread.Breastcancerisshowmorecontent

Thetumourstromaappearstobeamajorfactorintumourprogressionafterinitialtumourformation (ConklinandKeely,2007).Itinitiallyprotectsagainsttumourigenesis;butneoplasticcellscause changesandrecruitvariousothercelllineswithamultitudeoffunctions,formingatumourmicro–environment(TME).Thisisdefinedas"aheterogeneouspopulationofcellsconsistingofthetumor bulkplussupportingcells"(Bussardetal.,2006).Thetumourcellsrecruitthestromacellsandcause areactivephenotype,knownastumor–associatedstromalcells(TASCs)

Mesenchymalstemcells,endothelialcells,pericytes,fibroblastsandvariousotherimmunecellsare allcomponentsoftheTME,eachwithspecificfunctions.Whenactivated,theytakeonasimilarin functiontothosefoundininflammationandwoundhealingandcausefibroblastinfiltration, recruitmentofimmunecells,remodellingoftheextracellularmatrix.Thisiswhycancerhasbeen likenedtoawoundthatneverheals,thetumourstromabeingchronicallyactivatedandpromoting growthandangiogenesis(Dvorak,1984).

Therapidproliferationoftumourcellssoonexhauststheexistingvascularsupplyandbringsabouta hypoxicenvironmentintheTME(CoussensandWerb,2005)Endothelialandstromalcellsforma

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BreastCancer

Breastcancerisonlyoneof200differenttypesofcancer.Itisconsideredawoman'sdiseasebut bothmenandwomenhavethedisease.Everyyear,morethan200,000womenarediagnosedwith breastcancerTwelvepercentofallwomenwillgetthediseaseand35%ofthemwilldieBreast canceristheleadingcauseofdeathamongwomenwhoare40to55yearsold.

CanceroccurswhencellsdivideuncontrollablyCellskeepdividingeventhoughnewcellsarenot needed.Changefromnormaltocancerouscellsrequiresgenealterations.

Alteredgenesanduncontrolledgrowthmayleadtotumors.Thesetumorscanbebenign(NOT cancerous)ormalignant(cancerous).Benigntumorswon'tspreadbutitcandamagetissues around...showmorecontent...

Beingobesemayalsoincreaseyourrisk

chemicals–ResearchersintheNewYorkStateDepartmentofHealthhavefoundthatwomenon LongIslandwhogrewupwithinamileofachemicalplanthaveagreaterchanceofgettingbreast canceriftheylivedfurtherawayfromthechemicalplant.

race–EventhoughwhitewomenaremorelikelytogetcancerthanAfrican–Americanwomen, African–Americanwomenaremorelikelytodiefromcancer.Asian,Hispanic,andAmericanIndian womenhavealowerriskofgettingbreastcancer

Birthcontrolpills–Astudyshowedthatwomenusingbirthcontrolpillshaveaslightlygreaterrisk ofbreastcancer.

Hormonereplacementtherapy–MoststudiessuggestthatuseofHRTforreliefofmenopause symptomsformorethan5yearsmayslightlyincreasetheriskofbreastcancer.

Alcohol–Womenwhohave2to5drinksdailyhaveabout11/2timestheriskofwomenwhodrink noalcohol.

Symptoms

Thereareseveralsymptomsofbreastcancer.Earlycancermaynotshowanysymptomsatallbutas timegoesbyandthecancergrows,theremaybesymptoms

Youmaygetalumporathickeninginornearthebreast.Changeinitsshapeorcontour,swelling, thickening,poreenlargement,retractionorscalinessofthenipple,nippledischarge,painor tenderness.Itisusuallyfoundinaperson'sbreastasahardlumpthatispainless.Insomecases,pain andtendernessmayoccurBloody

BreastCancerEssay

BreastCancer

KindsofsupportBreastCancerClients'need.

HarpreetKaurMalhi

ScholarlyWritinginNursing

Wednesday

October27,2017

Breastcancerisnolongeramenaceasitwasyearsback;however,littleisknownonwhatthe patientsexperienceaftertreatment.Pauwels,Charlier,Lechner&VanHoof(2013)statethatthe periodoftransitiontosurvivorshipisfilledwithemotionaldistressandalowqualityoflife.Itis evidentthatthesurvivorshavetogothroughmanystrugglesandintherecentpast,therehavebeen interventionsthataremeanttoimproveontheirwellbeing.Noclearguidelinesexistonhowthe psychologicalinterventionsthatshouldbeappliedtoassistbreastcancerpatientstomakea quick...showmorecontent...

Learningonthebestcopingstrategieswillhelptodoawaywiththeirfearsandlearnonhowtorun thedaytodaystress.Depression,PTSD,orevenpsychologicalsufferingmaymaketreatmentof breastcancerquitedifficult(Hutchinson,2010).Betterhandlingoftheaccompanyingemotionswill helptoimprovethemedicalcarethatthepatientreceives

Foryoungerwomen,thetreatmentproceduremaybetougheronthem.Changessuchasinduced earlymenopause,lowerlevelofestrogencanbringissuessuchashotflashes,sweatingatnightand evenvaginaldrynessBesidescasesofinfertilityduetolowerestrogenlevels,thereisthepossibility ofexperiencinglowersexualdrive(Partridge,2013).Withthetreatment–inducedmenopause,there isahighpossibilityofweightgain;itiscommonlyaccompaniedbysleepdisturbanceandfatigue. Duetothetreatment,thereisapossibilityofhavinglowerbonemineraldeposits;thismayleadto bone–relateddeficiencies.Cardiovascularhealthissueshavealsobeenreported;besidesthebodily harmthattheycause,thereisagreatpossibilityofphysiologicaldisturbancethatwillneedexpert care(Partridge,2013).

Supportneededbythepatients

Partridge,(2013)statesthat;acomprehensiveapproachisneededtoaccordthepatientsthebestcare possible.Withthisknowledge,researchersdevelopedaprogramthataddressestheissuesfaced

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Breastcanceristhemostcommontypeofcancerinwomen,itaccountsforoneofeverythree diagnosesintheUnitedStates.Breastcancersaremalignancies,lifethreateningtumorsthat developsinoneorbothbreasts.

AfemalebreastconsistsoffattyandfibrousconnectivetissuesTheinteriorofthebreastisdivided intoabouttwentydifferentsectionscalledlobes.Eachofthelobesisfurtherdividedintolobules, whicharestructuresthatcontainsmallmilk–producingglands.Theseglandsplacethemilkintotiny ductsTheseductstakethemilkthroughoutthebreastandstoreinachamberlocatedbelowthe nipple.

Breastcancercaneitherbeinvasive(spreading)ornoninvasive(non–spreading).Aninvasivecancer penetrates...showmorecontent...

ChemicalsarealsosuspectedtocausebreastcancerXenoestrogensarechemicalswithestrogen–likeeffects,theyarefoundinpesticidesandothercommonindustrialproducts.Otherestrogen–like chemicalsthathaveastrongerassociationwithbreastcancerincludedieldrinandbeta–hexachloraocyclohexane.Althoughthesechemicalsareveryweakestrogens,onestudyshowedthat exposuretosingleweak–estrogencompoundsisn'tabigriskbutacombinationoftwoormore chemicalsresultinextremelyhighestrogenic

chemicals.Manywomen,whotookdiethylstilbestrol(DES)topreventmiscarriages,increasedthe riskforbreatcancerintheirchildren

Therearelostofwaystopreventcancerortrytopreventit.Oneoftheseisreducingyourfatintake. Onestudyshowsthattheresultofthisisthatthelevelofestrodiol,thepotentformofestrogen decreases.Anotherwaytofightbreastcanceristoeatplentyoffruitandvegetables.Manyfruits andvegetablescontainchemicalsthatmaybecancerfightersAconcentratedformoflimonene,a substancefoundincitrusskins,hasbeenfoundtoshrinkbreastcancerinanimals.Somestudies haveshownthatifyoubreast–fedformorethanfourmonthsitlowersyourriskofthecancer.Ina recentstudywomenwhohaveunderwentbreastreductionhavealowriskofgettingbreastcancer byfortypercent. There

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AccordingtotheAmericanCancerSociety,Everyyear,morethan200,000womenarediagnosed withbreastcancer;furthermoreTwelvepercentofallwomenwillcontractthedisease,and3.5%of themwilldiefrombreastcancer(AmericanCancerSociety,2005).Thereareriskfactorsthatmay leadtobreastcancer.Thereare4stagesofbreastcancerandseveraltreatments,althoughtreatments varyfromtypesandstagesofbreastcancerBreastcanceristheleadingcauseofdeathamong womenwhoare40to55yearsold(BreastCancer,2009).Whencellsdividesitcausescancerwhich thenchangesfromannormalcalltowhat'scalledacancerouscellthatrequiresgenealterations.The uncontrolledgrowthandaltergenesiswhatcausestumorstoshowmorecontent I'mnotsayingthatsomeonewillreallygetbreastcancerbecauseafewotherwomeninthefamily haveitbutknowthatthere'sasmallchanceisgood.Otherfactorsarewomanwhogetsmenopause andtheyareverytheageof50.Alsoayounggirlundertheageof12yrsoldwhostartsaperiod doesto.Womenover40whohavetherefirstpregnancyisatriskofgettingthedisease.Caucasian womenhaveamuchhigherbetterchanceofhavingbreastcancerbutablackwomanhasahigher riskofdying.OtherraceschancesarereallowlikeSpanish,AsianorIndianwomen.Accordingtoa study,womanwhotakesbirthcontrolhasaslightlygreaterriskofgettingbreastcancer.Most studiessuggestthatuseofHRT(HormoneReplacementTherapy)forreliefofmenopause symptomsformorethan5yearsmayslightlyincreasetheriskofbreastcancer(BreastCancer Statistics,2008)

Let'sgettothefourstagesofbreastcancer.Firstisstagezerowhichisnoninvasive,thatis, carcinomainsituwithnoaffectedmetastasisorlymphnodes.Stagezeroisthemostfavorable.Now StageOnebreastcancerislessthantwocentimetersingreatestdimensionandisonlyinthebreasts Stagetwoiswhenthecancerisnobiggerthentwocentimetersbuthasspreadtolymphnodes.With stagethreebreastcancersisalagersize,letssaygreaterthentwoinchesindiameter.Italsohasa greaterinvolvementfromthelymphnodesorinflammatorytype.

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BreastcancerwillstrikeoneineveryeightAmericanwomen.Thismakesitthemostcommon cancerinwoman.Approximately200,000womenarediagnosedwithbreastcancereachyear.Of thatnumber,40,000willdiefrombreastcancereachyear.(JournalofEnvironmentalHealth2003) Breastcancerisjustonetypeofcancer.Cancerouscellsarecellsthatgrowwithoutthenormal systemofcontrolsplaceduponthemBreastcancerdevelopsfromthemammaryducts80%ofthe time.Theother20%ofthetimethecancerdevelopsfromthelobulesofthebreasts.Whilebreast cancermayoccurinmen,thispaperwillprimarilyfocusonbreastcancerinwomen.Breastcancer is100timesmorelikelytoaffectwomenasitismenTherearetwoshowmorecontent Basicallythebreastsarelocatedofftothesidesofthesternum,onthefrontofthechestwall betweenthesecondandsixthribs.(AnatomyoftheHumanBody,Gray,H.)Duringpuberty hormonalchangescausethebreaststobegintodevelopandmature.Thisstimulationcomesfrom thereleaseofestrogenfromtheanteriorpituitary.Thebaseofeachbreastliesontopofthe pectoralismajor,obliquusexternusabdominis,andserratusanteriormusclesand

extendsupintotheaxillaryregion.Ontheexternalsurfaceofthebreast,betweenthe4thand5th ribsisthenipple.Thenippleismadeupofcontractilemusclefibersandiscapableofbecomingfirm anderectwhenstimulated.Thecolorofthenipplecanrangefromalightpinktobrown.Atthetip ofthenipplethereareuptotwentytinyopeningsfromthelactiferousductsThecirculararea surroundingthenippleiscalledtheareola.Thecoloroftheareolamayalsorangefromalightpink toadarkbrown.Duringpregnancytheareolawilldarken.Imbeddedintheareolaareareolarglands whichgivetheareolaaslightlybumpyappearanceTheseglandssecreteanoilykindofsubstance thatactsasaskinprotectorduringbreastfeeding.(TextbookofMedicalPhysiology,Guyton,2000) Thebreasttissueitselfisaseriesoflobulesandmammaryductsthatformapatternsimilarto clustersofgrapes.Thelobulesareroundsacsthatproducemilk.Theductsare

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