In regard to its origin, dynamics and consequences breast cancer can be considered to be the second leading cause of cancer death among US and European women (Smith-Bindman et al, 2003). Every year over 200,000 women are diagnosed with breast cancer, and though statistical data remains constant, the issue gets significant psychological and public resonance (Jemal et al, 2004).
The overall lifetime risk for American women constitutes 1:8, which essentially means that out of eight females born today, one will receive a breast cancer diagnosis during her lifetime (Ogden, 2004).
Mortality rates are highest among older African American women (American Cancer Society, 2001). Simultaneously, statistics reveals that diseased woman’s life expectancy decreases by nineteen years.
Although medical scientists and practitioners debate on the methods regarding disease treatment and how to diminish the number of breast cancer cases, many public health analysts indicate about an education exigency of young people. Despite the fact that the younger generations are not aware of the importance of detecting breast cancer early, with the help of teens getting involved and teaching others about breast cancer, more lives will be saved.
The educational program developed for young people to prevent, forecast and diminish consequences of breast cancer involves several important aspects. Primarily, audience should know the essence of the disease, in particular its nature, various risk factors associated with it and methods of its prevention. Younger generation should be informed about how breast cancer or its first signs could be detected, what constitutes post-diagnosis procedure and treatments of the disease.
However, from the critical point of view, the main objective of such programs is to prevent the appearance of the disease and decrease to the minimum lethal consequences.
This primary concern and emphasis are stipulated with the conditions under which if breast cancer is detected on its early stages, patients have from 78% to 92% survival rate (Ogden, 2004:10).
Breast cancer is considered to be a group of undifferentiated cells reproducing under extremely rapid rate in the area of the breast in women. The earliest changes usually appear in the epithelial cells of the terminal end buds of the breast milk system, where new cancer cells form tumors. If cancer cell are active, the tumor increases at significant rate and may result in metastasis.
Being a complex process in which cells are separated from their initial tumors and supplied trough blood and lymph systems to other organs, metastasis spreads the cancer throughout the body. According to generally accepted medical practice, if size of a lump does not exceed one centimeter, it is indicated as benign (Hart, 1999), however, in every case adequate medical consultation should be provided.
Medical specialists distinguish risk factors for breast cancer that individual can change and those that cannot be affected (Barton, 2005). Constant risk factors are considered to be being a woman, getting older, having a family history as well as previous breast cancer history, having radiation therapy to the chest area, being Caucasian, getting periods young, usually before 12 years old, having late menopause, never having children and having genetic mutation that increases individual’s risk.
There were several studies conducted regarding genetic mutation for breast cancer, and it was disclosed that 3%-10% of breast cancers are related to changes in either gene BRCA1 or the gene BRCA2 (Ogden, 2004). Simultaneously, younger audience should be taught that along with so called uncontrolled risk factors, there are several factors that can be affected by individual’s behavior.
Thus, taking hormone replacement therapy, birth control pills, not breastfeeding, moderate and heavy alcohol drinking, being overweight and not exercising can actually being qualified as risk factors for breast cancer, though not as much important as gender, age and family history (Barton, 2005:28).
However, factors mentioned above can be controlled by every woman in order to reduce chances of developing a breast malignancy. From the practical point of view, cancer risk factors are based on probabilities, therefore proper screening and early detection remain to be the most adequate methods in reducing the mortality associated with breast cancer.
During the education process, the main thing that should be emphasized is that the effectiveness of treatment is directly related to the stage on which a breast cancer is detected (Barton, 2005; Ogden, 2004). The common medical practice indicates that regular mammography screening allows decreasing the mortality of breast cancer by 30% (Hart, 1999:144), which means that every woman should get a yearly mammogram starting from age 40 or even earlier.
During the mammography screening, the x-ray picture sometimes detects various substances in the breast, essence, character and nature of which is not recognizable and thus, it may provoke unnecessary worrying of both patient and health professional (Barton , 2005). Young woman are recommended to have a compulsory clinical breast exam done by a health professional. In addition, during clinical breast exam everywoman has an opportunity to learn how to conduct self-examination for lumps and shape of the breast.
One should not underestimate the value of clinical breast exams or self-examination because 15% of tumors are felt but cannot be detected by regular mammographic screening (Fletcher et al, 2003:1674). Although a lump in the breast is the most common way women discover a breast cancer, younger women should understand that any changes in a breast require further medical consultation and investigation. Among the clinical tests that are conducted in modern oncological clinics, some women are a chance to know if they have a chance of getting the disease by simply tracing back cases of breast cancer throughout the history of relatives.
Contemporary oncologists consider the following signs to be those that require immediate attention from health specialist:
If these abnormalities have been detected, and it should be specifically emphasized during the education program, individual should get immediate consultation (physical exam) from a health professional, get a mammogram and possibly an ultrasound, and visit a breast surgeon for examination if needed. Contemporary medicine possesses various treatment techniques for breast cancer, in particular, radiotherapy, toxic chemotherapy combinations, hormonal treatments and prophylactic mastectomies are used to treat early lesions. 20-year follow-up data from the NSABP B-06 trial (Mirshahidi, 2004:25) have confirmed that radiation therapy clearly decreases the rate of locoregional recurrence in patients who undergo lumpectomy.
Usually, radiation treatment is given after, rather than before, chemotherapy (Mirshahidi, 2005:24). Newer radiation techniques include partial breast irradiation, partial breast irradiation and brachytherapy, and interstitial brachytherapy. These techniques are under investigation and, at this point, may be used in the context of a clinical trial (Giap, 2004).
Another effective treatment of the disease, adjuvant treatment, is defined as the use of systemic therapy for microscopic metastatic disease after surgical resection of the primary tumor. Chemotherapy and antiestrogen therapy are the two major forms of adjuvant treatment, and patients may be given one or both. A meta-analysis conducted by the Early Breast Cancer Trialists’ Collaborative Group (Mirshahidi, 2004: 25) showed the benefit of adjuvant therapy in premenopausal and postmenopausal women and in women with node-negative and node-positive disease.
Breast cancer can affect almost every individual, however there are certain risk factors according to which one woman has more chances for breast cancer diagnosis. From the statistical point of view, the lifetime risk of any woman getting the disease is about 1:8, however the lifetime risk of dying from breast cancer is lower than 1:28 (Ogden, 2004).
General education about the disease, possible risk factors and various screening and detection methods allow women to notice the disease or its signs before giving it a chance to spread. Simultaneously, education and enhanced awareness of younger generation regarding a breast cancer reveals new opportunities in preventing the disease, its consequences and diminishing lethal cases.
References
American Cancer Society. (2001). Cancer facts and figures, 2001 (Publication No. 5008.96). Atlanta: American Cancer Society
Hamid R. Mirshahidi, MD Jame Abraham, MD. (2004). Managing early breast cancer. Postgraduate Medicine. Minneapolis: Oct. 116(4), 23-27
Joy Ogden (2004). Understanding Breast Cancer, Wiley, 2004
Diane Hart. (1999). Diagnosis and treatment of breast cancer. Plastic Surgical Nursing. Pitman: Fall.19(3): 137-145
Wylie Burke (2005). “Taking Family History Seriously”, Annals of Internal Medicine. Philadelphia: 143(5):388-390
Huan B Giap (2004). “Accelerated breast brachytherapy: an effective and convenient alternative for selected patients with early-stage breast cancer.” Women’s Oncology Review. Boca Raton: 4(4):251-261
Mary B. Barton, MD (2005) “Breast cancer screening.” Postgraduate Medicine. Minneapolis: Aug 118(2): 27-35
Fletcher S.W, Elmore J.G. (2003). “Clinical practice. Mammographic screening for breast cancer.” New England Journal of Medicine; 348(17):1672-80
Smith-Bindman R., Chu P.W, Miglioretti D.L., et al. (2003). “Comparison of screening mammography in the United States and the United Kingdom.” JAMA; 290(16):2129-37
Jemal A, Clegg LX, Ward E, et al.( 2004). Annual report to the nation on the status of cancer, 1975-2001, with a special feature regarding survival. Cancer; 101(1):3-27
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