Breast cancer is the most common cancer in women worldwide, with over 1 million new cases each year. In the US, a woman has a 1 in 8 chance of developing breast cancer in her lifetime. While mammography and other screening can increase early detection and improve outcomes, breast cancer treatment continues to evolve with newer targeted therapies and an emphasis on quality of life. Research is also focused on prevention through lifestyle changes and chemoprevention, as well as developing vaccines for aggressive subtypes like triple negative breast cancer.
science has an evolving nature. what happened today may not be tomorrow, what is not today may happen tomorrow.
No one is complete so reading and thinking may open the door to the hidden ground.
Criteria I – Introduction (4 points)1. Describe the common comCruzIbarra161
Criteria I – Introduction (4 points)
1. Describe the common complaint/problem selected- breast cancer
2. Discuss the pathophysiology of the common complaint/problem.
3. Detail the necessary review of systems and what would be seen on physical examination for this complaint/problem.
4. Provide rationale from the literature to support your work.
In the United State, breast cancer is the leading cause of cancer death among female. Breast cancer ranks second (after lung cancer) as a cause of cancer death in women. In 2016, around 245, 229 new cases of female breast cases reported, and 41,487 women died of this disease (CDC, 2019). In 2018, approximately 63,960 cases of in situ disease and 266,120 cases of invasive disease were diagnosed.1 About 40,920 breast cancer-related deaths occurred in 2018, which represents 6.7% of all cancer-related deaths.2 Female breast cancer is most common in middle-aged and older women; median age at diagnosis is 62 years.2 In 2016, more than 3.5 mil- lion women were breast cancer survivors.3 The lifetime risk of developing breast cancer in the United States is 12.4% (1 in 8 women ). (ACS, 2019)
Breast cancer mortality was 41% higher among black women (29.2 deaths per 100,000 population) than white women (20.6 deaths per 100,000 population). Breast cancer death rates decreased during 2010–2014 among both blacks and whites, although differences in trends by race and age were found. Overall, breast cancer death rates decreased faster among white women (-1.9% per year) compared with black women (-1.5% per year). Among women aged <50 years, breast cancer death rates decreased at the same pace among black and white women, whereas white women aged ≥50 years had significantly larger decreases. The largest difference by race was observed among women aged 60–69 years: breast cancer death rates decreased 2.0% per year among white women compared with 1.0% among black women. Death rates from breast cancer have been declining since about 1990, in part due to better screening and early detection, increased awareness, and continually improving treatment options, decline in prescriptive hormone replacement therapy after menopause. (ACS, 2019).
Breast cancer is a disease in which cells in the breast grow out of control. The majority of breast cancers (95%) are sporadic; only a small proportion, particularly those diagnosed in young women, are due to a highly penetrant autosomal-dominant trait. Over the past 5 years there has been consider- able progress in the identification and localization of the genes responsible for hereditary breast cancer. Two in particular have grabbed the headlines; these are BRCA1 and BRCA2. Subtypes of breast cancer include those driven by specific hormones, such as estrogen, progestogen or the protein HER2. Sixty percent of breast cancers are estrogen positive. Twenty percent of breast cancers are HER2-positive. Another 20 percent are triple-negative breast cancers, a type of breast cancer that tes ...
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
science has an evolving nature. what happened today may not be tomorrow, what is not today may happen tomorrow.
No one is complete so reading and thinking may open the door to the hidden ground.
Criteria I – Introduction (4 points)1. Describe the common comCruzIbarra161
Criteria I – Introduction (4 points)
1. Describe the common complaint/problem selected- breast cancer
2. Discuss the pathophysiology of the common complaint/problem.
3. Detail the necessary review of systems and what would be seen on physical examination for this complaint/problem.
4. Provide rationale from the literature to support your work.
In the United State, breast cancer is the leading cause of cancer death among female. Breast cancer ranks second (after lung cancer) as a cause of cancer death in women. In 2016, around 245, 229 new cases of female breast cases reported, and 41,487 women died of this disease (CDC, 2019). In 2018, approximately 63,960 cases of in situ disease and 266,120 cases of invasive disease were diagnosed.1 About 40,920 breast cancer-related deaths occurred in 2018, which represents 6.7% of all cancer-related deaths.2 Female breast cancer is most common in middle-aged and older women; median age at diagnosis is 62 years.2 In 2016, more than 3.5 mil- lion women were breast cancer survivors.3 The lifetime risk of developing breast cancer in the United States is 12.4% (1 in 8 women ). (ACS, 2019)
Breast cancer mortality was 41% higher among black women (29.2 deaths per 100,000 population) than white women (20.6 deaths per 100,000 population). Breast cancer death rates decreased during 2010–2014 among both blacks and whites, although differences in trends by race and age were found. Overall, breast cancer death rates decreased faster among white women (-1.9% per year) compared with black women (-1.5% per year). Among women aged <50 years, breast cancer death rates decreased at the same pace among black and white women, whereas white women aged ≥50 years had significantly larger decreases. The largest difference by race was observed among women aged 60–69 years: breast cancer death rates decreased 2.0% per year among white women compared with 1.0% among black women. Death rates from breast cancer have been declining since about 1990, in part due to better screening and early detection, increased awareness, and continually improving treatment options, decline in prescriptive hormone replacement therapy after menopause. (ACS, 2019).
Breast cancer is a disease in which cells in the breast grow out of control. The majority of breast cancers (95%) are sporadic; only a small proportion, particularly those diagnosed in young women, are due to a highly penetrant autosomal-dominant trait. Over the past 5 years there has been consider- able progress in the identification and localization of the genes responsible for hereditary breast cancer. Two in particular have grabbed the headlines; these are BRCA1 and BRCA2. Subtypes of breast cancer include those driven by specific hormones, such as estrogen, progestogen or the protein HER2. Sixty percent of breast cancers are estrogen positive. Twenty percent of breast cancers are HER2-positive. Another 20 percent are triple-negative breast cancers, a type of breast cancer that tes ...
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
Myths And Facts About Breast Cancer.
Breast cancer is the most common cancer in the world, with around 2.26 million new cases diagnosed each year. With around 0.7 million fatalities per year worldwide, it is one of the major causes of death among female cancer patients. It is quite common in those aged 25 to 70, with peak prevalence in women aged 50 to 69.
Breast cancer occurs when a pre-cancerous tumour progresses to a malignant tumour in a multi-stage process that is triggered by abnormal and uncontrolled growth of normal cells. These abnormalities are brought on by physical carcinogens (ultraviolet and ionising radiation), chemical carcinogens (alcohol, aflatoxin, tobacco smoke), and biological carcinogens (viral infections, bacteria, or parasites). Breast cancer risk is also increased by genetic factors. 5 to 10% of breast cancer instances are caused by genetic abnormalities passed down through a family’s generations.
Wendy Noe, education coordinator for the Central Indiana Affiliate of Susan G. Komen for the Cure® presents an overview of breast cancer information, facts and advances in treatment.
In this document, there is a detailed information about the breast cancer and its pathogenicity, how to diagnose, and its types.
Also there is a full information about the ovaries and their main desorders.
Hope you enjoy it.
Breast cancer its sympton, diagonosis and treatementArbab Usmani
As the name suggests, it is a cancer that affects the
breasts or mammary glands. In technical terms it is a carcinoma of the breast which is either ducal or lobar. It is a breast malignancy which is more prominent in females than males and is the second most frequent cause of cancer death.
This is a Guide about Breast Cancer
PDF Source - http://www.sastasundar.com/
1 in 8 women will develop breast cancer in their lifetime. Breast cancer will claim more than 40,000 American lives in the year 2015. It is Myriad's mission to inform the world that we can save lives by becoming educated and proactive about breast cancer. For every day of October, Myriad presents a new fact or way to become involved in supporting the cause against breast cancer.
Breast Cancer Causes, Types, Symptoms, Signs, Stages and TreatmentOddwayInternational
Signs and symptoms of breast cancer include a lump in the breast, a rash, discharge from the nipple or pain in the breast area. Read more @ https://www.oddwayinternational.com/blog
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Myths And Facts About Breast Cancer.
Breast cancer is the most common cancer in the world, with around 2.26 million new cases diagnosed each year. With around 0.7 million fatalities per year worldwide, it is one of the major causes of death among female cancer patients. It is quite common in those aged 25 to 70, with peak prevalence in women aged 50 to 69.
Breast cancer occurs when a pre-cancerous tumour progresses to a malignant tumour in a multi-stage process that is triggered by abnormal and uncontrolled growth of normal cells. These abnormalities are brought on by physical carcinogens (ultraviolet and ionising radiation), chemical carcinogens (alcohol, aflatoxin, tobacco smoke), and biological carcinogens (viral infections, bacteria, or parasites). Breast cancer risk is also increased by genetic factors. 5 to 10% of breast cancer instances are caused by genetic abnormalities passed down through a family’s generations.
Wendy Noe, education coordinator for the Central Indiana Affiliate of Susan G. Komen for the Cure® presents an overview of breast cancer information, facts and advances in treatment.
In this document, there is a detailed information about the breast cancer and its pathogenicity, how to diagnose, and its types.
Also there is a full information about the ovaries and their main desorders.
Hope you enjoy it.
Breast cancer its sympton, diagonosis and treatementArbab Usmani
As the name suggests, it is a cancer that affects the
breasts or mammary glands. In technical terms it is a carcinoma of the breast which is either ducal or lobar. It is a breast malignancy which is more prominent in females than males and is the second most frequent cause of cancer death.
This is a Guide about Breast Cancer
PDF Source - http://www.sastasundar.com/
1 in 8 women will develop breast cancer in their lifetime. Breast cancer will claim more than 40,000 American lives in the year 2015. It is Myriad's mission to inform the world that we can save lives by becoming educated and proactive about breast cancer. For every day of October, Myriad presents a new fact or way to become involved in supporting the cause against breast cancer.
Breast Cancer Causes, Types, Symptoms, Signs, Stages and TreatmentOddwayInternational
Signs and symptoms of breast cancer include a lump in the breast, a rash, discharge from the nipple or pain in the breast area. Read more @ https://www.oddwayinternational.com/blog
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
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This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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1. Breast Cancer:
What every medical student should know.
Breast Cancer Awareness
Month
October 2009
For more information:
www.amsa.org
2. Women agonize... over cancer; we take as a
personal threat the lump in every friend's breast.
Martha Weinman Lear, Heartsounds
3. Impact: With 1 million new cases in the world each
year, breast cancer is the most common
malignancy in women and comprises 18% of
all women’s cancers.
Breast cancer incidence in women in the
United States is 1 in 8 (about 13%). Women
have a 3% chance of breast cancer causing
their death.
For women in the U.S., breast cancer death
rates are higher than those for any other
cancer besides lung cancer.
The American Cancer Society estimates that
each year, about 2000 new cases of invasive
breast cancer are diagnosed in men.
It is estimated that about $8.1 billion is spent
each year on breast cancer treatment in the
4. Epidemiology:
Over 75% of women who are diagnosed with breast cancer are age 50 or
older.
The five-year relative survival rate is now 98 percent for women with breast
cancer caught before it spreads beyond the breast (compared to 72 percent
in 1982).
Breast cancer incidence is greater in
women of higher socio-economic background.
The relationship of breast cancer risk with
socio-economic factors is most likely related to
life style differences like number of pregnancies
and age at first childbirth.
Death rates have been decreasing since 1990.
These decreases are thought to be the result
of treatment advances, earlier detection through
screening, and increased awareness.
5. Incidence and Mortality of Female Breast
Cancer Based on Race and Ethnicity in the
U.S.
Rate
Per
100,000
6. About 90% of breast cancers are due to genetic
abnormalities that happen as a result of the aging
process and life in general, not to inherited mutations.
Current
Age
Probability of breast cancer
in next 10 years
20 0.05% or 1 in 1,837
30 0.43% or 1 in 234
40 1.43% or 1 in 70
50 2.51% or 1 in 40
60 3.51% or 1 in 28
70 3.88% or 1 in 26
Lifetime risk: 12.28%; 1 in 8 women
Probabilities of Developing Invasive Breast Cancer Based on Age
7. Hereditary Breast Cancer:
While about 20-30% of women diagnosed with breast cancer
have a family history of breast cancer, only about 5-10% of
breast cancer cases are caused by inherited gene mutations.
BRCA1 and BRCA2 mutations are the most common.
Lifetime breast
cancer risk
Median age of breast
cancer (years)
General population 12% 61
BRCA1 65% 43
BRCA2 45% 41
8. Breast Cancer Kills Men,Too.
Less than 1% of all new breast cancer
cases occur in men.
Men with a BRCA1 mutation have a
1% risk of developing breast cancer
by age 70; BRCA2 mutations confer
a 6% risk.
Breast cancer prognosis, even in
stage I cases, is worse in men than in
women.
Treatment for male breast cancer has
usually been a mastectomy, which
may be followed by radiation,
hormone therapy (such as with
tamoxifen), or chemotherapy.
Risk factors for male
breast cancer
Testicular abnormalities: cryptorchidia,
congential inguinal hernia, orchiectomy, orchitis,
testicular trauma
Hormonal alterations:
Infertility, Klinefelter’s syndrome, obesity,
cirrhosis (and heavy alcohol intake)
Family history of breast cancer, mutations in
BRCA1/2, CHEK2, PTEN
Benign breast lesions:
Nipple discharge, breast cysts, breast trauma
Exposure to radiation or high temperatures
Old age
Jewish descent
9. Types of Breast Cancer
DCIS: Ductal Carcinoma In Situ
LCIS: Lobular Carcinoma In Situ
IDC: Invasive Ductal Carcinoma
ILC: Invasive Lobular Carcinoma
Inflammatory Breast Cancer
Male Breast Cancer
Recurrent and Metastatic Cancer
Ductal carcinoma in situ
(DCIS) is the most
common type of non-
invasive breast cancer.
Invasive ductal carcinoma (IDC) is the
most common type of breast cancer,
comprising about 80% of all breast
cancers.
10. Signs to watch out for:
a lump felt in the breast
an inverted nipple
nipple discharge (clear or bloody)
nipple pain
sores on the nipple and areola
enlarged lymph nodes under the arm
11. Signs and Symptoms
Rapid change in the appearance of
one breast (days or weeks), with
visible enlargement of one breast,
discoloration with red, purple, pink or
bruised appearance and warmth of
the affected breast suggests
Inflammatory Breast Cancer.
In inflammatory breast cancer, cancer cells invade local lymphatic ducts,
impairing drainage and causing edematous swelling of the breast.
Peau d’orange: The skin of the breast is tethered by the suspensory ligament of
Cooper, which, with the accumulation of fluid, can cause the breast to take on a
dimpled appearance similar to an orange.
12. Inflammatory Breast Cancer
Inflammatory breast cancer (IBC) accounts for between 1 percent and 6
percent of all breast cancer cases in the United States.
The 5-year survival rate for patients with IBC is between 25-50 percent,
significantly lower than the survival rate for patients with non-IBC breast
cancer.
IBC has a high risk of recurrence and is the most aggressive kind of
breast cancer. IBC is more likely to have metastasized at the time of
diagnosis than other breast cancer types.
IBC affects women at an average age of 59 — about three to seven
years younger than the average age at which other types of breast
cancer are diagnosed.
Men can develop the disease, but at an older age. Black women are
slightly more likely than are white women to have IBC.
13. Risk Factors
The most significant risk factors for
breast cancer include gender (being
female) and age (growing older).
Factors with minimal or no risk
include fertility treatment
abortion, deodorant and folic acid.
Short-term use of hormones for
treatment of menopausal symptoms
appears to confer little or no breast
cancer risk.
14. Factors that Increase the Relative Risk (RR)
for Breast Cancer in Women
RR>4.0
• Female
• Age (65+)
• Inherited genetic mutations associated with breast cancer such as BRCA1/BRCA2
• Two or more first-degree relatives with breast cancer diagnosed at an early age
• Personal history of breast cancer
• High density breast tissue
• Biopsy-confirmed atypical hyperplasia
2.1<RR<4.0
• One first-degree relative with breast cancer
• High-dose radiation to chest
• High bone density (post-menopausal)
1.1<RR<2.0
Factors affecting circulating hormones:
• Late age at first full-term pregnancy (>30 yrs)
• Early menarche(<12 yrs)
• Late menopause
• No full-term pregnancies
• No breastfeeding
• Recent oral contraceptive use
• Recent and long-term hormone replacement therapy
• Obesity
Other factors:
• Personal history of endometrium, ovary or colon cancer
• Alcohol consumption
• Height (tall)
• High socioeconomic status
• Jewish heritage
15. Surveillance
Mammography
Sonogram
MRI
Clinical and self breast exam
Risk Avoidance
Diet and Exercise
Chemoprevention
Tamoxifen
Raloxifene
Prophylactic Surgery
Bilateral Prophylactic Mastectomy
Oophorectomy
Breast Cancer Screening and Prevention
16. Mammograms:
for low-income women and the uninsured.
Mammograms are usually covered by health insurance for women
in the recommended age bracket. While some insurance plans
have no out-of-pocket expenses required, others charge a $10-$35
co-pay.
Uninsured patients pay the full-price cost of a mammogram, which
ranges from $80 to $120.
Some state and local health programs and employers provide
mammograms free or at low cost. Health departments, hospitals,
women’s centers, or other community groups may also have
information on how to access low-cost or free mammograms.
The Centers for Disease Control and Prevention (CDC) coordinates
the National Breast and Cervical Cancer Early Detection Program
to provide screening services, including clinical breast exams and
mammograms, to low-income, uninsured women throughout the
United States. Visit the CDC website to find contact information for
local programs
Information about low-cost or free mammography screening
programs is also available through NCI’s Cancer Information
Service (CIS) at 1–800–4–CANCER (1–800–422–6237).
17. Conventional Treatments
Surgery
Chemotherapy
Hormonal therapy
Radiation
Just over the horizon: breast
cancer vaccine trials are under
way with vaccines like NeuVax,
which stimulates anti-Her2
immune response, and
Stimuvax, moving into phase III
trials.
18. Triple Negative Breast Cancer:
Triple negative breast cancer (TNBC) is clinically characterized by the lack of
expression of estrogen, progesterone and HER2 hormone receptors.
Comprises about 10-20% of breast cancers: more than one out of every 10.
Does not respond to current hormonal therapy (such as tamoxifen or
aromatase inhibitors) or therapies that target HER2 receptors, such as
Herceptin (trastuzumab). Women diagonosed with TNBC generally face a
poorer prognosis.
Treatments that target other processes may be helpful in treating triple
negative breast cancer when combined with chemotherapy:
Avastin: interferes with VEGF (vascular endothelial growth factor),
inhibiting the growth of new blood vessels at the tumor site.
Erbitux: interferes with EGFR (epidermal growth factor receptor), which is
often overexpressed in triple negative cancer.
PARP inhibitors: inhibit poly (ADP-ribose) polymerase, an enzyme used
by cancer cells to repair DNA damage. One PARP inhibitor, dubbed BSI-
201, has been shown to improve survival in triple negative breast cancer
patients by 60% when added to standard chemotherapy drugs.
19. The Breast Cancer
Experience
Physical changes to the breasts
and side effects such as hair loss,
fatigue and lymphedema
Changes in sexuality and
desire, premature
menopause, infertility
Mental and emotional
changes such as
“chemobrain,” depression and
fear of recurrence
Positive lifestyle changes
such as increased exercise,
healthier eating, stress
reduction
Changes in relationships
with
family and friends
Financial hardships,
occupational changes
20. Complementary medicine can improve
quality of life for breast cancer patients:
Acupuncture
Meditation
Aromatherapy
Guided Imagery
Hypnosis
Journaling
Chiropractic Therapy
Massage
Spirituality & Prayer
Reiki
Support Groups
Tai Chi
Shiatsu
Yoga
Music Therapy
Progressive Muscle
Relaxation
21. In the year 2008, there were about 2.5
million women in the U.S. who considered
themselves breast cancer survivors.
Additional notes are based on website sources that are cited. These notes are meant to help structure your discussion. Feel free to edit slides and customize the presentation. This is a template to get you started!
To stress how prevalent this disease is, you could ask that attendees raise their hand if they know someone who has had breast cancer. Many students will likely have been touched in some way by the breast cancer experience.
http://www.breastcancer.org/symptoms/understand_bc/
“In the U.S., an average lifetime is about 80 years. So, it’s more accurate to say that 1 in 8 women in the U.S. who reach the age of 80 can expect to develop breast cancer. In each decade of life, the risk of getting breast cancer is actually lower than 13% for most women.”
http://www.cancer.gov/aboutnci/servingpeople/breast-snapshot.pdf
See the Susan G. Komen Foundation website for more info.: http://ww5.komen.org/
U.S. women have the highest incidence rates of breast cancer in the world
See the Breast Cancer Symptoms Guide:
Http://images.google.com/imgres?imgurl=http://breast-cancer-symptoms-guide.com/wp-content/uploads/2009/04/breast-cancer-incidence-ethnic-2007.jpg&imgrefurl=http://breast-cancer-symptoms-guide.com/breast-cancer-risk/&usg=__bFCOnzo1cPSex5CvVlRq8tx0uSM=&h=510&w=423&sz=91&hl=en&start=1&um=1&tbnid=vVccxWIAUAOSkM:&tbnh=131&tbnw=109&prev=/images%3Fq%3Dbreast%2Bcancer%2Bethnic%26hl%3Den%26rls%3Dcom.microsoft:*:IE-SearchBox%26rlz%3D1I7GGLL_en%26sa%3DN%26um%3D1
(chart includes data from 2000-2004)
“Compared to African American women, white women are slightly more likely to develop breast cancer, but less likely to die of it. One possible reason is that African American women tend to have more aggressive tumors, although why this is the case is not known. Women of other ethnic backgrounds — Asian, Hispanic, and Native American — have a lower risk of developing and dying from breast cancer than white women and African American women.”
http://breast-cancer-symptoms-guide.com/wp-content/uploads/2009/04/age-prob-breast-cancer-300x298.jpg
American Cancer Society, Surveillance Research 2007
The names BRCA1 and BRCA2 stand for breast cancer susceptibility gene 1 and breast cancer susceptibility gene 2, respectively.
See: http://www.cancer.gov/cancertopics/factsheet/risk/brca
Most breast and ovarian cancers occur in women over the age of 50. Women with harmful BRCA1 or BRCA2 mutations often develop breast or ovarian cancer before age 50.
A woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.
Regardless, women who have a relative with a harmful BRCA1 or BRCA2 mutation and women who appear to be at increased risk of breast and/or ovarian cancer because of their family history should consider genetic counseling to learn more about their potential risks and about BRCA1 and BRCA2 genetic tests.
Harmful BRCA1 mutations may also increase a woman’s risk of developing cervical, uterine, pancreatic, and colon cancer (1, 2). Harmful BRCA2 mutations may additionally increase the risk of pancreatic cancer, stomach cancer, gallbladder and bile duct cancer, and melanoma (3).
Male breast cancer, pancreatic cancer, and prostate cancer appear to be more strongly associated with BRCA2 gene mutations (2–4).
Mutations in several other genes, including TP53, PTEN, STK11/LKB1, CDH1, CHEK2, ATM, MLH1, and MSH2, have been associated with hereditary breast and/or ovarian tumors
Ovary removal can reduce in 51% the risk of breast cancer in women which have mutations in BRCA1 or BRCA2 genes
See American Cancer Society Guide to Male Breast Cancer: http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_male_breast_cancer_28.asp
http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_male_breast_cancer_28.asp
http://www.johnwnickfoundation.org/index.html
http://www.breastcancer.org/symptoms/types/dcis/
According to the American Cancer Society, about 60,000 cases of DCIS are diagnosed in the United States each year, accounting for about 1 out of every 5 new breast cancer cases.
There are two main reasons this number is so large and has been increasing over time:
People are living much longer lives. As we grow older, our risk of breast cancer increases.
More people are getting mammograms, and the quality of the mammograms has improved. With better screening, more cancers are being spotted early.
Discuss inflammatory breast cancer to highlight the unique presentation of a particularly aggressive form of breast disease.
http://www.mayoclinic.com/health/inflammatory-breast-cancer/DS00632/DSECTION=symptoms
Other conditions have symptoms resembling those of inflammatory breast cancer. A breast infection (mastitis) also causes redness, swelling and pain, but breast infections usually develop during breast-feeding. With an infection, you're likely to have a fever, which is unusual (but not unheard of) in inflammatory breast cancer.
Breast surgery or radiation therapy may block the lymphatic vessels in breast skin, temporarily making the breast swell and become discolored. When caused by surgery or radiation treatments, however, these changes gradually subside.
http://breastcancer.about.com/od/types/p/ibc.htm
Inflammatory breast cancer, unlike ductal or lobular breast cancers, is usually not detected until after it has reached a more advanced stage of development. It is treated first with chemotherapy, and then with surgery, which is exactly the reverse order in which ductal and lobular cancers are typically treated.
http://www.breastcancer.org/symptoms/understand_bc/risk/factors.jsp
“Although men can get breast cancer, too, women’s breast cells are constantly changing and growing, mainly due to the activity of the female hormones estrogen and progesterone. This activity puts them at much greater risk for breast cancer.”
http://www.breastcancer.org/symptoms/understand_bc/risk/factors.jsp
Weight. Being overweight is associated with increased risk of breast cancer, especially for women after menopause. Fat tissue is the body’s main source of estrogen after menopause, when the ovaries stop producing the hormone. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.
Diet. Diet is a suspected risk factor for many types of cancer, including breast cancer, but studies have yet to show for sure which types of foods increase risk. It’s a good idea to restrict sources of red meat and other animal fats (including dairy fat in cheese, milk, and ice cream), because they may contain hormones, other growth factors, antibiotics, and pesticides. Some researchers believe that eating too much cholesterol and other fats are risk factors for cancer, and studies show that eating a lot of red and/or processed meats is associated with a higher risk of breast cancer. A low-fat diet rich in fruits and vegetables is generally recommended.
Exercise. Evidence is growing that exercise can reduce breast cancer risk. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise 5 or more days a week.
Alcohol consumption. Studies have shown that breast cancer risk increases with the amount of alcohol a woman drinks. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk.
Smoking. Smoking is associated with a small increase in breast cancer risk.
Exposure to estrogen. Because the female hormone estrogen stimulates breast cell growth, exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Some of these risk factors are under your control, such as:
taking combined hormone replacement therapy (estrogen and progesterone; HRT) for several years or more, or taking estrogen alone for more than 10 years
being overweight
regularly drinking alcohol
Recent oral contraceptive use. Using oral contraceptives (birth control pills) appears to slightly increase a woman’s risk for breast cancer, but only for a limited period of time. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk.
Stress and anxiety. There is no clear proof that stress and anxiety can increase breast cancer risk. However, anything you can do to reduce your stress and to enhance your comfort, joy, and satisfaction can have a major effect on your quality of life. So-called “mindful measures” (such as meditation, yoga, visualization exercises, and prayer) may be valuable additions to your daily or weekly routine. Some research suggests that these practices can strengthen the immune system.
Radiation therapy to the chest. Having radiation therapy to the chest area as a child or young adult as treatment for another cancer significantly increases breast cancer risk. The increase in risk seems to be highest if the radiation was given while the breasts were still developing (during the teen years).
http://www.cancer.gov/cancertopics/factsheet/risk/brca#16
American Cancer Society Screening Recommendations:
Annual mammograms, starting at age 40
Clinical breast exams
every year starting at age 40
every 3 years for women age 20-39
Self-breast exams monthly, starting at age 20
Surveillance:
Mammography:
Mammography can detect cancers several years before it can felt through a clinical exam.
Mammography along with physical breast examination is the modality of choice for screening for catching early breast cancer.
It has been recommended that women age 40 and older should have mammograms every 1 to 2 years.
Digital mammograms represent a new technology that may be helpful in identifying breast cancers in younger women with dense breasts. Computer Aided Detection is being used more frequently in an attempt to improve the accuracy of mammograms.
MRI or magnetic resonance imagery is a sensitive tool but is extremely expensive and has a high number of false positives. MRIs in conjunction with mammograms are recommended only for women at the highest risk, meaning with a genetic mutation or a strong family history of breast or ovarian cancer.
Clinical and self breast exams:
A clinical breast examination, in which a doctor or nurse examines the breast for lumps or irregularities, is recommended once every three years starting at age 20, then once a year at age 40 and up.
Studies have shown that self-exams do not reduce breast cancer death rates, but at least 40% of breast cancers are identified by women doing self-exams.
Risk Avoidance:
Studies suggest that obesity after 50 plays a role in breast cancer and may increase the risk of developing post-menopausal breast cancer.
Dietary fats may increase your risk of developing breast cancer. Diets high in fruits, vegetables, and grains may help to reduce the risk. Some vitamins and minerals are thought to protect against breast cancer, specifically vitamins A, C, D, and E, and calcium, selenium, and iodine. Some doctors recommend that breast cancer patients take antioxidant supplements.
Monitor your alcohol intake. Small amounts of alcohol have been shown to be protective against heart disease, but excess alcohol may play a role in breast cancer.
Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol.
ExerciseStudies have shown that four hours per week of exercise reduced the risk of breast cancer by 50%.
The risk was even lower if exercise had been part of your regimen since the teens and 20s
Chemoprevention:
Tamoxifen is a type of drug called a selective estrogen receptor modulator (SERM). SERMs act by blocking any estrogen present in the body from attaching to the estrogen receptor on the cancer cells, slowing the growth of tumors and killing tumor cells. Tamoxifen can be used in both pre- and postmenopausal women.
http://www.mayoclinic.com/health/breast-cancer/DS00328/DSECTION=treatments-and-drugs
http://www.cancer.gov/STAR
The Study of Tamoxifen and Raloxifene, or STAR, is a clinical trial designed see how the drug raloxifene compares with the drug tamoxifen in reducing the incidence of breast cancer in postmenopausal women who are at increased risk of the disease.
Initial results of STAR show that the drug raloxifene is as effective as tamoxifen in reducing the breast cancer risk of the women on the trial. In STAR, both drugs reduced the risk of developing invasive breast cancer by about 50 percent. In addition, within the study, women who were assigned to take raloxifene daily and who were followed for an average of about four years, had 36 percent fewer uterine cancers and 29 percent fewer blood clots than the women who were assigned to take tamoxifen. Uterine cancers, especially endometrial cancers, are a rare but serious side effect of tamoxifen. Both tamoxifen and raloxifene are known to increase a woman's risk of blood clots.
Participants in STAR who were assigned to take raloxifene had fewer serious side effects from that drug than participants assigned to take tamoxifen, including fewer uterine cancers, blood clots, and cataracts
A few key points:
http://www.breastcancer.org/treatment/surgery/mast_vs_lump.jsp
Surgery: Research shows that lumpectomy followed by radiation is likely to be equally as effective as mastectomy for people with only one site of cancer in the breast and a tumor under 4 centimeters. Clear margins are also a requirement (no cancer cells in the tissue surrounding the tumor).
Chemotherapy: Discuss recent developments in genomic assays like Oncotype DX, which personalize treatment plans by analyzing pt’s genetic profiles to predict likelihood of chemotherapeutic response and adverse effects.
http://www.breastcancer.org/symptoms/testing/types/oncotype_dx.jsp
If you have early-stage, ER+ breast cancer, Oncotype DX is a test that can help you and your doctor make a more informed decision about whether or not you need chemotherapy.
When is radiation appropriate?
http://www.breastcancer.org/symptoms/testing/types/oncotype_dx.jsp
Brachytherapy, also known as internal radiation, is another way to deliver radiation therapy. Instead of aiming radiation beams from outside the body, radioactive seeds or pellets are placed directly into the breast tissue next to the cancer. It is often used as a way to add an extra boost of radiation to the tumor site (along with external radiation to the whole breast), although it may also be used by itself (see below). Tumor size, location, and other factors may limit who can get brachytherapy.
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Radiation_Therapy_5.asp
Brachytherapy, compared to whole body irradiation, is associated with many advantages such as reduction of the treatment duration from 6.5 weeks to 5 days, minimal scar tissue formation, and intact and unaffected implant. Since, it also helps to effectively control the tumor growth with lesser side effects, the partial radiation therapy may serve as an alternative treatment modality to women with early stage breast cancer following augmentation mammoplasty.
Vaccines:
http://www.reuters.com/article/pressRelease/idUS133892+23-Feb-2009+PRN20090223
http://www.washingtonpost.com/wp-dyn/content/article/2008/04/13/AR2008041301616.html
http://www.apthera.com/products.php?id=3
Discuss triple negative breast cancer to highlight a particularly hard to treat form of breast disease.
http://www.biparsciences.com/000010.html
http://bcresourcedirectory.org/directory/11-survivorship_index.htm
“From the very instant you receive your diagnosis of breast cancer until you take the very last breath of life, you are a survivor.
While survivorship is the goal of treatment, reaching and living it does not mean life becomes less complicated.”
Once a woman is diagnosed with breast cancer, the initial news and subsequent treatment regimens, which are often difficult physically and emotionally, will transform her life and the lives of loved ones and friends around her.
http://www.breastcancer.org/treatment/comp_med/types/
Along with conventional treatments such as chemotherapy, radiation and surgery, complementary medicine can play an important adjunct role in improving the well-being of breast cancer patients. Complementary medicine includes techniques such as acupuncture, herbal medicine, massage, support groups, and yoga. Sometimes called holistic medicine, complementary medicine typically addresses how disease affects the whole person: physically, emotionally, spiritually, and socially.
Examples:
Much research is being done on how acupuncture can help relieve some of the symptoms of cancer and side effects of cancer treatment. Acupuncture has been shown to help relieve fatigue, hot flashes, nausea, vomiting, and pain.
One study, completed at Duke University and published in 2002, compared the use of acupuncture to the use of Zofran (chemical name: ondansetron), an anti-nausea medication, before breast cancer surgery to reduce the nausea that can occur after surgery. The acupuncture treatment was found to work better than Zofran at controlling nausea.
2. Although there are no scientific studies showing that Reiki is effective in treating any disease, a Reiki treatment may be able to bring about feelings of:
deep relaxation
warmth or sleepiness
increased well-being
Support groups
There have been a number of studies about the potential benefits of support groups for people with breast cancer. In 2005, a review article compared 5 studies (one not yet complete) involving support groups for patients with metastatic breast cancer. The article reported that while one study identified increased survival time resulting from participation in support groups, 9 other studies did not show survival benefits. All of the studies, however, reported that participation in support groups resulted in positive effects on psychological well-being.
http://www.breastcancer.org/symptoms/understand_bc/statistics.jsp
http://www.clevelandleader.com/node/8843
Summary slide reviewing factors involved in improving breast cancer survival: increased awareness/screening, new treatments/technologies, advocacy efforts, etc.
Discuss how advocacy has been pivotal to the survival of women and men through efforts that raise awareness, advocate for research, and consolidate funding for the breast cancer cause.
Pass out “Ten Ways To Advocate for Breast Cancer Awareness” and Komen/Army of Women documents downloadable on AMSA’s website.