FREE ESSAY ON BREAST CANCER

BREAST CANCER

INCIDENCE
Breast cancer is the most common malignancy among women and has the highest fatality rate
of all cancers affecting this sex. It is the leading cause of death among women aged
35-54. In 1999 an estimated 175,000 women were diagnosed with breast cancer. That is one
woman every three minutes. At the same time 43,000 will die, at the rate of one every two
minutes. The incidence of men diagnosed with breast cancer is rare, however it does
occur. Approximately 1,300 men a year are diagnosed, and 400 die annually due to the
disease. A total of 75% of all breast cancers occur in women with no known risk factors.
80% of breast cancers occur in women aged 50 and up. The mortality rate would decrease if
every woman over 50 was informed and followed guidelines. When confined to the breast,
the survival rate is 95%. Studies have shown that more white women than black women get
breast cancer, however more black women die of breast cancer because they are not
diagnosed at an early stage. 
SIGNS AND SYMPTONS
Most breast cancers appear as a slowly growing, painless mass, though a vague discomfort
may be present. Physical signs include a retracted nipple, bleeding from the nipple,
distorted areola or breast contour, skin dimpling over the lesion, attachment of the mass
to surrounding tissues including the underlying fascia and overlying skin, and enlarged
lymph nodes. In most advanced stages of the disease the skin nodules with ultimate
breakdown and ulcer formation may be seen. Metastases should be sought immediately so
that further spread will not be a factor. Among the common sites of metastases are the
lungs and pleura, the skeleton (specifically the spine, pelvis, and skull), and the
liver. Whenever possible, distant spread of the disease should be confirmed by a lymph
nose biopsy, by x-ray, or by liver and bone scans using radioactive isotopes. 
WHO IS AT RISK?
All women and men are at risk of getting breast cancer. However personal history with
family members having breast cancer adds an increase to the risk factor. Contradictory to
this though studies have shown that 75% of breast cancer occurs in women with no history
and no known risk factors. Not ever having children, or having ones first child after 30
yrs., also increases the risk of breast cancer in women. Heavy alcohol abuse is a risk
factor as well. Studies have also shown that women who began menstruation early, twelve
years or less, and women who began menopause late, fifty-five years plus, also have a
greater risk of breast cancer. 
PREVENTION
There are three ways to attempt to detect prevention, however since there is no cure, one
cannot determine what actions to take to prevent. The most common technique for early
detection is by a regular doctors examination. The second technique at detecting breast
cancer is by a breast self-examination (BSE), and lastly, by mammogram. BSE should begin
when a woman is eighteen or older, so that the breast is fully developed. During the BSE
women should begin to learn what is normal and what is not in their breasts. Mammography
is the best method at detecting breast cancer. A woman should have a mammogram when she
is 40 yrs. old, and then one every two years until she is 50 yrs. old. Once a woman is 50
yrs. old she should have a mammogram annually because as ones age increases, so does the
risk of getting breast cancer. Many women also need to be educated about the risks of
breast cancer and how to detect it early. The majority of women with breast cancer do not
know about the fortunateness of detecting breast cancer early, never mind follow the
detection guidelines.
TREATMENT 
Therapy depends mainly on the extent of the disease and the patient's age. If there is
evidence of wider metastasic spread, treatment will be palliative. This means that
treatment will lessen the severity of pain, however it will not cure. When there is no
evidence of spread, the treatment of choice is total mastectomy and modified radical
mastectomy. This is an entire or partial removal of the affected breast. In the best
circumstances, the 10 yr. survival rate is greater than 50%. However these clinical cures
may recur with fatal outcome as late as 20 yr after surgery. 
Total or Partial Mastectomy 
Is now accepted as an equivalent alternative to conventional radical mastectomy for the
treatment of all primary operable breast cancers. The entire, or partial area of, breast
is removed together with virtually all of the axillary lymph nodes, but since the
pectoral muscles are preserved their function is left intact, the cosmetic result is far
superior. In addition, the procedure leads to far better breast reconstruction using
implants that often can be inserted 6-12 mos. after surgery. 
Radiotherapy
This technique is sometimes used instead of surgery. After a radical Mastectomy if
additional metastases are found, the internal lymph node chain may be irradiated because
of the high incidence of occult lymph node metastases in this area when the disease has
already reached the axilla. For recurrent cancer, palliative radiotherapy can be valuable
in controlling local chest wall or cervical lymph node recurrences and relieving pain
from skeletal metastases. Irradiation is of little value for large internal metastases. 
Hormonal Therapy
This treatment has proven to be of the greatest use in palliation of symptoms or in
delaying the advancement of breast cancer. It is most often combined with radiotherapy
when cancer recurs following a mastectomy and when the tumour is so advanced that surgery
is not indicated or is palliative. 
Chemotherapy
Chemotherapy is useful in patients that have a high risk of developing recurrent cancer
after a mastectomy.. Chemotherapy is used in the management of patients with recurrent
breast cancer usually after the failure of previous hormonal manipulations. A variety of
chemotherapeutic agents are used in various combinations, sometimes with a corticosteroid
to suppress endogenous adrenal function or with the estrogen antagonist tamoxifen. The
agents in chemotherapy have demonstrated value in halting or delaying the appearance of
metastases, especially in premenopausal patients, and in treating recurrences.