An Overview of Breast Cancer
Introduction
Breast cancer still remains one of the major problems in public health, and regardless of contemporary efforts to avoid or prevent the cancer malady; the rate is increasing in several nations and is anticipated to go up further over the next 20 years. In most countries, there has been an increase in cases of women with elevated risk factors associated with breast cancer, and the increased rate is not even surprising. The major breast cancer risks factors include late first pregnancy age, lower menarche age, fewer pregnancies, later menopause, and shorter or no breastfeeding periods. Additionally, hormone replacement therapy (HRT), inactivity, obesity increase, and consumption of alcohol are the other possible risk factors which may possibly lead to breast cancer burden while the hereditary breast cancer impact is also on the rise. This paper provides an overview of breast cancer and how it is currently impacting public health today.
History and an overview Breast Cancer
Breast Cancer together with the uterus cancer and skin cancer were mentioned as early as before the fourth century which was during the Hippocratic writings. Despite having been studied for about twenty five centuries, breast cancer defied all those efforts and in fact went on to increase at around the middle of the 19th century and to date its cause is still a mystery to most scientists with its frequency still increasing. With female breast being the femininity, fertility and beauty symbol of all times, it has however challenged physicians in disease since antiquity and when the knife was applied due to surgery’s rule of roost for cancer therapy, breast disfigurement was inevitable.
Thus, attempts by physicians to overcome it by destructing the cell or chemo-radiotherapy, cell receptors targeted therapy or bio modulation and physical removal or surgery and to understand the this cancer crafty nature which is hormone-responsive has become a complex maze which is the history of breast cancer. Finding the right tools that can enable this disease diagnosis early enough has also become an intense exploration saga. Over two millennia of surgery domination story and evolution from fatal choices to minimum damage has also been told including the narrative of the change to finesse from crudity due to chirurgical practice change on path biological breast cancer basis (Homer, 1966).
In addition, a surgical papyrus discovered by Edwin Smith that date back to 2,500 B.C has provided breast cancer accounts that are authentic and is attributed to the Egyptian physician-architect known as the Imhotep. According to Breasted (1984), if the disease was spread all over the breast, bulging and cool to touch the case was deemed incurable. The ancient Greeks also offered relief from breast maladies in order to exhort divinity according to evidences in Greek temples which was the dwelling place of the medicine god or Asclepius which was votive offerings shaped like breasts (Lyons & Petrucelli, 1978). Homer (1966) implies that the theory of Hippocrates in 400 B.C on blood, phlegm, and yellow and black bile or humours imbalance and the breast cancer classic descriptions progressive stages represent the early suppositions on cancer causes.
Moreover, in preserving the Greek traditions in the 1st century A.D, Leonides of Alexandria skilfully and boldly detailed his approach of cautery and incision. He stipulated leaving wide margins of excision and removing limited extent tumours only which foreshadowed contemporary surgical practice’s oncological principles whereas in 200 A.D, Galen, concluded that it was a systemic disease after attributing breast cancer to accumulation of black bile in the blood (De Moulin , 1983). According to these ancient physicians, menstruation cessation was somehow linked to cancer and they postulated that in fact there was probability that old age was somehow associated to cancer. This theory led Galen who had coined the word crab to represent cancer to exemplify the enlarged veins glowing from the cancer after having neglected the use of ligatures in order to get rid of black bile through allowing the surgical wounds to bleed freely.
Currently, breast cancer remains the most common of all cancers in women in United States as well as the second leading cancer death cause. Nearly three million women were estimated to be breast cancer survivors as of January 1, 2012 in the United States. Estimates predict this number to rise to about four million before 2022. However, overall survivor rate recently increased to 90% for 2001 to 2007 from 75% between 1975 and 1977 which is good news for women with breast cancer. This has greatly been enabled by the fact that there is early detection through the use of hormone therapy treatments, better chemotherapy and increased use of mammography as well as widespread knowledge of early signs and symptoms by the affected females (NCCN, 2012).
Moreover, there are usually no symptoms caused during the early stages of breast cancer although later on there are changes on how the breast feels and looks as tumours grow. The indication of a breast problem may be the changes in the breast tissue and generally, breast cancer does not cause pain in the early stages. This calls for regular screenings which are actually the exams and tests used to find diseases like cancer in those individuals who fails to show or have any symptoms with a goal of finding the cancer before it begins to show up the symptoms. If breast cancers are discovered since they can be felt, generally, they are more likely to have spread elsewhere which is why it is advisable for women to go for regular checkups so that they can be found when still confined to the breast and still small and in case of any breast pain or breast cancer symptoms that do not go away the woman should see her health care provider (Colditz & Bohlke, 2014).
Normally, there are common changes like underarm area thickening or a lump, breast shape or size change, bloody discharge from the nipple and retraction of the nipple. In other cases the breast skin dimples or ridges. As for the very aggressive breast cancer which is somehow rare and whose symptoms develop fast over a period of months or weeks, lymph nodes swell Albrand and Terret (2008). They may be located at the collarbone or under the arm and even on both places. This breast cancer is known as the “inflammatory breast cancer”. It is more common among women of African-American origin and usually attacks the younger generation. Moreover, the woman experiences breast size increase, tenderness, burning and aching in addition to heaviness. It is called inflammatory due to its nature of inflaming the breast such that it looks red and swollen.
However, breast cancer’s most cases of occurrence are by chance. Probably, factors combination that includes hormonal, lifestyle and environmental factors are the mostly suspected contributors although the actual causes are still largely unknown. Mutations or changes in certain genes are also thought to be linked with breast cancer at a percentage of between 5 and 10% with BRCA 2 and BRCA 1 genes being the most common of them. During their lifetimes, women with “BRCA 1” or “BRCA 2” mutations are at an elevated risk that may develop several other types of cancer in the course of their existence in addition to ovarian cancer and breast cancer.
Additionally, women whom families have a breast cancer history must gather as much details as possible about those family members that include cancer type and onset age. Diagnosis age, affected relatives number and specific lineage also increase the breast cancer development risk in line with the history of the family. Genetic component is more likely to be involved when one is diagnosed at a younger age. Other causes and risk factors may include, Cancer from the other breast, Diet with saturated fat due to high intake, Oral contraceptives, Age at menopause after 54 years, Exposure to ionising radiation, Hormone replacement therapy, Body mass index, being Elderly (Albrand &Terret, 2008).
Furthermore, a significant impact on public health in the United State is caused by cancer and many problems which are associated with it. This issues which take a toll at a population level includes the economic burden driven by the lost of productivity and the costs linked to illness and therapy, years of life, cancer long time effects and treatment on the survivors. In addition, as some cancer incidence and population ages rates rise in United States, the impact of cancer on public health will keep on rising (Colditz & Bohlke, 2014).
On the other hand, since cancer usually affects individual patients and their families in different ways, the cost of studying its impact on large populations is very expensive in United States. Moreover, while interpreting the results from population-based research into policies and practices that can improve public health, carrying out research that involves assessing very large groups of people is associated with intrinsic challenges. According to National Cancer institute (2015), cancer therapies are approximately $30,000 per month while the newly cancer drugs cost amount to an average of $10,000 per month. Hence, due to the side effects of chemotherapy involved, patients are also required to pay for drugs that are found to alleviate these side effects. The pay provider and facility fees are also a major problem associated with cancer treatments. Only 24 percent of direct cancer costs are accounted from drugs. But 54 percent of costs are accounted from hospital and outpatient facilities and 22 percent is accounted from physicians fees.
Patients with breast cancer can be diagnosed or treated using different types of treatment available in heath care. However, some treatments of breast cancer are clinical trials while others are standard. A clinical trial treatment involves a research study that is apparent intended to get hold of the necessary information on latest treatments or assist on improving modern treatments on patients suffering from cancer. The new treatment may possibly turn out to be the standard treatment, once clinical trials provide evidence that a new treatment is well improved than the existing standard treatment. The standards treatment includes surgery, targeted therapy, chemotherapy, hormone therapy, and radiation therapy (Komen, 2012). However, there is no confident way to prevent breast cancer.
Therefore, public health professionals should create awareness and educate people about the options that will help prevent or treat the breast cancer. It is always reported that early detection of cancer usually helps to control the breast cancer. Public health cares should therefore educate people on how to conduct Breast Cancer Early Detection Plan that involves Breast Self-Exam (BSE) in order to save some people lives. In addition, public awareness that is associated with developing breast cancer risk factors should be made to the public by the health professionals.
Conclusion
This paper has provided an overview of breast cancer and how it is currently impacting public health today. Appreciable reductions in breast cancer risk can result from the application of measures that are already available that include lifestyle prevention and chemoprevention. Furthermore, new avenues for prevention in the future can be gained through the breast cancer risk and development understanding and awareness biology. However, measures that will enable to assess risk while explaining the pros and cons associated with treatment and appropriate therapies prescription will be needed.
References
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Colditz, G. & Bohlke, K. (2014). Priorities for the primary prevention of breast cancer. CA Cancer J Clin, 54:177–186.
De Moulin, D. (1983). A short history of breast cancer. Boston, pp. 1–107.
Homer, I. (1966).A Signet Classic. New American Library, New York, p. 36
Komen, G. (2012). Understanding Breast Cancer Guide. Retrieved from http://ww5.komen.org/understandingbreastcancerguide.html.
Lyons, A. & Petrucelli, R. (1978). An illustrated history. Harry Abrams Publishers, New York..
National Cancer Institute (2015). Targeted Therapies for Breast Cancer Tutorial. Retrieved from http://www.cancer.gov/cancertopics/understandingcancer/targetedtherapies/breastcanc er
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