Abstract
This study was meant to find out the level of understanding of the various aspects of breast cancer in the society especially concerning its causes and the susceptible group. A survey was conducted and it was noted that there was some awareness about breast cancer in the society, however, it was not adequate. The study, therefore, also seeks to bring to light the approaches that have been proposed to combat the disease before it metastasizes.
Introduction
Cancer is a group of diseases collectively characterized by the multiplication of body cells that are no longer controlled by the body. There are several types of cancer affecting different parts of the human body. Normally, cancer causes harm to the body because of the mechanical pressure it exerts on the surrounding body organs especially hollow organs like the blood vessels and the intestines. Also, some types of cancers cause harm to the body because of over secretion of a specific hormone which alters the normal functioning of the body. Based on the severity of the effects caused by the specific cancer, these diseases are divided into two major groups; benign cancers under which all the cancers that have developed in a specific body part but have not spread are classified, and malignant cancers in which group are found all the different kinds of cancers that started in one part of the body but have spread to other parts of the body causing different mechanical or hormonal effects.
Breast cancer primarily affects breasts, but it can spread to other body parts in advanced cases. A spread of cancer to a new body part is called metastasis and it can occur when the cancer cells get into the blood stream and are transported to other parts or when cancer cells get into the lymphatic vessels and are transported in lymph to other body parts. The incidence of breast cancer is high among elderly and post menopause women although a new increase in its incidence among pre menopause women has been observed recently . It can also affect men as well despite the incidence being low. The current increase in interest in breast cancer stems from the higher number of young women in their late twenties and thirties being diagnosed with advanced cancers despite the old belief that older women are the once who are more at risk. And thus the question is, what really is causing breast cancer among young women, what awareness is there in society on the disease, what measures can be taken to reduce the incidences and what remedy can be sought for in future? Does the society have adequate understanding of the causes of breast cancer?
Method
Results and Discussion
Based on an online survey done via Survey Monkey, it was clear that many of the members of society (72%) do not know the possible causes of breast cancer compared to the 27% who said they knew of a few risk factors. Surprisingly, 73% said they knew somebody who had had breast cancer compared to the 27% who said they did not know anybody who had had breast cancer . This shows the higher prevalence of breast cancer in society currently. A higher number of the respondents said they knew cancer had treatment and were positive that being diagnosed with breast cancer is not a death sentence. Also, 70% of the respondents said breast cancer is hereditary (which is consistent with the scientific discovery) and that both genders can get the disease. Some of the treatment methods they gave include chemotherapy, radiation therapy, mastectomy and lumpectomy. Many of the respondents (76%) said the female gender is more likely to get the disease as compared to the male gender. Only 9% of the respondents admitted to going for breast cancer tests on a yearly basis. This survey gives insight on the willingness of the people to learn more about breast cancer which can greatly help in the reduction of its prevalence. It also points out the need to create awareness on the importance of breast cancer examination such as mammograms.
The study is below contrasted to other previous information from various secondary sources.
Causes
Many authorities in cancer research and treatment affirm that advancing age is the main risk factor to development of breast cancer. This goes hand in hand with the fact that previously, many of the women diagnosed with breast cancer were elderly and usually post-menopausal. For a long time this was the unquestioned truth on the aetiology of breast cancer until younger women started being diagnosed with advanced breast cancers while still in their late twenties or thirties. This prompted many cancer researchers and institutions to question the validity of age as the main risk factor which later led to a new understanding of other risk factors. Cancer research, in the UK for instance, has singled out hormonal factors as the other contributors to the risk of getting breast cancer. These include having children later in life, the use of birth control pills and having fewer children. This is consistent with the observation made in hormone replacement therapy patients, in the year 2002, where the programme had to be stopped because the women that were on the synthetic hormones had a very high risk of breast cancer that continuing with the study was considered unethical. Surprisingly, one year after the women stopped using the synthetic hormones, the incidence of cancer among them dropped drastically by 7 per cent.
A study in the United States found that birth control pills contain the same hormones that lead to breast cancer. These hormones are estrogen and progestin. Dr. Mercola indicates another surprising discovery that milk can be a risk factor for breast cancer. The recombinant bovine growth hormone that is given to dairy cows as a drug to boost milk production leads to increased levels of insulin growth factor 1 in the milk produced. The insulin growth factor 1 has a potent growth stimulating effect in human breast tissue which is even more in the presence of estrogen. This has been accused of increasing the incidence of transformation of normal breast cells to malignant cells. In a study conducted, pre-menopausal women with high levels of insulin growth factor one levels had a seven fold increase in breast cancer. These cancers were mostly aggressive.
The National Cancer Institute indicated that exposure to ionizing radiation increases the risk of developing breast cancer, especially during puberty. For instance, young girls who receive radiation therapy to the chest to treat childhood cancers have an increased incidence of breast cancer compared to their peers who do not get radiation therapy. The increasing campaign for women to go for mammography at least once a year has also come under scrutiny. Mammography has a primary hazard which is ionizing radiation which can greatly increase the risk of cancer. Other factors which have been implicated in the development of breast cancer include female sex, genetic predisposition, lack of breast feeding and obesity. Smoking tobacco has also been observed to increase the risk of breast cancer. Information from cancer.org indicates that the long term risk for smokers ranges from 35% to 50%. Furthermore, it indicates that genetics is the main cause in 5 to 10 per cent of all the cases . A group of cancers caused by the inheritance of mutated gene are referred to as family cancer syndromes. An example is the genetically inherited hereditary breast-ovarian cancer syndrome in which case the person carries the BRCA1 and BRCA2 gene mutations.
Signs and symptoms
The early signs of breast cancer that can be noticed is a lump in the breast that feels different from the other breast tissue. Other indicators may include one of the breasts becoming bigger than the other, a nipple being inverted or changing shape or its position, having a rash on or around the nipple, the skin on the breast dimpling, having constant pain in a part of the breast or the armpit on the side of that breast and swelling under the arm pit on the same side of the breast.
Diagnosis
Information from the medical news today shows that early detection of cancer is important since it greatly improves the chances of successful treatment, hence survival. Clinicians use information gathered from signs and symptoms and other advanced procedures to diagnose cancer. The mostly used screening methods; physical examination of the breast by a clinician and mammography are very important in the detection of a lump in the breast or the change in consistency of the different regions of the breast. If the screening methods are not conclusive, a clinician can do a fine needle aspiration of breast tissue, in which a needle is used to remove a small amount of fluid from the breast for microscopic examination to help get the diagnosis. This procedure can be performed in a clinician’s office and has a good degree of accuracy in breast cancer diagnosis. Other screening tests which can be done on the patient include magnetic resonance imaging and ultrasound. Also, a biopsy of the lump can be taken for microscopic analysis to find out if the cells making up the lump are malignant or benign to enable the clinician decide on the best method of managing the patient. Lerman et al, note, in their study of cancer biomarkers and prevention, that genetic screening is important for those women who have first degree relatives who have been diagnosed with breast cancer. Of all the different methods of diagnosis, microscopic examination of breast tissue is taken to be the definitive way to diagnose breast cancer.
Management
The management of a breast cancer patient depends on many factors which include the stage of the cancer. Highly aggressive treatments are preferred in case of poor patient prognosis and if the risk of cancer recurrence is high. In the case of breast cancer, a multidisciplinary approach is normally preferred. Surgery is normally done in which case the tumor is removed with some amount of the surrounding tissue. Sometimes, if the cancer is very aggressive, the whole breast may be removed, what is called mastectomy, and later on if the patient desires, reconstructive surgery can be done. Drugs are also given post-surgery (adjuvant therapy). These drugs are grouped into different classes which include; hormone blocking drugs in those breast cancers that require estrogen for them to continue growing. These cancers are detected by the presence of estrogen and progesterone receptors on their surface. These drugs act either by blocking the receptors or by blocking the production of the hormones. The second group of medications used for adjuvant therapy is chemotherapy. It is normally preferred for breast cancers in stages 2-4 and is very beneficial for diseases that are estrogen receptor negative. They are used for a period of 3 to 6 months. The third group of post-surgery medication is radiation therapy. It is given post-surgery to the regional lymph nodes and the area where the lump was attached. According to the information from the medical news today, this medication can reduce the risks of recurrence by 50 to 66 percent.
Prevention
Several authorities in cancer research and treatment have for long affirmed the need for prevention measures instead of the current curative measures much emphasized. This is because successful treatment of breast cancer is not always guaranteed and its cost is very high which makes sense for the need to increase awareness on the different risk factors and the possible ways of reducing the possibilities of getting the disease.
Many of the preventive measure are centered on those life styles. A research review by the American Institute of Cancer Research indicated that 40% of cases of breast cancer in the United States were preventable by making wiser lifestyle choices. These include avoiding high consumption of sugars, especially fructose. Fructose has been implicated in breast cancer causation. Optimization of vitamin D levels has been shown to greatly reduce the risk of breast cancer occurring. This is because vitamin D is able to enter cells and trigger apoptosis which is important in the prevention of cancer development. Also, vitamin D has been shown to work synergistically with all the anti-tumor drugs with no adverse effects. Maintaining a healthy weight is also important in prevention of breast cancer. This is because excess fat in the body acts as a gland secreting estrogen which is the culprit hormone in breast cancer causation.
Since Omega-3 deficiency has been linked to causation of cancer, getting plenty of high quality animal based Omega-3 fats helps reduce the risk of cancer development. Exclusive breastfeeding among mothers has also been shown to greatly reduce the possibility of getting breast cancer. Avoiding synthetic hormone replacement therapy and birth control pills also reduces the risk of getting breast cancer. This is because the hormones contained in these medications have been shown to be the main cause of breast cancer. Also, since iodine deficiency has been linked to development of breast cancer, getting adequate iodine supply in diet is also important in reducing the possibility of getting breast cancer.
Other that lifestyle modification which reduces the incidence by 28 to 42 per cent, is removing both breasts before the development of any noticeable cancer (prophylactic bilateral mastectomy) in people diagnosed with the BRCA1 and BRCA2 gene mutations is of great importance. Recently selective estrogen receptor modulators have been used. The National Cancer Institute indicates that data from trials using tamixofen (estrogen receptor modulator) suppresses breast cancer recurrence. They, it causes side effects such as hot flashes, endometrial cancer and thromboembolism.
Conclusion
References
cancer.org. (2013). Heredity and Cancer. Retrieved from American Cancer Society: http://www.cancer.org/cancer/cancercauses/geneticsandcancer/heredity-and-cancer
Dr. Mercola. (2013, March 21). More Younger Women Getting Breast Cancer. Retrieved from Mercola.com: http://articles.mercola.com/sites/articles/archive/2013/05/21/breast-cancer-young-women.aspx
Lerman , C., Hawk, E. K., Brown, E. P., & Rebbeck, T. R. (2008, November 01). Cancer Epidemiology, Biomarkers & Prevention and Cancer Prevention Research: Two Journals, a Common Goal . Retrieved from AARC JOURNALS: http://cancerpreventionresearch.aacrjournals.org/content/1/6/393.short
medicalnewstoday.com. (2013). What Is Cancer? What Causes Cancer? Retrieved from Medical News Today: http://www.medicalnewstoday.com/info/cancer-oncology/
National Cancer Institute. (2013). Breast Cancer Prevention. Retrieved from Cancer.gov: http://www.cancer.gov/cancertopics/pdq/prevention/breast/HealthProfessional
surveymonkey.com. (2013, November 26). Survey on Breast Cancer. Retrieved from SurveyMonkey: https://www.surveymonkey.com/analyze/8whQ2kTKvoitkckCm7iAoebYdduA_2BQF5BxGWd_2FfrrU0_3D
