Abstract
Breast Cancer is quite common among women. In the USA, around 12% of the female population get breast cancer. During the 1980s and the 1990s breast cancer was on the rise in the USA due to over usage of hormone in the birth control process. Presently, around 2.8 million females have breast cancer. Due to advancement in detection and treatment,about 90% of breast cancer patients get cured and live for a minimum of 5 years and more . There are various detection techniques for this condition, which include physical examination, mammogram and ultrasound. If detected early, small surgery with medication can completely cure this illness. In the advanced stages, full scale surgery, radiation and chemotherapy are used. Several lifestyle habits such as smoking andconsumption of high fat food and alcohol increase the chances of having cancer of the breast. Due to non-availability of medical house staff, the role of advanced practice nurses (APN) in the treatment of patients with breast cancer has been expanding. The role of APNs now covers more than consulting, educating and creating a comprehensive lifestyle routine; they are also responsible for assuming the position and responsibilities of a house staff.
Overview
Cancer of the breast develops in breast tissues. This condition shows several symptoms, such as breast lump, changes in the shape of the breast, nipple discharge, reddish and scaling on skin breasts and skin dimpling. Starting from genetic conditions to hormone imbalance, there are various reasons for developing cancer of the breast (NCI, 2016). Presently, there are approximately 2.8 million US women who are either going through or have just finished treatment (NCI, 2016). Next to skin cancer, this condition is considered as the most common cancer that affects female gender. From 1980 to 2000, breast cancer cases increased significantly. However, since 2000, the number of breast cancer patients has gone down steadily. Among the different countries with cases of this condition, USA still holds the record of most number of patients with this type of cancer. In the USA, it is estimated that almost 12% women will develop invasive breast cancer over the course of their lifetime. In the year 2015, it was reported that the number of patients newly diagnosed with invasive breast cancer reached 231,840 together with 60,290 newly diagnosed patients with non-invasive (in-situ) breast cancer (Breastcancer.org, 2015). In addition, around 40,000 females died due to breast cancer in the year 2015. The number of females over 50 years old with breast cancer is decreasing at a rate faster than women aged below 50 years (NCI, 2016). A person’s risk for this condition becomes higher (more than twice the risk) if a relative, specifically within the first-degree, like daughter, sister, and mother, is diagnosed with cancer of the breast. About 5% to 10% cases of cancer of the breast can be linked to genetic causes. This essay will discuss the factors affecting cancer, recommended therapy options and discuss the role that advanced practitioner nurses (APN) in treating patients who are suffering from breast cancer.
Factors Affecting Breast Cancer
Different risk factors can enhance the chances of acquiring breast cancer. However, gender and biological age have been found to be a significant risk factor for this condition. Other factors include obesity, lack of physical activities, alcohol consumption, menopause, hormone replacement therapy, ionizing radiation, family history, childbirth at a very young age, childbirth at an advanced age or the lack of children (NCI, 2016). There are also risk factors that may be modified, such as the consumption of alcohol. The risk of having breast cancer may be reduced if moderation is employed against this kind of risk. Fixed risk factors, like age and sex, cannot be modified. Smoking tobacco also increases the risk for the condition. Moreover, it is observed that if a woman begins to smoke early in life, her chances of acquiring breast cancer increases significantly. For lifelong smokers, the risk of breast cancer is almost 50% more than non-smokers (Breastcancer.org, 2015). Mortality rate among patients is also increased with regular sitting for a prolonged period of time and lack of exercise. Although there is lacking evidence suggesting that oral contraceptives contribute to the development of breast cancer, hormonal birth control is statistically associated with premenopausal breast cancer. During the 1980s, there was a belief that abortion increases the risk of breast cancer; Until this date, however, there is no evidence to support of this connection (Breastcancer.org, 2015). Dietary factors also influence the risk of breast cancer, and these include a diet high in fat and high alcohol consumption . Furthermore, 10% of the total cases of breast cancer are associated with genetic factors. A woman whose mother has breast cancer has 50% more chance of developing the same disease than a woman without the family history ofbreast cancer (NCI, 2016). Medical conditions, like atypical ductal hyperplasia also increase the chance of breast cancer significantly.
Diagnosis
There are different ways to detect breast cancer. Historically, physical exam has been the most common method of checking for breast cancer. Mammogram is another method that helps diagnose breast cancer (Harmer, 2011). However, mammogram is also one of the most controversial tests as many believed that mammogram is also a risk factor for the condition. Many studies that were conducted recently have suggested that mammogram does not increase the chances of breast cancer. Ultrasound test and MRI of magnetic resonance imaging are also frequently used methods for detecting breast cancer (NCI, 2016). These two methods are generally used when physical exam or mammogram cannot detect any irregularity. Biopsy is another technique in which removal of cells or tissues is viewed under microscope to check for breast cancer signs (Harmer, 2011).
If cancer is detected using diagnostic test, then further tests, such as progesterone receptor test and estrogen test, human epidermal growth factor, type 2 receptor test, and multi-gene test are conducted to understand the extent of cancer spread (NCI, 2016).
Evidence Based Treatment and Recommendations
The treatment and chances of recovery in case of breast cancer depend on several factors, including breast cancer stage, its type, receptor level of estrogen hormone and progesterone hormone, condition of tumor tissue, the rate at which the tumor grow, age, general health, and menopausal status. In developed nations, like UK and the USA, about 90% patients survive for a minimum of 5 years after the completion of treatment (Breastcancer.org, 2015). In recent years, advances in life-saving breast cancer treatment are made. Over the years, patients are given around one to two options for the treatment of breast cancer. Presently, treatment options for this condition include radiation treatment, surgery, chemotherapy, and hormonal therapy (Harmer, 2011). Surgery refers to the removal of the breast tumor and some tissues that surround it. Mastectomy involves total breast removal, whereas lumpectomy refers to the removal of only a small part or tissues of the breast. Prevention of hormonal growth is the most common medication treatment for breast cancer. Tamoxifen is commonly used for this type of medication. Tamoxifen is not only recommended during treatment, but also at least for another 10 years to minimize the risk of relapse (Harmer, 2011). Chemotherapy is not usually used for patients with early stage of breast cancer. Only stage three and four breast cancer patients undergo chemotherapy for a period of three to six months (Harmer, 2011). Radiation is often used as a supplemental treatment to surgery. After the surgery of breast cancer patient, radiation is directed to the regional lymph nodes and tumor bed to destroy any remaining microscopic tumor cells.
Prevention
In recent years, the U.S. Food and Drug Administration (FDA) gives more focus on preventive activities rather than treatment. FDA recommends the maintenance of a healthy body mass index (BMI), limiting alcohol intake, less smoking and breastfeeding as some good lifestyle measures that can significantly reduce the chances of developing cancer in the breast. Based on estimates, if the lifestyle changes are implemented properly in the USA, then the cases breast cancer will reduce by 42% (Harmer, 2011). Apart from lifestyle measures, doctors recommend Tamoxifen to women who have higher chances of developing breast cancer due to genetic reasons. These medications have a positive correlation to the reduction in the figures of cases of breast cancer. However, mortality rate remains unaffected because cancer is detected at an advanced stage.
Role of Advanced Practice Nurses
Cancer of the breast is a special type of cancer that affects women and requires different approaches by the advanced practice nurses (APN). With the increased trend of decreased availability of house staff, the duties of APNs have changed over the last few years. Apart from their normal area of practice, APNs now need to expand their knowledge and skills to play the task and responsibilities of house staff (Leslie, 1995). Historically, APNs have been responsible for developing, implementing, and evaluating programs for quality care, planning and providing nursing care to complex patients, and educating staff. However, in case of breast cancer, APNs are responsible for theducational preparation of direct caregiver. In many cases, APNs are now expected to assume the role of direct caregivers of patients as the majority of the breast cancer patients are aged above 50 years and this number will only increase with the aging of the Baby Boomer generation (Vogel, 2003). In order to improve the condition of breast cancer patients, advanced practice oncology nurses are also expected to provide leadership.
APNs play a significant role in the primary and secondary prevention of cancer of the breast due to their holistic perspective (Harmer, 2011). Advanced practice skills of APNs enable them to intervene at all levels of healthcare of the breast cancer patients. APNs use their advanced knowledge and practice skill to educate women about the risk factors for breast cancer and to initiate screening programs aimed at early detection and intervention of breast cancer. APNs monitor treatment and screening services for women and promote high quality care by educating both professional and non-professional house staff and other primary caregivers. Advocacy on behalf of women health issues impacting screening for breast cancer and care is an additional facet of an APN’s role (Harmer, 2011).
Conclusion
A cancer that affects the tissues of the breast is known as breast cancer. Lump, breast shape changes, fluid oozing out of nipples and red scaly patches are several symptomss of breast cancer. Around 2.8 million females in the USA are currently suffering from this condition. This can be detected using tests such as physical exam, mammogram, and ultra-sonography. Due to advanced treatment options, more than 90% breast cancer patients survive and live a healthy life. If detected at an early stage, breast cancer can be cured dcompletely with medications and small scale surgery. In the advanced stages, chemotherapy and large scale surgery are the only treatment options. It is observed that several lifestyle choices such as smoking and drinking alcohol can significantly increase the chances of breast cancer. APNs play a big role in the treatment of breast cancer patients and can also act as an advocate so that the overall lifestyle of women across the USA may be improved. APNs are ideal healthcare providers to evaluate the breast cancer risk, provide risk education, synthesize existing data, and make recommendations for lifestyle changes.
References
Harmer, V. (2011). Screening for breast cancer: the nurse's role. Independent Nurse, 2011(10). Retrieved on 4th February 2016 from <http://dx.doi.org/10.12968/indn.2011.3.10.86688>
Vogel, W. (2003). The Advanced Practice Nursing Role in a High-Risk Breast Cancer Clinic. Oncology Nursing Forum, 30(1), 115-122. Retrieved on 4th February 2016 from <http://dx.doi.org/10.1188/03.onf.115-122>
Leslie, N. (1995). Role of the nurse practitioner in breast and cervical cancer prevention. Cancer Nursing, 18(4), 251???257. Retrieved on 4th February 2016 from <http://dx.doi.org/10.1097/00002820-199508000-00001>
BreastCancer.Org (2015). U.S. Breast Cancer Statistics. Retrieved on 4th February 2016 from <http://www.breastcancer.org/symptoms/understand_bc/statistics>
National Cancer Institute (NCI). (2016). Breast Cancer. Retrieved on 4th February 2016 from <http://www.cancer.gov/types/breast/patient/breast-treatment-pdq>
