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Breast Cancer

Breast Cancer

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Breast cancer is one of the leading causes of cancer deaths all over the world. In general, cases of cancer have been on the rise, and breast cancer is one of the common types of cancer. It affects both men and women, although women are affected to a greater extent. There have been advances made in the treatment of breast cancer that has seen the decline in the number of deaths due to the disease in the recent past. According to statistics, as of January of 2019, more than 3.1 million women in the United States have a history of breast cancer, meaning that they either finished treatment or are currently receiving treatment. There has been an increase in awareness that has allowed women to get screening so that they can be diagnosed in early stages where there is hope for a cure. Some of the key areas of concern when it comes to breast cancer are the types of breast cancer, causes, prevention, symptoms, risk factors, and treatments available.

There are several types of breast cancer, depending on the spread of the cancerous tissue. The most common type is invasive ductal carcinoma that makes up about 80% of all breast cancers diagnosed. This type of cancer is called invasive because the cancerous tissues have multiplied to other parts of the breast tissue. Other types of breast cancers are inflammatory breast cancer, angiosarcoma, Paget’s disease of the breast, male breast cancer, recurrent breast cancer, invasive lobular carcinoma, among others. There are five stages to every type of cancer, and breast cancer is no different. Doctors use three factors to settle on the stage of cancer. The first is the size and location of the primary tumor. The second factor is the lymph nodes that have been affected by cancer, including the number and location. The third facto is metastasis that involves the extent to which cancer has spared to other parts of the body. Stage zero is noninvasive ductal carcinoma in situ (DCIS), while stages I to IV describe invasive cancers.

Cancer is caused by an abnormal and rapid growth of breast tissue cells, and these cells form a lump or a mass. The rate of growth for these abnormal cells is much higher than that of healthy cells, and the healthy cells are soon overpowered. The cancerous cells spread to the lymph nodes, or they and metastasize to other parts of the body. Breast cancer begins in tissues and cells in the breast, such as the milk-producing ducts or the glandular tissues of the breast. It is difficult to pinpoint the exact cause of cancer, but scientists attribute it to some particular risk factors from lifestyle, hormonal, and environmental factors. Women who have a first degree relative with cancer such as their sister, mother, or daughter, have a higher chance of developing cancer. About 5 to ten percent of all cases of breast cancer are associated with genetic factors. Breast cancer gene 1 and 2 or BRCA1 and BRCA2 respectively are the well-known genes linked to a higher possibility of breast and ovarian cancer in women. People who have a family history of cancer are advised to get tested for genetic mutations that increase the chances of cancer. A genetic counselor also a person understand the risks and benefits associated with genetic testing and walk them through the complicated emotional process.

Women are advised to get screened for cancer periodically. Most of the time, a person begins to notice changes and abnormalities in their breasts, and this is what prompts them to seek medical examination. The earlier a person is diagnosed, the higher the chance that they can be cured. Some of the most common signs and symptoms of breast cancer include a lump or solidified breast tissue that feels dissimilar from the adjoining tissue (Moodley et al. 2018). The second symptom is an overall difference or change in the size, appearance, or shape of the breast. Some changes, such as a dimple in the skin covering the breast, also warrant investigation. The skin around the nipple may also begin to peel, flake, scale, or crust. The skin over the breast can also redden or pit like the skin of an orange, and anyone who notices these symptoms must seek medical attention immediately.

There are many risk factors that can amplify a person’s likelihood of getting cancer. One of these is age; the older a person gets, the higher the chance of getting cancer. This is the main reason why women over the age of 45 advised to get a mammogram annually. The second risk factor for getting breast cancer is being female. Although breast cancer affects both men and women, women have a elevated risk of getting breast cancer. The third risk factor is a family history of breast cancer (Barnard et al 2015). If a mother, daughter, or sister had a breast cancer diagnosis at a young age, it raises the chance that a person will develop cancer. A person who has a personal history of breast conditions such as typical hyperplasia of the breast also faces a higher risk. Some gene mutations associated with breast cancer are passed from parents to their children, and this predisposes the children to breast cancer (Barnard et al. 2015). These genes include BRCA1 and BRCA2, but they do not necessarily point to the inevitability that a person will develop breast cancer and other types of cancer.

Additionally, women who get their first child after the age of 30 may also be at higher risk, as do women who have never been pregnant. Higher risk is also associated with menses; for example, women who began their period before 12 and those who begin menopause at an older age have a higher chance of developing breast cancer (Kamińska et al. 2015). Those women who take medications to treat signs and symptoms of menopause face a higher risk of developing the disease, but this risk decreases when they stop the medication (Forman et al. 2015). Another factor that increases the chances of breast cancer is obesity. Radiation treatments to the chest, especially as a child, could increase the probability of a person developing breast cancer as they grow older. Alcohol consumption also enhances the danger of developing breast cancer.

There are some preventive options that women can pursue when they are found to have a high risk of developing breast cancer. After consulting with their doctors, women with significant t risk can choose to have prophylactic mastectomy or prophylactic oophorectomy. A mastectomy is the removal of healthy breast tissue, while oophorectomy is the removal of healthy ovaries to reduce the chances of breast and ovarian cancers. Preventive medications are also available, although they are only limited to very high-risk women because of the severe side effects they can cause. Some of these medications are Estrogen-blocking medications such as Aromatase inhibitors that reduce the risk of women who have unusually high chances of developing breast cancer (Forman et al 2015).

All women should also make adjustments in their daily life that will increase awareness and lower their risk of getting breast cancer. One way to do this is by talking to the doctor about regular breast cancer screenings. As a person grows older, the frequency of mammograms needs to increase based on doctors’ recommendations. Women should familiarize themselves with their breasts by examining them regularly so they can identify any irregularities as soon as they appear. Alcohol consumption should be limited to one day if a person has to drink; otherwise, they should avoid alcohol altogether. Exercising regularly is also an important way to improve overall health and wellbeing; thirty minutes of exercise a few days a week is recommended. Postmenopausal women should consult their doctors about the risks and benefits of postmenopausal therapy because it increases the chances of developing breast cancer. Maintaining a healthy weight through exercise and diet also helps in reducing the risk of getting breast cancer. The Mediterranean diet is an excellent example of a healthy diet that helps to maintain a healthy weight (Toledo et al. 2015). Some of the common foods included in this diet are plant-based foods including fruits, nuts, legumes, and vegetables. Healthy fats like olive oil and fish should also be chosen over butter and red meat.

In conclusion, breast cancer is one of the most common types of breast cancer in the country, second only to skin cancer. For this reason, it is important for people to get as much information as possible about the types, causes, risk factors, symptoms, and possible measures to prevent breast cancer. Breast cancer affects both men and women but women to a larger extent. The main signs and symptoms of breast cancer have to do with the appearance of the breast; thus, women should examine them as often as they could. Risk factors include age, genetics, postmenopausal therapy, obesity, exposure to radiation, among others. The general prevention measures include maintaining a healthy weight through diet and exercise, limiting postmenopausal therapy, regular mammograms, and avoiding alcohol. For women who have a significant risk of developing breast cancer, they can choose to remove their healthy breasts and ovaries and also take preventive medications.

References

Barnard, M. E., Boeke, C. E., & Tamimi, R. M. (2015). Established breast cancer risk factors and risk of intrinsic tumor subtypes. Biochimica et Biophysica Acta (BBA)-Reviews on Cancer, 1856(1), 73-85.

Forman, M. R., Winn, D. M., Collman, G. W., Rizzo, J., & Birnbaum, L. S. (2015). Environmental exposures, breast development and cancer risk: through the looking glass of breast cancer prevention. Reproductive Toxicology, 54, 6-10.

Kamińska, M., Ciszewski, T., Łopacka-Szatan, K., Miotła, P., & Starosławska, E. (2015). Breast cancer risk factors. Przeglad menopauzalny= Menopause review, 14(3), 196.

Moodley, J., Cairncross, L., Naiker, T., & Constant, D. (2018). From symptom discovery to treatment-women’s pathways to breast cancer care: a cross-sectional study. BMC cancer, 18(1), 312.

Toledo, E., Salas-Salvadó, J., Donat-Vargas, C., Buil-Cosiales, P., Estruch, R., Ros, E., … & Gómez-Gracia, E. (2015). Mediterranean diet and invasive breast cancer risk among women at high cardiovascular risk in the PREDIMED trial: a randomized clinical trial. JAMA internal medicine, 175(11), 1752-1760.

A. Hook

Paper 2 – Research Proposal

Formal Requirements:

500-800 words. Typed, double-spaced, 12-pt Times New Roman font, 1-inch margins.

You may use first person (I) when discussing your research, but an objective third person is often better for analysis.

You may NOT use the second person (you) in your analysis.

Must have quotes, paraphrase, and summaries with citations from three relevant research sources.

Instructions:

Paper 2 will be a written proposal for your Research Paper Project, which will later include Paper 3 – Annotated Bibliography (with a Research Presentation) and Paper 4 – The Research Paper. Before you begin detailed research, you need to find a real-world, arguable research problem approved by your instructor, so writing this proposal will help you plan your project and articulate your potential arguments. The real-world, arguable problem for Paper 2 must come from your current or planned Texas State major or a potential career after graduation. The proposal must include:

I. Introduction (one paragraph): Write an intro for the Research Proposal emphasizing your reasons for writing about your chosen topic and the importance of the issue to your future career.

A. Hook: Remember to use a little pathos to hook the reader. Snag your reader’s interest with vivid, concrete language, with human interest. Be subtle but be interesting.

B. Development: Discuss the problem in your future career and include some audience analysis (Consider: Who is your audience/opposition? Walk in their shoes for a while and try to determine why they think like they do, and what are the best, most compelling arguments for their position. What about your argument for change, for a new perspective, scares them the most? Now that you have become them, have understood their fears and resistance, what would be the most persuasive ways to overcome their fears and resistance?) Transition to your thesis statement at the end of this paragraph and see if you don’t have a great suspended, or climactic paragraph.

C. Thesis Statement (one sentence): A thesis statement is one sentence, and always an opinion. In this case it’s an arguable position on a controversial topic. You may end up taking a fairly moderate position on the topic, but your thesis is still specific. (Example: While many think political parties serve to organize the administration of government, mainstream parties in America have polarized the nation by building mistrust among lawmakers and stifling other potential voices in our democratic republic.)

II. Background/History of the subject (one paragraph): Trace a brief history of your controversy and bring the reader up to date on where the issue stands today. Do this section in chronological order, briefly hitting major landmarks from the beginning of the controversy until its current state. You should do basic research online (on the web and/or through the library website) to get this information. Direct quotations for basic history aren’t necessary, but any paraphrase or summary of sources MUST BE CITED using the MLA format.

III. Proofs: Based on your preliminary research, discuss what you want to prove {2 thesis points (not including the counterargument in your refutation)} as your paragraph topics. Use complete topic sentences to label each proof, and include any quotes/paraphrases/summaries from your sources that you will cite as evidence. MLA CITATIONS REQUIRED. Explain how this evidence will support your proposed thesis and what kinds of other evidence you will need to fully develop the argument. [SEE SUGGESTED OUTLINE ON NEXT PAGE.]

III. Proofs (continued).

A. Topic sentence about thesis point #1.

1. Evidence, ideally paraphrased, MLA cited in parentheses.

2. Explanation how this evidence addresses your point and relates to the further research needed.

3. Evidence, ideally paraphrased, MLA cited in parentheses.

4. Explanation how this evidence addresses your point and relates to the further research needed.

B. Topic sentence about thesis point #2.

1. Evidence, ideally paraphrased, MLA cited in parentheses.

2. Explanation how this evidence addresses your point and relates to the further research needed.

3. Evidence, ideally paraphrased, MLA cited in parentheses.

4. Explanation how this evidence addresses your point and relates to the further research needed.

IV. Refutation (one paragraph): While some elements of refutation should be covered in your Proofs, this paragraph will focus on naming and then refuting (disproving) any counterargument unaddressed or you have yet to overcome. The opposing view should already appear as part of your thesis, but the refutation should give the specific attack(s) that the opposing view would make against your thesis claim. Based on preliminary research, discuss these possible counterarguments and any evidence you have for refutation. CITE EVIDENCE.

V. Conclusion (one paragraph): Sum up what you’ve already proven about your topic and what still needs to be proved. Bear in mind that a conclusion is future-oriented, gives the reader a directive about the future, about why this topic is important and deserves further research. If possible, employ subtle yet effective pathos here, and vivid, concrete language.

VI. Works Cited Page: Full list of cited sources on its own page in the paper. Put on the last page in correct MLA format with sources alphabetized by first line.

Rubric:

15 points Well-developed, clear thesis statement that proposes a research topic.

15 pointsSufficient preliminary evidence to support background of the subject, proofs, etc.

40 pointsStrong overall organization, topic/transition sentences, and intro/conclusion paragraphs.

15 pointsCorrect MLA Format.

15 pointsAttended conference with printed draft and sources.

Deadlines:

Bring written thesis statement to classThursday2/26

Bring research proposal draft and sources to one-on-one conference (sign up on TRACS)2/28, 3/05

Final Draft Due on TRACS /Assignments by 11:55pmWednesday 3/8

Breast cancer is highly prevalent in women

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Breast cancer

Breast cancer is highly prevalent in women. Globally, it is the prominent cause of cancer deaths in women. Clinicians and scientists are persistently seeking better ways to improve prognosis of the patients. The term breast cancer coalesces a group of mammalian tumor subtypes, each with a unique molecular and cellular source as well as clinical traits. The prognosis of the disease is worse for particular subtypes and in poorly developed countries where the diagnosis is done late. This paper will focus on the epidemiology, etiology, pathophysiology, treatment, and prognosis of breast cancer. The paper will give new insight into the management of the condition.

For a long time, breast cancer used to have a high mortality rate in cancer patients, but now it has been surpassed by lung cancer. In the US, it accounts for approximately 30% of all cancers among women. Most of the early cases are often asymptomatic. The US predicts that there will about 276,480 cases diagnosed in women in 2020 and 2620 cases in men. The number of cases in the US soared in the 1980s because of a widespread increase in screening (Siegel, Kimberly & Ahmed). Breast cancer cases surged outside the US, with the highest incidence reported in Westernized countries due to the increased awareness and screening. Women in these countries have altered reproductive patterns, which may explain the reason for the increased cases. A mammogram diagnosis is a confirmatory diagnosis for breast cancer. Guidelines recommend the use of a triple approach to diagnose the condition. It consists of clinical examination, needle biopsy, and breast imaging. Due to constant public awareness, more screening and early diagnosis are made in developed countries worldwide.

Breast cancer presents with the following signs and symptoms: axillary lump, skin changes, nipple abnormalities, increase or decrease in breast size, or a change in its shape. Cancer develops when there is a change in molecular and cellular structures of the mammalian epithelial cells that causes uncontrolled cell growth and dysfunctional apoptosis. Research into the genetic profiles of the cancers has shown there are several discrete subtypes of this cancer. The subtypes are grouped based on the presence or absence of ER, PR, and HER2. The intrinsic subtypes of breast cancer are luminal A, basal-like, HER2-positive, and luminal B. Each of these subtypes has its distinct features that guide its clinical management. The basal-like subtype shares many features with ovarian cancers (Tomczak et al.).

The etiology of breast cancer is founded on epidemiological studies. There are several risk factors for the disease. Firstly, age and gender. Sporadic cases are few in women aged below 40 years. However, the number increases immensely above that age. Breast cancer occurs at conspicuously greater numbers in women than men. One could easily say that it is a condition for women, just like the way prostate cancer is for men. Secondly, a positive family history exacerbates the risk of getting breast cancer. Family is one of the most intensely researched factors. A person has a 4-time lifetime risk if a mother and sister get the condition. The risk increases to 5 times when there are two or more first-degree relatives diagnosed with breast cancer (DeSantis). Thirdly, reproductive, and steroid hormone factors. For example, a late age to first pregnancy, nulliparity, late onset of menopause increases the person’s susceptibility to the condition. Clinical trial data have demonstrated the benefits of the use of SERMs agents such as tamoxifen and raloxifene. Oral contraceptives and hormonal replacement therapy are common in women of childbearing age, which significantly predisposes them to breast cancer. Fourth, lifestyle risk factors. Diet rich in fruits, vegetables, and grains, monounsaturated fatty acids, low alcohol intake provides a protective effect on women. Other factors include obesity and environmental factors such as smoking, alcohol use, and carcinogens (Tao).

In the clinical setting, management of breast cancer is done through surgery, radiation, or chemotherapy. The three approaches are frequently combined to achieve better results. There are two types of surgery mainly done namely, lumpectomy and total mastectomy. To reduce residue disease, radiation therapy is done after surgery. Pharmacotherapy is utilized regularly and can be either hormonal or chemotherapeutic. Some of these include methotrexate, cyclophosphamide, carboplatin, docetaxel, and trastuzumab. HER2 positive cancers may be treated with HER2-targeted therapy in combination with angiogenesis inhibitors. The SERM agents are used in the prophylaxis of breast cancer. Some women with a high risk of getting breast cancer opt for prophylactic mastectomy (Waks & Eric).

HER2 subtype is accompanied by a poorer prognosis. As a result, adjuvant therapy with trastuzumab, pertuzumab, and lapatinib is recommended to avoid worse outcomes. Anthracycline-based agents like doxorubicin also improve prognosis in this group of patients. There are two types of DCIS cancers: comedo and non-comedo. The worst prognosis occurs with comedo DCIS. 10-20% of LCIS women develop invasive metastatic breast cancer in about 15 years. Metastatic breast cancer leads to death within 3-5 years (DeSantis).

One of the goals of therapy is to avoid metastasis since it has a poor outcome. Early breast examination and imaging can help to ensure early diagnosis as it has been shown to have the best outcomes. Consequently, each country should put in measures to sensitize the public on the necessity of regular screening. Going forward, there is a need to encourage the world population to adopt a healthy lifestyle. In addition, to mitigating cancers, an appropriate lifestyle prevents a myriad of diseases.

Works cited

DeSantis, Carol E., et al. “Breast cancer statistics, 2019.” CA: a cancer journal for clinicians 69.6 (2019): 438-451.

Siegel, Rebecca L., Kimberly D. Miller, and Ahmedin Jemal. “Cancer statistics, 2019.” CA: a cancer journal for clinicians 69.1 (2019): 7-34.

Tao, ZiQi, et al. “Breast cancer: epidemiology and etiology.” Cell biochemistry and biophysics 72.2 (2015): 333-338.

Tomczak, Katarzyna, Patrycja Czerwińska, and Maciej Wiznerowicz. “The Cancer Genome Atlas (TCGA): an immeasurable source of knowledge.” Contemporary oncology 19.1A (2015): A68.

Waks, Adrienne G., and Eric P. Winer. “Breast cancer treatment: a review.” Jama 321.3 (2019): 288-300.