Breast Cancer in Women

Introduction

Breast cancer is the second most common cancer among women, the first being skin cancer. It is a major problem through out the world and is more common in the developed countries. In the United States of America every eight women is suffering from breast cancer. According to recent statistics, 175,000 American women were diagnosed with breast cancer in one year and 43,300 died of the disease. About one third of these women did not have a family history of breast cancer (National Institutes of Health, 1995).

Problem Statement

Despite the government's recommendation that women not get a mammogram until 50, it is vital for women to receive earlier screening.

US preventive Service Task Force on Mammogram and Breast Cancer's (USPSTF's) Recommendations

The (US preventive Service Task Force on Mammogram and Breast Cancer) USPSTF's recommendations are based on its assessment of net benefit—identified benefits minus identified harms. The USPSTF will only make a recommendation if it judges the available evidence to be of high enough quality that it can have high or moderate certainty as to the magnitude of the net benefit.

Table: Age-Specific Screening Results from the Breast Cancer Surveillance Consortium

Age Group (Y)

No. of procedures to diagnose one case of invasive breast cancer

Mammography

Additional Imaging

Biopsy

40-49

556

47

5

50-59

294

22

3

The number needed to invite for screening (over several rounds of screening and at least 11 years of follow-up) to prevent one breast cancer death in women aged 39-49 was 1,904, compared with 1,339 in women aged 50-59.

The USPSTF also considered pain and psychologic responses as harms. The USPSTF notes that "anxiety, distress, and other psychosocial effects... fortunately are usually transient, and some research suggests that these effects are not a barrier to screening... Other potential harms, such as pain caused by the procedure, exist but are thought to have little effect on mammography use." (ACOG, 2009)

Radiation therapy is another common treatment for breast cancer. Radiation involves the use of high-energy x-rays to damage cancer cells and retard further growth. The radiation may come from a radioactive source outside the body, or it can come from radioactive pellets placed directly in the breasts. It is not uncommon for a patient to receive both internal and external radiation. For external radiation, patients must visit the hospital or clinic each day. When this regimen follows breast-sparing surgery, the treatments are given five days a week for five to six weeks. At the end of that time, an extra "boost" of radiation is often given to the place where the tumor was removed. Hospital stays are required for implant radiation. Some common side effects of radiation therapy include swelling of the breast and dry skin at the radiation site.

Chemotherapy is one of the systemic therapies doctors use to fight breast cancer. Chemotherapy uses drugs to kill cancer cells, and it usually involves a combination of those drugs. Traditional chemotherapy is administered in cycles; a treatment period followed by a recovery period, then another treatment, and so on (NIH 23). Like radiation therapy, chemotherapy can be administered on an outpatient ...