Breast cancer is considered to be the second most common type of cancer in the US women. According to the National Cancer Institute (2018), most women diagnosed with this disease are over 50, but younger women can also have it. Signs of breast cancer include a lump or thickening in or near the breast; a change in the breast. There is a good chance of recovery if the disease is detected in its early stage. This essay investigates preventive services for patients at risk of breast cancer as well as drug treatment options for people diagnosed with it.
Preventive services for patients who are at risk of breast cancer include medications for risk reduction of the disease and screening for breast cancer using film mammography. According to the Agency for Healthcare Research and Quality (2014), women who are over 35 are recommended to take tamoxifen and raloxifene which act as the selective estrogen receptor modulators and reduce the risk of breast cancer. It should be mentioned that tamoxifen may be taken by both premenopausal and postmenopausal women who are over 35, while raloxifene is recommended for postmenopausal women only.
Screening for breast cancer using film mammography is advised for women over 40 years who do not have risk factors regarding genetics. It should be highlighted that women aged 50-74 are recommended to screen every two years. It has been found out that screening with film mammography significantly reduces breast cancer mortality for women aged 50-74 years (Agency for Healthcare Research and Quality, 2014). Among the negative effects of screening, one may note radiation exposure and biopsies.
Despite the fact that ethnicity is not generally considered to be among risk factors for breast cancer, it is a fact that Afro-Americans are disproportionately affected by the disease. According to Allicock, Graves, Gray, and Troester (2013), even though African-American women have a lower lifetime risk of breast cancer, their mortality rate is higher compared to white women. It may be concluded that Afro-American women tend not to use preventive services. This might result from a complex of biological and nonbiological factors such as income, health, unawareness, standards of living.
Genetic susceptibilities allow for identification of women who are at elevated risk for breast cancer. In particular, this regards genetic testing for BRCA1 and BRCA2. According to Padamsee, Wills, Yee, and Paskett (2017), these genetic mutations might be responsible for 20-80% of the likelihood of breast cancer in women. Up to 80% of BRCA mutation carriers in some populations may undergo BPM (Bilateral prophylactic mastectomy) or BPSO (Bilateral prophylactic salpingo-oophorectomy) within five years of genetic testing. It has been found that known BRCA mutation carriers choose BPM more frequently than other women at elevated risk (Hartmann & Lindor, 2016). Apart from BRCA mutations, mutations in other genes, such as CDH1, CHEK2, and NBN might also lead to an increase in breast cancer risk.
Even though the majority of women with breast cancer undergo surgery along with radiation therapy, drug therapy is commonly used as a supplemental treatment. There are three categories of drug therapy which are used by patients diagnosed with breast cancer: chemotherapy, hormone therapy, and targeted therapy. Chemotherapy uses drugs which kill cancer cells so they will never grow and divide. Medications may be injected into a vein using an intravenous tube, under the skin or into a muscle. Common drugs used in chemotherapy include carboplatin, cisplatin, docetaxel, pegylated, fluorouracil, methotrexate, and eribulin (Cancer Net Editorial Board, 2014).
It has been proven that sometimes combinations of medications appear to be even more effective than single drugs. Speaking of side-effects of chemotherapy, they vary depending on the drug and dose. Short-term implications include fatigue, nausea, hair loss, diarrhea and loss of appetite. In rare cases, long-term implications as nerve damage or secondary cancers may occur.
Drugs used in hormone therapy block hormones, particularly estrogen, from contributing to the growth of malignant cells. Hormone therapy may be used either by itself or after chemotherapy in order to avoid recurrence of breath cancer. It may also be used before or after surgery. Medicines include tamoxifen, aromatase inhibitors like anastrozole, exemestane, and letrozole. Hot flashes, vaginal dryness, and night sweats are common short-term side effects of hormone therapy (Cancer Net Editorial Board, 2014). Long-term side effects may include the risk of osteoporosis, broken bones, and risk of heart attack.
Targeted therapy drugs, such as lapatinib, pertuzumab, neratinib, and trastuzumab, prompt the immune system of a person to destroy cancer cells while limiting damage to healthy ones. This kind of therapy is often combined with chemotherapy. The most common short-term side effects with targeted therapies are diarrhea, nausea, vomiting, muscle pain, and skin rashes. Long-term side effects include blood cancer, heart damage, and congestive heart failure.
To sum up, women who are at risk of breast cancer are highly recommended to take medications or undergo screening for breast cancer using film mammography. It should be mentioned that Afro-American women less likely benefit from prevention services compared to white women; whereas BRCA mutation carriers choose surgery more often than other patients. Drug treatment options for people diagnosed with breast cancer vary depending on the mechanism of dealing with cancer cells and include chemotherapy, hormone therapy, and targeted therapy.
References
Agency for Healthcare Research and Quality. (2014). Section 2. Recommendations for adults. Web.
Allicock, M., Graves, N., Gray, K., & Troester, M. A. (2013). African-American women’s perspectives on breast cancer: Implications for communicating risk of basal-like breast cancer. Web.
Cancer Net Editorial Board. (2014). Breast cancer: Treatment options. Web.
Hartmann, L. C., & Lindor, N. M. (2016). The role of risk-reducing surgery in hereditary breast and ovarian cancer. Obstetrical & Gynecological Survey, 71(10), 598-599. Web.
National Cancer Institute. (2018). Breast cancer treatment. Web.
Padamsee, T. J., Wills, C. E., Yee, L. D., & Paskett, E. D. (2017). Decision making for breast cancer prevention among women at elevated risk. Web.