The Wonderful War on Drugs essays

The Wonderful War on Drugs essays In recent years the so-called war on drugs has taken over the streets and back alleys of suburban America. It has caused a problem that mirrors the prohibition days of the 1920s and early 30s. Politicians trying to play tough guy, are only contributing to more violence. Their laws have created an underground drug-trade, in which modern drug-dealers have taken the place of the bootleggers of old. The real question is whether or not this war is working. Most people would like to believe that it is, and there are a few statistics that show it has. But just watch any news program, and you will see this war has failed miserably. Drug-related crimes happen constantly in todays society, and in recent years have involved increasing numbers of innocent bye standards. Daily, police officers face ruthless dealers, who would rather shoot at a cop than spend 25 years in prison. On top of all that, there has been no real proof of a decline in drug use among people in America. Is this war r eally the best answer to Americas widespread drug problem? Should the government be allowed to spend billions annually fighting this hopeless war? Looking at this information you begin to realize that, not only does this war affect every person in the U.S., but it is also a war with no winners. War is never pretty, and the war on drugs is no exception. For this war to work it must stop drugs in at least one of three areas. Either by stopping drugs at the border, stopping drug dealers at home, or preventing drug use within the country. Military and law enforcement has failed to accomplish any of these, and it is not because of limited funds. Last year state and federal governments spent $30 billion plus on the battle against drugs(Anony71). This outrageous spending hasnt made a dent in the modern drug-trade. Politicians are trying to a...

Breast Cancer

Some methods used to diagnose breast carcinoma are mammograms, MRI’s, and biopsies (NCI, 2010). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). Each stage has different prognoses with varying survival rates as well (Marissa, 2011). There are also many ways to prevent breast cancer including maintain a healthy weight, avoiding the alcohol consumption, and by getting an annual mammogram (Reynolds, 2010). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. women, making it the first truly common breast cancer susceptibility gene (Metcalf Metcalf, 2008). Other breast diseases besides breast cancer are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). These diseases do not necessarily lead to breast cancer and can be treated (Sacks, 2011; Silverman, 1994). Keywords: – breast cancer, ducts, lobules, tumor, invasive (infiltrating carcinoma), noninvasive (noninfiltrating carcinoma), Ductal Carcinoma In Situ (DCIS), Invasive Lobular Carcinoma (ILC), intraductal carcinoma, nonfunctioning breast tissue, estrogen, lymph nodes, mammogram, MRI (magnetic resonance imaging), core biopsy, somatic mutations, fine needle aspiration biopsy, stereotactic biopsy, FGFR2, BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, metastasis, fat necrosis, fibrocystic breast disease Breast Cancer Cells are the building blocks of living things and cancer grows out of normal cells in the body (Dugdale, 2010). Cancer is the uncontrolled growth of abnormal cells in the body (Dugdale, 2010). Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer doesn’t allow normal blood function by abnormal cell division in the blood stream (Peter, 2011). Normal cells in the body follow an orderly process of growth, division, and death, this is called apoptosis, and when this process breaks down, cancer begins to form (Peter, 2011). Cancer has been around since prehistoric times, and breast cancer is one of the earliest forms to have been mentioned (Eisenpreis, 1999). In the United States, breast cancer death rates are higher than those for any other cancer, besides lung cancer (breastcancer. org, 2012). Today, about 1 in 8 women (12%) will develop breast cancer in her lifetime (Martin, 2012). Breast cancer is a cancer that starts in the tissues of the breast (Yi-Bin David, 2011). In rare cases, breast cancer can start in other areas of the breast (Yi-Bin David, 2011). Breast cancer can be invasive or noninvasive (Yi-Bin David, 2011). Invasive meaning it has spread from the milk duct (lobule) to the other tissues in the breast (Eisenpreis, 1999). Noninvasive means that it has not yet invaded other breast tissue (Yi-Bin David, 2011). Types of Breast Cancer Breast cancer can begin in different areas of the breast – the ducts, the lobules, or sometimes, the tissue in between (breastcancer. org, 2012). There are several different types of breast cancer, including breast cancer in men (breastcancer. org, 2012). Some include Ductal Carcinoma In Situ, Invasive Lobular Carcinoma, and Male Breast Cancer (breastcancer. rg, 2012). Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is a noninvasive breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues of the breast (Yi-Bin David, 2011). It may progress to invasive cancer if it is left untreated (Yi-Bin David, 2011). DCIS is the earliest form of breast cancer and is usually found during a mammogram done as part of breast cancer screening (Mayo Clinic Staff, 2011). Because of the increased use of mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years (Mayo Clinic Staff, 011). When a woman has DCIS, she is at higher risk for the cancer coming back or also at higher risk for developing a new breast cancer than a person who has never had breast cancer before (breastcancer. org, 2012). Experts believe that 20 to 50% of women with DCIS will later develop an invasive breast cancer within 10 years of the DCIS diagnosis (Hoffman, 2010). The risk of lymph node involvement with ductal carcinoma in situ is only 1% to 2% so the lymph nodes under the arm do not need to be removed, as may be  the case with other types of breast cancer (Hoffman, 2010). In seven out of 10 cases, breast-conserving lumpectomies – instead of mastectomies – were an effective treatment option (Hoffman, 2010). This will depend upon the size of your tumor and the extent of its spread throughout your breast and the surrounding lymph nodes (Hoffman, 2010). While DCIS isn’t life-threatening, it does require treatment to prevent the condition from becoming invasive (Mayo Clinic Staff 2011). Most recurrences happen within 5 to 10 years after the first diagnosis and the chances of that happening are under 30 percent (breastcancer. rg, 2012). Invasive Lobular Carcinoma is an invasive type of breast cancer that begins in the milk-producing glands (lobules) of the breast (Mayo Clinic Staff, 2011). When a person has ILC, this means that the cancer cells have broken out of lobule where they started and they now have the potential to spread to other areas or tissues of the body (Mayo Clinic Staff, 2011). This type of cancer is more difficult to se e on imaging because of the way it grows with spreading branches (Hopkins, 2012). The treatments for invasive lobular carcinoma fall into two broad categories: Local and Systemic Treatment. Local treatments treat the tumor and the areas surrounding it, such as the chest and lymph nodes (breastcancer. org, 2012). Systemic treatments travel throughout the body to destroy any type of cancer cells that may have left the original tumor and traveled to other tissues to reduce the risk of the cancer coming back (breastcancer. org, 2012). ILC cells can proceed to infiltrate fatty tissue and create a web-like mass (Stephan, 2008). This web of cancer cells may feel like a thickened area of breast tissue, and may not cause concern or pain at first (Stephan, 2008). Unfortunately, if it is left undetected, ILC can develop into a mass that is about ? inch ( 2 centimeters) to about 2 inches (5 centimeters) or bigger in size, before causing more noticeable symptoms (Stephan, 2008). Breast cancer in men is a very rare disease (Attebery, Adams ; Weiss, 2011). But the truth is that boys and girls, men and women all have breast tissue (Attebery, Adams ; Weiss, 2011). Men have a small amount of nonfunctioning breasts tissue (breast tissue that cannot produce milk) that is concentrated in the area directly behind the nipple on the wall of the chest (Attebery, Adams ; Weiss, 2011). A type of breast cancer that has spread outside of the duct and into the surrounding tissue is called invasive or infiltrating carcinoma (ASC, 2012). Some symptoms that may occur in males developing breast cancer include lumps, changes to the nipple or breast skin, or discharge of fluid from the nipple (National Cancer Institute, 2011). Men who have an altered gene related to breast cancer have an increased risk of developing breast cancer (National Cancer Institute, 2012). The major problem is that breast cancer in men is more often than not diagnosed later than breast cancer in women because men are less likely to be suspicious of an abnormality in that area (Wax, 2012). Also, their small amount of breast tissue is harder to feel, making it more difficult to catch these cancers early, and allowing tumors to spread more quickly to the surrounding tissues (Wax, 2012). Breast cancer in men is detected the same way as breast cancer is detected in women – through self-examination, clinical examination, or mammography (x-ray of the breast) (ASC, 2012). Methods for Diagnosis Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms (American Cancer Society, 2011). This is why getting the recommended screening tests before any symptoms develop is so important (American Cancer Society, 2011). Three types of methods used for diagnosis are mammograms, MRI’s, and biopsies (NCI, 2010). A mammogram is a low-dose x-ray picture of the breast and can be used to check for breast cancer in women who don’t have any signs or symptoms of the disease. (NCI, 2010) The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine (Webmd, 2010). There are different types of mammograms including Screening mammograms and Diagnositc mammograms (Webmd, 2010). Mammograms detect tiny bits of calcium that develop in dead cancer cells (Hoffman, 2010). As more and more cancer cells age and die, theses calcifications grow nd on the mammogram, they appear as a shadowy area (Hoffman, 2010). Current guidelines from the American College Radiology, the American Cancer Society, and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40, even if they have no symptoms or family history of breast cancer (ACR, 2010). For every 1,000 women who have screening mammogram: 100 are recalled to get more mammogr aphy or ultrasound images, 20 are recommended for needle biopsy and 5 are diagnosed with breast cancer (ACR, 2010). A mammography unit is a rectangular box that houses the tube in which x-rays are produced (Radiological Society of North America, 2011). Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate (Radiological Society of North America, 2011). A brief medical history and a history of specific problems related to the breast, such as pain or a palpable lump (one that is felt), is obtained prior to the mammogram (Stoppler, 2011). All jewelry and clothing in the chest and breast area are removed prior to the mammogram (Stoppler, 2011). The patient’s breasts are then placed on a firm flat panel and a gentle, but firm pressure is applied to the breast with another panel, resulting in compression of the breast between the two panels (Stoppler, 2011). The compression of the breast is necessary to obtain quality mammograms and spreads the breast tissue out so that the x-ray image displays the inner breast tissue with good resolution (Stoppler, 2011). Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them (Radiological Society of North America, 2011). As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black (Radiological Society of North America, 2011). The results of the mammogram can be given to the patient either by the radiologist at the completion of the mammogram or by the patient’s doctor who ordered the mammogram (Stoppler, 2011). An abnormal mammogram does not mean you have cancer (Stoppler, 2011). In some cases, it may just be an area of thicker or denser breast tissue, a cyst, or a benign lump such as a fibro adenoma (Stoppler, 2011). Unlike mammography which uses low dose x-rays to produce an image of the breast, MRI (Magnetic Resonance Imaging) uses powerful magnetic fields and radio waves to create images of the breast (Imaginis, 2012). The MRI system has the ability to switch magnetic fields and radio waves to achieve views in any plane and from any orientation while x-ray mammography requires re-orientation of the breast and mammography system for each view desired (Imaginis, 2012). MRI is a huge magnet and the woman gets put in the middle of the magnet; the magnetic field is turned on and then turned off again (Eisenpreis, 1999). The way the magnetized cells return to normal gives an image (Eisenpreis, 1999). The MRI finds lumps better than it tells whether or not they are cancerous (Eisenpreis, 1999). However, MRI can be good at showing how big a cancer is, once it has been found on the mammogram (Eisenpreis, 1999). A breast biopsy removes a sample of breast tissue that is looked at under a microscope to check for breast cancer and is usually done to check a lump found during a breast examination or a suspicious area found on a mammogram, ultrasound, or magnetic resonance imaging (MRI) (Marshall, 2009). During a fine-needle aspiration biopsy, the doctor inserts a thin needle into a lump and removes a sample of cells or fluid (Marshall, 2009). Nowadays, doctors might have decided to do something called stereotactic biopsy, where a patient lies on a table, with her breasts hanging down (Eisenpreis, 1999). A mammogram is taken to show where the lump is and a device holding a needle quickly shoots in and removes a few cells from the lesion (Eisenpreis, 1999). There is also something called a core biopsy that uses a larger needle to take out a piece of tissue, instead of just cells (Eisenpreis, 1999). A doctor numbs your skin with a shot of numbing medicine where the biopsy needle will be inserted and once the area is numb, a small cut is made in the skin from where the needle with a special tip is inserted into breast tissue (Marshall, 2009). Three to twelve samples will be taken to acquire the most accurate results (Marshall, 2009). Classifications and Associated Prognoses The stages of breast cancer are usually expressed as a number on a scale of 0 through IV – with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body (Marisa, 2011). Cancer stage is based on four characteristics; the size of the cancer, hether the cancer is invasive or non-invasive, whether the cancer is in the lymph nodes, whether the cancer has spread to other parts of the body beyond the breast (Marisa, 2011). Sometimes doctors use the term â€Å"locally advanced† or regionally advanced† to refer to large tumors that involve the breast skin, underlying chest structures, changes to the breast’s shape, and lymph node enlargement that is visible or that the doctor can feel during an exam (Marisa , 2011). The three ways that cancer spreads in the body are: Through tissue where cancer invades surrounding normal tissue, through the lymph system where the cancer invades the lymph system and travels through the lymph vessels to other places in the body, and through the blood, where cancer invades the veins and capillaries and travels through the blood to other places in the body (NCI, 2009). When cancer cells break away from the primary (original) tumor and travel through the lymph nodes or blood to other places in the body, another (secondary) tumor may form (NCI, 2009). This process is called metastasis (NCI, 2009). The stage of the breast cancer can help the patient and the doctor understand the prognosis (the most likely outcome of the disease) and make decisions about treatment, along with all the other results in the pathology report (Marisa, 2011). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). The TNM staging system classifies cancers based on their T, N, and M stages (ACS, 2012). The letter â€Å"T† followed by a number 0 to 4 describes the tumor’s size and spread to the skin or to the chest wall under the breast (ACS, 2012). The letter â€Å"N† followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected. The letter â€Å"M† followed by a 0 or 1 indicates whether the cancer has spread to distant organ (ACS, 2012). There are typically five stages (0 to 4) with sub-stages that indicate the prognosis for breast cancer (Lippman, 2005). Stage 0 where the carcinoma is insitu and no lymph nodes are affected had 99 percent 5 year survival rate (ACS, 2012). Stage IA also has a high rate, 92 percent, in which the tumor is equal to 2 centimeters (ACS, 2012). In stage IB, the tumor is 2 centimeters with micro metastases in 1 to 3 axillary lymph nodes but the cancer has not spread to distant sites (ACR, 2012). In stage IIA, the cancer cells have moved to the ipsilateral nodes and the 5 year survival rate lowers to 82 percent (Lippman, 2012). In stage IIB, the cancer cells have spread to movable ipsilateral nodes and the tumor is over 5 centimeters (Lippman, 2012). The 5 year survival rate lowers to 65 percent (ACS, 2012). In stage IIIA, there is no evidence of a primary tumor and no distant spreading (ACS, 2012). The 5 year survival rate lowers to 47 percent (Lippman, 2005). The tumor could be between 2 and 5 centimeters but there is still no distant spreading at this point (ACS, 2012). In stage IIIB the tumor has extended to the chest wall but there is still no distant metastases (Lippman, 2005). The 5 year survival rate lowers again to a 44 percent (Lippman, 2005). In stage IV the cancer can be any size (any T) and may or may not have spread to nearby lymph nodes (any N) (ACS, 2012). It has spread to distant organs or to lymph nodes far from the breast (M1) (ACS, 2012). The most common sites of spread are the bone, liver, brain, or lung (ACS, 2012). The survival rate lowers to 14 percent (Lippman, 2005). Prevention Methods Three ways to prevent breast cancer are by maintaining a healthy weight, avoiding alcohol consumption, and getting an annual mammogram (Reynolds, 2010). Mammogram screening, early diagnosis and better treatments have all contributed to the reduction in breast cancer cases by around 2 percent a year and the improved survival rate in the U. S. (Reynolds, 2010). Experts say now the focus needs to shift on improving personal lifestyle habits to prevent the disease even more (Reynolds, 2010). Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread (NCI, 2010). A medical team found an 11 percent lower risk of breast cancer in those women consuming the more healthful diet, including more whole grains, fruits and vegetables and less fatty, processed foods (Reynolds, 2010). They also found that those consuming large amounts of alcohol had a 21 percent increased risk (Reynolds, 2010). Drinking alcohol during adolescence has been linked to an increased risk of breast cancer, especially for girls with a family history of the disease (Reynolds, 2010). Exercise also plays a role in the reduction of breast cancer risk (Reynolds, 2010). In one study from the Women’s Health Initiative, as little as 1. 25 to 2. 5 hours per week of brisk walking reduced a woman’s risk by 18 percent (Reynolds, 2010). Walking 10 hours a week reduce the risk more (Reynolds, 2010). Diet and exercise can lead to weight reduction, another positive lifestyle change that can influence breast cancer disease risk (Reynolds, 2010). Many breast cancers are fueled by estrogen, a hormone produced in fat tissue (Reynolds, 2010). Experts suspect that more fat tissue equals more estrogen resulting in more cases of breast cancer that could possibly be avoided (Reynolds, 2010). Genetic ; Hereditary Influence According to researchers, the mutations in the gene, which is called FGFR2, raise the risk of breast cancer by 20 to 60 percent. (Metcalf ; Metcalf, 2008). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. omen, making it the first truly common breast cancer susceptibility gene (Metcalf ; Metcalf, 2008). Women with faulty copies of the genes BRCA1 or BRCA2 have 50 percent to 85 percent chance of getting breast cancer in their lifetimes, but they are rare genes and only account for 5 percent to possibly 10 percent of breast cancer cases (Metcalf ; Metcalf, 2008). Only 7% of all breast cancers are hereditary (Hirshaut ; Pressman, 2008). Of these hereditary cancers, 45% is caused by BRCA1 while 35% is caused by BRCA2 (Hirshaut ; Pressman, 2008). (Hirshaut ; Pressman, 2008). Variations of the  BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, and  TP53  genes increase the risk of developing breast cancer (Chen, 2007). The  AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, and  RAD51  genes are associated with breast cancer (Chen, 2007). Cancers occur when a buildup of genetic mutations in critical genes – those that control cell growth and division or the repair of damaged DNA – allow cells to grow and divide uncontrollably to form a tumor (Honrado, Osorio, Palacios ; Benitez, 2006). These changes, which are called somatic mutations, are not inherited (Honrado, Osorio, Palacios ; Benitez, 2006). Less commonly, gene mutations inherited from a parent increase the risk of developing cancer (Honrado, Osorio, Palacios ; Benitez, 2006). In people with these inherited genetic changes, additional somatic mutations in other genes must occur for cancer to develop (Honrado, Osorio, Palacios ; Benitez, 2006). Additional factors that may influence a person’s risk of developing breast cancer include gender, age, ethnic background, a history of previous breast cancer, certain changes in breast tissue, and hormonal factors (Thompson ; Easton, 2004). A history of breast cancer in closely related family members is also an important risk factor, particularly if the cancer occurred at an early age (Thompson ; Easton, 2004). Women who have inherited certain mutations in these genes have a high risk of developing breast cancer, ovarian cancer, and several other types of cancer during their lifetimes (Thompson ; Easton, 2004). Inherited changes in several other genes, including CDH1, PTEN, STK11, and TP53, have been found to increase the risk of developing breast cancer (Thompson ; Easton, 2004). In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved (Walsh ; King, 2007). For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant patter, which means one copy of the altered gene in each cell is sufficient to increase a person’s chance of developing cancer (Walsh ; King, 2007). In other cases, the inheritance of breast cancer risk is unclear (Walsh ; King, 2007). It is important to emphasize that people inherit an increased risk of cancer, not the disease itself (Walsh ; King, 2007). Not all people who inherit mutations in these genes will develop cancer (Walsh ; King, 2007). Other Breast Diseases Two other diseases found in the breast other than breast carcinoma are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). Fybrocystic breast disease is a commonly used phrase to describe painful, lumpy breasts (Sacks 2011). Hormones made in the ovaries can make a woman’s breasts feel swollen, lumpy, or painful before during menstruation each month (Sacks 2011). Fibrocysitc changes in the breast with the menstrual cycle affect over half of women (Sacks, 2011). Symptoms are usually worse right before the menstrual period, and then improve after the period starts (Sacks, 2011). Symptoms can include pain in both breasts, breasts that feel swollen and heavy, pain or discomfort under the arms, and thick or lumpy breasts (Sacks, 2011). This disease can be treated with medication like acetaminophen or ibuprofen (Sacks, 2011). Breast Fat necrosis is a benign condition that can occur in your breast (Silverman. 1994). It consists of fatty tissue that has been bruised, injured, or has died (Silverman, 1994). Once fatty tissue has been injured or has died, it can gradually change into scar tissue or may collect as liquid within an oil cyst (Silverman, 1994). Fat necrosis does not lead to the development of breast cancer, but it may sometimes cause breast pain (Silverman, 1994). An area of fat necrosis in your breast may feel like a fairly hard lump, or like a section of thick skin (Silverman, 1994). The person may see some drainage from the nipple that is nearest to the bruised region (Silverman, 1994). The nipple may sometimes even pull inward a little bit or the breast skin may dimple above the lump of fat necrosis (Silverman, 1994). Each case of fat necrosis is unique, so treatments will vary but if the fat necrosis has occurred recently, using warm compresses may help it subside (Silverman, 1994). When fat necrosis causes pain, the person can use ibuprofen and aspirin, but if that doesn’t help, ask your doctor if a prescription medication may be used (Silverman, 1994). About 39,520 women in the U. S. were expected to die in 2011 from breast cancer, though death rates have been decreasing since 1990 — especially in women under 50 (â€Å"Learn about cancer,† 2011). These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness (â€Å"breastcancer. org,† 2012). References Peter, C. (2011, October 20). Medical news today. Retrieved from http://www. medicalnewstoday. com/info/cancer-oncology/ breastcancer. org. (n. d. ). (2012, March 14). Retrieved from http://www. breastcancer. org/symptoms/understand_bc/statistics. jsp Yi-Bin , C. , ; David , Z. (2011, 15 12). A. d. a. m. medical encyclopedia. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001911/ Mayo Clinic Staff. (2011, June 23). Ductal carcinoma in situ (dcis). Retrieved from http://www. mayoclinic. com/health/dcis/DS00983 Avon Foundation Breast Cancer (n. d. ). In http://www. hopkinsmedicine. org/avon_foundation_breast_center/breast_cancers_other_conditions/invasive_lobular_carcinoma. html. Stephan, P. (2008, July 24). Invasive Lobular Carcinoma. Retrieved from about. com website: http://breastcancer. about. com/od/types/p/ilc. html Dugdale, D. (2010, August 14). Pubmed. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0002267/ Martin, L. (2012, January 18). Breast cancer facts. WebMD. Retrieved from http://women. webmd. om/guide/breast-cancer-arm-yourself-with-facts National Cancer Insitute. (2012). National cancer institute. Retrieved from http://www. cancer. gov/cancertopics/pdq/treatment/malebreast/Patient/page1 Attebery, L. , Adams, J. H. , ; Weiss, M. (2011, november 22). Male breast cancer. Retrieved from http://www. breastcancer. org/symptoms/types/male_bc/ National Cancer Institute. ( 2011). Male breast cancer. Retrieved from http://www. nlm. nih. gov/medlineplus/malebreastcancer. html Wax, A. (2011). Breast cancer in men: Symptoms, causes, treatments. Retrieved from http://www. webmd. com/breast-cancer/guide/breast-cancer-men American Cancer Society. (2011, September 29). American cancer society. Retrieved from http://www. cancer. org/Cancer/BreastCancer/DetailedGuide/breast-cancer-diagnosis NCI. (2010, September 22). National cancer institute. Retrieved from http://www. cancer. gov/cancertopics/factsheet/detection/mammograms Marshall, S. (2010, November 12). Webmd. Retrieved from http://women. webmd. com/mammogram-16573 Hoffman, M. (2010 February 18). Ductal carcinoma (invasive and in situ. Retrieved from http://www. webmd. com/breast-cancer/ductal-carcinoma-invasive-in-situ ACR. (2012). Mammography facts. Retrieved from http://www. ammographysaveslives. org/facts. aspx Hirshaut, Y. , ; Pressman, P. I. (2008). Breast cancer: The complete guide. (5th ed. ). New York, NY: Bantam Dell. Radiological Society of North America. (2011, June 24). Radiologyinfo. org. Retrieved from http://www. radiologyinfo. org/en/info. cfm? pg=mammo ASCO. (2011, January 26). Breast Cancer- Male Retrieved from http://www. cancer. net/patient/Cancer Types/Breast Cancer – Male/? skid= Stoppler, M. C. (2011). Medicinenet. Retrieved from http://www. medicinenet. com/mammogram/article. html Imaginis. (2012). Breast cancer mri – magnetic resonance imaging. Retrieved from http://www. maginis. com/mri-scan/magnetic-resonance-breast-imaging-mri-mr-3 Eisenpreis, B. (1999). A young woman’s guide to breast cancer prevention. New York: The Rosen Publishing Group. Marshall, S. (2009, April 29). Breast biopsy. Retrieved from http://women. webmd. com/breast-biopsy Metcalf, T. , Metcalf, G. (2008). Perspective on diseases and disorders. (1 ed. ). Michigan: Thomson Gale. Chen, S. ( 2007, April 10). Meta-analysis of BRCA1 and BRCA2 penetrance. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Honrado, E. , Osorio, A. , Palacios, J. , Benitez, J. (2006, September 25). Pathology and gene expression of hereditary breast tumors associated with brca1, brca2 and chek2 gene mutations. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer/show/References Thompson, D. , Easton, D. (2004, July 9). The genetic epidemiology of breast cancer genes. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Walsh, T. , King, M. (2007, February 11). Ten genes for inherited breast cancer. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Marisa , W. (2011, August 03). Stages of breast cancer. Retrieved from http://www. breastcancer. org/symptoms/diagnosis/staging. jsp NCI. 2009). Breast cancer treatment (pdq). Retrieved from http://www. cancer. gov/cancertopics/pdq/treatment/breast/Patient/page2 Lippman, M. E. (2005). Cancer monthly. Retrieved from http://www. cancermonthly. com/cancer_basics/breast. asp American Cancer Society. (2012, March 06). Breast cancer. Retrieved from http://www. cancer. org/Cancer/BreastCancer/DetailedG uide/breast-cancer-staging Reynolds, D. (2010, March 26). Emaxhealth. Retrieved from http://www. emaxhealth. com/1506/98/36185/one-third-breast-cancer-cases-avoided-diet-and-exercise. html NCI. (2010, September 22). National cancer institute. Retrieved from http://www. cancer. ov/cancertopics/factsheet/detection/mammograms Sacks, D. N. (2011, November 16). Fibrocystic breast disease. Retrieved from http://www. nlm. nih. gov/medlineplus/ency/article/000912. htm Silverman, P. (1994, July). Breast fat necrosis – symptoms, causes and treatments. Retrieved from http://breastcancer. about. com/od/whenitsnotcancer/tp/Breast-Fat-Necrosis. htm American Cancer Society. U. S. Breast cancer statistics. (2011, September 29). Retrieved from http://www. cancer. org/Cancer/BreastCancer/index Hail, J. (2011, 09). National breast cancer foundation, inc.. Retrieved from http://www. nationalbreastcancer. org/About-Breast-Cancer/ Breast Cancer Breast Cancer Breast Cancer Some methods used to diagnose breast carcinoma are mammograms, MRI’s, and biopsies (NCI, 2010). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). Each stage has different prognoses with varying survival rates as well (Marissa, 2011). There are also many ways to prevent breast cancer including maintain a healthy weight, avoiding the alcohol consumption, and by getting an annual mammogram (Reynolds, 2010). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. women, making it the first truly common breast cancer susceptibility gene (Metcalf Metcalf, 2008). Other breast diseases besides breast cancer are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). These diseases do not necessarily lead to breast cancer and can be treated (Sacks, 2011; Silverman, 1994). Keywords: – breast cancer, ducts, lobules, tumor, invasive (infiltrating carcinoma), noninvasive (noninfiltrating carcinoma), Ductal Carcinoma In Situ (DCIS), Invasive Lobular Carcinoma (ILC), intraductal carcinoma, nonfunctioning breast tissue, estrogen, lymph nodes, mammogram, MRI (magnetic resonance imaging), core biopsy, somatic mutations, fine needle aspiration biopsy, stereotactic biopsy, FGFR2, BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, metastasis, fat necrosis, fibrocystic breast disease Breast Cancer Cells are the building blocks of living things and cancer grows out of normal cells in the body (Dugdale, 2010). Cancer is the uncontrolled growth of abnormal cells in the body (Dugdale, 2010). Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer doesn’t allow normal blood function by abnormal cell division in the blood stream (Peter, 2011). Normal cells in the body follow an orderly process of growth, division, and death, this is called apoptosis, and when this process breaks down, cancer begins to form (Peter, 2011). Cancer has been around since prehistoric times, and breast cancer is one of the earliest forms to have been mentioned (Eisenpreis, 1999). In the United States, breast cancer death rates are higher than those for any other cancer, besides lung cancer (breastcancer. org, 2012). Today, about 1 in 8 women (12%) will develop breast cancer in her lifetime (Martin, 2012). Breast cancer is a cancer that starts in the tissues of the breast (Yi-Bin David, 2011). In rare cases, breast cancer can start in other areas of the breast (Yi-Bin David, 2011). Breast cancer can be invasive or noninvasive (Yi-Bin David, 2011). Invasive meaning it has spread from the milk duct (lobule) to the other tissues in the breast (Eisenpreis, 1999). Noninvasive means that it has not yet invaded other breast tissue (Yi-Bin David, 2011). Types of Breast Cancer Breast cancer can begin in different areas of the breast – the ducts, the lobules, or sometimes, the tissue in between (breastcancer. org, 2012). There are several different types of breast cancer, including breast cancer in men (breastcancer. org, 2012). Some include Ductal Carcinoma In Situ, Invasive Lobular Carcinoma, and Male Breast Cancer (breastcancer. rg, 2012). Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is a noninvasive breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues of the breast (Yi-Bin David, 2011). It may progress to invasive cancer if it is left untreated (Yi-Bin David, 2011). DCIS is the earliest form of breast cancer and is usually found during a mammogram done as part of breast cancer screening (Mayo Clinic Staff, 2011). Because of the increased use of mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years (Mayo Clinic Staff, 011). When a woman has DCIS, she is at higher risk for the cancer coming back or also at higher risk for developing a new breast cancer than a person who has never had breast cancer before (breastcancer. org, 2012). Experts believe that 20 to 50% of women with DCIS will later develop an invasive breast cancer within 10 years of the DCIS diagnosis (Hoffman, 2010). The risk of lymph node involvement with ductal carcinoma in situ is only 1% to 2% so the lymph nodes under the arm do not need to be removed, as may be  the case with other types of breast cancer (Hoffman, 2010). In seven out of 10 cases, breast-conserving lumpectomies – instead of mastectomies – were an effective treatment option (Hoffman, 2010). This will depend upon the size of your tumor and the extent of its spread throughout your breast and the surrounding lymph nodes (Hoffman, 2010). While DCIS isn’t life-threatening, it does require treatment to prevent the condition from becoming invasive (Mayo Clinic Staff 2011). Most recurrences happen within 5 to 10 years after the first diagnosis and the chances of that happening are under 30 percent (breastcancer. rg, 2012). Invasive Lobular Carcinoma is an invasive type of breast cancer that begins in the milk-producing glands (lobules) of the breast (Mayo Clinic Staff, 2011). When a person has ILC, this means that the cancer cells have broken out of lobule where they started and they now have the potential to spread to other areas or tissues of the body (Mayo Clinic Staff, 2011). This type of cancer is more difficult to se e on imaging because of the way it grows with spreading branches (Hopkins, 2012). The treatments for invasive lobular carcinoma fall into two broad categories: Local and Systemic Treatment. Local treatments treat the tumor and the areas surrounding it, such as the chest and lymph nodes (breastcancer. org, 2012). Systemic treatments travel throughout the body to destroy any type of cancer cells that may have left the original tumor and traveled to other tissues to reduce the risk of the cancer coming back (breastcancer. org, 2012). ILC cells can proceed to infiltrate fatty tissue and create a web-like mass (Stephan, 2008). This web of cancer cells may feel like a thickened area of breast tissue, and may not cause concern or pain at first (Stephan, 2008). Unfortunately, if it is left undetected, ILC can develop into a mass that is about ? inch ( 2 centimeters) to about 2 inches (5 centimeters) or bigger in size, before causing more noticeable symptoms (Stephan, 2008). Breast cancer in men is a very rare disease (Attebery, Adams ; Weiss, 2011). But the truth is that boys and girls, men and women all have breast tissue (Attebery, Adams ; Weiss, 2011). Men have a small amount of nonfunctioning breasts tissue (breast tissue that cannot produce milk) that is concentrated in the area directly behind the nipple on the wall of the chest (Attebery, Adams ; Weiss, 2011). A type of breast cancer that has spread outside of the duct and into the surrounding tissue is called invasive or infiltrating carcinoma (ASC, 2012). Some symptoms that may occur in males developing breast cancer include lumps, changes to the nipple or breast skin, or discharge of fluid from the nipple (National Cancer Institute, 2011). Men who have an altered gene related to breast cancer have an increased risk of developing breast cancer (National Cancer Institute, 2012). The major problem is that breast cancer in men is more often than not diagnosed later than breast cancer in women because men are less likely to be suspicious of an abnormality in that area (Wax, 2012). Also, their small amount of breast tissue is harder to feel, making it more difficult to catch these cancers early, and allowing tumors to spread more quickly to the surrounding tissues (Wax, 2012). Breast cancer in men is detected the same way as breast cancer is detected in women – through self-examination, clinical examination, or mammography (x-ray of the breast) (ASC, 2012). Methods for Diagnosis Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms (American Cancer Society, 2011). This is why getting the recommended screening tests before any symptoms develop is so important (American Cancer Society, 2011). Three types of methods used for diagnosis are mammograms, MRI’s, and biopsies (NCI, 2010). A mammogram is a low-dose x-ray picture of the breast and can be used to check for breast cancer in women who don’t have any signs or symptoms of the disease. (NCI, 2010) The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine (Webmd, 2010). There are different types of mammograms including Screening mammograms and Diagnositc mammograms (Webmd, 2010). Mammograms detect tiny bits of calcium that develop in dead cancer cells (Hoffman, 2010). As more and more cancer cells age and die, theses calcifications grow nd on the mammogram, they appear as a shadowy area (Hoffman, 2010). Current guidelines from the American College Radiology, the American Cancer Society, and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40, even if they have no symptoms or family history of breast cancer (ACR, 2010). For every 1,000 women who have screening mammogram: 100 are recalled to get more mammogr aphy or ultrasound images, 20 are recommended for needle biopsy and 5 are diagnosed with breast cancer (ACR, 2010). A mammography unit is a rectangular box that houses the tube in which x-rays are produced (Radiological Society of North America, 2011). Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate (Radiological Society of North America, 2011). A brief medical history and a history of specific problems related to the breast, such as pain or a palpable lump (one that is felt), is obtained prior to the mammogram (Stoppler, 2011). All jewelry and clothing in the chest and breast area are removed prior to the mammogram (Stoppler, 2011). The patient’s breasts are then placed on a firm flat panel and a gentle, but firm pressure is applied to the breast with another panel, resulting in compression of the breast between the two panels (Stoppler, 2011). The compression of the breast is necessary to obtain quality mammograms and spreads the breast tissue out so that the x-ray image displays the inner breast tissue with good resolution (Stoppler, 2011). Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them (Radiological Society of North America, 2011). As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black (Radiological Society of North America, 2011). The results of the mammogram can be given to the patient either by the radiologist at the completion of the mammogram or by the patient’s doctor who ordered the mammogram (Stoppler, 2011). An abnormal mammogram does not mean you have cancer (Stoppler, 2011). In some cases, it may just be an area of thicker or denser breast tissue, a cyst, or a benign lump such as a fibro adenoma (Stoppler, 2011). Unlike mammography which uses low dose x-rays to produce an image of the breast, MRI (Magnetic Resonance Imaging) uses powerful magnetic fields and radio waves to create images of the breast (Imaginis, 2012). The MRI system has the ability to switch magnetic fields and radio waves to achieve views in any plane and from any orientation while x-ray mammography requires re-orientation of the breast and mammography system for each view desired (Imaginis, 2012). MRI is a huge magnet and the woman gets put in the middle of the magnet; the magnetic field is turned on and then turned off again (Eisenpreis, 1999). The way the magnetized cells return to normal gives an image (Eisenpreis, 1999). The MRI finds lumps better than it tells whether or not they are cancerous (Eisenpreis, 1999). However, MRI can be good at showing how big a cancer is, once it has been found on the mammogram (Eisenpreis, 1999). A breast biopsy removes a sample of breast tissue that is looked at under a microscope to check for breast cancer and is usually done to check a lump found during a breast examination or a suspicious area found on a mammogram, ultrasound, or magnetic resonance imaging (MRI) (Marshall, 2009). During a fine-needle aspiration biopsy, the doctor inserts a thin needle into a lump and removes a sample of cells or fluid (Marshall, 2009). Nowadays, doctors might have decided to do something called stereotactic biopsy, where a patient lies on a table, with her breasts hanging down (Eisenpreis, 1999). A mammogram is taken to show where the lump is and a device holding a needle quickly shoots in and removes a few cells from the lesion (Eisenpreis, 1999). There is also something called a core biopsy that uses a larger needle to take out a piece of tissue, instead of just cells (Eisenpreis, 1999). A doctor numbs your skin with a shot of numbing medicine where the biopsy needle will be inserted and once the area is numb, a small cut is made in the skin from where the needle with a special tip is inserted into breast tissue (Marshall, 2009). Three to twelve samples will be taken to acquire the most accurate results (Marshall, 2009). Classifications and Associated Prognoses The stages of breast cancer are usually expressed as a number on a scale of 0 through IV – with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body (Marisa, 2011). Cancer stage is based on four characteristics; the size of the cancer, hether the cancer is invasive or non-invasive, whether the cancer is in the lymph nodes, whether the cancer has spread to other parts of the body beyond the breast (Marisa, 2011). Sometimes doctors use the term â€Å"locally advanced† or regionally advanced† to refer to large tumors that involve the breast skin, underlying chest structures, changes to the breast’s shape, and lymph node enlargement that is visible or that the doctor can feel during an exam (Marisa , 2011). The three ways that cancer spreads in the body are: Through tissue where cancer invades surrounding normal tissue, through the lymph system where the cancer invades the lymph system and travels through the lymph vessels to other places in the body, and through the blood, where cancer invades the veins and capillaries and travels through the blood to other places in the body (NCI, 2009). When cancer cells break away from the primary (original) tumor and travel through the lymph nodes or blood to other places in the body, another (secondary) tumor may form (NCI, 2009). This process is called metastasis (NCI, 2009). The stage of the breast cancer can help the patient and the doctor understand the prognosis (the most likely outcome of the disease) and make decisions about treatment, along with all the other results in the pathology report (Marisa, 2011). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). The TNM staging system classifies cancers based on their T, N, and M stages (ACS, 2012). The letter â€Å"T† followed by a number 0 to 4 describes the tumor’s size and spread to the skin or to the chest wall under the breast (ACS, 2012). The letter â€Å"N† followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected. The letter â€Å"M† followed by a 0 or 1 indicates whether the cancer has spread to distant organ (ACS, 2012). There are typically five stages (0 to 4) with sub-stages that indicate the prognosis for breast cancer (Lippman, 2005). Stage 0 where the carcinoma is insitu and no lymph nodes are affected had 99 percent 5 year survival rate (ACS, 2012). Stage IA also has a high rate, 92 percent, in which the tumor is equal to 2 centimeters (ACS, 2012). In stage IB, the tumor is 2 centimeters with micro metastases in 1 to 3 axillary lymph nodes but the cancer has not spread to distant sites (ACR, 2012). In stage IIA, the cancer cells have moved to the ipsilateral nodes and the 5 year survival rate lowers to 82 percent (Lippman, 2012). In stage IIB, the cancer cells have spread to movable ipsilateral nodes and the tumor is over 5 centimeters (Lippman, 2012). The 5 year survival rate lowers to 65 percent (ACS, 2012). In stage IIIA, there is no evidence of a primary tumor and no distant spreading (ACS, 2012). The 5 year survival rate lowers to 47 percent (Lippman, 2005). The tumor could be between 2 and 5 centimeters but there is still no distant spreading at this point (ACS, 2012). In stage IIIB the tumor has extended to the chest wall but there is still no distant metastases (Lippman, 2005). The 5 year survival rate lowers again to a 44 percent (Lippman, 2005). In stage IV the cancer can be any size (any T) and may or may not have spread to nearby lymph nodes (any N) (ACS, 2012). It has spread to distant organs or to lymph nodes far from the breast (M1) (ACS, 2012). The most common sites of spread are the bone, liver, brain, or lung (ACS, 2012). The survival rate lowers to 14 percent (Lippman, 2005). Prevention Methods Three ways to prevent breast cancer are by maintaining a healthy weight, avoiding alcohol consumption, and getting an annual mammogram (Reynolds, 2010). Mammogram screening, early diagnosis and better treatments have all contributed to the reduction in breast cancer cases by around 2 percent a year and the improved survival rate in the U. S. (Reynolds, 2010). Experts say now the focus needs to shift on improving personal lifestyle habits to prevent the disease even more (Reynolds, 2010). Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread (NCI, 2010). A medical team found an 11 percent lower risk of breast cancer in those women consuming the more healthful diet, including more whole grains, fruits and vegetables and less fatty, processed foods (Reynolds, 2010). They also found that those consuming large amounts of alcohol had a 21 percent increased risk (Reynolds, 2010). Drinking alcohol during adolescence has been linked to an increased risk of breast cancer, especially for girls with a family history of the disease (Reynolds, 2010). Exercise also plays a role in the reduction of breast cancer risk (Reynolds, 2010). In one study from the Women’s Health Initiative, as little as 1. 25 to 2. 5 hours per week of brisk walking reduced a woman’s risk by 18 percent (Reynolds, 2010). Walking 10 hours a week reduce the risk more (Reynolds, 2010). Diet and exercise can lead to weight reduction, another positive lifestyle change that can influence breast cancer disease risk (Reynolds, 2010). Many breast cancers are fueled by estrogen, a hormone produced in fat tissue (Reynolds, 2010). Experts suspect that more fat tissue equals more estrogen resulting in more cases of breast cancer that could possibly be avoided (Reynolds, 2010). Genetic ; Hereditary Influence According to researchers, the mutations in the gene, which is called FGFR2, raise the risk of breast cancer by 20 to 60 percent. (Metcalf ; Metcalf, 2008). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. omen, making it the first truly common breast cancer susceptibility gene (Metcalf ; Metcalf, 2008). Women with faulty copies of the genes BRCA1 or BRCA2 have 50 percent to 85 percent chance of getting breast cancer in their lifetimes, but they are rare genes and only account for 5 percent to possibly 10 percent of breast cancer cases (Metcalf ; Metcalf, 2008). Only 7% of all breast cancers are hereditary (Hirshaut ; Pressman, 2008). Of these hereditary cancers, 45% is caused by BRCA1 while 35% is caused by BRCA2 (Hirshaut ; Pressman, 2008). (Hirshaut ; Pressman, 2008). Variations of the  BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, and  TP53  genes increase the risk of developing breast cancer (Chen, 2007). The  AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, and  RAD51  genes are associated with breast cancer (Chen, 2007). Cancers occur when a buildup of genetic mutations in critical genes – those that control cell growth and division or the repair of damaged DNA – allow cells to grow and divide uncontrollably to form a tumor (Honrado, Osorio, Palacios ; Benitez, 2006). These changes, which are called somatic mutations, are not inherited (Honrado, Osorio, Palacios ; Benitez, 2006). Less commonly, gene mutations inherited from a parent increase the risk of developing cancer (Honrado, Osorio, Palacios ; Benitez, 2006). In people with these inherited genetic changes, additional somatic mutations in other genes must occur for cancer to develop (Honrado, Osorio, Palacios ; Benitez, 2006). Additional factors that may influence a person’s risk of developing breast cancer include gender, age, ethnic background, a history of previous breast cancer, certain changes in breast tissue, and hormonal factors (Thompson ; Easton, 2004). A history of breast cancer in closely related family members is also an important risk factor, particularly if the cancer occurred at an early age (Thompson ; Easton, 2004). Women who have inherited certain mutations in these genes have a high risk of developing breast cancer, ovarian cancer, and several other types of cancer during their lifetimes (Thompson ; Easton, 2004). Inherited changes in several other genes, including CDH1, PTEN, STK11, and TP53, have been found to increase the risk of developing breast cancer (Thompson ; Easton, 2004). In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved (Walsh ; King, 2007). For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant patter, which means one copy of the altered gene in each cell is sufficient to increase a person’s chance of developing cancer (Walsh ; King, 2007). In other cases, the inheritance of breast cancer risk is unclear (Walsh ; King, 2007). It is important to emphasize that people inherit an increased risk of cancer, not the disease itself (Walsh ; King, 2007). Not all people who inherit mutations in these genes will develop cancer (Walsh ; King, 2007). Other Breast Diseases Two other diseases found in the breast other than breast carcinoma are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). Fybrocystic breast disease is a commonly used phrase to describe painful, lumpy breasts (Sacks 2011). Hormones made in the ovaries can make a woman’s breasts feel swollen, lumpy, or painful before during menstruation each month (Sacks 2011). Fibrocysitc changes in the breast with the menstrual cycle affect over half of women (Sacks, 2011). Symptoms are usually worse right before the menstrual period, and then improve after the period starts (Sacks, 2011). Symptoms can include pain in both breasts, breasts that feel swollen and heavy, pain or discomfort under the arms, and thick or lumpy breasts (Sacks, 2011). This disease can be treated with medication like acetaminophen or ibuprofen (Sacks, 2011). Breast Fat necrosis is a benign condition that can occur in your breast (Silverman. 1994). It consists of fatty tissue that has been bruised, injured, or has died (Silverman, 1994). Once fatty tissue has been injured or has died, it can gradually change into scar tissue or may collect as liquid within an oil cyst (Silverman, 1994). Fat necrosis does not lead to the development of breast cancer, but it may sometimes cause breast pain (Silverman, 1994). An area of fat necrosis in your breast may feel like a fairly hard lump, or like a section of thick skin (Silverman, 1994). The person may see some drainage from the nipple that is nearest to the bruised region (Silverman, 1994). The nipple may sometimes even pull inward a little bit or the breast skin may dimple above the lump of fat necrosis (Silverman, 1994). Each case of fat necrosis is unique, so treatments will vary but if the fat necrosis has occurred recently, using warm compresses may help it subside (Silverman, 1994). When fat necrosis causes pain, the person can use ibuprofen and aspirin, but if that doesn’t help, ask your doctor if a prescription medication may be used (Silverman, 1994). About 39,520 women in the U. S. were expected to die in 2011 from breast cancer, though death rates have been decreasing since 1990 — especially in women under 50 (â€Å"Learn about cancer,† 2011). These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness (â€Å"breastcancer. org,† 2012). References Peter, C. (2011, October 20). Medical news today. Retrieved from http://www. medicalnewstoday. com/info/cancer-oncology/ breastcancer. org. (n. d. ). (2012, March 14). Retrieved from http://www. breastcancer. org/symptoms/understand_bc/statistics. jsp Yi-Bin , C. , ; David , Z. (2011, 15 12). A. d. a. m. medical encyclopedia. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001911/ Mayo Clinic Staff. (2011, June 23). Ductal carcinoma in situ (dcis). Retrieved from http://www. mayoclinic. com/health/dcis/DS00983 Avon Foundation Breast Cancer (n. d. ). In http://www. hopkinsmedicine. org/avon_foundation_breast_center/breast_cancers_other_conditions/invasive_lobular_carcinoma. html. Stephan, P. (2008, July 24). Invasive Lobular Carcinoma. Retrieved from about. com website: http://breastcancer. about. com/od/types/p/ilc. html Dugdale, D. (2010, August 14). Pubmed. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0002267/ Martin, L. (2012, January 18). Breast cancer facts. WebMD. Retrieved from http://women. webmd. om/guide/breast-cancer-arm-yourself-with-facts National Cancer Insitute. (2012). National cancer institute. Retrieved from http://www. cancer. gov/cancertopics/pdq/treatment/malebreast/Patient/page1 Attebery, L. , Adams, J. H. , ; Weiss, M. (2011, november 22). Male breast cancer. Retrieved from http://www. breastcancer. org/symptoms/types/male_bc/ National Cancer Institute. ( 2011). Male breast cancer. Retrieved from http://www. nlm. nih. gov/medlineplus/malebreastcancer. html Wax, A. (2011). Breast cancer in men: Symptoms, causes, treatments. Retrieved from http://www. webmd. com/breast-cancer/guide/breast-cancer-men American Cancer Society. (2011, September 29). American cancer society. Retrieved from http://www. cancer. org/Cancer/BreastCancer/DetailedGuide/breast-cancer-diagnosis NCI. (2010, September 22). National cancer institute. Retrieved from http://www. cancer. gov/cancertopics/factsheet/detection/mammograms Marshall, S. (2010, November 12). Webmd. Retrieved from http://women. webmd. com/mammogram-16573 Hoffman, M. (2010 February 18). Ductal carcinoma (invasive and in situ. Retrieved from http://www. webmd. com/breast-cancer/ductal-carcinoma-invasive-in-situ ACR. (2012). Mammography facts. Retrieved from http://www. ammographysaveslives. org/facts. aspx Hirshaut, Y. , ; Pressman, P. I. (2008). Breast cancer: The complete guide. (5th ed. ). New York, NY: Bantam Dell. Radiological Society of North America. (2011, June 24). Radiologyinfo. org. Retrieved from http://www. radiologyinfo. org/en/info. cfm? pg=mammo ASCO. (2011, January 26). Breast Cancer- Male Retrieved from http://www. cancer. net/patient/Cancer Types/Breast Cancer – Male/? skid= Stoppler, M. C. (2011). Medicinenet. Retrieved from http://www. medicinenet. com/mammogram/article. html Imaginis. (2012). Breast cancer mri – magnetic resonance imaging. Retrieved from http://www. maginis. com/mri-scan/magnetic-resonance-breast-imaging-mri-mr-3 Eisenpreis, B. (1999). A young woman’s guide to breast cancer prevention. New York: The Rosen Publishing Group. Marshall, S. (2009, April 29). Breast biopsy. Retrieved from http://women. webmd. com/breast-biopsy Metcalf, T. , Metcalf, G. (2008). Perspective on diseases and disorders. (1 ed. ). Michigan: Thomson Gale. Chen, S. ( 2007, April 10). Meta-analysis of BRCA1 and BRCA2 penetrance. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Honrado, E. , Osorio, A. , Palacios, J. , Benitez, J. (2006, September 25). Pathology and gene expression of hereditary breast tumors associated with brca1, brca2 and chek2 gene mutations. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer/show/References Thompson, D. , Easton, D. (2004, July 9). The genetic epidemiology of breast cancer genes. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Walsh, T. , King, M. (2007, February 11). Ten genes for inherited breast cancer. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Marisa , W. (2011, August 03). Stages of breast cancer. Retrieved from http://www. breastcancer. org/symptoms/diagnosis/staging. jsp NCI. 2009). Breast cancer treatment (pdq). Retrieved from http://www. cancer. gov/cancertopics/pdq/treatment/breast/Patient/page2 Lippman, M. E. (2005). Cancer monthly. Retrieved from http://www. cancermonthly. com/cancer_basics/breast. asp American Cancer Society. (2012, March 06). Breast cancer. Retrieved from http://www. cancer. org/Cancer/BreastCancer/DetailedG uide/breast-cancer-staging Reynolds, D. (2010, March 26). Emaxhealth. Retrieved from http://www. emaxhealth. com/1506/98/36185/one-third-breast-cancer-cases-avoided-diet-and-exercise. html NCI. (2010, September 22). National cancer institute. Retrieved from http://www. cancer. ov/cancertopics/factsheet/detection/mammograms Sacks, D. N. (2011, November 16). Fibrocystic breast disease. Retrieved from http://www. nlm. nih. gov/medlineplus/ency/article/000912. htm Silverman, P. (1994, July). Breast fat necrosis – symptoms, causes and treatments. Retrieved from http://breastcancer. about. com/od/whenitsnotcancer/tp/Breast-Fat-Necrosis. htm American Cancer Society. U. S. Breast cancer statistics. (2011, September 29). Retrieved from http://www. cancer. org/Cancer/BreastCancer/index Hail, J. (2011, 09). National breast cancer foundation, inc.. Retrieved from http://www. nationalbreastcancer. org/About-Breast-Cancer/ Breast Cancer Breast Cancer

Analyzing a visual Argument Essay Example | Topics and Well Written Essays - 750 words

Analyzing a visual Argument - Essay Example ting units together with a refashioned bumper and front grille so as to adopt a similar rounder, smoother style, just like the one tailored for the Range Rover model of 2010. Discovery 4 also has got body-colored bumpers and wheel arches just like Discovery 3.Generally there are optional lamps that can run during the day even as LED lights are prominently featured in both rear and front lamp units. The interior of LR4 is also redesigned, in line with other new styles that have been introduced elsewhere in other LR ranges for 2010.Thus; there is an update of the instrument cluster having a redesigned analogue tachometer as well as speedometer gauges for enhanced clarity. Consequently, the fuel /analogue temperature gauges of the preceding model have as well as the information electronic display been substituted by a singular TFT screen able to display information in a variety of formats and modes. In addition, the interior has further been enhanced by a redesigned centre console that comprises of simplified and redesigned controls and switches. The LR4 has also got a new kind of seat design as well as a broader range of obtainable interior materials-even those that previously were a preserve of models of Range Rover. The main objective of redesigning the interior was so as to lift the car upmarket; having higher-specification models whose main target is the executive and luxury markets. Most of the changes made to this vehicle are mechanical. The land Rover Discovery4 has got 2 engines from Jaguar LR’s ‘Gen III’ range. This new version, therefore is characterised by 2 similar advanced turbochargers .This system offers superior output than the previous engine as well as reduces carbon dioxide emissions by about 10%.An enhanced version of the ZF 6 speed sequential/automatic gearbox is now fixed. It comprises of taller gearing so as to capitalize on new engine’s superior torque output as well as an up to date lock-up system to additionally reduce consumption

Expending the exhaustion doctrine to publicity in Dior v Evora (1997) Essay

Expending the exhaustion doctrine to publicity in Dior v Evora (1997) ECR I-6013 was a crucial mistake, as it inevitably damages the essential function of the trade mark. Discuss - Essay Example and logos does not only enable business owners to protect their investments on a specific and distinct brand name but also gives the marketed goods under a trademark an identity which is distinguish from other similar products and services3. It also gives them the legal right to sue anyone who uses the trademark in an illegal manner.4 Once a trademark is completely registered, a person or a company will automatically have a legal protection against those people who would copy or imitate their product signs and symbols.5 In other words, a fraud may occur in case another individual or business entity is uses any signs or symbols that have already been registered under the trademark law.6 In general, the IP protection law has been established in order to ensure that every creative individual who were able to invent a distinctive idea, design, or a product will continuously get credit for their effort and achievements. Trademarks which falls under the category of IPRs, is being represented with a symbol  ® or â„ ¢ after a company name, logo, pictures, a slogan, or a combination of these.7 In general, a trademark serves the purpose of protecting signs and symbols that are being identified with a specific goods and services that belongs to an individual, a business organization or even the government.8 In the process of having legal protection, business owners could retain an exclusive right over the use of a registered mark. Likewise, it also provides them the authority to allow other people to use the registered mark in exchange of a monetary payment or purely by consent. Unlike the intellectual property right law which is believed to promote monopolistic competition within the domestic and international markets9, competition law promotes free trade and healthy competition among the local and international businesses10. Since competition law which includes the concept of parallel import is very much focused on eliminating and reducing the cases of monopolistic

Letters From The Samantha :: essays research papers

An interesting short story is "Letters from The Samantha" by Mark Helpin. This story tells the fascinating tale, in the form of never sent letters, of an ape brought aboard an iron-hulled sailing ship in 1909 by Samson Low, the ship’s captain. Although the author makes a point to tell the reader, through Samson Low, that the animal does not symbolize anything or mean anything, in fact, "He stands for nothing" (280), several arguments can be made to contradict this. One could argue that the ape symbolized the untamed and rarely used wild side of Samson Low through a comparison of their personalities, appearances, and the way they are treated by others. Samson Low was a captain of a ship owned by the Green Star Line. He is a stickler for rules and the proper code of conduct. When writing to his company, he reminds them of "the complete absence of disciplinary action against me" (271). This serves to highlight that he has never been in trouble or bro ken the rules. He is comfortable and comforted by his pattern of obedience and thinks others must be as well: "Though my subordinates sometimes complain, they are grateful no doubt, for my firm rule and tidiness" (271). His ship is always on time or even ahead of schedule. The picture painted is of a steady, reliable, conservative man who always does the appropriate thing in a situation. However, a typhoon the ship sails through reveals a different, less predictable side. When describing the typhoon, Samson thinks, "I confess that I have wished to be completely taken up by such a thing, to be lifted into the clouds†¦" (272). This is hardly the thought of a truly buttoned-down man. He also imagines surrendering to the seas, "But I have not, and will not." (272). While he seems content with his life, Samson Low’s secret yearnings sometimes show through. It is because of this Samson seems jealous of the ape and the things it has experienced. Sa mson has only dreamed while the ape has actually lived. The ape, when first aboard, climbs the rigging to the highest point from there he has a total view of the ship below and all that goes on much like a "pharaonic" captain would do. While in the rigging the ape shrieks and hollers frightening the crew until the captain climbs up to it.

Heavy Metal Music

Imagine, if you will, being surrounded by millions of people, waiting in anticipation for the band to come on. You can't breathe because the people are being squeezed into you by their neighbors. You are sweating, trying to catch every bit of oxygen you can from the air, while others are jumping up and down, hitting you as they wait for the band. Finally, the band comes on stage and you are excited, and they start with: (play music here). This, is what heavy metal music is all about. I have been listening to heavy metal music since I was an infant. My first CD was Metallica's Master of Puppets CD that my dad let me have. I have researched many heavy metal bands as the years have gone by. I know what you are thinking, what does heavy metal music have to do with me? Well, metal music is all around you. You can walk down the street and hear someone's radio playing it. You can hear it in some rap songs, like; â€Å"Bring the Noize† by Public Enemy with Anthrax, and â€Å"Let's Go† by Trick Daddy who took the intro of â€Å"Crazy Train† by Ozzy Osbourne, and put a beat over it. You can even hear it in country music from Cross Canadian Ragweed as they took a solo by heavy metal guitarist Dimebag Darrell and put it in their song, â€Å"Dimebag.† Heavy metal music is one of the most copied genres of music out there. Today I am going to tell you about what heavy metal really is, the beginning of heavy metal, and the impact that heavy metal has had on today's society. First, what is heavy metal music? Dee Snider, the spokesman of all that is heavy metal, defines metal as, â€Å"Drum-pounding-, bass-booming-, guitar-distorted-, and singer-belting-music.† That is the worldwide definition of heavy metal. Heavy metal brings together three genres of music, blues, psychedelic rock, and classical music. Early bands included keyboards, or organs, into their music, but recent bands have gone away from using the keyboard. Heavy metal usually, but not always, contains a single formula. A drummer, a bassist, a rhythm guitarist, a lead guitarist, and a singer, who may or may not play some kind of instrument. With this formula, it is obvious that their music is purely based on the instruments. A heavy metal drummer uses a larger drum setup than most other rock genres. The singer of the heavy metal band is very important, equally important as the guitarists. The singers can have a large vocal range, like that of Ronnie James Dio of the band Rainbow, or they can be mellow like that of James Hetfield of Metallica. The guitarists' high distortion is the key to metal music. This gives it the heavy metal â€Å"sound.† Also, unlike many other genres of rock, the bassist is important to the band. It is not uncommon to hear a bassist throw in his/her own solo into the song. As a whole, the band uses very high volume. The louder the music, the better. Now that you know what heavy metal is, I will tell you about the beginning of it. The start of metal can be very confusing. For instance, Deena Weinstein, in her book, Heavy Metal: The Music and Its Culture, credited Black Sabbath with the start of heavy metal, but this is not entirely true. Carlos M. Pozo, in his book Caucasion Power Blues, wrote, â€Å"Blue Cheer's cover of â€Å"Summertime Blues† by Eddie Cochrane, is the first heavy metal song.† â€Å"In-A-Gadda-Da-Vida† by Iron Butterfly is another one of the earliest heavy metal songs. Then, in 1969, came Black Sabbath. At about the same time as Sabbath, another big metal band emerged. This band went by the name of Led Zeppelin. Even though these two bands did not start heavy metal, they brought it to the public. Sabbath and Zeppelin are two of the most popular rock, let alone heavy metal, bands of all time. They faced much criticism at first, but as more people hated them, others started loving them. These people were the â€Å"rebels†, the ones that did not want to listen to their parents because it was their lives, not their parents'. Because of these â€Å"rebels,† heavy metal's popularity has grown drastically over the years. Regardless of what their parents said, they continued buying heavy metal albums, sometimes they even bought more than usual, in spite of their parents. This sparked rise of heavy metal in later years. That is how heavy metal began, now it is time to learn about the impact it has had on society. Heavy metal has had a drastic impact on society today. According to Encyclopedia Metallica, which is an online website that displays news about Metallica, â€Å"All Metallica albums are banned in Jordan because newspapers called them â€Å"satanists† and â€Å"devil-worshipers.† People were listening to Metallica and destroying things around town, so they had to ban Metallica. During the '80s, parents disliked the heavy metal music so much, they decided to try to get some kind of warning on the albums. This resulted in the Parental Advisory sticker on every explicit CD you see today. This is not the only impact that heavy metal music has had. In 1990, heavy metal band, Judas Priest, were sued because the parents of James Vance, and Ray Belknap believed that Priest's music contained subliminal messages that forced these two men to commit suicide. It was found that these two men were highly suicidal before finding Judas Priest, therefore, Priest were found innocent. This is, yet, another situation where the parents dislike heavy metal so much, that they blame the bands for the death of their children. Sadly, this is a recurring action taken by the parents that will not stop until the hate of heavy metal music is gone, which will not happen any time soon. This is the impact that heavy metal has had on society. Heavy metal music has been alive since the '60s. Even though Black Sabbath are credited with being the first worldwide popular heavy metal band, they did not start it. Heavy metal has become quite popular since it began, and has changed society from day one. So, today you learned what heavy metal music is, about the beginning of heavy metal, and it's impact on society. So, I leave you with a quote from AC/DC, â€Å"For those about to rock, we salute you!†

The Legacy Of The Golden State - 1633 Words

The Golden State has been portrayed and imagined as a state that had the potential of becoming a beacon of modernity, originality and beauty. Boosters of the region sold California as a romantic destination that rivaled scenarios from the country it tried to emulate, Spain. This imagination brought forth growth, both economically and socially, to cities like Los Angeles but with danger and controversy in their way. In the process of building a defining image for California, these boosters embraced but erased the people and cultures that existed in California before the arrival of the Anglos. They essentially took away what these cultures had built upon in California and took them as their own while keeping these cultures out of the picture. This racial exclusion persisted throughout 20th century California. One city where this exclusion was persistent was Los Angeles which throughout much of its 20th century history, the habitants of Los Angeles practiced racial exclusion both explic itly and implicitly. Such arguments like the rise of suburbanization, natural disasters having a double standard in terms of social class and the exclusion of the races in California’s history warrant that the city and state alike had problems in dealing with racial tensions; so much so that the booster tried so seemingly to hide from everyone else. Regardless, everyone living in Southern California was put in danger by these boosters who kept information about the nature of the area from all itsShow MoreRelatedImpact Of Sports In The 1920s884 Words   |  4 Pagesâ€Å"The 1920s has been called the Golden Age of American Sports†(Sumner par 1). The roaring twenties had many sports icons and many sports upcomings. 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During his lifetime, he studied variety of subjects and brought knowledge to all aspects (Blackburn). He viewed that as a human, a subject who’s determined goal is to reach virtue and Arà ªte, is connected with nature and its balance (Golden Mean). Aristotle also viewed a good life as political questions. He analyzed that human’s basic shape of desire and aim is formed at the age of six (Hare). The good life, then, was defined by Aristotle as ‘the activity of the soul in accordance withRead MoreCase Study : Heineken s Beer Market1607 Words   |  7 Pages MGMT720 Project Team 4 Paper Topic: Heineken in Myanmar Assignment C: Personal trust building Matthew Luk Introduction: The Myanmar’s beer market that has long been dominated by Myanmar Brewery, a state-owned firm which is closely connected with the Myanmar military, with ~80 percent market share. 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Instead the legacy of his life remains with the the individuals he has a made an impact on. His love rests in the soils of the earth as he has reaped the rewards of kindness and rewarded to every individual. I imagine that as my Grandfather passes the age the eighty five years old a golden cord is tied between him and my great grandmother. This golden cord is vital lifeline between theRead MoreExplain the Archaeological/Written Evidence of the Uniqueness of Tutankhamun’s Tomb in the Eighteenth Dynasty.1264 Words   |  6 PagesExplain the archaeological/written evidence of the uniqueness of Tutankhamun’s tomb in the Eighteenth Dynasty. Tutankhamun was an Eighteenth Dynasty pharaoh whose legacy extends to the present, and currently one of the best-known ancient Egyptians of all-time. The â€Å"Boy King† inherited the throne at the age of nine, his reign lasting only ten years before his sudden unexpected death. 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