Causes, Management And Perception Of Breast Cancer Among Female Students

INTRODUCTION

1.1 Background of the Study

Breast cancer is the most common cancer in women worldwide. It is also the principal cause of death from cancer among women globally. It is a leading cause of death in West Africa with approximately 30000 new cases in 2008 and more than 16000 deaths. The incidence appears to be significantly lower in Eastern Africa with approximately 18000 new cases and a corresponding 10000 deaths during the same year (Ferlay, D. Forman ‘GLOBOCAN’ 2008 v1.2). Despite the high incidence rate in western countries, 89% of women diagnosed with breast cancer are still alive 5years after their diagnosis, which is due to early detection and treatment (Parkin 2008).Worldwide breast cancer accounts for about 22% of all female cancer and 15% of cancer death among women (Edwards et al.,2002). The incidence of breast cancer is rising in every country of the world especially in developing countries such as India. In 1940, the lifetime risk of developing cancer was 5% or one in 20. (Madigan MP et al., 1995).Every woman is at a risk for breast cancer. If she lives to be 85yrs of age there is a 12% chance that she will develop breast Cancer sometimes during her lifetime. As a woman ages, her risk of developing breast cancer rises dramatically .fewer than 5% 0f cases are discovered before the age of 35yrs and majority of all breast cancer are found in women over the age of  50yrs. Many of the established risk factors are linked to oestrogens (lancet oncology, 2001).

In 2008, about 182,500 new cases of breast cancer and 67,800 of cancer in situ were diagnosed in the united state. About 40,000 women die of breast cancer each year. However2.5million breast cancer survivors have been recorded. Death of breast cancer are declining in recent years, a reflection of earlier diagnosis from screening mammograms, improving therapies and a dramatic increase in the use of hormone replacement therapy (HRT) in post-menopausal women.

1.2 Cancer

Cancer is a common disease, and more than one in three people will develop some form of cancer in their lifetime. Although more than a quarter of a million people develop cancer each year in the UK, It is predominantly a disease of the elderly with (74%) of new cases diagnosed in people aged over 60yrs. The most common single cause of death (22%) is lungs cancer, which is potentially preventable by reduction in tobacco smoking. In women, breast cancer is the most common (31%)followed by bowel cancer(12%) then lungs cancer(12%)  while in men, prostate cancer is now the most common (24%) followed by lungs cancer(15%) and then bowel cancer (14%).(Cancer research UK 2010).

1.2.1 Aetiology of cancer

The cause of cancer may be categorized as either environmental or genetic although, these may be interrelated and the cause of some cancers maybe multi factorial. Lifestyle factors play a large part in the development of many Cancers. Cigarette smoking had been identified as the single most important cause of preventable disease and premature death in the UK. The beneficial effect of stopping smoking on the cumulative risk of death from lung cancer reduces with increasing age (Doll et al., 2004).

Smoking causes about 90% of lung cancer death and the link between tobacco and cancer where establish more than 50yrs ago. The most important lifestyle factor for bowel cancer is diet while cervical cancer is primarily linked to sexual behavior through the transmissible agent human Papilloma virus (HPV) and secondarily to smoking.

1.2.2 Genetic factor

A number of rare tumors are known to be associated with an inherited predisposition where an individual is born with a marked susceptibility to cancer. This is due to the inheritance ofa single genetic mutation which may be sufficient to greatly increase the risk of one or more types of cancer. When this is prevented, the cancer cell tend to have their onset at a younger age (Garber and Offit, 2015)

1.3 Definitions of Terms

Breast cancer

Breast cancer can be defined as a cancerous growth that inhabits the tissues of the breast. In this type of cancer, the cells in the breast grow abnormally and in an uncontrolled way. (Patients medical.com)

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. The damaged cells can invade surrounding tissues but with early detection and treatment, most people continue a normal life. (Susan G. Komen)

Breast cancer occurs when cells in the breast divide and grow without their normal control. They tend to grow slowly and take a long time for the lump to be large enough to feel.

Breast cancer is defined as a disease which is caused by the development of malignant cells in the breast which originates in the lining of the milk gland or ducts of the breast. (Medical Dictionary)

Cancer

Cancer is the uncontrolled growth and spread of cells. It can affect almost any part of the body. The growth often invade surrounding tissues and can metastasize to distinct sites.(WHO definition)

Cancer involves a group of relatively normal cells dividing without the controls that usually prevent the cells from growing beyond their usual size, site and nutritional base (clinical pharmacy and therapeutics)

Cancer also known as malignant tumor or malignant neoplasm is a group of disease involving abnormal cell growth with the potential to invade or spread to other parts of the body (Wikipedia.com)

1.4 Types of Breast Cancer

There are primarily two types of breast cancer and they are named after the part of the breast in which they start;

Invasive breast cancer(lobular carcinoma)

Non invasive breast cancer (ductal carcinoma)

Invasive breast cancer: This is also known as the lobular carcinoma breast cancer. It occurs when abnormal cells from inside the milk lobes or glands break out into nearby breast tissues. The lobes are located inside the breast under the ducts. About 8% of breast cancer is lobular.

Non invasive breast cancer: This is also known as the ductal carcinoma cancer. It starts in the cells which line the breast duct beneath d nipple and areola. The abnormal cells do not spread to nearby tissues they remain in place. Although, they do not spread to tissues outside the ducts, they can develop into invasive breast cancer in which case a mastectomy may be needed and also chemotherapy can be recommended. About 85% and 90% of all breast cancer are ductal. Ductal carcinomas in situ has been suggested to be renamed ductal intraepithelial neoplasia to emphasize its non-life threatening nature (the lancet 2005, vol.365)

Less common types of breast cancer

• Inflammatory breast cancer: This uncommon type of invasive breast cancer accounts for about 1% to 3% of all breast cancers. Usually there is no single lump or tumor. Instead, inflammatory breast cancer (IBC) makes the skin on the breast looks red and feels warm. It also may give the breast skin a thick, pitted appearance that looks a lot like an orange peel. Doctors now know that these changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels in the skin. The affected breast may become larger or firmer, tender, or itchy.