By Glenna Murdock, RN, contributor
Oct. 16, 2009 - It is estimated that 200,000 cases of breast cancer will be diagnosed in the United States this year. Breast cancer is primarily a disease of women—one in eight will be diagnosed with breast cancer in her lifetime—with men comprising just one percent of newly diagnosed cases annually. Over the past three decades there have been significant advances in the diagnosis and treatment of the disease and this October ― the 25th anniversary of National Breast Cancer Awareness Month ― seems an appropriate time to look back and see how far we’ve come.
“Society’s willingness to talk more openly about the disease has been the major factor in creating an awareness of the importance of screening and early detection,” said Susan Brown, MS, RN, director of health education for Susan G. Komen for the Cure®, an organization dedicated to breast cancer research, screening, treatment, support, education and eradication.
“The organization was founded in 1982, which was about the time we began to talk about breast cancer,” Brown said. “The first Race for the Cure, which raises funds for research, was held in 1983. As a result of the awareness it generated, greater numbers of women began utilizing screenings, such as mammography, which caused the incidence of breast cancer diagnoses to increase for a few years during the 1980s. Since 1999 the incidence has decreased by two percent each year.”
Since 1983, Komen for the Cure has given $1.3 billion for research and community grants, made possible by annual Race for the Cure and Three-day Walk events, plus other fund raising efforts, As a result, the organization has played a major role in contributing to these tangible victories:
- More early detection. Today nearly 75 percent of women receive regular mammograms, compared to less than 30 percent in 1982.
- More hope. The five-year survival rate for those diagnosed with a localized, non-invasive tumor is now 98 percent. In 1982 it was 74 percent.
- More research. The federal government now funnels $900 million annually into breast cancer research, treatment and prevention as opposed to just $30 million in 1982.
- More survivors. There are 2.5 million breast cancer survivors in the United States—the largest number of survivors of any cancer.
New Breast Cancer Resources and Treatments
In the past, the breast cancer journey was one of isolation, with limited information and few sources to call upon for guidance. Today the support of those with breast cancer, their friends and family (known as co-survivors) is vastly different from what was available in 1982. Komen for the Cure, for instance, offers a helpline manned by trained counselors and oncology social workers who can make referrals and answer questions, help callers find treatment centers near them and direct them to sources for financial assistance, among other services. Hospitals often offer similar resources for those in their communities.
“As nurses, we have a tremendous opportunity to educate patients and their families,” Brown remarked, “but breast cancer research is a very dynamic, constantly changing field. It is a challenge for us to stay current and well informed.”
Brown recommends the Komen for the Cure web site as a reliable resource where nurses can find up-to-date information about the latest treatments for breast cancer. Nurses can also take a quiz on the site to test their knowledge about the disease. The quiz questions are changed quarterly.
Nurses might also recommend, and use, an early detection plan offered by The National Breast Cancer Foundation, Inc. This interactive tool sends reminders for self-exams, clinical exams and mammograms. The National Breast Cancer Awareness Month site also offers helpful information on the disease, including current news, events and advice on where to get help.
Based on ever-evolving research findings, breast cancer treatment has changed and continues to change markedly. Radical mastectomy was once the preferred treatment for all breast cancer but now is used far less than other therapies.
“Treatment is much more personalized than in the past,” stated Katherine McKenzie, Ph.D., manager of research dissemination and outreach for the California Breast Cancer Research Program, who has worked in breast cancer research for 20 years. “Whereas we were once concerned with how a tumor looked, we now use genetic samples to test for markers and receptors. This allows treatment to be customized to individual patients and their specific tumor.”
Prior to the identifying of genetic markers, it was difficult to know what tumors would respond to a certain drug therapy. Patients were often treated with drugs that were ineffective.
Compared to three decades ago, patients also are much more involved in their treatment, according to McKenzie.
“Patients are using Web sites such as www.BreastCancerTrials.org to get themselves into drug trials. They can enter their own information to find appropriate trials for which they might qualify. Women who want to be involved in breast cancer research can look for research projects that are a good match for them at www.armyofwomen.org.
“One of the critical challenges with breast cancer,” McKenzie continued, “is determining the causes. A major stumbling block is that breast cancer is very complicated and there will be many causes, not just one. Only research will get us to the breakthroughs that will teach us how to not just treat breast cancer, but prevent it.”
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