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R.Ph.S Encouraged to Expand Breast Cancer Counseling

Magazine article Editor & Publisher

R.Ph.S Encouraged to Expand Breast Cancer Counseling

Article excerpt

With one out of every eight women in the United States expected to develop breast cancer and with a diagnosis of breast cancer predicted to occur every three and a half minutes, pharmacists are likely to encounter women who need information and support.

At the National Community Pharmacists Association Rx Expo '99, held recently in Ft. Lauderdale, Fla., Ronald W. Maddox, Pharm.D., dean, Campbell University School of Pharmacy, Buies Creek, N.C., provided an update on new developments in therapy and prevention. Maddox's wife, Suzan, a breast cancer survivor of eight years and owner of Maddox Oncology Products Inc., Lillington, N.C., was also on hand to discuss ways pharmacists can offer their support to enable breast cancer patients to lead quality lives.

Pointing out that it is estimated that there were 178,700 new cases of breast cancer in the United States and 43,900 deaths in 1998, Ronald Maddox said, "The good news is that if we detect breast cancer early and treat it in an aggressive fashion, we can go about controlling some of these numbers and the impact it's having on patients." In terms of detection, he recommended that women have annual physical exams and do monthly breast self-exams. They should also have mammograms, starting at age 40. Maddox said, however, that mammograms in younger patients are not as sensitive because these women have more muscle tissue.

"We've come a long way when you look at detection and evaluation," Maddox declared. He added that progress has also been made in the treatment of breast cancer. Treatment has been to remove the lymph nodes for evaluation to determine how many of them have tumors. Stage 1 breast cancer is localized to the breast. In stage 2, the cancer has migrated to the lymph nodes. "As you go in and cut lymph nodes, the surgery is dramatic," said Maddox.

Indicating that a BRCA (breast cancer) gene is associated with a high incidence of breast cancer, Maddox said that if there is breast cancer history in a woman's family, she may want to be evaluated for this gene. While there are scarce data to support a mastectomy for women having this gene, the questions arise as to whether the patient should be proactive and consider a mastectomy.

"Now, because of early detection and treatment, 75% to 90% of patients will survive more than five years. In the past, the survival rate was 50% to 60%. This is good news to pharmacists dealing with patients," Maddox said. He recommended that pharmacists be proactive in terms of providing information and suggested they use the Gail Model Assessment Tool, which estimates a woman's risk of developing breast cancer over the next five years as well as over her lifetime. …

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