What Pharmacists Need to Know about Breast Cancer

By Williamson, John S; Wyandt, Christy M | Drug Topics, March 4, 2002 | Go to article overview

What Pharmacists Need to Know about Breast Cancer


Williamson, John S; Wyandt, Christy M, Drug Topics


The Department of Medicinal Chemistry and the Department of Pharmaceutics, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi

A few facts about breast cancer that everyone should know:

* Breast cancer is the most common form of cancer in U.S. women. It is the second-leading cause of cancer death for all women (after lung cancer) and the leading cause of death in women between the ages of 40 and 55.

* In the United States, one out of nine women will develop breast cancer in her lifetime.

* Every woman is at risk for breast cancer, with more than 70% of the cases occurring in women who have no identifiable risk factors.

* Mammography is the most frequent means of discovering breast cancer. Widespread use of regular screening mammography has been the primary contributor to recent improvements in the breast cancer survival rate.

* Breast self-examination has not been demonstrated to affect breast cancer survival.

* In the United States, more than 80% of biopsied breast abnormalities are found to be benign.

* Currently, 62% of breast cancers are discovered at an early, "localized" stage, and the five-year survival after treatment is 96%.

* The incidence of breast cancer increases with age, most significantly after age 40. Approximately 80% of all invasive breast cancers occur in women over age 50.

This year in the United States, the lives of approximately 192,000 women will be changed forever as they are diagnosed with breast cancer. In coping with such a diagnosis, it is not uncommon for the patient to experience a broad range of emotions, such as anger, fear, denial, frustration, loss of control, confusion, grief, loneliness, isolation, and depression. Concerns about self-image, future priorities, sexuality, family members, medical bills, and possible death are likely to surface upon receiving such unexpected and overwhelming news. In addition to being the expert on traditional cancer chemotherapies, today's pharmacist can be expected to play a crucial role in providing patients with important and timely information dealing with breast cancer, including its etiology, the statistical risks and risk factors, the traditional and cutting-edge therapies, and the detection methods.

Cancer, the disease

Cancer begins with a simple mutagenic process causing cells to multiply when new cells are no longer needed. These erroneously dividing cells generally form a tumor, which can be benign or malignant. By definition, benign tumors are not cancer; instead, it is the malignant tumors that invade and damage nearby tissues and organs. Cancer cells can break away from the primary tumor and enter the bloodstream or the lymphatic system and find a new physiological site to bind to and begin multiplying through a process called metastasis. When a malignant tumor invades nearby tissue, it is known as infiltrating or invasive cancer; when it spreads to another part of the body, the disease is called metastatic cancer. Breast cancer often metastasizes first to the lymph nodes under the arm.

The risks

Data show that the number of breast cancer cases in women aged 20-39 has been essentially stable over the past 10 years. The most significant increase in breast cancer diagnoses has been for women over 50 years old, which is thought to be due in part to detection of disease with increasing use of screening mammography.

Although some risk factors for developing breast cancer have been identified, more than 70% of cases occur in women who have no identifiable risk factors. Nevertheless, risk increases as a woman ages, if there is family history of breast cancer, if the individual has never had children or had a first child after age 30, or if there has been prior treatment with radiation therapy.

Age is the most identifiable risk factor associated with breast cancer, with more than 80% of breast cancer cases occurring in women over 50. …

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