Disease Focus of the Month – Breast Cancer

Like the case in vast majority of tumors, breast cancer etiology is not yet completely understood.

The genes associated with breast cancer are BRCA-1 and BRCA-2, whose mutations are transmitted in the family with an autosomal dominant pattern. Women who have mutations in these genes have 50- 85% chance of developing breast cancer over their lifetime.

Age increases the risks of developing breast cancer and most cases occur in women around the age of 50. Women having early menarche or late menopause, nulliparous women or women who bears their first child at very late age (> 35 years) are prone to this cancer.

The hormonal regulation of breast is also related to the development of breast cancer, but mechanisms are still poorly understood. Sex hormones can act as “promoters” of the tumor if other agents “triggers” have induced malignant changes. There is no agreement on whether hormone replacement therapy (mainly estrogen) increases the risk of breast cancer in postmenopausal women.

Today, thanks to the early detection programs for breast cancer by mammography, about 80% of women who were found to have no symptoms at the time of diagnosis, were diagnosed with early stage cancer (4).

In breast cancer, diagnosis is an important part of the process and should be as accurate and early as possible. The best screening program is the combination of breast self-examination, regular gynecological exams and mammograms (4).

Finally, although most breast cancers (99%) occur in women, this disease also affects men. Predisposing risk factors in men are hyperestrogenism states, family history of breast cancer and radiation exposure (5).

Bibliography:

(1) Abella Jové M, Martínez Aguilera M. En: Torrens Sigalés R, Martínez Bueno C. Enfermería de la Mujer. 1ª ed. Madrid: DAE (Difusión Avances de Enfermería); 2001. Cap. 18 p. 389-407.
(2) Swearingen P L, Ross D G. Manual de enfermería médico-quirúrgica: intervenciones enfermeras y tratamientos interdisciplinarios. 4ª ed. Madrid: Harcourt; 2001. 932 p.
(3) Bueno Revert F. En: Donat Colomer F. Enfermería maternal y ginecológica. 1ª ed. Barcelona: Masson; 2001. Cap. 24 p. 461-485.
(4) Abella Jové M, Martínez Aguilera M. En: Torrens Sigalés R, Martínez Bueno C. Enfermería de la Mujer. 2ª ed. Madrid: DAE (Difusión Avances de Enfermería); 2009. Cap. 25 p. 497-515.
(5) Mantik Lewis S, McLean Heitkemper M, Ruff Dirksen S. Enfermería medicoquirúrgica: valoración y cuidados de problemas clínicos. 6ª ed. Madrid: Elsevier, Mosby; 2004. Cap. 50 p. 1400-142

Author: Ana Fernández-Hernández

Facultad de Enfermería y Fisioterapia
Universidad de Alcalá de Henares (Madrid)
Spain.