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Breast Cancer Research

Abstract

According to the Healthy People 2020 project aiming at improving the health and well-being of females, breast cancer is a challenging disorder among women. The paper focuses on the prevalence of breast cancer among Hispanic women after menopause. Hispanic females have fewer rates of cancer occurrence in comparison with non-Hispanic. Nonetheless, the mortality rates from the disorder are greater. The critical risk factors can be age and obesity because they can provoke breast cancer. The nurses must include in the plan of patients care the explanation and discussion of the risks of obesity to affect breast cancer and to provide information regarding the appropriate diet and the number of physical exercises. At the same time, the other preventive measures can be raloxifene and tamoxifen that have proved to decrease the breast cancer rates among postmenopausal women. Moreover, in case of breast cancer occurrence, the APRN has to suggest some therapies and explain their strengths and weaknesses to the patients. Such therapies can be chemotherapy, targeted therapy, and immunotherapy. Hence, among postmenopausal Hispanic women, breast cancer is a serious challenge, and APRNs must provide all possible information regarding managing tools such as healthy food, physical activity, chemotherapy, targeted therapy, immunotherapy, raloxifene, and tamoxifen use.

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Introduction

Nowadays, breast cancer is a great problem for women from a global perspective. The US population is not an exception. To improve the general health and well-being of the population, the authorities have provided the Healthy People 2020 initiative that identifies the main health challenges. Breast cancer is one of them due to the increasing prevalence. A bright example can be Hispanic women after menopause. In general, the prevalence of breast cancer among this population is lower in comparison to the non-Hispanic women, but the mortality rate from this disorder is much greater. Therefore, it is critical to address this disease most appropriately to improve the population's health. According to the research, the greatest risk factor of breast cancer for such a population is obesity. The lack of appropriate nutrition and physical activity can affect breast cancer. Hence, among postmenopausal Hispanic women, breast cancer is a serious challenge, and APRNs must provide all possible information regarding managing tools such as healthy food, physical activity, chemotherapy, targeted therapy, immunotherapy, raloxifene, and tamoxifen use.

Breast Cancer

Healthy People are the objectives and goals set with the ten-year targets provided for guiding the national health promotion and disorder prevention attempts to improve the health of all populations in the US. Therefore, Healthy People 2020 is the fourth generation of the initiative aiming at decreasing health disparities through the health approach determinant, their tracking, and measuring, promotion of peoples' health long life duration and well-being. This initiative pays attention to the health of girls and women through addressing sixteen topics and problems. One of them is fighting breast cancer (American Cancer Society, 2015). This is a great challenge in the US. Breast cancer is a great problem from the global perspective and a highly challenging disorder for women both from psychological and physiological points of view. Therefore, breast cancer is a frequent disorder among women and it was found that 20% enhancement in breast cancer since 2008 in the world with new diagnoses of 1.7 million in 2012 (American Cancer Society, 2015). Breast cancer is a disorder group that provokes cells in the body to change and grow out of the control. Most of the cancer cell types usually form a lump called a tumor that bears the name after the body part where it has originated. Therefore, breast cancer is a great threat and challenge to female health and well-being.

Breast Cancer Prevalence among Hispanic Women after Menopause

There is a great problem with breast cancer experience among Hispanic women after menopause. The risk of breast cancer among Hispanic women is around thirty percent lower in comparison to non-Hispanic women, the risk estimate is attenuated to around 1.0 after adjustment for socioeconomic factors and screening history (Sexton et al., 2011). Therefore, age is a risk factor because older age increases the breast cancer risk, while younger age reduces this risk. Hispanic women get breast cancer diagnosis on more advanced phases and usually have larger tumors in comparison with non-Hispanic women (Sexton et al., 2011). Moreover, breast tumors among Hispanic women are more commonly estrogen receptor-negative in comparison to the non-Hispanic women and the poor prognostic factors provoke the significantly lower five-year survival rates among Hispanic women in comparison to non-Hispanic women (Sexton et al., 2011). It is possible to see the differences between populations, which is significant in rates.

The Hispanic population is great. It comprises 15% of the American population and keeps growing, but there is a lack of researches regarding the influence of breast cancer risk on the Hispanic population (Hines et al., 2010). Regarding postmenopausal women's risks, there are differences between migrants from rural and urban areas. The risk was twice higher among the US-born Hispanic women in comparison to recent migrants that lived in the US for less than ten years or came to the US at age less than forty (John, Phipps, Davis, & Koo, 2005). Furthermore, in comparison to the US-born postmenopausal women, foreign-born women gained lower breast cancer risk even after forty years of US residence. Additionally, greater breast tumors were found in the first-generation Hispanics in comparison to the US-originated Hispanics, and among postmenopausal Hispanic women from twenty-five to thirty percent lower risk remained among the long-term residents and people they came to the US before the 20 years (John et al., 2005). Therefore, such a factor has a great impact on breast cancer occurrence.

The prevalence of breast cancer among Hispanic women is quite challenging. In general, Hispanic women have a lower prevalence of breast cancer in comparison to non-Hispanic women, but at the same time, they experience greater mortality risks after the diagnosis (Hines et al., 2010). In particular, the recent statistic showed that Hispanic women die from breast cancer by 22 % more often than non-Hispanic women (Sexton et al., 2011). In the research postmenopausal Hispanic women were more likely to be related to the over breast cancer risk in comparison to the non-Hispanic women, especially menopause before the age of fifty (Hines et al., 2010). Characteristics related to the raised risk were low physical activity, not breastfeeding, earlier age at menarche, and higher body mass index. Besides, height and family history strongly affect the cancer risk increase among postmenopausal Hispanic women (Hines et al., 2010). Therefore, breast cancer is a great challenge that demands serious measures.

Therapeutic Approach

There are several therapies aimed to manage breast cancer. The researches have proved that tamoxifen can be efficiently applied for invasive berates cancer prevention. It is the selective estrogen receptor modulator, which proved to promote the reduction of breast cancer of 49% among 13000 postmenopausal women (Gobel, Triest-Robertson, & Vogel, 2009). Therefore, tamoxifen is the most efficient in preventing estrogen receptor-positive breast cancer. Women that benefited most were with the genetic predisposition for BRCA1 and BRCA2 mutation, atypical ductal hyperplasia, or LCIS history (Gobel et al., 2009). The related risks include the high thromboembolic events incidence and endometrial cancer. Therefore, this intervention is highly individualized. Moreover, raloxifene has a similar effect on reducing breast cancer (Gobel et al., 2009). It is the second-reintegration SRM approved for the reduction of postmenopausal breast cancer.

Another alternative is chemotherapy, which is a part of neoadjuvant therapy that can continue for three to six months depending on the drug used. In case the drug's working mechanism is known, the former can be applied together with other drugs for better treatment (Singh & Basu, 2015). The possible side effects can be arm nerve damage, bones weakening in the treated area, lymphedema, fatigue, tiredness, pain in the breast area, breast swelling, and skin reaction (Singh & Basu, 2015). Another effective intervention can be the targeted therapy. Current treatment includes highly specific, targeted, and non-toxic therapies that can be personalized to the individual patient's tumor. The side effects can be fatigue, alopecia, the drop in several red types of blood and white cells, sore mouth, skin rash, diarrhea, nausea, and flu-like symptoms (Singh & Basu, 2015). Hence, this approach can be effective.

Nowadays, doctors apply immunotherapy quite often. For instance, greater disorder-free survival can be found among people with high intraepithelial CD3+T lymphocytes level during treatment with adjuvant anthracycline grounded therapy, while there are no similar relations between the 5-fluorouracil, methotrexate, cyclophosphamide, and intratumoral CD#+T lymphocytes (Singh & Basu, 2015). Hence, breast cancer treatment grounds the disorder's immunogenic nature. The first step within breast cancer immunotherapy development was the providing of vaccines against the tumor-related antigens (Singh & Basu, 2015). At the same time, there are several other platforms live vaccines derived from the cell extracts or whole tumor cells, dendric cells grounded vaccines, DNA grounded vaccines, and cell-grounded vaccines (Singh & Basu, 2015). Therefore, such treatment has great potential and includes various approaches.

Another critical issue for preventing breast cancer is weight control. There is a strong connection between obesity and breast cancer risk, which a researcher can clearly see on the example of Hispanic women. It was found that the weight gains from puberty through adulthood raised the postmenopausal breast cancer risk (Sexton et al., 2015). Several types of research took place to identify the relationship between breast cancer and obesity among Hispanic women, which are a fast-rising population with increasing obesity problems. Hispanic women with obesity have a higher risk to get cancer by 2.5 times in comparison to lean women. The recent report proved that the obesity influence on the cancer risk strongly relates to the menopausal status. In particular, adult weight gain between 15 and 50 years among Hispanics relates to the postmenopausal breast cancer risk (Sexton et al., 2015). Therefore, obesity is a risk factor that has a strong connection to postmenopausal breast cancer among the Hispanic population. Women must have a specific diet aimed at weight regulation and obesity prevention that would help to decrease the breast cancer risk (Sexton et al., 2015). Such a therapeutical approach has to be promoted by the healthcare providers as a critical condition that can help to prevent the possible disorder among the Hispanic population.

APRN Role

Oncology APRNs have a unique position in educating patients and the public about the recommended cancer risk reduction and screening guidelines. The nurse's practice includes the spread of information on disorder prevention and health promotion (Gobel et al., 2009). Cancer prevention and screening are the main responsibilities of nurses needed to diagnose cancer in the earliest phase. According to the requirement, the APRNs have to be able to interpret, evaluate, assess the cancer risk assessment, and provide a recommendation regarding the best strategies for cancer screening and prevention (Gobel et al., 2009). They have to provide culturally sensitive cancer prevention and early detection services and take part in the resource development that concentrates on primary prevention and wellness through the lifespan (Gobel et al., 2009).

The nurses have to provide guidelines regarding the exercises and diet to avoid the obesity that appears to be the major breast cancer prediction. Hence, maintaining a healthy lifestyle and diet is a critical condition for preventing breast cancer (Gobel, Triest-Robertson, & Vogel, 2009). Especially it is crucial for postmenopausal women because they have a high risk of breast cancer occurrence. There are several reasons for the obesity challenge, and one of them is that the US proposes a great number of foods full of sugars, fats, and calories (Gobel et al., 2009). Such food is usually cheaper and promoted more intense in comparison to healthy food and is served in great amounts by fast-food restaurants and chains. Therefore, the nurse has to explain and advise the diet with vegetables and fruits. Similarly, physical activity also influences the decreased rates of breast cancer (Gobel et al., 2009). It is necessary to recommend performing physical activity for at least thirty minutes, five or more days per week, and vigorous activity for at least twenty minutes three or more days per week (Gobel et al., 2009). Therefore, the nurse has to provide patients with recommendations regarding balanced, healthy nutrition and appropriate physical activity to prevent breast cancer.

In the case of other interventions, the APRN has to provide a detailed explanation regarding all possible alternatives and be able to discuss all benefits and disadvantages of each treatment. For implementing the intervention in the patient's care plan, it is critical to discuss with the patients all disorder-related aspects and provide the appropriate advice and recommendations (Gobel et al., 2009). Therefore, the nurse has an important role in frames of therapy implementation through the risk assessment that directs a potential candidate through the therapy aspects, references to the appropriate clinical trials, and referral to the qualified colleague for further management and evaluation (Gobel et al., 2009). Hence, the nurse's role in assisting the patient is crucial for managing breast cancer.

Conclusion

Breast cancer is a serious challenge and threat for females and the second reason for the most common causes of cancer death among women. The prevalence of breast cancer is huge, and it keeps rising. Breast cancer can be a great threat for Hispanic women after menopause. In general, Hispanic women in the US have a lower prevalence of breast cancer in comparison to non-Hispanic women, but their mortality rate from this disorder is higher. Hispanics are the fastest-growing population in the US, and it is critical to research the breast cancer prevalence and management among them. Obesity tends to be in tight relation to breast cancer. The obesity rates in the US are extremely high and continue to rise due to the great amount of fast food and lack of physical activities. The nurses must include in the plan of patients care the explanation and discussion of the risks of obesity to affect breast cancer and to provide information regarding the appropriate diet and the number of physical exercises. At the same time, the other preventive measures can be raloxifene and tamoxifen that proved to decrease the breast cancer rates among postmenopausal women. Moreover, in case of breast cancer occurrence, the APRN has to suggest some therapies and explain their strengths and weaknesses to the patients. Such therapies can be chemotherapy, targeted therapy, and immunotherapy. Hence, the role of APRNs in helping women to manage breast cancer is great because they screen, explain, and advise the possible solutions. Breast cancer is a great challenge occurring among postmenopausal Hispanic women, and it is highly important to address their health problems appropriately to reduce breast cancer prevalence.

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