Why women generally get breast cancer rather than other cancers?

Why women generally get breast cancer rather than other cancers?

ABSTRACT
Background
It is evident that when a person is affected with disease, he becomes aware of some treatment and he likes to follow the instruction of the physicians and prescription of him and he also makes some restriction on all over the lifestyle of him. The advanced technology is fast enough to eradicate the problems of human beings and they are easy to find out some solutions and some recommendations for the problems that emerge out in the world. In this study, the author of the study like to discuss about the disease breast cancer, especially based on women who are at the higher risk in affecting the breast cancer.
Aims and objectives The ultimate aim of this study is an evaluation of the subject that is why breast cancer is getting increased in women rather than other cancers. It is affected to one million women in world wide. In UK it is estimated that it is thirty percent for women. And it is clear that one in nine women in the UK will get breast cancer sometime during their life. Regarding these things, it is clear that this study will have an outlook on the statistics of UK breast cancer, since it is completed by me as an overseas student in the UK. Moreover this is the study that is subjected to the diseases of women, breast cancer in women.
Data resources
The data and the information for the subject were gathered from the selected articles for the subject and from other resources that are interlinked with the subject question.
Study Selection
Systematic research study is used for this research to explore the full meaning of the subject question in an easy way of style.
Results
It is undeniable fact that women are suffering from disease and pain rather than men. If we take the example of the pain for giving birth to a child, she suffers a lot to sustain the generation in the world. Considering these things, it is questionable that women are getting full support from the part of the health care. To a great extant she is supported significantly and she is taken care everywhere. However she is the victim of some diseases rather than men and they suffer a lot with the affect of it. The main outcomes that can be collected from this study is the risk factors and the solution of breast cancer and have an overview on the research question that is why women are generally affected with breast cancer rather than other cancers.
Conclusion
The conclusion of this study will not only be from my opinion and perceptions but the relevant and apt knowledge that is extracted from books and journals will be borrowed for it.

Table of contents
Abstract 2 - 3
1.0 Chapter 1:
1.1 introduction 5 1.2 Definition of terms 8 1.3 Aims and objectives 10 2.0 Chapter 2: literature Review 11 2.1 Findings of the articles 11 2.2 Review of literature 12 2.2.1 Theme 1 12 2.2.2 Theme 2 18
3. 0 chapter 3: Conclusion 21
Appendix 23
Bibliography 24

1.0 Chapter 1:
1.1 Introduction
Research background
Breast cancer is one of the most common cancers in human especially in women. According to (Henderson), 30 percent of females are suffering with breast cancer world widely and in UK it is seen in 1 out of 9 women at any time of their life span. The main reasons that are focused by the researchers as the reasons of breast cancer are age, reproductive factors, geographical variation, age at first pregnancy, inheritance, life style, alcohol consumption, weight, radiation, changes in hormone and hormone replacement therapy. This study will mainly focused on the breast cancer in women, it also will discuss about the mortality and morbidity rate and prevention of breast cancer.
It is unknown fact that, why a women is under the clutches of breast cancer. There are some reasons can be related to it. They are combination of genetic, environmental and life style factors. Two genes have been identified by the scientists that are more likely to be defective in women with breast cancer. For some other cancers, these genes are also responsible. But the two events matured genes are considered as the responsible for about five to ten percent of breast cancer cases (Ravdin, 2001). The most common problem treating breast cancer is that it is not a single disease, there are different types of breast cancers and the underlying problem is that they can only be diagnosed at different stages of development and can grow at different rates. If we take the anatomy of the breast, it is clear that breasts of a woman are made up of fat, connective tissue and thousands of tiny glands and these are known as lobules that produces milk. Breast cancer is severe and can be affected in different parts of the breast. Normally it is divided into non invasive and invasive types. Non-invasive breast cancer is also known as cancer or carcinoma in situ or pre-cancerous cells (Jacobs and Finlayson, 2010). It is seen in the ducts of the breast but it doesn’t develop outside the breast. These types of cancer is seen as rare sight with lump in the breast and generally seen on a mammogram. Non invasive cancer is most common in ducal carcinoma in situ (DCIS) (Tot, 2010).
In breast cancer, hormone takes an important role. Research has identified a connection between oestrogen levels, that is the sex hormone of female, and the risk of developing breast cancer. Even if the breast cancer causes have not been identified clearly, the risk factors are certain (Keating, 2007). Getting older, in postmenopausal women, eighty percent of breast cancer takes place. But it is unusual in younger women’s.
Risk factors
There are lot of factors that may affect the risk for breast cancer and other diseases. When a women exercise, it is questionable that how strenuously she exercises, the smoking behaviour, the work environment, the types of chemicals she has been exposed to and more. According to the study done by the Charles Bankhead (may 2011), focused on some women who drank at least five cups of coffee daily. When they were analysed, they had a lower risk of postmenopausal breast cancer. This analysing was done according to two large cohort studies. According to Jingmei Li, and co authors, the consumption of coffee can reduce the breast cancer to a great extent. The authors of the study mention that coffee has a paradoxical relationship with breast cancer risk. The complex mix of coffin and poly phenols of the beverages complex mix mentions a potential to confer both carcinogenic and chemo preventive characteristic. On the basis of some previous studies it is apparent that the high consumption of coffee may modestly reduce breast cancer risk (Statistical Information Team, 2009).
With the help of better treatment and earlier detection, the survival of breast cancer rates is higher than ever before. In UK it is a most common cancer that is affected in women and the statistics of breast diagnosed women is rising. Apart from women there are three hundred men are under diagnosed breast cancer each year (Collaborative Group on Hormonal Factors in Breast Cancer, 2002). Like all cancers, the development of risk factors for breast cancer depending on a number of factors. It varies from person to person. It may affect to a women who has not children and it may affect with a women who has children also (Key, Verkasalo and Banks). It is said that the breast cancer ranged from four to nine percent happens in the case of hereditary and many of other factors for developing this disease by life style. According to the scientist’s estimation about forty two percent of breast cancer in UK could be prevented by maintaining a healthy weight. The other preventions are physically active and fit and not drinking alcohol.
According to (Walker, 2003), being overweight or obese means the lack of physical activity, Drinking alcohol and not breastfeeding when one has a baby. Other risk factors that lead to the breast cancer in women are Age – one’s risks increases as when one gets older, Starting one’s periods at a younger age (before age 12), Late menopause (over age 55), Family history – particularly a close relative diagnosed before age 50, Taking HRT – risk continues to increase slightly the longer one takes HRT but decreases gradually once one stops and the contraceptive pill – breast cancer risk increases slightly when taking the pill, but slowly returns to normal after one stop.
Major factors which related to Breast cancer
AGE:Age is considered as the strongest risk factor for breast cancer. When a woman gets older it is higher her risk to be affected with breast cancer. The table clearly shows the incidence and mortality data in the year 2008 (cancer research UK). Another one is Reproductive history: Women who are in developed countries are higher in risk diagnosed with breast cancer compared with women from less developed countries. It is explained that women in developed countries have fewer children and the breast feeding is limited. The third factor related to breast cancer is Oral contraceptives (OCs): The use of oral contraceptives (OCs) is the reason to increases the risk of breast cancer in current and recent users. But it is difficult to find out the significant excess risk ten or more years after stopping use (cancer research UK). Hormone replacement therapy: is the another factor which is related to the breast cancer. Women currently taking the hormone replacement therapy (HRT) have sixty six percent increased risk of breast cancer compared with non users (Ross, Paganini-Hill, Wan, & Mike, 2000 (cancer research UK). The last factor in relation with cancer is Family history: It doubled the risk of breast cancer for a woman who has a mother or sister diagnosed breast cancer. If there are two relatives or more affected the risk increases further. For faulty BRCA genes, genetic testing is available on the NHS for women with a very strong family history. Increased defencelessness to breast cancer is also a feature of several rare, family cancer syndromes (cancer research UK).

1.2 definitions of terms 1.2.1. What is cancer?
According to Verschraegen et al (2005), Cancer is defined as the result of uncontrolled cell growth. Human bodies are filled with trillions of cells, they are working together. In cancer, when one of the cells not paying attention to the normal signals that tells cells to grow, stop growing or even to die. With the support of blood and lymph systems cancer cells are able to spread to other parts of the body. Cancer can’t be defined as one disease. Hundred different types of cancer are affected by human being these days. Most cancers are given names related to the organ or type of cell in which they start. For an illustration the colon cancer is derived from colon. When cancer starts with basal cells of the skin it is named basal cell carcinoma.
1.2.2 Breast cancer
Breast cancer is a common cancer among women (affected by approximately one million women worldwide) (EMRO Technical Publications, 2006). It occurs rarely in men. Breast cancer is a malignant tumour that starts from cells of the breast as its name indicates. It can occur in both sex but it is more common in women (Hunt, 2001). The chances of breast cancer are more common in women whereas the chances of breast cancer are very rare in men due to its anatomy and function (Soerjomataram et al, 2005). In UK, around 50000 people are diagnosed with breast cancer every year, out of which 300 are men. Statistics say that the lifetime risk of breast cancer in UK is 1 in 8, which means 1 in every 8 people is at the risk of developing breast cancer at some point in their life. But the positive side is that 7 out of 8 women do not affect with breast cancer. Approximately 81 per cent breast cancers occur in women who are over the age of 50. 50-69 age groups is said to be the most vulnerable age group of developing breast cancer (cancer research UK). A recent statistics released by American Cancer Society estimates that around 230480 new cases of invasive breast cancer in women have been reported in United States and about 39520 deaths have occurred due to breast cancer (American cancer society). The most common site of breast cancer is at the ducts which are called ductile cancer and some begin in the lobules (Lobular cancer) and only a small number start in other tissues (Bustelo, 2005).
1.2.3 Anatomy of the breast
According to Klauber-DeMore (2006), shape of the breast varies among patients. The knowledge of the anatomy of the breast makes sure the secure surgical planning. Most important asymmetries are revealed in many patients when the breasts are carefully examined.
Producing milk is the fundamental function of breasts. Each breast holds with milk producing glance. They are called lobules or alveoli. These glances produce milk from the nutrients and water that they are provided from the blood stream. Fifteen to twenty lobes or grape bunches can be seen in a breast. Since breast has not any muscles but some tiny ones in the nipples, any kinds of exercise can’t change the appearance of the breast. The breast is backed up by bands of tissues, semi elastic, and called coppers ligaments. When the breast pulls down with gravity, the ligaments stretch over time. As the reason the breast starts drooping or sagging. A women’s breast is made up of glands that make breast milk (Lobules), ducts (small tubes that carry milk from the lobules to nipple), fatty and connective tissue, blood vessels and lymph vessels (Kopans, 2007). The cross-sectional diagram of the Breast gives the clear idea about the breast in the Figure 1.

1.3 Aim and Objectives
The aim of the study is a critical analysis of the subject why women generally get breast cancer rather than other cancers.
Objectives
The main objective of this essay is to analyse why breast cancer is most common in women than other types of cancers.
Methodology
A literature review is a description of the literature based on a particular field or topic. It gives the clear explanation of what has been said, the appropriate methods and methodologies for the selected topic. In fact it can be called as a primary research. It borrows data and information from other sources. This study is done in the form of a literature review for the research question why breast cancer is getting increased in women rather than other type of cancers. This work mainly focuses on some articles that are done as a research study on the same topic.
This study is mainly being supported with some relevant articles; there are many sites that helpful for the successful completion of this project. The other main factor is key words used for finding out the relevant articles related to the subject. The key words that help for the searching of research articles are breast cancer, women with breast cancer, pregnancy and breast cancer, breast carcinoma, breast cancer risk in women, breast neoplasm, risk factors of breast cancer. There are many articles, books, journals and websites helped for finding out the relevant supportive points for the research. The books are very important and providing accurate information about the subject. The websites used for the selection of articles are American cancer society, JAMA, INSERM, Springer Science + Business Media, Pub Med, PMC, BMC and Croatian Medical Journal.

2.0 Chapter 2: Literature review
2.1 Findings of the articles
THEME 1:
Hormone replacement therapy and breast cancer
According to Olsson (2003), the research is focused to the risk related to the breast cancer and symptoms and related biological mechanisms in the breast cancer. The study gets a broader attention because of its importance and the area of coverage. The medical therapies and changes of medications.

According to Chen et al (2002), the study mainly focused to the association between the breast cancer and the HRT. The study mainly focused to the risk factors related to the Breast cancer.
According to Baur et al (2007), the hormones are also the risk factors related to the breast cancer. There are some hormones are very affecting factors of the Breast cancer.
The author Fourier et al (2009), give the picture about the hormone replacement therapy and the affect of this in to the breast.
THEME 2:
Physical activity and breast cancer resist cancer risk
According to Chen et al (2011), the necessity of the physical activity and the role of physical activity in the Breast cancer risk are very strong.
From the past study the need of physical activity is done by: Park (2011), the physical activity is every time has a strong relation with breast cancer. And the details will discuss in this study later.

According to Holmes et al (2009), the research is based on the significance of physical activities, the researchers of the article try to get an effective study and to provide a good result.

The other article provides in the study shows it’s content and main theme.

2.0 Review of literature
The review of the literature based on the topic why women are affected with breast cancer than that of the other forms of the cancer. The breast cancer is very common in now a day in women, when we take the ratio of the other forms of the cancers in women, the breast cancer have got the prior seat in the case of the women than the other forms of cancer. With the support of some evidence the study is going forward with the same stand that is the breast cancer in women are very common than the other forms of the cancer and proving the statement.
From the view of critics, the articles used for the support of the study give some evidence related to the topic. The risk factors and major causes of the disease and also some controlling methods are providing by the researches which are selected for the support of the study. But none of the research articles give a perfect and confident way for the removal of root causes of the disease.
THEME 1:
Hormonal therapy is applicable for breast cancer to be treated in two ways. Firstly, lowers the estrogens amount in the body. Secondly, blocks the action of estrogens on cancer cells and breast. In the article done by Fournier et al (2005), “the breast cancer risk in relation to different type of hormone replacement therapy in the E3N-EPIC cohort”, is in the background of most of the epidemiological studies that have revealed the progress of breast cancer risk connected to hormone replacement therapy (HRT) implementation (Stahlberg et al, 2004). This study is in advantage because of the availability and the essentialities related to the knowledge of the risk of hormone replacement therapy researching are very few. The authors measured the risk of breast cancer connected with HRT use in fifty four thousand five hundred and forty eight postmenopausal women who were not experienced with HRT a year before entering the E3N-EPIC cohort study. During the follow up, the researchers were able to find out nine hundred forty eight primaries invasive breast cancers were diagnosed. With the support of multi variegate Cox proportional hazards models, data became analysed. The findings from the research are the mean duration of HRT implementation was 2.8 years in the specified cohort. Moreover, the increasing risk in HRT users were compared with the non users was identified 1.2 the relative risk was 1.1 for the persons who used only the estrogens. It was 1.3 when it was in the combination with oral progestogens (Toniolo et al, 2000). In the comparison between hormone replacement therapy and hormone replacement therapy containing micronized progesterone, it was significantly greater the risk in first method with relative risk was 1.4 than 0.9 from the second method. When it is in the combinations with synthetic progestins, it is identified that the oral and transdermal / percutaneous use were connected with important increased risk, for transdermal / percutaneous estrogens it was the case even when the exposure was less than two years. The authors reach in a conclusion that in the combination with synthetic progesterone even the short term use of estrogens may be the risk factor to increase the breast cancer. Micronized progesterone would be proffered to synthetic progestin in short term HRT even if, this research gets an affordable conclusion. The authors are not fully satisfied with their result and they recommend some more studies on the specified subject to reveal more and more details about the breast cancer risk and hormone replacement therapy.
The research by Chen et al (2002), focused on the association of HRT with breast cancer. By this research the researchers find out a great fact related to the subject was the use of HRT for a long term increases the risk for the breast cancer in future. For this research the researchers used a repeated case study with 705 postmenopausal women of the members in Group health cooperative of Puget Sound (GHC). The participants are aged 50 to 74 years. The outcome from that research was the long term use of HRT of either estrogens alone or estrogens with progestin increased from 60 to 85%. Again the longer use of HRT and use of combination therapy currently is increasing the risk of lobular breast cancer. The usage of HRT for a long term increases the risk up to 50% for the non lobular cancer. These researches conclude with, the usage of HRT for a long term increases the risk for breast cancer and it may lead to lobular tumours.
The research about breast cancer in women is common than other cancer forms is supported by many articles. The major points that included in the research is Hormone Replacement Therapy (HRT), for the back support of this point the article done by Olsson, Ingvar and Bladstrom (2003), in their research the increasing risk of Brest carcinoma with the use of HRT for a long term (Olsson et al, 2001). The used method for this research was a population based group study conducted on 1990-1992. From the research it is evident that the risk of breast carcinoma is based on the type and duration of usage of HRT. The result of this research shows a clear picture about how the HRT usages lead to breast carcinoma. Based on the study conducted on December 2001, there were 298,649 persons represented in that research. The original number of disease case was slightly more (that is, 556) than the expected (that is, 508.37). The standard morbidity ratio was 1.09, and confidence interval (CI) was range 1.00 to 1.19. The main reasons that shown for the breast carcinoma from the article are type and duration of HRT, age, time of usage like during pregnancy, family history. From the research the observation shows, the longer duration of HRT usage shows high risk for the breast carcinoma. When take a comparison with non users of HRT, the users of HRT have high possibility for the breast carcinoma, that is the hazard ratio is 4.65, confidence interval (CI)=2.39-8.84, that is 95%. For the longer combined user the HR= 2.23 and CI=.90-5.56, the HR=3.74 and CI=.94-14.97 in the case of gestagen only, when it combined with estriol the HR-1.89, CI=.81-4.39. The authors of this research conclude that, the Use of HRT with progestin in a longer time significantly increase the risk of breast carcinoma than the use of estradiol. This shows the type of hormone is also very important factor for the cause of breast carcinoma. The duration of HRT is also a major factor that affects the risk of breast carcinoma up to a range. The women with natural menopause are less risk for the breast carcinoma than the HRT users. With the help of Cox regression analysis, the researchers did this research successfully. The article proves that, the risk of breast carcinoma is very high in HRT users than the non users with the support of strong evidence. In the critical analyse of the article done by Fournier et al (2005), found that the combined used synthetic progestin even short term usage of oestrogen can causes the breast cancer. And they suggest that the micronized progesterone may be preferable to synthetic progestin in HRT for short term. The materials and methods used for this study are relevant to achieve the real goal of the research. The method, E3N used in this research is a French prospective study that investigated cancer risk factors in 98,997 women who were born in between 1925 and 1950. All women for the study are with the MGEN, a health insurance scheme that is mainly focused on covering teachers. From the year June 1990 after the clear consent form the participants the questionnaires were taken twenty four month interval to complete. The questionnaires were included a life style characteristics. Two reminders were sent to non respondents for each questionnaire. In January 1992, in questionnaire, the first recording was about the information on life time use of hormonal treatments. To get the clear information a booklet was presented with extensive list and colour photographs. These things were belong to hormonal treatments that were marketed in France and were mailed to all study participants.
In each questionnaire participants were asked to be identified the diagnosing of breast cancer with the request from their physicians’ addresses and permission to contact them. With the support of family members and the insurance company file, the death rate in the cohort was identified. With the help of National Service on Causes of Deaths, the cause of the death information was gained. Some of the updating was done on receipt of each new questionnaire to make sure that the constructed menopause variables were as correct as possible, date of menopause, type of menopause, date of last menstruation, date of start of menopausal symptoms and date of hysterectomy. There was not a determination for women whom age at menopause. Some of the things were excluded from the analysis that is related to the postmenopausal women who had diagnosed cancer other than a basal cell carcinoma before the start of follow up. There was no consideration for women who had reported using HRT before the year preceding the start of follow up. With the cause of the addition of common users at baseline causes a bogus selection in to the study of uncovered women who did not build up breast cancer, especially, after a small period of use. In short, this study mainly focuses on the increased risk of breast cancer connected with HRT use. It shows that, the connection between HRT use and breast cancer risk most likely differentiate on the basis the type of progestin used. This study make confirm with the previous findings of an increase in invasive breast cancer risk with estrogens associated with synthetic progestin’s compared with no HRT use. The authors in the study reveal that the short period of their follow up was not good to allow them to study the effect of HRTs on breast cancer risk by time since last use. There was no possibility of study the impact of sequential versus continues associated therapy and the information was not recorded on regimen. The authors welcome the upcoming studies based on E3N. They expect that, the risk of breast cancer connected with longer HRT will clearly be assessed in the future.
According to Chen et al (2002), the subject study was selected from women enrolled in GHC continuously for at least two years of diagnosis base. In March 1997, the major foundation of information based on the use of HRT was the GHC computerised pharmacy data base. This database is included with some clear information about all prescriptions dispensed from GHC pharmacies. They are included date, drug name, dosage, combination, pill quantity and route of administration. With the support of questionnaire, the lifetime use of HRT was estimated. For all female members of GHC, they were aged forty years or older, questionnaire was sent. The questionnaire form was completed with eighty five percent of qualified women and the information was restructured at the time of each mammogram. There was a conducting for analysing the two separate of HRT use. The first one is lifetime use. It is included the use before the establishment of pharmacy data base. Secondly the usage of recently was examined in the five and ten years period before the reference date. With the support of pharmacy data base the exposure for this analysis got determined. This study has several strength and some limitations as well. The strength of the study is it didn’t require the subject participation. The opportunity of selection bias was least. The limitation of the study is there was no information on some potential confounders. For the questionnaire survey the authors didn’t collect the information on history of previous breast biopsies, breast feeding, physical activity, alcohol use and educational level. However this limitation can be accepted with the comparison of the prior studies that were not able to collect this information accurately. In short, this study gives handful knowledge of hormone replacement therapy that is related to breast cancer. The research by Olsson, Ingvar and Bladstrom, used the materials and methods to find out, the HRT containing progestin’s relation to breast cancer carcinoma accurately and perfectly. The authors selected forty thousand women aged twenty five to sixty five years from south Swedish health care region (Investigators WHIRCT, 2002). They were welcomed to be in the part of standardised written interview based on the risk factors of malignant melanoma and breast carcinoma. Among them, none of the women was having a past history of malignancy. The interview was done between 1990 and 1992. For participation in the interview, the consent was got from approximately seventy four percent of all women. The questionnaire form had to be filled with age at menarche, parity, age at first full term pregnancy, age at menopause, type of menopause, oral contraceptive use HRT use, family history of cancer carcinoma, the habit of sun bathing, constitutional factors and the habit of smoking and alcohol. For the estimation of cumulative risk for different exposure groups, the authors used the life table actuarial method. The presentation of analysing, both for women who used one brand and who used more than one brand. There was a follow up since the time of interview to the first event of breast carcinoma, death or the end of follow up. Using the same group of women in south Sweden, the authors reported previously that the risk of breast carcinoma in association with HRT use after more than 4 years of exposure was around doubled compared with the non users.

From the research done by Dent et al (2008), about breast cancer, they focused their research to compare women with triple negative breast cancer and other types of breast cancer in clinical character, normal history and outcomes. From that study the researchers of the article found out the triple negative breast cancers are more aggressive from clinical view, but the risk effect is temporary than the other types of breast cancers (van de Rijnet al, 2002). For finding a good and quality oriented result the authors studied a group of women that is 1601. The follow up time of the research was 8.1 years. The study was held in Women’s college hospital in Toronto .Triple-negative breast cancers are defined as those that were estrogens receptor negative, progesterone receptor negative, and HER2neu negative (Lakhani et al, 2005).
The results of the study were the median track time of the 1,601 women was 8.1 years. From 1601 patients there was 180 patients had triple-negative breast cancer that is 11.2 %. When compared with women with other types of breast cancer, those with triple-negative breast cancer had an increased probability of far reappearance and death within 5 years of diagnosis but not it sure about thereafter (Foulkese et al, 2003). The pattern of reappearance was also qualitatively different; among the triple-negative group, the risk of distant recurrence peaked at ∼3 years and declined rapidly thereafter. Among the “other” group, the recurrence risk seemed to be constant over the period of follow-up.
The prototype of recurrence was also qualitatively dissimilar; in the middle of the triple-negative group, the danger of far-away reappearance pointed at ∼3 years and declined quickly afterwards. In the midst of the “other” group, the reappearance risk seemed to be steady over the period of follow-up. Study patients: The authors of the article considered a collection of women with unrelenting breast cancer treated at the Henrietta Banting Breast Centre (HBBC). With the help of HBBC database was helped to get the patients details, which have primary breast cancer at Women 's College Hospital. Immunohistochemistry: For each patient with chief breast cancer in the database, a position of agent paraffin-embedded slides was requested for antibody discoloration in the reference laboratory of W.M. Hanna. discoloration was done between 2000 and 2004. ER and PR status were resolute by means of immunohistochemistry. Follow-up: The follow-up of the investigation has been sustained with the assist of database director by reviewing clinical charts and conversed patients by telephone. Outcomes: In general survival was distinct as from the time of analysis to last notes or time of death. Breast-specific continued existence was strong-minded from time of analysis until death from breast cancer (Lakhani et al, 2005).
Analysis: Baseline demographic and growth characteristics were compared between the triple-negative and other groups by means of at test for means and χ2 statistic for frequencies (Jones et al, 2004). To measure whether cancer size concurrent with nodal positivity, we did χ2 tests for tendency in the triple-negative and other groups. The authors analysed the changes in means of discovery between the triple-negative and other group using the χ2 statistic.
In concise, by triple-negative category of breast cancers is chiefly strange in its recurrence than other type of breast cancers. This pattern is measured by a rapidly rising rate in the first 2 years following diagnosis, a zenith at 2 to 3 years followed by a refuse in reappearing risk over the next 5 years, and a very low down risk of recurrence afterwards. Unlike women with other types of breast cancers, the most usually women with triple-negative cancers who had no proof of growth after 8 years did not happen again after that (Nielsen et al, 2004).

THEME 2:
According to Holmes et al (2009) is based on the significance of physical activities, according to the researchers it is a good medicine to decrease the cancer risk and it offers a novel life to the people who are paying attention to be going along with the physical activities. Physical activity is any physical movement shaped by very thin muscles; such pressure group results in a spending of energy. Physical action is a significant constituent of energy equilibrium, a word used to describe how weight, diet, and physical activity power health, including cancer risk (http://www.cancer.gov/cancertopics/factsheet/prevention/physicalactivity)
Researchers have recognized that usual physical action can get better health by (1) serving to manage weight. (2) Maintaining healthy bones, muscles, and joints. (3) Plummeting the risk of rising high blood pressure and diabetes. (4) Promoting psychological well-being. (5) Dropping the danger of death from heart disease. (6) Dropping the risk of early death (Bianchini F, Kaaks R, Vainio, 2002).
In adding to these health benefits, researchers are learning that physical action can also influence the danger of cancer. There is persuasive proof that physical action is linked with a condensed danger of cancers of the colon and breast. Several studies also have reported links between physical activity and a condensed risk of cancers of the prostate, lung, and lining of the uterus (endometrial cancer) (McTiernan et al, 2003). In spite of these health benefits, recent studies have exposed that more than 50 percent of Americans do not connect in enough usual physical action.
The purpose of the article is to decide whether physical activity among women with breast cancer down their risk of death from breast cancer compared with more inactive women (Kramer et al, 2000). It was a potential observational study based on responses from 2987 female registered nurses in the Nurses’ Health Study who were diagnosed with stage I, II, or III breast cancer between 1984 and 1998 and who were followed up until death or June 2002, whichever came first. The main result anlysed from this study is Breast cancer death risk according to physical activity category metabolic equivalent task [MET].
Compared with women who occupied in less than 3 MET-hours per week of physical activity, the attuned family member risk (RR) of death from breast cancer was 0.80 (95% self-assurance interval Three MET-hours is equivalent to walking at average pace of 2 to 2.9 mph for 1 hour (Michaud et al, 2001). The advantage of physical activity was chiefly apparent among women with hormone-responsive tumours. The RR of breast cancer death for women with hormone-responsive tumours who occupied in 9 or more MET-hours per week of action compared with women with hormone-responsive tumours who occupied in fewer than 9 MET-hours per week was Compared with women who occupied in fewer than 3 MET-hours per week of activity, the complete unadjusted death risk drop was 6% at 10 years for women who occupied in 9 or more MET-hours per week.
It is concluded by the authors that physical activity after a breast cancer diagnosis may reduce the risk of death from this disease. The greatest benefit occurred in women who performed the equivalent of walking 3 to 5 hours per week at an average pace, with little evidence of a correlation between increased benefit and greater energy expenditure. Women with breast cancer who follow US physical activity recommendations may improve their survival.

3.0 Chapter 3:
Conclusion
In conclusion, it is clear that the articles and their findings that we have gone through in this study mention that there should be some more studies to evaluate the problems of breast cancer clearly and there should be fast and future looking remedy for it. In the article eastrogens and antistrogens stimulate release of bone resorbing activity by cultered human breast cancer cells; mentions about some breast tumours are able to produce more prostaglandins than others. The chance for spreading these tumours is more easily. This study points out that estrogens receptor positive breast tumours have a higher ostolytic activity and spread more easily to bone. In fact, this study mentions that, patients with advanced breast cancer would develop acute, severe, hypocalcaemia when treated with estrogens or anti estrogens. This study is an examination of the authors to find out the effects of estrogens and its connected compounds on the release of bone resorbing activity by cultured human breast cancer cells in vitro.
From the articles we have gone through for this study, mentions that the increment of breast cancer in women are based on some facts. The first one is age. In fact, quarter of breast cancers that affect women under the age of fifty. Between the ages of fifty and sixty nine, half of the breast cancer occurs. Women, who are more than seventy years old, the quarter of the cancer development takes place. Geographical variation is the other factor for increasing the breast cancer. In different countries, the statistics of breast cancer is varying. The biggest difference we can see in between eastern and western countries. If we go through the statistics of recent breast cancer figures, it is crystal clear that, it is higher the rate in western countries than in Asian countries. For example, in England and Wales it is 72.7% women are diagnosed breast cancer. Reproductive factors are the other common factor to develop the breast cancer in women. Women who have had the menstruating early in life or who have had a late menopause have increased risk of breast cancer. The women who have their first child after the age of thirty it doubled the chance than that of women who have their first child before the age of twenty. Above all, the highest risk of breast cancer goes to women who have their first child after the age of thirty five. These women are considered as the highest risky ones diagnosed breast cancer than that of women who have no children. These findings mention about a menstrual cycle effect.
In western countries, it is found out that up to ten percent of breast cancer takes place with the affect of inherited factor. It comes from either through parent or some family members who have passed on the abnormal gene without developing cancer themselves. Women who are with certain venin changes in their breast are at increased risk of breast cancer. These women often present with a breast lump, have an operation and breast tissue changed shows severe over growth of the cells lining the breast lobules. Technically this breast condition is called severe typical epithelial hyperplasia. Radiation is the other risk factor that is the reason for breast cancer. Clear observation and studies on teenage girls point out that radiation is the risk factor for them to develop breast cancer especially those who were exposed to radiation during the Second World War. Other risk factor that connected with radiation is repeated x-rays for tuberculosis. It is found out that, girls who are first x rayed between the ages of ten and fourteen years would be the reason to be affected with the radiation from ex- rays. With the advanced technology and findings tuberculosis are prevented. As the reason, the risk is less significant today. If we take the example of some women diagnosed Hodgkin’s disease are supposed to receive radiation therapy to the chest have an increased risk of breast cancer. When they are in their older age they not only developed unilateral but bilateral breast cancer. It is pointed out that, when some radiation is used to one breast, there is some chances to diagnose breast cancer to other breast.
Life style is the other common factor that leads to breast cancer in women. being overweight is connected with a doubling of the risk of breast cancer in post menopausal women where as amongst pre menopausal women obesity is connected with reduced breast cancer incidents. Alcohol intake is the other risk factor that leads to breast cancer. But this alcohol intake is not consistent to be discussed clearly that it is one of the leading factors for breast cancer. Women, who take the contraceptive pill, are at a slight increased risk while they take the pill and they remain at risk for ten years after coming of the pill. Hormone replacement therapy is the other factor to develop the breast cancer. It is the increased risk of breast cancer among the present users of hormone replacement therapy and those who have stopped using it one to four years previously; there is an increased risk of breast cancer.
There are some recommendations can be provided for the early detection of breast cancer. 1. Early mammograms are advised starting at age forty and continuing for as long as a woman is in good health. 2. Clinical breast exam about every three years for women in their twenties and thirties and every year for women forty and over. 3. Women should be careful about their breast normally looks and feel and report any breast change promptly to their health care provider. 4. Breast self exam is an option for women starting in their twenties. In fact, to wipe out the breast cancer completely, there should be some action plan from the part of the government and the health care organisations as well. First of all, the breast cancer patients should be assisted when current income and resources do not meet their basic living needs. Secondly, provide interim financial safety net to assist them while they are undergoing treatment. Thirdly, advocate for the clients when they can benefit from referrals to other organisations which provide further types of cancer support services. Apart from all these things, there should be an interconnection between the patient and the doctor. Breast cancer should be detected in the early stages of it by women themselves. When there is a joint co-operation in between a patient and doctor goes through, the solution for breast cancer will be an easy task to be done to a great extant.

Appendix
Figure 1:

Anatomy of the breast

Total Words -7336 ref- 846 words

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Bibliography: 1.2.3 Anatomy of the breast According to Klauber-DeMore (2006), shape of the breast varies among patients