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 The leading web portal for pharmacy resources, news, education and careers November 20, 2017
Pharmacy Choice - Breast Cancer Disease State Management - November 20, 2017

Breast Cancer Disease State Management

Risk Factors for Breast Cancer: BRAC1 and BRAC2
by Karen Siroky, RN, MSN, Clinical Education Director, RxSchool

In the United States, breast cancer is the most common non-skin cancer and the second leading cause of cancer-related death in women. Approximately $8.1 billion is spent each year on treatment of breast cancer. 1 in 8 women will be diagnosed with cancer of the breast during their lifetime. The median age for diagnosis is 61 years of age.

The incidence of breast cancer is highest in whites, but African Americans have higher mortality rates than other racial or ethnic group in the U.S. The gap in mortality between African Americans and whites is wider now than it was in the early 1990s.

Although the breast cancer diagnosis rate has increased since the early 1990s, the overall breast cancer death rate has dropped steadily. This is largely due to increasing awareness of breast cancer resulting in earlier detection, as well as advances in medical technology producing more effective treatment options.

In spite of these advances, in 2009 there were 192,000 estimated new cases over 40,000 deaths.

Commonly known risk factors include age ( risk increases with advancing age), previous history of breast cancer, family history, abnormal breast tissue changes, early onset of menses, latefirst pregnancy, nulliparous (never been pregnant), latemenopause and certain hormonal therapy.

Other less commonly known factors include obesity, lack of physical activity and increased alcohol consumption. Studies are underway to determine if there are other environmental factors that may also link to breast cancer.

In addition to these risk factors, newer, significant risk factors relate to the identification of 2 specific genetic mutations: BRAC1 (breast cancer susceptibility gene 1) and BRAC2 (breast cancer susceptibility gene 2). A woman’s lifetime risk of developing breast and/or ovarian cancer is significantly increased if she inherits a BRCA1 or BRCA2 mutation. Such a woman has an increased risk of developing breast and/or ovarian cancer at an early age (before menopause) and often has multiple, close family members who have been diagnosed with these diseases. Both mutations also increase the risk of various other cancers.

Studies have shown that people who inherit these genes are five times more likely than the general population to develop breast cancer.

If a woman (or man) has a very strong family history with several members who have developed breast cancer, they may pursue genetic testing for the BRAC1 or BRAC2 gene mutations. If the results are negative, the lifetime risk for that person will be the same as the general population- in other words there is no guarantee she will NOT develop breast cancer, especially if she has one or more of the other risk factors.

If the results are positive, several options exist, including close surveillance or prophylactic surgery (including hysterectomy, oopherectomy, and/or mastectomy). Other additional steps may include avoiding behaviors that increase risk and possible chemoprevention- taking specific medications that are shown to retard breast cancer growth (e.g. tamoxifen).

The message is clear- great strides are being made against breast cancer, and the added information that genetic testing provides is critical to further reducing the occurrence and deaths from breast cancer. But there is still work to be done to further refine these tests and to provide much needed education, counseling, and increased options when the tests show that a person has this dangerous mutation.
(Source: National Cancer Institute, 2010)

Want to learn more about breast cancer and current treatments? Take RxSchool’s online enduring CE Course Breast Cancer Today: A Whole New World of Options, earn 3 CPE and learn more about the newest diagnostic and treatment options for breast cancer.

Links - Breast Cancer
Center For Disease Control Health Topic: Cancer THE CDC page devoted to all types of Cancer

The Avon Walk for Breast Cancer has been designed to allow people of all fitness levels to have a safe, challenging and rewarding experience while raising money and awareness for breast cancer research.

The Breast Cancer Site was founded to help offer free mammograms to underprivileged women nationwide -- women for whom early detection would not otherwise be possible. Since its launch in October 2000, the site has established itself as a clear leader in online activism and in the fight to prevent breast cancer deaths.

American Cancer Society is a nationwide, community- based voluntary health organization.

The National Cancer Institute established under the National Cancer Act of 1937, is the Federal Government's principal agency for cancer research and training.

The Canadian Cancer Society is a national community-based organization of volunteers, whose mission is the eradication of cancer and the enhancement of the quality of life of people living with cancer.

National Breast Cancer Coalition works to increase federal funding for breast cancer research and collaborate with the scientific community to implement new models of research; improve access to high quality health care and breast cancer clinical trials for all women; and expand the influence of breast cancer advocates in all aspects of the breast cancer decision making process.

The Susan G. Komen Breast Cancer Foundation have raised more than $240 million for breast cancer research, education, screening and treatment. It is credited as the nation's leading catalyst in the fight against breast cancer.

The National Breast Cancer Foundation mission is to save lives by increasing awareness through education and providing mammograms for those in need.

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