Breast Cancer Treatment Breast cancer is not an illness which can be cured with medication, it is a fatal disease. If not detected at an early stage it is incurable. A famous Chinese proverb states "We cannot control the wind, but we have the power to adjust its sails"; in the same manner, we cannot prevent breast cancer, but it is in our power to take appropriate measures to reduce its fatality. Annual mammography screening is one of the ways to detect this disease at an early stage. Doctors recommend women to get it done at least once in a year. Despite all this, African-American women do not give much attention to this. Cancer screening, spreading awareness about its side effects and health related issues are concepts alien to these women. Such an attitude constitutes a major obstacle in the way of dealing with this disease. This article attempts to identify the liaison between social, psychological and cultural factors affecting women's ability to accept the bitter truth of life. This study takes into account even the tiniest details of this syndrome, starting with its side effects to making it curable in some way. This topic has proved to be quite famous amongst researchers who explored almost all possible areas, including the individual's reaction to dealing with the different challenges of life, most appropriate procedures for cancer screening and constituents of Health Belief Model (HBM) (Ries et al., 2002).

Background

The fatal disease of breast cancer prevails throughout the world. Approach of women regarding the existence of this disease varies in each region and this affects the mortality rates of the particular region. For example, research work highlighted an incompatible relationship between the fatality and prevalence rates of African-American women when compared to Caucasian-American women. Although frequency of this disease amongst Caucasian-American women is higher, the death rates of African-American women surpass the other (Ries et al., 2002) This inconsistency was first identified in 1976, and since then it has been reported frequently in various population-based surveys conducted by Surveillance, Epidemiology and End Results (SEER) program (Ries et al., 2003). This research also revealed that African-American women are more prone to the inception of this disease.

Studies show that low prevalence rates are inconsistent with the high fatality rates of African-American women. There is no reasonable explanation for this discrepancy. An attempt has been made to arrive to a rational conclusion by mentioning the advanced stage distribution amongst African-American women, but the actual question remains unanswered (Ries et al., 2002-03).

Contraceptives and Steroid Hormone (CASH) study focuses on the prevalence of breast cancer disease among African-American women. Although the factors behind high prevalence rates have been discussed, the study failed to establish the exact reasons for their existence (Mayberry, 1992; 1994).

Mayberry and Stoddard-Wright (1992) further investigated the CASH study to ascertain that the familial and gynecological factors affected the prevalence rates in a different way. The analysis was based on various breast cancer cases (a total of 3,934 Caucasian-American women, and around 490 African-American women) and its preventive measures (a total of 3,901 Caucasian-American women, and a total of 485 African-American women). The different factors taken into consideration include surgical menopause, family history and age at menarche. Family history had a greater effect on African-American women as compared to Caucasian-American women. This is evident from facts which state that the existence of breast cancer amongst first and second degree family history for African-American (odds ratios, 1.61 and 1.71, respectively) is greater than that of Caucasian-American women (odds ratio, 2.16 for first-degree relatives, and 1.44 for second-degree relatives). Along with this, African-American women have been noted to have an early age for start of menstrual cycle. Study reveals that this also increases breast cancer risk but fails to deduce a logical reason for this statement (Bernstein et al., 2003).

Another study relates the frequency of this disease with its age of inception and the resulting conclusions are worth having a look at (Ries et al., 2002; 2003). Theory indicates that the possibility of getting diagnosed with this fatal disease increases with age. Research contradicts with this point as the prevalence rate is higher for those African-American women who are younger than 45. Rates for Caucasian-American women in this age group are low on the other hand. Fifth decade is the meeting point for both ethnicities as prevalence rates are almost equal, but it does not last long. For women over the age of 50, the relationship graph takes a U-turn. Now, prevalence rates for Caucasian-American...

This relationship is also evident in numerical terms. According to statistics, only 20% of Caucasian-American women get diagnosed with this disease under the age of 50, whereas the percentage for African-American women is around 30-40% (National Cancer Data Base, 2004).
Regardless of the details and statistical facts, this is an observable fact that cannot be relied upon. This is because the notion was first introduced in 1960s (Krieger, 1990) and SEER program was initiated in 1970s. SEER program is the most deep-rooted and authentic program for the maintenance of cancer-based data in U.S.

The research conducted by Pathak and colleagues (2000) is amongst the researchers who took an initiative to explore the details behind the occurrence of breast cancer at an early age. This study builds a relationship between the postpartum period and premenopausal breast cancer risk. The study was based on an analysis that indicated that African-American women experienced child bearing at an early stage which results in breast cancer risk. Palmer and colleagues (2003) further contribute to these details by stating an interesting fact in The Black Women's Health Study. They identified a twofold connection between pregnancy and breast cancer risk. Early pregnancy increases breast cancer risk before the age of 45, but reduces the same risk when a woman crosses the age limit of 45 years.

Another factor for breast cancer is postmenopausal obesity (Colditz, 2000). In the non-existence of ovarian function, estrogen levels increase as a result of fatty tissue metabolism of adrenal gland steroids. This factor has been exploited by Flegal and colleagues (2003) who scrutinized the Third National Health and Nutrition Examination Survey (NHANES III) and identified that the ratio of obese women (body mass > 30) amongst African-American women under the age of 40 was more than 50%, and the ratio of overweight women within the same age group was more than 80%. The reasons behind this relationship are still undiscovered however. Although researchers have identified physical inactivity, and inappropriate intake of micro nutrients amongst the factors that lead to high risk of breast cancer, logical justification is still missing (Forshee, 2003). On the contrary, the prevalence rates in the postmenstrual age group are significantly lower for these women.

In spite of the innumerous efforts to avert this disease, the occurrence rates have taken an increasing trend since 1980s (American Cancer Society [ACS], 2005). Along with this, the inconsistencies between incidental and mortality rates for African-American and white women continue to rise. Based on the extensive research work, ACS anticipated that around 211,240 women in U.S. will be diagnosed with this disease and from this around 40,410 will lose their lives.

As mentioned earlier, the occurrence rate for African-American women is lower than that for Caucasian-American women (119.9 per 100,000 compared with 141.7 per 100,000), however, fatality rate for the same is higher. (35.4 per 100,000 compared with 26.4 per 100,000) (ACS) Although the actual reasons behind this inconsistency have not been documented, researchers have proposed a few in an attempt to resolve the query. These reasons include lack of awareness about cancer and the fact that it is curable, ineffective communication, lack of financial support and limited access to health care (Paskett et al., 2004; Schwartz, Crossley-May, Vigneau, Brown, & Banerjee, 2003; Smedley, Stith, & Nelson, 2003).

Problem Statement

Breast cancer is the top ranked disease amongst women (American Cancer Society, 2006a). Besides being the most popular form of cancer, it is also the major contributor to high ratio of cancer related deaths in U.S.. Following the increasing prevalence rates, it is projected that 212,910 women will be diagnosed with breast cancer in 2006, with 6,290 women in North Carolina (American Cancer Society, 2006a). The prediction for breast cancers started from 2005, and in the first year of prediction, 250 women were expected to be diagnosed with this syndrome (Central Cancer Registry & American Cancer Society, 2005).

Once a woman is diagnosed with cancer, the first question to consider is whether it is fatal or not. The answer lies in the stage at which cancer is detected. The disease is curable if detected at an early stage. This is evident from the fact that the ratio for endurance is 98% for those women whose cancer was diagnosed at an early stage as compared to 26% for those women whose cancer reached the advanced stage (American Cancer Society, 2005a). Research has revealed that African-American women mostly become victims of advanced stage cancer increasing the death rates for this demographic (Ghafoor et al., 2003; Li, Malone, &…