Breast cancer is one of the most common and threatening types of cancer affecting females worldwide. The incidence of this serious degenerative disease drastically increases with age. Management and treatment of breast cancer is a challenging, but realistic process that requires increased specialization and meaningful collaboration of numerous health care professionals, including surgeons, radiation professionals, experts in oncology, geneticists, nurses, and reconstructive surgeons. The current paper is aimed at shedding light on the pathophysiology of breast cancer in older female individuals. In addition, much emphasis will be placed on accurate diagnosis of the disease and effective treatment options that lead to positive health outcomes.
Pathophysiology of Breast Cancer
Taking into account estimations of researchers who study pathophysiology of breast cancer, this progressive disease that develops from breast tissues mainly in females occurs because of close interaction between certain environmental factors and genetically susceptible hosts (Shah, Rosso, & Nathanson, 2014). Cells are classified as cancerous when they lose their unique ability to stop dividing when it is necessary, do not attach to other normal cells, and do not die at a specific period of time. Experts in health care estimate that age of persons, a variety of reproductive factors, personal and family history of this threatening disease, gender, genetic pre-disposition, and multiple environmental factors are main factors that are directly linked with increased risks for the development of breast cancer in older female populations (Shah et al., 2014). Evidence suggests that there are numerous fixed and modifiable factors, especially onset of menopause, hormone levels, alcohol abuse, and physical inactivity of older females that contribute to considerable mortality rates caused by breast cancer among older women (Shah et al., 2014).
Statistics clearly and unambiguously indicates that a lump is the most common and noticeable symptom of this disease in females of different age groups, including older individuals (Elomrani et al., 2015). However, there are many other signs and symptoms of breast cancer that contribute to an early and timely detection of the disease, especially changing positing or shape of a nipple, thickening, a rash on a nipple or around it, constant and severe pain, breast density, itching, redness, swelling, inversion of a nipple, warmth, unexpected weight loss, and many other indicators (Elomrani et al., 2015). Breast cancer is associated with negative physical and psychosocial sequelae because this disease is included to the category of metastatic diseases that usually affect many other organs of a human body, especially bones, liver, lungs, and even human brain (Elomrani et al., 2015).
In general, the stage of breast cancer is considered to be the most significant and influential component associated with classification of this progressive disease as it affects its prognosis and outcomes (Elomrani et al., 2015). Stage four cancer that is commonly referred to as metastatic breast cancer is characterized by the worst prognosis and is usually managed with a harmonious combination of different effective types of treatment, including surgery, regular radiation, chemotherapy, and many other targeted procedures and therapies (Elomrani et al., 2015). On the contrary, stage one is usually characterized by excellent prognosis as this early stage of cancer in older women is often successfully treated with lumpectomy and radiation (Aebi, Davidson, Gruber, & Cardoso, 2011). Although the second and third stages of breast cancer are usually characterized by a poorer prognosis than the first stage of the disease as greater risks of recurrence are typical for this stage, statistical data prove that these stages of breast cancer in developed countries are effectively treated with surgery and chemotherapy (Aebi et al., 2011). In general, older female individuals experience this progressive disease that results in a variety of physical and psychological complications in different manners (Aebi et al., 2011). Thus, age of individuals is the most significant factor that impacts the way patients cope with and manage a breast cancer diagnosis. Management of breast cancer in older women should be complex because this specific population requires adapted treatment options.
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Diagnosis of Breast Cancer
Regardless of the fact that most types of breast cancer in the elderly female populations are usually detected by biopsy, many health professionals insist on specialized laboratory examinations (Elomrani et al., 2015). Regular breast self-examination and physical examinations are of utmost importance as these efficient methods motivate older females to be familiar with their normal anatomy and encourage them to contribute to their own healthcare (Elomrani et al., 2015). According to the information provided in the NCCN guidelines, annual clinical examination of breasts and regular BSE significantly decrease an average risk of cancer in female individuals after 40-50 years of age (Elomrani et al., 2015). The role of mammography is fundamental as results of studies with participation of the experimental group demonstrate that periodic mammography screening and regular clinical examinations result in decreased mortality rates by above one third (Elomrani et al., 2015). A series of contemporary randomized control trials clearly indicate and prove benefits of this method for females aged from 40 to 70 years (Shah et al., 2014). Magnetic resonance imaging or MRI has gained considerable popularity as this effective modality ensures a chance to detect, assess, stage, and manage breast cancer in older females (Yang et al., 2011). In addition, many qualified and experienced physicians emphasize increased significance of the breast ultrasound as this adjunctive screening provides clinicians with an opportunity to screen older female individuals for breast cancer in in dense breasts when sensitivity of mammography is very low (Yang et al., 2011). Taking into account the differential diagnosis of breast cancer, this heterogeneous disease includes a variety of common and uncommon conditions, including fibroadenoma, breast abscess, invasive breast cancer, ADH, DCIS, phyllodes, and many others (Yang et al., 2011).
The most common pharmacological methods of management and treatment of breast cancer in older women include surgery, dissection of axillary lymph nodes, adjuvant therapy, radiotherapy, and adjuvant hormonal therapy (Elomrani et al., 2015). Since most randomized trials provide convincing evidence that the incidence of breast cancer considerably increases with age, management and treatment must aim for maximum effectiveness and efficiency. In spite of the fact that reactions of older female individuals to pharmacological treatment are different, advanced age should not be viewed as the main limitation to treatment (Elomrani et al., 2015). On the contrary, the most common non-pharmacological measures include a variety of physical, cognitive, and behavioral tactics and strategies, ensure a chance to relieve pain and slow down the progression of this degenerative disease, and are associated with avoiding stress and anxiety, progressive relaxation, musical therapy, and many other effective non-invasive methods (Elomrani et al., 2015). The role of client management self-care and education is predominant because these methods foster global cancer awareness (Aebi et al., 2011). As older female individuals are categorized as most-at-risk populations, the government should considerably increase awareness of the public of breast cancer and its threatening consequences, eliminate specific risk behaviors, and promote significance of early cancer detection (Aebi et al., 2011).
Thus, breast cancer is one of the leading causes of death among older females and its incidence drastically increases with age. The role of regular screening is fundamental as it contributes to early detection of this degenerative disease that is the leading cause of mortality in older females in different corners of the globe. Client self-care and education of the public are extremely important as these strategies and tactics promote early breast cancer detection and contribute to breast cancer prevention in people of different ages and genders, especially older female individuals as the risky population.