Why Did The Cold War Start And How Did It Develop Over Its...

Why did the Cold War start and how did it develop over its first three decades? During WWII the United States and the Soviet Union fought together as allies against the Axis powers. However, it was not without tension on both sides. After WWII ended the tension between both sides continued and gradually increased. For two years they tried to come to some sort of agreement over their differences over the division of Europe, postwar economic aid, and the atomic bomb through negotiation and discussion. (Divine 2013, p. 666). Their main disagreement was who was in control of postwar Europe. The two sides could never come to an agreement that would be acceptable to both sides and so they decided to just occupy different regions in the way they each wanted to. The United States did not like Soviet communism and the soviets resented the United States refusal to treat the USSR as a legitimate part of the international community. â€Å"In such a hostile atmosphere, no single party was entirely to blame for the Cold War; in fact, some historians believe it was in evitable† (Cold War History). Containment, first proposed by George Kennan in 1947, became the basic strategy of the United States throughout the Cold War. Kenna believed that if the United States stood firm on their resistance to Soviet expansion that it would eventually compel Moscow to adopt more peaceful policies. In 1946, in his famous â€Å"Long Telegram,† the diplomat George Kennan (1904-2005) explained this policy:Show MoreRelatedRough Justice : Battle For Fix The World, One Prosecution At A Time By David Bosco1134 Words   |  5 Pages The book Rough Justice: Battle to Fix the World, One Prosecution at a Time was authored by David Bosco. 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The veterans marched up Pennsylvania Avenue to acquire their relief. However, MacArthur and Hoover stopped the veterans at their core in a final â€Å"battle† calling them â€Å"communists and persons with criminal records.† 2. What is Rugged Individualism? a.Read MoreSocial Development, Political Development And Scientific Development2004 Words   |  9 Pagesoccurred since the past decades and been improved ever since. The three developments I will mentioning are social development, political development and scientific development. Firstly am going to begin by introducing the major cause of death in the 1900 and another cause of death today. With that in mind I will also be including how the cause were or are dealt with now. Furthermore I will examine the developments separately and the impact they have on the health status. As the Great War (WW1) was coming

Streams of Silver Epilogue Free Essays

Drizzt, Wulfgar, and Catti-brie came into Longsaddle a few days later, road weary and still wrapped in a shroud of grief. Harkle and his kin greeted them warmly and invited them to stay at the Ivy Mansion for as long as they desired. But though all three of them would have welcomed the opportunity to relax and recover from their trials, other roads summoned them. We will write a custom essay sample on Streams of Silver Epilogue or any similar topic only for you Order Now Drizzt arid Wulfgar stood at the exit of Longsaddle the very next morning, with fresh horses provided by the Harpells. Catti-brie walked down to them slowly, Harkle holding back a few steps behind her. â€Å"Will you come?† Drizzt asked, but guessed by her expression that she would not. â€Å"Would that I could,† Catti-brie replied. â€Å"Ye’ll get to the halfling, I don’t fear. I’ve another vow to fulfill.† â€Å"When?† Wulfgar asked. â€Å"In the spring, by me guess,† said Catti-brie. â€Å"The magic of the Harpells has set the thing to going; already they’ve called out to the clan in the dale, and to Harbromm in Citadel Adbar. Bruenor’s kin’ll be marchin’ out afore the week’s end, with many allies from Ten-Towns. Harbromm promises eight thousand, and some of the Harpells have pledged their help.† Drizzt thought of the undercity he had viewed in his passage of the lower levels, and of the bustle of thousands of gray dwarves, all outfitted in shining mithril. Even with all of Clan Battlehammer and their friends from the dale, eight thousand battle-seasoned dwarves from Adbar, and the magical powers of the Harpells, the victory would be hard won if won at all. Wulfgar also understood the enormity of the task that Catti-brie would face, and doubt came to him about his decision to set out with Drizzt. Regis needed him, but he could not turn away from Catti-brie in her need. Catti-brie sensed his torment. She walked up to him and kissed him suddenly, passionately, then jumped back. â€Å"Get yer business done and over, Wulfgar, son of Beornegar,† she said. â€Å"And get ye back to me!† â€Å"I, too, was Bruenor’s friend,† Wulfgar argued. â€Å"I, too, shared in his vision of Mithril Hall. I should be beside you when you go to honor him.† â€Å"Ye’ve a friend alive that needs ye now,† Catti-brie snapped at him. â€Å"I can set the plans to going. Ye get yerself after Regis! Pay Entreri all he’s got coming, and be quick. Mighten be that ye’ll get back in time to march to the halls.† She turned to Drizzt, a most-trusted hero. â€Å"Keep him safe for me,† she pleaded. â€Å"Show him a straight road, and show him the way back!† On Drizzt’s nod, she spun and ran back up to Harkle and toward the Ivy Mansion. Wulfgar did not follow. He trusted in Catti-brie. â€Å"For the halfling and the cat,† he said to Drizzt, clasping Aegis-fang and surveying the road before them. Sudden fires glowed in the drow’s lavender eyes, and Wulfgar took an involuntary step back. â€Å"And for other reasons,† Drizzt said grimly, looking out over the wide southland that held the monster he might have become. It was his destiny to meet Entreri in battle again, he knew, the test of his own worth to defeat the killer. â€Å"For other reasons.† * * * Dendybar’s breath came hard to him as he viewed the scene, Sydney’s corpse stuffed into a corner of a dark room. The specter, Morkai, waved his arm and the image was replaced by a view of the bottom of Garumn’s Gorge. â€Å"No!† Dendybar screamed when he saw the remains of the golem, headless and lying among the rubble. The mottled wizard shook visibly. â€Å"Where is the drow?† he demanded of the specter. Morkai waved the image away and stood silent, pleased at Dendybar’s distress. â€Å"Where is the drow?† Dendybar repeated, more loudly. Morkai laughed at him. â€Å"Find your own answers, foolish mage. My service to you is ended!† The apparition puffed into fire and was gone. Dendybar leaped wildly from his magic circle and kicked the burning brazier over. â€Å"I shall torment you a thousand times for your insolence!† he yelled into the emptiness of the room. His mind spun with the possibilities. Sydney dead. Bok dead. Entreri? The drow and his friends? Dendybar needed answers. He could not forsake his search for the Crystal Shard, could not be denied the power he sought. Deep breaths steadied him as he concentrated on the beginnings of a spell. He saw the bottom of the gorge again, brought the image into sharp focus within his mind. As he chanted through the ritual, the scene became more real, more tangible. Dendybar experienced it fully; the darkness, the hollow emptiness of the shadowy walls and the almost imperceptible swish of air running through the ravine, the jagged hardness of the broken stone under his feet. He stepped out of his thoughts and into Garumn’s Gorge. â€Å"Bok,† he whispered as he stared down at the twisted and broken form of his creation, his greatest achievement. The thing stirred. A rock rolled away from it as it shifted and struggled to rise before its creator. Dendybar watched in disbelief, amazed that the magical strength he had imbued upon the golem was so resilient as to survive such a drop, and such mutilation. Bok stood in front of him, waiting. Dendybar studied the thing for a long moment, pondering how he might begin to restore it. â€Å"Bok!† he greeted it emphatically, a hopeful grin coming to him. â€Å"Come, my pet. I shall take you back home and mend your wounds.† Bok took a step forward, crowding Dendybar against the wall. The wizard, still not understanding, started to order the golem away. But Bok’s remaining arm shot up and grasped Dendybar by the throat, lifting him into the air and choking off any further commands. Dendybar grabbed and flailed at the arm, helpless and confused. A familiar laugh came to his ears. A ball of fire appeared above the torn stump of the golem’s neck, transforming into a familiar face. Morkai. Dendybar’s eyes bulged in terror. He realized that he had overstepped his limits, had summoned the specter too many times. He had never truly dismissed Morkai from this last encounter, and suspected rightly that he probably wouldn’t have been strong enough to push the specter from the material plane even if he had tried. Now, outside of his magic circle of protection, he was at the mercy of his nemesis. â€Å"Come, Dendybar,† Morkai grinned, his dominating will twisting the golem’s arm. â€Å"Join me in the realm of death where we might discuss your treachery!† A snap of bone echoed across the stones, the ball of fire puffed away, and wizard and golem tumbled down, lifeless. * * * Farther down the gorge, half buried in a pile of debris, the fires of the burning dragon had died to a smoky smolder. Another rock shifted and rolled away. How to cite Streams of Silver Epilogue, Essay examples

Project Report Corporate Financial Accounting †MyAssignmenthelp.com

Question: Discuss about the Project Report Corporate Financial Accounting. Answer: Introduction: Capital budgeting is a part of investment appraisal techniques. This planning process is used by the companies to evaluate the various investment long term opportunities. Capital budgeting process evaluates the various projects according their cash flows, present value factors, their net present value, internal rate of return, payback period, accounting rate of return etc (Zimmerman and Yahya-Zadeh, 2011). long term investment opportunities for a business could be new products, new plants, replacement of old machineries, new machinery, research development projects etc. for analyzing the best project, company takes the help of various tools which are available such as sensitivity analysis, scenario analysis, break even analysis, simulation technique analysis (Bierman and Smidt, 2012). It is required for every organization to evaluate the best investment proposal from the available proposals. And this could only be possible if the best corporate decision strategies have been adopted b y the company. Corporate decision making is a process which aids the organization into looking over various aspects and then makes a best decision for every dilemma of the business. Corporate decision making is a continuums process which takes place at every step in an organization. Corporate decision making sets a companionship among all the factors of the company and the stakeholders of the company (Gervais, Heaton and Odean, 2011). This report tells the user about various techniques and analysis which would aid the organization to select the best investment proposal according to the requirement of the company. Sensitivity analysis: Sensitivity analysis is a tool which is used by the various parties to evaluate that how many diversified values of a free variable would affect a specific variable which has been estimated through many assumptions. This analysis is also known as what if analysis. It has been observed that normally, every entire quantitative factor of an investment such as cash outflow, cash inflow, discount rate, cost of capital, project duration etc are recognized with certainty but in reality, it rarely takes place (Bierman and Smidt, 2012). Sensitivity analysis helps the companies to overcome the same problem. The techniques of sensitivity analysis could be applied over various planning activities and not only on capital budgeting decision. This analysis helps an organization into evaluating that how the distribution of possible internal rate of return and net present value for a proposal under context is impacted consequently to make a change into a single variable which is dependent in nature. This analysis could take place only be changing into one variable at a time. Sensitivity analysis evaluates a value for every input and offers a decision making process to the company to choose the best project. Such as if a products selling price would be reduced by 10% and at the same time, the internal rate of return would also be changed due to changes into the total life of the project from 3 years to 5 years. Than sensitivity analysis, helps the organization to make a better decision about investment (Bennouna, Meredith and Marchant, 2010). As according to the above case, every factor will be changed due to change into a single variable of the investment proposal. Such as changes into the selling price will change the NPV of the project and the total life of the project will make an impact over the internal rate of return. Than the calculated NPV is plotted into a graph to depict that how sensitive the net present value could be due to changes into the related factors. The below figure depict that the slope of line in the below graph depicts that how sensitive the net present value is to make a change into each input. The steeper the slope would be, the more sensitive the net present value would be to make changes into the variable. (Hall and Millard, 2010) Sensitivity analysis is used widely because of its ability and simplicity to focus over the specific estimates. Mainly it is used in the banking industry to evaluate the projects which are related to the funding. This analysis offers critical idea about the success or failure of the project. Scenario analysis: It has been observed that the sensitivity analysis is used widely as a risk analysis technique but this analysis has some limits. Therefore, sensitivity analysis has been extended to deal with various probability distributions of various inputs and further, scenario analysis also aids the more variables at a single time so that the combined effect could also be analyzed with the changes in more than one variable (Adair, 2011). Scenario analysis also offers a specific answer to this solution. Scenario analysis mainly answers the question of that how bad can a project look. Various times, mangers just take an assumption and forget to make other assumptions according to the competitors relation and economy consideration etc. in scenario analysis; factors are evaluated according to the scenario which has been built by the managers. These aspects could range from economy state to the competitors response on firms any action. Secondly, the components are determined the number of scenario analysis for every factor. Basically, three scenarios are determined according to the base, average and worst case. Though, it might vary according to the long range (Garrison, Noreen, Brewer and McGowan, 2010). The third component of scenario analysis is to focus over the critical aspects and build a scenario for every factor and lastly, in the forth component, probabilities of each scenario are evaluated. This scenario could b e based upon many macro factors such as interest rate, exchange rate and various micro factors such as reaction of competitor. Factors Normal case Best case Worst case Yield - + 20% - 30% Exchange rate - + 5% - 5% Transportation cost - -15% +25% Marketing cost - -8% +23% Sales cost - + 5 % - 15% Sales price 1.03 1.05 1.00 Cash inflow 10 % 19 % 3% NPV 1 2.5 -2.3 (Burns and Walker, 2015). The above tale depict that the three scenarios are there for every investment proposal in front of the company, through this analysis, it has been found that the three scenarios are available in front of the company which are best, normal, worst. Through this scenario, it becomes easy for the managers to choose the best investment proposal. Break even analysis: Break even analysis helps an organization into selecting the best project according to the cost and revenue relationship. In this project, various tools of an investment proposal are determined and then the level of breakeven is analysed. The breakeven level of an investment project is the point where the total associated cost is equal to the total revenue earned by the company. This analysis a graph is plotted and the total revenue slope and the cost slope are drawn. The point where both the slopes are interacted with each other is the point of breakeven (Shim, Siegel and Shim, 2011). Break even analysis generates an idea about the positive return from an investment. This analysis depict that the fixed cost of a project s not directly linked with the production level and thus the breakeven level get impacted through the fixed cost of the project. In addition, variable cost of a project directly makes a change into the volume of output. The study of breakeven analysis is a great tool to identify the relationship between the returns, variable cost and fixed cost. Breakeven point offers an idea that when an investment proposal would generate positive return as well as it could be determined according to some mathematical calculations and graph (Grant, 2016). This analysis helps an organization to calculate the level of production through which the positive returns could be earned by the company. And the entire cost could be concerned properly.(Bodie, 2013) The above graph of breakeven point depict that the total 9 units are required to be produce by the company to cover all the cost. Further, production would help the company to make profits. These calculations help the company to identify the best available project in the market. And this analysis also help the company to determine the total return which could be get by the company after investing into the particular project. Further, it has also been analyzed that how much cost would be paid by the company even in the case of no production and how much units are required by the company to produce to reach over a point where the cost and the revenue are equal (Fortson, 2011). Simulation techniques: This analysis is also known as Monte Carlo simulation. It ties sensitivity as well as probability distribution together. This method is based upon various mathematical calculations. The main fundamental appeal of this technique is to offer decision makers along with a probability distribution of net present values rather than an only single estimation about the estimated net present value. This technique ties all the related factors and then makes a corporate decision about the various investment opportunities for an organization. Firstly, in this analysis, a simulation exercise takes place to investigate over the investment proposal and than many related key factors are involved to estimate the affected project and their inter relationship with other factors. This technique involves modelling of cash flows to disclose entire key factors which are influenced by both the cash payments and receipts and their relationship with other factors. Simulation technique involves the relationship of net present value with various parameters and exogenous variables. It specifies the parameters value and probability distribution of exogenous factors and variables. Further, a value is selected randomly from probability distribution of every exogenous variable. In addition, NPV is determined corresponding to the random generated value of variables and pre specified variables of parameters. The 3rd and 4th steps are repeated again to get a large number of simulated net present values (Wright et al, 2010). Lastly, the probability distribution is plotted and mean and standard deviation of return are computed to collect the risk level of a project. Simulation techniques are analyzed to determine the best investment project form the various available projects in the market. This analysis mainly shows its concern about the probability distribution and the sensitivity analysis. This study helps the organization to identify and evaluate the best available investment proposal from the available projects into the company (Godfray et al, 2010). This analysis aids the company to evaluate the best business plan for the company in concern of the profits. This analysis technique is a tool which is mainly uses by the association to make a superior decision about diverse investments i.e. the total time in which corporation would be proficient to reverse the entire connected cost. Conclusion: In the above study, capital budgeting technique has been investigated and it has been found that this planning process is used by the companies to evaluate the various investment long term opportunities. Capital budgeting process evaluates the various projects according their cash flows, present value factors, their net present value, internal rate of return, payback period, accounting rate of return etc. for this study, various tools such as sensitivity analysis, scenario analysis, break even analysis, simulation technique analysis have been analyzed and it has been found that all the analysis are helpful for the company to identify the best project from the available projects. Through this study, it has been found that all the projects are helpful for the company in diverse situation. Sensitivity analysis is a tool which is used by the various parties to evaluate that how many diversified values of a free variable would affect a specific variable which has been estimated through many assumptions. Scenario analysis mainly answers the question of that how bad can a project look. Various times, mangers just take an assumption and forget to make other assumptions according to the competitors relation and economy consideration etc. In addition, Break even analysis helps an organization into selecting the best project according to the cost and revenue relationship. In this project, various tools of an investment proposal are determined and then the level of breakeven is analysed. Lastly, a simulation exercise takes place to investigate over the investment proposal and than many related key factors are involved to estimate the affected project and their inter rel ationship with other factors. And these analyses help the company to determine the total return and risk which could be faced by the company after investing into the particular project References: Adair, T., 2011. Corporate Finance Demystified 2/E. McGraw Hill Professional. Bennouna, K., Meredith, G.G. and Marchant, T., 2010. Improved capital budgeting decision making: evidence from Canada. Management decision, 48(2), pp.225-247. Bierman Jr, H. and Smidt, S., 2012. The capital budgeting decision: economic analysis of investment projects. Routledge. Bierman Jr, H. and Smidt, S., 2012. The capital budgeting decision: economic analysis of investment projects. Routledge. Bodie, Z., 2013. Investments. McGraw-Hill. Burns, R. and Walker, J., 2015. Capital budgeting surveys: the future is now. Fortson, J.G., 2011. Mortality risk and human capital investment: The Impact of HIV/AIDS in Sub-Saharan Africa. The Review of Economics and Statistics, 93(1), pp.1-15. Garrison, R.H., Noreen, E.W., Brewer, P.C. and McGowan, A., 2010. Managerial accounting. Issues in Accounting Education, 25(4), pp.792-793. Gervais, S., Heaton, J.B. and Odean, T., 2011. Overconfidence, compensation contracts, and capital budgeting. The Journal of Finance, 66(5), pp.1735-1777. Godfray, H.C.J., Beddington, J.R., Crute, I.R., Haddad, L., Lawrence, D., Muir, J.F., Pretty, J., Robinson, S., Thomas, S.M. and Toulmin, C., 2010. Food security: the challenge of feeding 9 billion people. science, 327(5967), pp.812-818. Grant, R.M., 2016. Contemporary Strategy Analysis Text Only. John Wiley Sons. Hall, J. and Millard, S., 2010. Capital budgeting practices used by selected listed South African firms. South African Journal of Economic and Management Sciences, 13(1), pp.85-97. Shim, J.K., Siegel, J.G. and Shim, A.I., 2011. Budgeting basics and beyond (Vol. 574). John Wiley Sons. Wright, M.M., Daugaard, D.E., Satrio, J.A. and Brown, R.C., 2010. Techno-economic analysis of biomass fast pyrolysis to transportation fuels. Fuel, 89, pp.S2-S10. Zimmerman, J.L. and Yahya-Zadeh, M., 2011. Accounting for decision making and control. Issues in Accounting Education, 26(1), pp.258-259.

Lifestyle theory free essay sample

Introduction The chance of a women being raped, in most cases, has a high correlation with their lifestyle they choose to live. The lifestyle exposure theory can help explain the probability of a rape occurring. Where a women lives, the time of day she choose to travel, the type of transportation she uses, her economic statues, if she has any family obligation, and what type of societal and cultural constraints that are imposed on her all effect the type of lifestyle she lives. In turn affects how and what type of potential offenders she will come into contact with. Victimization Type There is a word in our vocabulary that can elicit an emotional and defensive stand in almost all people in our society- the word is rape. By just reading the word most people feel some type of negative reaction whether it is: disgust, embarrassment, fear, repulsion, concern for the victim, hatred for the offender, or all of these or more. We will write a custom essay sample on Lifestyle theory or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page How is the word rape definite? In January of this year the DOJ changed the definition of rape- â€Å"The carnal knowledge of a female forcibly and against her will.†, that is used in the UCR (UCR Part I Offenses), which was categorized as â€Å"forcible rape† and had remand unchanged since 1929 and excluded victims of anal/oral sex, rape with an object, male rape and statutory rape (Shields). To a wider, more inclusive definition with the title of â€Å"rape† to show that all forms of rape could be considered under this definition-â€Å"The penetration, no matter how slight of the vagina or anus with any body part or object, without the consent of the victim.† (Attorney General). With the change in the definition that law enforcement used to define rape there was a shift from the type of violence and aggression that just included women and ignored males and a number of other aspects to situations where it wasn’t a gender specific crime and the penalties for rape were on similar punishment scale. The crime of rape is still a very women dominated on the victim side and males being the offenders. There are three different categories of rape: stranger rape, acquaintance rape, and marital rape. Stranger rape is thought to be the most common but in all actuality acquaintance rape is the most prevalent followed by marital raped-which for the longest time wasn’t considered rape-than stranger rape is the least prevalent. For the purpose of this paper I am going to focus more on the category of stranger rape  (Roberson and Wallace). Rape is considered to be a stranger rape when the offender is unknown to the woman. Any type of rape is detestable and the repercussions of the crime are similar despite whether it was someone the woman knew or not. It is thought that the victims of stranger rape recover from the emotional, mental, and physical affects more quickly than those victims of martial and acquaintance rape, because victims of stranger rape usually don’t have to go through the feelings of betrayal and loss of trust from a person they knew (Definition of Stranger Rape). Theory Lifestyle-exposure theory more commonly known as Lifestyle theory was developed in 1978 by Michael Hindelang, Michael Gottfredson, and James Garofalo when they published a book titled: Victims of Personal Crime: An Emprical Foundation for a Theory of Personal Victimization. Through the research for this book it was found that in a person’s victimization they can play a more suitable target for an offender. With the development of this theory it opened new doors in the world of victimology by suggesting that choices a victim makes in their every life and dealings with others can either increase their chances at being victimized or it can decrease their chances (Hindelang, Gottfredson, Garofalo). These scholars helped shift the focus more fully on the victim and less on the offender by stating that victims could be held in some part responsible for their victimization just by the lifestyle characteristics they posses. Through earlier theorists and the typologies they used it help refine victimization research in that it was noted that being victimized wasn’t a completely random, out of the blue, type of event it was previously thought to be; but a big down fall, so to speak, was that these older theories tended to viewed as blaming the victim for them being victimized and not placing adequate blame on the offender. With the emergence of the lifestyle theory it pushed the past the bad karma of victim blaming and gave a better understanding of what type of relationships and or associations the victim had to the offender and vise versa in view of what their lifestyles were and the location of where the victimization took place (McGrath). So a big question is how would one define a lifestyle? Hindelang, Gottfredson, and Garofalo defined a lifestyle, for the purpose of this theory, as â€Å"†¦as daily activities and leisure activities in which individuals participate on a routine basis†. It  also includes the choices a person makes on their own freewill and those â€Å"imposed on by constraints†, such as societal structures and or cultural expectations. The main point of the lifestyle theory that Hindelang, Gottfredson, and Garofalo were making is that the more lifestyles a person places themselves in or are involved in they are also placing themselves in a closer range for potential offenders, which in turn makes them a more suitable target to be victimized (Hindelang, Gottfredson, Garofalo). To expand on some of these lifestyle constraints the first that comes to mind is the societal expectation that are made of a person’s behavior. The different roles a person has in society shapes what kind of lifestyle is expected of them to live in many ways. With the majority of crime and criminal behaviors happening on a street level and usually after dark it’s expected that the people that stayed home at night, like new parents, are at a far less likelihood to be victimized than say someone that works all day and decides to unwind by going out late at night to party it up at a bar. That kind of person is less likely to be victimized if they don’t fall into the category of being young-under the age of 25, single, and male but women who fall into this category are more likely to a victim of a sexual crime. It’s thought the younger single people are somewhat less likely to have employment or part time employment so they are freer to go different places they choose at all times of the day or night, whereas, an older single person usually has more responsibilities such as full time employment and other bills to worry about but are still more likely to be victimized than new parents because they don’t have the big responsibility on kids (Robinson). Secondly, other lifestyle constraints that can influence a person’s chosen lifestyle is their economic status, their education level, and if they any family obligations. These types of constraints on a person’s lifestyle can influence what that person can do with their money, the type or quality of job they can qualify for, and what situation family obligations can put them in. a person that has a low SES is far more likely to live in the inner city, ghetto neighborhoods, where crime rates are higher and so forth, whereas, a person with a higher SES can afford to live farther out of the city, gated communities, and could possibly afford a security system for their property. In conjunction with a person’s economic status their education level plays a similar role in that the higher their  education level it’s thought the better the job they will have, which in turn can influence where they live. With family obligations the constraint aspect can go either way, such as, if a person is needed to pick up another job this will keep that person out of the house for longer periods of time and in closer proximity to potential offenders. Whereas, a person is needed at the house to be a caretaker to someone is off the streets and further out of the equation of crime (Robinson). Another aspect of a person’s economic situation is their subcultural and structural constraints. These can fit into how well a person handle things around them getting worse that aren’t in their full control-like a failing economy and they lose their job. Each individual person deals with that type of stressor in different ways-one could seek physical workout as a stress reliever and works on looking for a new job in positive, acceptable ways; another could slip into depression and start to self medicate with drugs and alcohol to push the feelings of pain and failure away and without a job they have no way of supporting their habit so they turn to criminal behaviors to support the new habit; where another could just fall into a deep depression and never want to get out of bed so their responsibilities fall to another person. In either situation the person chooses, mainly, where the put themselves on scale of being victimized (Theoretical Perspective). Since lifestyle theory is purposed towards being crime specific a person’s location can play a major role in their victimization risk being either high or low-meaning that a person’s risk level will vary depending on the type of crime. For instance, a student decides to study at the library instead of at their apartment- it’s fairly safe to say that a person would feel the library is a safe place to be when one is looking at criminal activity such as murder but when it comes to looking at the criminal activity of personal thefts it’s not such a safe place. An unattended backpack, laptop, and/or textbooks become very attractive items to steal very quickly (McGrath). A final aspect of lifestyle theory, which is mentioned by Garofalo, is time. Depending on what time it is during the day or night a person’s lifestyle choices or constraints can influence what type, if any, crime they could be exposed to. For instance, if a person doesn’t have their own vehicle that usually leaves them with limited options-one being public transportation, such as the bus. Taking the bus during the day is statistically less dangerous, fewer crime  opportunities, than it would after six in the evening. This is because the atmosphere changes, so to speak. During the day there are more people going to and from work and running errands, whereas, in the evenings more people are off work and alcohol and drugs can become factored in which is favorable to increase a person’s likelihood of victimization (Garofarlo, 1987). Applied When evaluating stranger rape and how to best predict the occurrence of this crime the victimology theory that would help best describe it, is Lifestyle Theory. In breaking down the events that lead up to a rape, particularly stranger rape, there is something appealing about the victim at ignites an offender to act, the victim’s lifestyle. Lifestyle theory goes into very specific details on how a victim’s chosen lifestyle makes them more or less attractive to an offender. Those resembling: where they live, inner city or rural; what societal roles are expected of them; the persons age and relationship status; their economic situations, poor middle class or wealthy; their education level which can be influenced by their economic status; if they have family obligation, if any; structural constraints, loss of a job; the places they choose to visit; the time of day they travel; and the type of transportation they use, bus vs. having their own vehicle. There are many myths about rape, such as, that women want to be raped, they like it rough and hard, how a woman dresses is saying they are asking for sex. None of these myths have any footing in this theory analysis or any other that is concerned with victimology. When a young, single women routinely travels late at night and is known to live alone specially when she is farther in the city- her lifestyle by choice or constraint makes her far more appealing target for the crime of rape, whereas, a young, single woman that travels before six in the evening, has her own vehicle and lives with a bunch of other people is not an appealing target. It’s similar with a young, single woman that likes to go out and party it up at the bar with drugs and alcohol- her target suitability is far greater than that of a woman that like to party but does it at friend’s house where there isn’t any drugs and limited alcohol. In reality every choice a woman makes in her everyday life will influence what, if any, type of potential offender she will attract to her- especially in cases of rape. Conclusion Lifestyle theory helped open new ways of understanding criminal victimization specially in being more crime specific which in a help in the crime of rape. It moved past the daunting section in victimology history of victim blaming and into the understanding that victimization isn’t a completely random act but one that could reasonably predict potential indicators of what could lead up to a person being victimized particularly in the crime of rape. Every decision people make in their lives, such as, time they travel, how they travel, where they live, their education level, family obligation, societal expectation, and cultural constrains- will bring them closer to potential offenders or put them farther away.

Free Essays on South Sister

SOUTH SISTER Redmond Oregon is where my brother lives. The town is located near the Oregon’s cascade range where there are several large snow covered volcanoes. I well be focusing on the south sister, which is the youngest and highest of a trio of closely grouped volcanoes called the three sisters. The south sister could be a threat to my brother because he lives only a few miles away, and according to sources the volcano may be coming to life. South sister is a composite volcano 10,358 feet high, it cone is comprised of adesite, dacite and rhyodacite, and is relatively young compared to its neighboring volcanoes. The latest eruptions on south sister occurred in two closely spaced episodes about 200 years ago. The eruption was a modest eruption producing small pyroclastic flows and tephra. But preceding that, similar style eruptions up to ten times larger occurred during and just before the last ice age 30,000-15,000 years ago. These larger eruptions produced pyroclastic flows that covered over a very large area from sisters to bend(see map) and tephra fallout deposits as thick as 42 feet. Such an eruption would be catastrophic today due to the mass population located near the base of the volcano. The wilderness around the volcano is becoming increasingly populated. Some 110,000 people live in areas that were criss-crossed by rivers of hot ash and rubble in previous Sister eruptions. According to (Ann Carns, 2002) the south sister volcano is beginning to show signs of activity after several thousand years of slumber. About a year ago scientist at the (USGS) detected a bulge in the earths crust near the base of the south sister. Using radar data they found that the ground of the south sister swelled about 4 in since 1996. This swelling has continued at a rate of about 1 in per year. In addition to the swelling small amounts of gas (chloride and sulfate) from molten rock are showing up in some spring waters around the bulge... Free Essays on South Sister Free Essays on South Sister SOUTH SISTER Redmond Oregon is where my brother lives. The town is located near the Oregon’s cascade range where there are several large snow covered volcanoes. I well be focusing on the south sister, which is the youngest and highest of a trio of closely grouped volcanoes called the three sisters. The south sister could be a threat to my brother because he lives only a few miles away, and according to sources the volcano may be coming to life. South sister is a composite volcano 10,358 feet high, it cone is comprised of adesite, dacite and rhyodacite, and is relatively young compared to its neighboring volcanoes. The latest eruptions on south sister occurred in two closely spaced episodes about 200 years ago. The eruption was a modest eruption producing small pyroclastic flows and tephra. But preceding that, similar style eruptions up to ten times larger occurred during and just before the last ice age 30,000-15,000 years ago. These larger eruptions produced pyroclastic flows that covered over a very large area from sisters to bend(see map) and tephra fallout deposits as thick as 42 feet. Such an eruption would be catastrophic today due to the mass population located near the base of the volcano. The wilderness around the volcano is becoming increasingly populated. Some 110,000 people live in areas that were criss-crossed by rivers of hot ash and rubble in previous Sister eruptions. According to (Ann Carns, 2002) the south sister volcano is beginning to show signs of activity after several thousand years of slumber. About a year ago scientist at the (USGS) detected a bulge in the earths crust near the base of the south sister. Using radar data they found that the ground of the south sister swelled about 4 in since 1996. This swelling has continued at a rate of about 1 in per year. In addition to the swelling small amounts of gas (chloride and sulfate) from molten rock are showing up in some spring waters around the bulge...

Breast Cancer

Some methods used to diagnose breast carcinoma are mammograms, MRI’s, and biopsies (NCI, 2010). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). Each stage has different prognoses with varying survival rates as well (Marissa, 2011). There are also many ways to prevent breast cancer including maintain a healthy weight, avoiding the alcohol consumption, and by getting an annual mammogram (Reynolds, 2010). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. women, making it the first truly common breast cancer susceptibility gene (Metcalf Metcalf, 2008). Other breast diseases besides breast cancer are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). These diseases do not necessarily lead to breast cancer and can be treated (Sacks, 2011; Silverman, 1994). Keywords: – breast cancer, ducts, lobules, tumor, invasive (infiltrating carcinoma), noninvasive (noninfiltrating carcinoma), Ductal Carcinoma In Situ (DCIS), Invasive Lobular Carcinoma (ILC), intraductal carcinoma, nonfunctioning breast tissue, estrogen, lymph nodes, mammogram, MRI (magnetic resonance imaging), core biopsy, somatic mutations, fine needle aspiration biopsy, stereotactic biopsy, FGFR2, BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, metastasis, fat necrosis, fibrocystic breast disease Breast Cancer Cells are the building blocks of living things and cancer grows out of normal cells in the body (Dugdale, 2010). Cancer is the uncontrolled growth of abnormal cells in the body (Dugdale, 2010). Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer doesn’t allow normal blood function by abnormal cell division in the blood stream (Peter, 2011). Normal cells in the body follow an orderly process of growth, division, and death, this is called apoptosis, and when this process breaks down, cancer begins to form (Peter, 2011). Cancer has been around since prehistoric times, and breast cancer is one of the earliest forms to have been mentioned (Eisenpreis, 1999). In the United States, breast cancer death rates are higher than those for any other cancer, besides lung cancer (breastcancer. org, 2012). Today, about 1 in 8 women (12%) will develop breast cancer in her lifetime (Martin, 2012). Breast cancer is a cancer that starts in the tissues of the breast (Yi-Bin David, 2011). In rare cases, breast cancer can start in other areas of the breast (Yi-Bin David, 2011). Breast cancer can be invasive or noninvasive (Yi-Bin David, 2011). Invasive meaning it has spread from the milk duct (lobule) to the other tissues in the breast (Eisenpreis, 1999). Noninvasive means that it has not yet invaded other breast tissue (Yi-Bin David, 2011). Types of Breast Cancer Breast cancer can begin in different areas of the breast – the ducts, the lobules, or sometimes, the tissue in between (breastcancer. org, 2012). There are several different types of breast cancer, including breast cancer in men (breastcancer. org, 2012). Some include Ductal Carcinoma In Situ, Invasive Lobular Carcinoma, and Male Breast Cancer (breastcancer. rg, 2012). Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is a noninvasive breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues of the breast (Yi-Bin David, 2011). It may progress to invasive cancer if it is left untreated (Yi-Bin David, 2011). DCIS is the earliest form of breast cancer and is usually found during a mammogram done as part of breast cancer screening (Mayo Clinic Staff, 2011). Because of the increased use of mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years (Mayo Clinic Staff, 011). When a woman has DCIS, she is at higher risk for the cancer coming back or also at higher risk for developing a new breast cancer than a person who has never had breast cancer before (breastcancer. org, 2012). Experts believe that 20 to 50% of women with DCIS will later develop an invasive breast cancer within 10 years of the DCIS diagnosis (Hoffman, 2010). The risk of lymph node involvement with ductal carcinoma in situ is only 1% to 2% so the lymph nodes under the arm do not need to be removed, as may be  the case with other types of breast cancer (Hoffman, 2010). In seven out of 10 cases, breast-conserving lumpectomies – instead of mastectomies – were an effective treatment option (Hoffman, 2010). This will depend upon the size of your tumor and the extent of its spread throughout your breast and the surrounding lymph nodes (Hoffman, 2010). While DCIS isn’t life-threatening, it does require treatment to prevent the condition from becoming invasive (Mayo Clinic Staff 2011). Most recurrences happen within 5 to 10 years after the first diagnosis and the chances of that happening are under 30 percent (breastcancer. rg, 2012). Invasive Lobular Carcinoma is an invasive type of breast cancer that begins in the milk-producing glands (lobules) of the breast (Mayo Clinic Staff, 2011). When a person has ILC, this means that the cancer cells have broken out of lobule where they started and they now have the potential to spread to other areas or tissues of the body (Mayo Clinic Staff, 2011). This type of cancer is more difficult to se e on imaging because of the way it grows with spreading branches (Hopkins, 2012). The treatments for invasive lobular carcinoma fall into two broad categories: Local and Systemic Treatment. Local treatments treat the tumor and the areas surrounding it, such as the chest and lymph nodes (breastcancer. org, 2012). Systemic treatments travel throughout the body to destroy any type of cancer cells that may have left the original tumor and traveled to other tissues to reduce the risk of the cancer coming back (breastcancer. org, 2012). ILC cells can proceed to infiltrate fatty tissue and create a web-like mass (Stephan, 2008). This web of cancer cells may feel like a thickened area of breast tissue, and may not cause concern or pain at first (Stephan, 2008). Unfortunately, if it is left undetected, ILC can develop into a mass that is about ? inch ( 2 centimeters) to about 2 inches (5 centimeters) or bigger in size, before causing more noticeable symptoms (Stephan, 2008). Breast cancer in men is a very rare disease (Attebery, Adams ; Weiss, 2011). But the truth is that boys and girls, men and women all have breast tissue (Attebery, Adams ; Weiss, 2011). Men have a small amount of nonfunctioning breasts tissue (breast tissue that cannot produce milk) that is concentrated in the area directly behind the nipple on the wall of the chest (Attebery, Adams ; Weiss, 2011). A type of breast cancer that has spread outside of the duct and into the surrounding tissue is called invasive or infiltrating carcinoma (ASC, 2012). Some symptoms that may occur in males developing breast cancer include lumps, changes to the nipple or breast skin, or discharge of fluid from the nipple (National Cancer Institute, 2011). Men who have an altered gene related to breast cancer have an increased risk of developing breast cancer (National Cancer Institute, 2012). The major problem is that breast cancer in men is more often than not diagnosed later than breast cancer in women because men are less likely to be suspicious of an abnormality in that area (Wax, 2012). Also, their small amount of breast tissue is harder to feel, making it more difficult to catch these cancers early, and allowing tumors to spread more quickly to the surrounding tissues (Wax, 2012). Breast cancer in men is detected the same way as breast cancer is detected in women – through self-examination, clinical examination, or mammography (x-ray of the breast) (ASC, 2012). Methods for Diagnosis Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms (American Cancer Society, 2011). This is why getting the recommended screening tests before any symptoms develop is so important (American Cancer Society, 2011). Three types of methods used for diagnosis are mammograms, MRI’s, and biopsies (NCI, 2010). A mammogram is a low-dose x-ray picture of the breast and can be used to check for breast cancer in women who don’t have any signs or symptoms of the disease. (NCI, 2010) The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine (Webmd, 2010). There are different types of mammograms including Screening mammograms and Diagnositc mammograms (Webmd, 2010). Mammograms detect tiny bits of calcium that develop in dead cancer cells (Hoffman, 2010). As more and more cancer cells age and die, theses calcifications grow nd on the mammogram, they appear as a shadowy area (Hoffman, 2010). Current guidelines from the American College Radiology, the American Cancer Society, and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40, even if they have no symptoms or family history of breast cancer (ACR, 2010). For every 1,000 women who have screening mammogram: 100 are recalled to get more mammogr aphy or ultrasound images, 20 are recommended for needle biopsy and 5 are diagnosed with breast cancer (ACR, 2010). A mammography unit is a rectangular box that houses the tube in which x-rays are produced (Radiological Society of North America, 2011). Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate (Radiological Society of North America, 2011). A brief medical history and a history of specific problems related to the breast, such as pain or a palpable lump (one that is felt), is obtained prior to the mammogram (Stoppler, 2011). All jewelry and clothing in the chest and breast area are removed prior to the mammogram (Stoppler, 2011). The patient’s breasts are then placed on a firm flat panel and a gentle, but firm pressure is applied to the breast with another panel, resulting in compression of the breast between the two panels (Stoppler, 2011). The compression of the breast is necessary to obtain quality mammograms and spreads the breast tissue out so that the x-ray image displays the inner breast tissue with good resolution (Stoppler, 2011). Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them (Radiological Society of North America, 2011). As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black (Radiological Society of North America, 2011). The results of the mammogram can be given to the patient either by the radiologist at the completion of the mammogram or by the patient’s doctor who ordered the mammogram (Stoppler, 2011). An abnormal mammogram does not mean you have cancer (Stoppler, 2011). In some cases, it may just be an area of thicker or denser breast tissue, a cyst, or a benign lump such as a fibro adenoma (Stoppler, 2011). Unlike mammography which uses low dose x-rays to produce an image of the breast, MRI (Magnetic Resonance Imaging) uses powerful magnetic fields and radio waves to create images of the breast (Imaginis, 2012). The MRI system has the ability to switch magnetic fields and radio waves to achieve views in any plane and from any orientation while x-ray mammography requires re-orientation of the breast and mammography system for each view desired (Imaginis, 2012). MRI is a huge magnet and the woman gets put in the middle of the magnet; the magnetic field is turned on and then turned off again (Eisenpreis, 1999). The way the magnetized cells return to normal gives an image (Eisenpreis, 1999). The MRI finds lumps better than it tells whether or not they are cancerous (Eisenpreis, 1999). However, MRI can be good at showing how big a cancer is, once it has been found on the mammogram (Eisenpreis, 1999). A breast biopsy removes a sample of breast tissue that is looked at under a microscope to check for breast cancer and is usually done to check a lump found during a breast examination or a suspicious area found on a mammogram, ultrasound, or magnetic resonance imaging (MRI) (Marshall, 2009). During a fine-needle aspiration biopsy, the doctor inserts a thin needle into a lump and removes a sample of cells or fluid (Marshall, 2009). Nowadays, doctors might have decided to do something called stereotactic biopsy, where a patient lies on a table, with her breasts hanging down (Eisenpreis, 1999). A mammogram is taken to show where the lump is and a device holding a needle quickly shoots in and removes a few cells from the lesion (Eisenpreis, 1999). There is also something called a core biopsy that uses a larger needle to take out a piece of tissue, instead of just cells (Eisenpreis, 1999). A doctor numbs your skin with a shot of numbing medicine where the biopsy needle will be inserted and once the area is numb, a small cut is made in the skin from where the needle with a special tip is inserted into breast tissue (Marshall, 2009). Three to twelve samples will be taken to acquire the most accurate results (Marshall, 2009). Classifications and Associated Prognoses The stages of breast cancer are usually expressed as a number on a scale of 0 through IV – with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body (Marisa, 2011). Cancer stage is based on four characteristics; the size of the cancer, hether the cancer is invasive or non-invasive, whether the cancer is in the lymph nodes, whether the cancer has spread to other parts of the body beyond the breast (Marisa, 2011). Sometimes doctors use the term â€Å"locally advanced† or regionally advanced† to refer to large tumors that involve the breast skin, underlying chest structures, changes to the breast’s shape, and lymph node enlargement that is visible or that the doctor can feel during an exam (Marisa , 2011). The three ways that cancer spreads in the body are: Through tissue where cancer invades surrounding normal tissue, through the lymph system where the cancer invades the lymph system and travels through the lymph vessels to other places in the body, and through the blood, where cancer invades the veins and capillaries and travels through the blood to other places in the body (NCI, 2009). When cancer cells break away from the primary (original) tumor and travel through the lymph nodes or blood to other places in the body, another (secondary) tumor may form (NCI, 2009). This process is called metastasis (NCI, 2009). The stage of the breast cancer can help the patient and the doctor understand the prognosis (the most likely outcome of the disease) and make decisions about treatment, along with all the other results in the pathology report (Marisa, 2011). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). The TNM staging system classifies cancers based on their T, N, and M stages (ACS, 2012). The letter â€Å"T† followed by a number 0 to 4 describes the tumor’s size and spread to the skin or to the chest wall under the breast (ACS, 2012). The letter â€Å"N† followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected. The letter â€Å"M† followed by a 0 or 1 indicates whether the cancer has spread to distant organ (ACS, 2012). There are typically five stages (0 to 4) with sub-stages that indicate the prognosis for breast cancer (Lippman, 2005). Stage 0 where the carcinoma is insitu and no lymph nodes are affected had 99 percent 5 year survival rate (ACS, 2012). Stage IA also has a high rate, 92 percent, in which the tumor is equal to 2 centimeters (ACS, 2012). In stage IB, the tumor is 2 centimeters with micro metastases in 1 to 3 axillary lymph nodes but the cancer has not spread to distant sites (ACR, 2012). In stage IIA, the cancer cells have moved to the ipsilateral nodes and the 5 year survival rate lowers to 82 percent (Lippman, 2012). In stage IIB, the cancer cells have spread to movable ipsilateral nodes and the tumor is over 5 centimeters (Lippman, 2012). The 5 year survival rate lowers to 65 percent (ACS, 2012). In stage IIIA, there is no evidence of a primary tumor and no distant spreading (ACS, 2012). The 5 year survival rate lowers to 47 percent (Lippman, 2005). The tumor could be between 2 and 5 centimeters but there is still no distant spreading at this point (ACS, 2012). In stage IIIB the tumor has extended to the chest wall but there is still no distant metastases (Lippman, 2005). The 5 year survival rate lowers again to a 44 percent (Lippman, 2005). In stage IV the cancer can be any size (any T) and may or may not have spread to nearby lymph nodes (any N) (ACS, 2012). It has spread to distant organs or to lymph nodes far from the breast (M1) (ACS, 2012). The most common sites of spread are the bone, liver, brain, or lung (ACS, 2012). The survival rate lowers to 14 percent (Lippman, 2005). Prevention Methods Three ways to prevent breast cancer are by maintaining a healthy weight, avoiding alcohol consumption, and getting an annual mammogram (Reynolds, 2010). Mammogram screening, early diagnosis and better treatments have all contributed to the reduction in breast cancer cases by around 2 percent a year and the improved survival rate in the U. S. (Reynolds, 2010). Experts say now the focus needs to shift on improving personal lifestyle habits to prevent the disease even more (Reynolds, 2010). Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread (NCI, 2010). A medical team found an 11 percent lower risk of breast cancer in those women consuming the more healthful diet, including more whole grains, fruits and vegetables and less fatty, processed foods (Reynolds, 2010). They also found that those consuming large amounts of alcohol had a 21 percent increased risk (Reynolds, 2010). Drinking alcohol during adolescence has been linked to an increased risk of breast cancer, especially for girls with a family history of the disease (Reynolds, 2010). Exercise also plays a role in the reduction of breast cancer risk (Reynolds, 2010). In one study from the Women’s Health Initiative, as little as 1. 25 to 2. 5 hours per week of brisk walking reduced a woman’s risk by 18 percent (Reynolds, 2010). Walking 10 hours a week reduce the risk more (Reynolds, 2010). Diet and exercise can lead to weight reduction, another positive lifestyle change that can influence breast cancer disease risk (Reynolds, 2010). Many breast cancers are fueled by estrogen, a hormone produced in fat tissue (Reynolds, 2010). Experts suspect that more fat tissue equals more estrogen resulting in more cases of breast cancer that could possibly be avoided (Reynolds, 2010). Genetic ; Hereditary Influence According to researchers, the mutations in the gene, which is called FGFR2, raise the risk of breast cancer by 20 to 60 percent. (Metcalf ; Metcalf, 2008). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. omen, making it the first truly common breast cancer susceptibility gene (Metcalf ; Metcalf, 2008). Women with faulty copies of the genes BRCA1 or BRCA2 have 50 percent to 85 percent chance of getting breast cancer in their lifetimes, but they are rare genes and only account for 5 percent to possibly 10 percent of breast cancer cases (Metcalf ; Metcalf, 2008). Only 7% of all breast cancers are hereditary (Hirshaut ; Pressman, 2008). Of these hereditary cancers, 45% is caused by BRCA1 while 35% is caused by BRCA2 (Hirshaut ; Pressman, 2008). (Hirshaut ; Pressman, 2008). Variations of the  BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, and  TP53  genes increase the risk of developing breast cancer (Chen, 2007). The  AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, and  RAD51  genes are associated with breast cancer (Chen, 2007). Cancers occur when a buildup of genetic mutations in critical genes – those that control cell growth and division or the repair of damaged DNA – allow cells to grow and divide uncontrollably to form a tumor (Honrado, Osorio, Palacios ; Benitez, 2006). These changes, which are called somatic mutations, are not inherited (Honrado, Osorio, Palacios ; Benitez, 2006). Less commonly, gene mutations inherited from a parent increase the risk of developing cancer (Honrado, Osorio, Palacios ; Benitez, 2006). In people with these inherited genetic changes, additional somatic mutations in other genes must occur for cancer to develop (Honrado, Osorio, Palacios ; Benitez, 2006). Additional factors that may influence a person’s risk of developing breast cancer include gender, age, ethnic background, a history of previous breast cancer, certain changes in breast tissue, and hormonal factors (Thompson ; Easton, 2004). A history of breast cancer in closely related family members is also an important risk factor, particularly if the cancer occurred at an early age (Thompson ; Easton, 2004). Women who have inherited certain mutations in these genes have a high risk of developing breast cancer, ovarian cancer, and several other types of cancer during their lifetimes (Thompson ; Easton, 2004). Inherited changes in several other genes, including CDH1, PTEN, STK11, and TP53, have been found to increase the risk of developing breast cancer (Thompson ; Easton, 2004). In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved (Walsh ; King, 2007). For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant patter, which means one copy of the altered gene in each cell is sufficient to increase a person’s chance of developing cancer (Walsh ; King, 2007). In other cases, the inheritance of breast cancer risk is unclear (Walsh ; King, 2007). It is important to emphasize that people inherit an increased risk of cancer, not the disease itself (Walsh ; King, 2007). Not all people who inherit mutations in these genes will develop cancer (Walsh ; King, 2007). Other Breast Diseases Two other diseases found in the breast other than breast carcinoma are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). Fybrocystic breast disease is a commonly used phrase to describe painful, lumpy breasts (Sacks 2011). Hormones made in the ovaries can make a woman’s breasts feel swollen, lumpy, or painful before during menstruation each month (Sacks 2011). Fibrocysitc changes in the breast with the menstrual cycle affect over half of women (Sacks, 2011). Symptoms are usually worse right before the menstrual period, and then improve after the period starts (Sacks, 2011). Symptoms can include pain in both breasts, breasts that feel swollen and heavy, pain or discomfort under the arms, and thick or lumpy breasts (Sacks, 2011). This disease can be treated with medication like acetaminophen or ibuprofen (Sacks, 2011). Breast Fat necrosis is a benign condition that can occur in your breast (Silverman. 1994). It consists of fatty tissue that has been bruised, injured, or has died (Silverman, 1994). Once fatty tissue has been injured or has died, it can gradually change into scar tissue or may collect as liquid within an oil cyst (Silverman, 1994). Fat necrosis does not lead to the development of breast cancer, but it may sometimes cause breast pain (Silverman, 1994). An area of fat necrosis in your breast may feel like a fairly hard lump, or like a section of thick skin (Silverman, 1994). The person may see some drainage from the nipple that is nearest to the bruised region (Silverman, 1994). The nipple may sometimes even pull inward a little bit or the breast skin may dimple above the lump of fat necrosis (Silverman, 1994). Each case of fat necrosis is unique, so treatments will vary but if the fat necrosis has occurred recently, using warm compresses may help it subside (Silverman, 1994). When fat necrosis causes pain, the person can use ibuprofen and aspirin, but if that doesn’t help, ask your doctor if a prescription medication may be used (Silverman, 1994). About 39,520 women in the U. S. were expected to die in 2011 from breast cancer, though death rates have been decreasing since 1990 — especially in women under 50 (â€Å"Learn about cancer,† 2011). These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness (â€Å"breastcancer. org,† 2012). References Peter, C. (2011, October 20). Medical news today. Retrieved from http://www. medicalnewstoday. com/info/cancer-oncology/ breastcancer. org. (n. d. ). (2012, March 14). Retrieved from http://www. breastcancer. org/symptoms/understand_bc/statistics. jsp Yi-Bin , C. , ; David , Z. (2011, 15 12). A. d. a. m. medical encyclopedia. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0001911/ Mayo Clinic Staff. (2011, June 23). Ductal carcinoma in situ (dcis). Retrieved from http://www. mayoclinic. com/health/dcis/DS00983 Avon Foundation Breast Cancer (n. d. ). In http://www. hopkinsmedicine. org/avon_foundation_breast_center/breast_cancers_other_conditions/invasive_lobular_carcinoma. html. Stephan, P. (2008, July 24). Invasive Lobular Carcinoma. Retrieved from about. com website: http://breastcancer. about. com/od/types/p/ilc. html Dugdale, D. (2010, August 14). Pubmed. Retrieved from http://www. ncbi. nlm. nih. gov/pubmedhealth/PMH0002267/ Martin, L. (2012, January 18). Breast cancer facts. WebMD. Retrieved from http://women. webmd. om/guide/breast-cancer-arm-yourself-with-facts National Cancer Insitute. (2012). National cancer institute. Retrieved from http://www. cancer. gov/cancertopics/pdq/treatment/malebreast/Patient/page1 Attebery, L. , Adams, J. H. , ; Weiss, M. (2011, november 22). Male breast cancer. Retrieved from http://www. breastcancer. org/symptoms/types/male_bc/ National Cancer Institute. ( 2011). Male breast cancer. Retrieved from http://www. nlm. nih. gov/medlineplus/malebreastcancer. html Wax, A. (2011). Breast cancer in men: Symptoms, causes, treatments. Retrieved from http://www. webmd. com/breast-cancer/guide/breast-cancer-men American Cancer Society. (2011, September 29). American cancer society. Retrieved from http://www. cancer. org/Cancer/BreastCancer/DetailedGuide/breast-cancer-diagnosis NCI. (2010, September 22). National cancer institute. Retrieved from http://www. cancer. gov/cancertopics/factsheet/detection/mammograms Marshall, S. (2010, November 12). Webmd. Retrieved from http://women. webmd. com/mammogram-16573 Hoffman, M. (2010 February 18). Ductal carcinoma (invasive and in situ. Retrieved from http://www. webmd. com/breast-cancer/ductal-carcinoma-invasive-in-situ ACR. (2012). Mammography facts. Retrieved from http://www. ammographysaveslives. org/facts. aspx Hirshaut, Y. , ; Pressman, P. I. (2008). Breast cancer: The complete guide. (5th ed. ). New York, NY: Bantam Dell. Radiological Society of North America. (2011, June 24). Radiologyinfo. org. Retrieved from http://www. radiologyinfo. org/en/info. cfm? pg=mammo ASCO. (2011, January 26). Breast Cancer- Male Retrieved from http://www. cancer. net/patient/Cancer Types/Breast Cancer – Male/? skid= Stoppler, M. C. (2011). Medicinenet. Retrieved from http://www. medicinenet. com/mammogram/article. html Imaginis. (2012). Breast cancer mri – magnetic resonance imaging. Retrieved from http://www. maginis. com/mri-scan/magnetic-resonance-breast-imaging-mri-mr-3 Eisenpreis, B. (1999). A young woman’s guide to breast cancer prevention. New York: The Rosen Publishing Group. Marshall, S. (2009, April 29). Breast biopsy. Retrieved from http://women. webmd. com/breast-biopsy Metcalf, T. , Metcalf, G. (2008). Perspective on diseases and disorders. (1 ed. ). Michigan: Thomson Gale. Chen, S. ( 2007, April 10). Meta-analysis of BRCA1 and BRCA2 penetrance. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Honrado, E. , Osorio, A. , Palacios, J. , Benitez, J. (2006, September 25). Pathology and gene expression of hereditary breast tumors associated with brca1, brca2 and chek2 gene mutations. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer/show/References Thompson, D. , Easton, D. (2004, July 9). The genetic epidemiology of breast cancer genes. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Walsh, T. , King, M. (2007, February 11). Ten genes for inherited breast cancer. Retrieved from http://ghr. nlm. nih. gov/condition/breast-cancer Marisa , W. (2011, August 03). Stages of breast cancer. Retrieved from http://www. breastcancer. org/symptoms/diagnosis/staging. jsp NCI. 2009). Breast cancer treatment (pdq). Retrieved from http://www. cancer. gov/cancertopics/pdq/treatment/breast/Patient/page2 Lippman, M. E. (2005). Cancer monthly. Retrieved from http://www. cancermonthly. com/cancer_basics/breast. asp American Cancer Society. (2012, March 06). Breast cancer. Retrieved from http://www. cancer. org/Cancer/BreastCancer/DetailedG uide/breast-cancer-staging Reynolds, D. (2010, March 26). Emaxhealth. Retrieved from http://www. emaxhealth. com/1506/98/36185/one-third-breast-cancer-cases-avoided-diet-and-exercise. html NCI. (2010, September 22). National cancer institute. Retrieved from http://www. cancer. ov/cancertopics/factsheet/detection/mammograms Sacks, D. N. (2011, November 16). Fibrocystic breast disease. Retrieved from http://www. nlm. nih. gov/medlineplus/ency/article/000912. htm Silverman, P. (1994, July). Breast fat necrosis – symptoms, causes and treatments. Retrieved from http://breastcancer. about. com/od/whenitsnotcancer/tp/Breast-Fat-Necrosis. htm American Cancer Society. U. S. Breast cancer statistics. (2011, September 29). Retrieved from http://www. cancer. org/Cancer/BreastCancer/index Hail, J. (2011, 09). National breast cancer foundation, inc.. Retrieved from http://www. nationalbreastcancer. org/About-Breast-Cancer/ Breast Cancer Breast Cancer Breast Cancer Some methods used to diagnose breast carcinoma are mammograms, MRI’s, and biopsies (NCI, 2010). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). Each stage has different prognoses with varying survival rates as well (Marissa, 2011). There are also many ways to prevent breast cancer including maintain a healthy weight, avoiding the alcohol consumption, and by getting an annual mammogram (Reynolds, 2010). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. women, making it the first truly common breast cancer susceptibility gene (Metcalf Metcalf, 2008). Other breast diseases besides breast cancer are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). These diseases do not necessarily lead to breast cancer and can be treated (Sacks, 2011; Silverman, 1994). Keywords: – breast cancer, ducts, lobules, tumor, invasive (infiltrating carcinoma), noninvasive (noninfiltrating carcinoma), Ductal Carcinoma In Situ (DCIS), Invasive Lobular Carcinoma (ILC), intraductal carcinoma, nonfunctioning breast tissue, estrogen, lymph nodes, mammogram, MRI (magnetic resonance imaging), core biopsy, somatic mutations, fine needle aspiration biopsy, stereotactic biopsy, FGFR2, BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, metastasis, fat necrosis, fibrocystic breast disease Breast Cancer Cells are the building blocks of living things and cancer grows out of normal cells in the body (Dugdale, 2010). Cancer is the uncontrolled growth of abnormal cells in the body (Dugdale, 2010). Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer doesn’t allow normal blood function by abnormal cell division in the blood stream (Peter, 2011). Normal cells in the body follow an orderly process of growth, division, and death, this is called apoptosis, and when this process breaks down, cancer begins to form (Peter, 2011). Cancer has been around since prehistoric times, and breast cancer is one of the earliest forms to have been mentioned (Eisenpreis, 1999). In the United States, breast cancer death rates are higher than those for any other cancer, besides lung cancer (breastcancer. org, 2012). Today, about 1 in 8 women (12%) will develop breast cancer in her lifetime (Martin, 2012). Breast cancer is a cancer that starts in the tissues of the breast (Yi-Bin David, 2011). In rare cases, breast cancer can start in other areas of the breast (Yi-Bin David, 2011). Breast cancer can be invasive or noninvasive (Yi-Bin David, 2011). Invasive meaning it has spread from the milk duct (lobule) to the other tissues in the breast (Eisenpreis, 1999). Noninvasive means that it has not yet invaded other breast tissue (Yi-Bin David, 2011). Types of Breast Cancer Breast cancer can begin in different areas of the breast – the ducts, the lobules, or sometimes, the tissue in between (breastcancer. org, 2012). There are several different types of breast cancer, including breast cancer in men (breastcancer. org, 2012). Some include Ductal Carcinoma In Situ, Invasive Lobular Carcinoma, and Male Breast Cancer (breastcancer. rg, 2012). Ductal carcinoma in situ (DCIS), or intraductal carcinoma, is a noninvasive breast cancer in the lining of the milk ducts that has not yet invaded nearby tissues of the breast (Yi-Bin David, 2011). It may progress to invasive cancer if it is left untreated (Yi-Bin David, 2011). DCIS is the earliest form of breast cancer and is usually found during a mammogram done as part of breast cancer screening (Mayo Clinic Staff, 2011). Because of the increased use of mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years (Mayo Clinic Staff, 011). When a woman has DCIS, she is at higher risk for the cancer coming back or also at higher risk for developing a new breast cancer than a person who has never had breast cancer before (breastcancer. org, 2012). Experts believe that 20 to 50% of women with DCIS will later develop an invasive breast cancer within 10 years of the DCIS diagnosis (Hoffman, 2010). The risk of lymph node involvement with ductal carcinoma in situ is only 1% to 2% so the lymph nodes under the arm do not need to be removed, as may be  the case with other types of breast cancer (Hoffman, 2010). In seven out of 10 cases, breast-conserving lumpectomies – instead of mastectomies – were an effective treatment option (Hoffman, 2010). This will depend upon the size of your tumor and the extent of its spread throughout your breast and the surrounding lymph nodes (Hoffman, 2010). While DCIS isn’t life-threatening, it does require treatment to prevent the condition from becoming invasive (Mayo Clinic Staff 2011). Most recurrences happen within 5 to 10 years after the first diagnosis and the chances of that happening are under 30 percent (breastcancer. rg, 2012). Invasive Lobular Carcinoma is an invasive type of breast cancer that begins in the milk-producing glands (lobules) of the breast (Mayo Clinic Staff, 2011). When a person has ILC, this means that the cancer cells have broken out of lobule where they started and they now have the potential to spread to other areas or tissues of the body (Mayo Clinic Staff, 2011). This type of cancer is more difficult to se e on imaging because of the way it grows with spreading branches (Hopkins, 2012). The treatments for invasive lobular carcinoma fall into two broad categories: Local and Systemic Treatment. Local treatments treat the tumor and the areas surrounding it, such as the chest and lymph nodes (breastcancer. org, 2012). Systemic treatments travel throughout the body to destroy any type of cancer cells that may have left the original tumor and traveled to other tissues to reduce the risk of the cancer coming back (breastcancer. org, 2012). ILC cells can proceed to infiltrate fatty tissue and create a web-like mass (Stephan, 2008). This web of cancer cells may feel like a thickened area of breast tissue, and may not cause concern or pain at first (Stephan, 2008). Unfortunately, if it is left undetected, ILC can develop into a mass that is about ? inch ( 2 centimeters) to about 2 inches (5 centimeters) or bigger in size, before causing more noticeable symptoms (Stephan, 2008). Breast cancer in men is a very rare disease (Attebery, Adams ; Weiss, 2011). But the truth is that boys and girls, men and women all have breast tissue (Attebery, Adams ; Weiss, 2011). Men have a small amount of nonfunctioning breasts tissue (breast tissue that cannot produce milk) that is concentrated in the area directly behind the nipple on the wall of the chest (Attebery, Adams ; Weiss, 2011). A type of breast cancer that has spread outside of the duct and into the surrounding tissue is called invasive or infiltrating carcinoma (ASC, 2012). Some symptoms that may occur in males developing breast cancer include lumps, changes to the nipple or breast skin, or discharge of fluid from the nipple (National Cancer Institute, 2011). Men who have an altered gene related to breast cancer have an increased risk of developing breast cancer (National Cancer Institute, 2012). The major problem is that breast cancer in men is more often than not diagnosed later than breast cancer in women because men are less likely to be suspicious of an abnormality in that area (Wax, 2012). Also, their small amount of breast tissue is harder to feel, making it more difficult to catch these cancers early, and allowing tumors to spread more quickly to the surrounding tissues (Wax, 2012). Breast cancer in men is detected the same way as breast cancer is detected in women – through self-examination, clinical examination, or mammography (x-ray of the breast) (ASC, 2012). Methods for Diagnosis Breast cancer is sometimes found after symptoms appear, but many women with early breast cancer have no symptoms (American Cancer Society, 2011). This is why getting the recommended screening tests before any symptoms develop is so important (American Cancer Society, 2011). Three types of methods used for diagnosis are mammograms, MRI’s, and biopsies (NCI, 2010). A mammogram is a low-dose x-ray picture of the breast and can be used to check for breast cancer in women who don’t have any signs or symptoms of the disease. (NCI, 2010) The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine (Webmd, 2010). There are different types of mammograms including Screening mammograms and Diagnositc mammograms (Webmd, 2010). Mammograms detect tiny bits of calcium that develop in dead cancer cells (Hoffman, 2010). As more and more cancer cells age and die, theses calcifications grow nd on the mammogram, they appear as a shadowy area (Hoffman, 2010). Current guidelines from the American College Radiology, the American Cancer Society, and the Society for Breast Imaging recommend that women receive annual mammograms starting at age 40, even if they have no symptoms or family history of breast cancer (ACR, 2010). For every 1,000 women who have screening mammogram: 100 are recalled to get more mammogr aphy or ultrasound images, 20 are recommended for needle biopsy and 5 are diagnosed with breast cancer (ACR, 2010). A mammography unit is a rectangular box that houses the tube in which x-rays are produced (Radiological Society of North America, 2011). Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate (Radiological Society of North America, 2011). A brief medical history and a history of specific problems related to the breast, such as pain or a palpable lump (one that is felt), is obtained prior to the mammogram (Stoppler, 2011). All jewelry and clothing in the chest and breast area are removed prior to the mammogram (Stoppler, 2011). The patient’s breasts are then placed on a firm flat panel and a gentle, but firm pressure is applied to the breast with another panel, resulting in compression of the breast between the two panels (Stoppler, 2011). The compression of the breast is necessary to obtain quality mammograms and spreads the breast tissue out so that the x-ray image displays the inner breast tissue with good resolution (Stoppler, 2011). Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them (Radiological Society of North America, 2011). As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black (Radiological Society of North America, 2011). The results of the mammogram can be given to the patient either by the radiologist at the completion of the mammogram or by the patient’s doctor who ordered the mammogram (Stoppler, 2011). An abnormal mammogram does not mean you have cancer (Stoppler, 2011). In some cases, it may just be an area of thicker or denser breast tissue, a cyst, or a benign lump such as a fibro adenoma (Stoppler, 2011). Unlike mammography which uses low dose x-rays to produce an image of the breast, MRI (Magnetic Resonance Imaging) uses powerful magnetic fields and radio waves to create images of the breast (Imaginis, 2012). The MRI system has the ability to switch magnetic fields and radio waves to achieve views in any plane and from any orientation while x-ray mammography requires re-orientation of the breast and mammography system for each view desired (Imaginis, 2012). MRI is a huge magnet and the woman gets put in the middle of the magnet; the magnetic field is turned on and then turned off again (Eisenpreis, 1999). The way the magnetized cells return to normal gives an image (Eisenpreis, 1999). The MRI finds lumps better than it tells whether or not they are cancerous (Eisenpreis, 1999). However, MRI can be good at showing how big a cancer is, once it has been found on the mammogram (Eisenpreis, 1999). A breast biopsy removes a sample of breast tissue that is looked at under a microscope to check for breast cancer and is usually done to check a lump found during a breast examination or a suspicious area found on a mammogram, ultrasound, or magnetic resonance imaging (MRI) (Marshall, 2009). During a fine-needle aspiration biopsy, the doctor inserts a thin needle into a lump and removes a sample of cells or fluid (Marshall, 2009). Nowadays, doctors might have decided to do something called stereotactic biopsy, where a patient lies on a table, with her breasts hanging down (Eisenpreis, 1999). A mammogram is taken to show where the lump is and a device holding a needle quickly shoots in and removes a few cells from the lesion (Eisenpreis, 1999). There is also something called a core biopsy that uses a larger needle to take out a piece of tissue, instead of just cells (Eisenpreis, 1999). A doctor numbs your skin with a shot of numbing medicine where the biopsy needle will be inserted and once the area is numb, a small cut is made in the skin from where the needle with a special tip is inserted into breast tissue (Marshall, 2009). Three to twelve samples will be taken to acquire the most accurate results (Marshall, 2009). Classifications and Associated Prognoses The stages of breast cancer are usually expressed as a number on a scale of 0 through IV – with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body (Marisa, 2011). Cancer stage is based on four characteristics; the size of the cancer, hether the cancer is invasive or non-invasive, whether the cancer is in the lymph nodes, whether the cancer has spread to other parts of the body beyond the breast (Marisa, 2011). Sometimes doctors use the term â€Å"locally advanced† or regionally advanced† to refer to large tumors that involve the breast skin, underlying chest structures, changes to the breast’s shape, and lymph node enlargement that is visible or that the doctor can feel during an exam (Marisa , 2011). The three ways that cancer spreads in the body are: Through tissue where cancer invades surrounding normal tissue, through the lymph system where the cancer invades the lymph system and travels through the lymph vessels to other places in the body, and through the blood, where cancer invades the veins and capillaries and travels through the blood to other places in the body (NCI, 2009). When cancer cells break away from the primary (original) tumor and travel through the lymph nodes or blood to other places in the body, another (secondary) tumor may form (NCI, 2009). This process is called metastasis (NCI, 2009). The stage of the breast cancer can help the patient and the doctor understand the prognosis (the most likely outcome of the disease) and make decisions about treatment, along with all the other results in the pathology report (Marisa, 2011). A staging system is standardized way for the cancer care team to summarize information about how far a cancer has spread (ACS, 2012). The most common system used to describe the stages of breast cancer is the American Joint Committee on Cancer (AJCC) TNM system (ACS, 2012). The TNM staging system classifies cancers based on their T, N, and M stages (ACS, 2012). The letter â€Å"T† followed by a number 0 to 4 describes the tumor’s size and spread to the skin or to the chest wall under the breast (ACS, 2012). The letter â€Å"N† followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected. The letter â€Å"M† followed by a 0 or 1 indicates whether the cancer has spread to distant organ (ACS, 2012). There are typically five stages (0 to 4) with sub-stages that indicate the prognosis for breast cancer (Lippman, 2005). Stage 0 where the carcinoma is insitu and no lymph nodes are affected had 99 percent 5 year survival rate (ACS, 2012). Stage IA also has a high rate, 92 percent, in which the tumor is equal to 2 centimeters (ACS, 2012). In stage IB, the tumor is 2 centimeters with micro metastases in 1 to 3 axillary lymph nodes but the cancer has not spread to distant sites (ACR, 2012). In stage IIA, the cancer cells have moved to the ipsilateral nodes and the 5 year survival rate lowers to 82 percent (Lippman, 2012). In stage IIB, the cancer cells have spread to movable ipsilateral nodes and the tumor is over 5 centimeters (Lippman, 2012). The 5 year survival rate lowers to 65 percent (ACS, 2012). In stage IIIA, there is no evidence of a primary tumor and no distant spreading (ACS, 2012). The 5 year survival rate lowers to 47 percent (Lippman, 2005). The tumor could be between 2 and 5 centimeters but there is still no distant spreading at this point (ACS, 2012). In stage IIIB the tumor has extended to the chest wall but there is still no distant metastases (Lippman, 2005). The 5 year survival rate lowers again to a 44 percent (Lippman, 2005). In stage IV the cancer can be any size (any T) and may or may not have spread to nearby lymph nodes (any N) (ACS, 2012). It has spread to distant organs or to lymph nodes far from the breast (M1) (ACS, 2012). The most common sites of spread are the bone, liver, brain, or lung (ACS, 2012). The survival rate lowers to 14 percent (Lippman, 2005). Prevention Methods Three ways to prevent breast cancer are by maintaining a healthy weight, avoiding alcohol consumption, and getting an annual mammogram (Reynolds, 2010). Mammogram screening, early diagnosis and better treatments have all contributed to the reduction in breast cancer cases by around 2 percent a year and the improved survival rate in the U. S. (Reynolds, 2010). Experts say now the focus needs to shift on improving personal lifestyle habits to prevent the disease even more (Reynolds, 2010). Early detection of breast cancer with screening mammography means that treatment can be started earlier in the course of the disease, possibly before it has spread (NCI, 2010). A medical team found an 11 percent lower risk of breast cancer in those women consuming the more healthful diet, including more whole grains, fruits and vegetables and less fatty, processed foods (Reynolds, 2010). They also found that those consuming large amounts of alcohol had a 21 percent increased risk (Reynolds, 2010). Drinking alcohol during adolescence has been linked to an increased risk of breast cancer, especially for girls with a family history of the disease (Reynolds, 2010). Exercise also plays a role in the reduction of breast cancer risk (Reynolds, 2010). In one study from the Women’s Health Initiative, as little as 1. 25 to 2. 5 hours per week of brisk walking reduced a woman’s risk by 18 percent (Reynolds, 2010). Walking 10 hours a week reduce the risk more (Reynolds, 2010). Diet and exercise can lead to weight reduction, another positive lifestyle change that can influence breast cancer disease risk (Reynolds, 2010). Many breast cancers are fueled by estrogen, a hormone produced in fat tissue (Reynolds, 2010). Experts suspect that more fat tissue equals more estrogen resulting in more cases of breast cancer that could possibly be avoided (Reynolds, 2010). Genetic ; Hereditary Influence According to researchers, the mutations in the gene, which is called FGFR2, raise the risk of breast cancer by 20 to 60 percent. (Metcalf ; Metcalf, 2008). A genetic mutation that raises the risk of breast cancer is found in up to 60 percent of U. S. omen, making it the first truly common breast cancer susceptibility gene (Metcalf ; Metcalf, 2008). Women with faulty copies of the genes BRCA1 or BRCA2 have 50 percent to 85 percent chance of getting breast cancer in their lifetimes, but they are rare genes and only account for 5 percent to possibly 10 percent of breast cancer cases (Metcalf ; Metcalf, 2008). Only 7% of all breast cancers are hereditary (Hirshaut ; Pressman, 2008). Of these hereditary cancers, 45% is caused by BRCA1 while 35% is caused by BRCA2 (Hirshaut ; Pressman, 2008). (Hirshaut ; Pressman, 2008). Variations of the  BRCA1,  BRCA2,  CDH1,  PTEN,  STK11, and  TP53  genes increase the risk of developing breast cancer (Chen, 2007). The  AR,  ATM,  BARD1,  BRIP1, CHEK2, DIRAS3,  ERBB2,  NBN,  PALB2,  RAD50, and  RAD51  genes are associated with breast cancer (Chen, 2007). Cancers occur when a buildup of genetic mutations in critical genes – those that control cell growth and division or the repair of damaged DNA – allow cells to grow and divide uncontrollably to form a tumor (Honrado, Osorio, Palacios ; Benitez, 2006). These changes, which are called somatic mutations, are not inherited (Honrado, Osorio, Palacios ; Benitez, 2006). Less commonly, gene mutations inherited from a parent increase the risk of developing cancer (Honrado, Osorio, Palacios ; Benitez, 2006). In people with these inherited genetic changes, additional somatic mutations in other genes must occur for cancer to develop (Honrado, Osorio, Palacios ; Benitez, 2006). Additional factors that may influence a person’s risk of developing breast cancer include gender, age, ethnic background, a history of previous breast cancer, certain changes in breast tissue, and hormonal factors (Thompson ; Easton, 2004). A history of breast cancer in closely related family members is also an important risk factor, particularly if the cancer occurred at an early age (Thompson ; Easton, 2004). Women who have inherited certain mutations in these genes have a high risk of developing breast cancer, ovarian cancer, and several other types of cancer during their lifetimes (Thompson ; Easton, 2004). Inherited changes in several other genes, including CDH1, PTEN, STK11, and TP53, have been found to increase the risk of developing breast cancer (Thompson ; Easton, 2004). In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved (Walsh ; King, 2007). For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant patter, which means one copy of the altered gene in each cell is sufficient to increase a person’s chance of developing cancer (Walsh ; King, 2007). In other cases, the inheritance of breast cancer risk is unclear (Walsh ; King, 2007). It is important to emphasize that people inherit an increased risk of cancer, not the disease itself (Walsh ; King, 2007). Not all people who inherit mutations in these genes will develop cancer (Walsh ; King, 2007). Other Breast Diseases Two other diseases found in the breast other than breast carcinoma are breast fat necrosis and fibrocystic breast disease (Sacks, 2011; Silverman, 1994). Fybrocystic breast disease is a commonly used phrase to describe painful, lumpy breasts (Sacks 2011). Hormones made in the ovaries can make a woman’s breasts feel swollen, lumpy, or painful before during menstruation each month (Sacks 2011). Fibrocysitc changes in the breast with the menstrual cycle affect over half of women (Sacks, 2011). Symptoms are usually worse right before the menstrual period, and then improve after the period starts (Sacks, 2011). Symptoms can include pain in both breasts, breasts that feel swollen and heavy, pain or discomfort under the arms, and thick or lumpy breasts (Sacks, 2011). This disease can be treated with medication like acetaminophen or ibuprofen (Sacks, 2011). Breast Fat necrosis is a benign condition that can occur in your breast (Silverman. 1994). It consists of fatty tissue that has been bruised, injured, or has died (Silverman, 1994). Once fatty tissue has been injured or has died, it can gradually change into scar tissue or may collect as liquid within an oil cyst (Silverman, 1994). Fat necrosis does not lead to the development of breast cancer, but it may sometimes cause breast pain (Silverman, 1994). An area of fat necrosis in your breast may feel like a fairly hard lump, or like a section of thick skin (Silverman, 1994). The person may see some drainage from the nipple that is nearest to the bruised region (Silverman, 1994). The nipple may sometimes even pull inward a little bit or the breast skin may dimple above the lump of fat necrosis (Silverman, 1994). Each case of fat necrosis is unique, so treatments will vary but if the fat necrosis has occurred recently, using warm compresses may help it subside (Silverman, 1994). When fat necrosis causes pain, the person can use ibuprofen and aspirin, but if that doesn’t help, ask your doctor if a prescription medication may be used (Silverman, 1994). About 39,520 women in the U. S. were expected to die in 2011 from breast cancer, though death rates have been decreasing since 1990 — especially in women under 50 (â€Å"Learn about cancer,† 2011). These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness (â€Å"breastcancer. org,† 2012). References Peter, C. (2011, October 20). Medical news today. Retrieved from http://www. medicalnewstoday. com/info/cancer-oncology/ breastcancer. org. (n. d. ). 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