The Failure of Rome’s Economy and the Fall of the Roman...

The failure of Rome’s economy contributed majorly to the fall of Rome. The Roman Economy during the late Republic and Early Empire was based heavily on Agriculture and Commerce. Agriculture in ancient Rome was not only a necessity, but was idealized among the social elite as a way of life. Cicero had considered agriculture to be the best of all Roman Occupations (Sarudy). There had been a lot of trading between the provinces of the empire, and all regions of the empire were largely economically interdependent. Egypt was also important in providing wheat to Rome. Shipments of Egyptian wheat may have amounted to 20 million modii (an Ancient Roman measurement) or more annually. Twenty million modii of wheat was nearly enough for up to half†¦show more content†¦Emperor Domitian, who ruled from 81 A.D. to 96 A.D., had left the Roman Empire in a nearly balanced economy during the greater part of his reign. It is estimated that Domitian’s annual income was more than 1,200 million sestertii (Roman Currency) which over one-third would presumably have been spent maintaining the Roman army. The other major of major expense was the extensive reconstruction of Rome (Domitian). An Emperor that greatly impacted the Roman economy was Nero, who ruled from 54 A.D. to 68 A.D. When complaints arose that the poor were overly taxed, Nero attempted to repeal all indirect taxes. The Senate convinced him that this action would bankrupt the public treasury. In result, Nero cut taxes from 4.5% to 2.5% (Bluejayblog) Government taxes were also ordered to become public. In order to lower the cost of food imports, Nero declared that merchant ships were tax-exempt. After Rome burned in 64, Nero enacted a public relief effort to restore Rome. For a few construction projects, he created the large Domus Aurea and attempted to have a canal dug at the Isthmus of Corinth. However, these projects had cost vast amounts of money which quickly drained the economy. Eventually dur ing Nero’s reign, he had devalued Roman Currency for the first time in Roman History. Weight reduced of the denarius from 1/84 per Roman pound to 1/96 per Roman pound (3.90 grams to 3.4 grams) (Comparette). Weight of the aureus dropped fromShow MoreRelatedThe Rise Of The Roman Empire1611 Words   |  7 PagesRome was an empire with extremely high aspirations and expectations from. Its founders chose to steal women from neighboring villages, in order to grow its population. These aggressive and expansionary ideologies remained within the personalities of every Roman, living inside the great empire 755 years later. And yet despite its vast military presence and growing cities and towns, the Roman Empire and its capital still succumbed to a barbarian takeover. This was widely regarded as one of the greatestRead MoreEssay about The Fall of the Roman Empire1275 Words   |  6 PagesThe Fall of the Roman Empire A reason that leads to Romes inability to remain self-sustaining as an Empire was its lack of technology. Technological advance did not increase at a rate proportional to the increase of the people per square mile. This lead to the inability of the Romans to become self-sustaining. Once again the slave trade was a reason that their technology levels failed to increase. The bulk of work done in the Roman Empire was always carried out by the slaves. This providedRead MoreChristianity And The Fall Of The Western Roman Empire1349 Words   |  6 Pagesand the fall of the Western Roman Empire as it related to theatre but I was intrigued to learn more. It didn’t seem sensible that the fall of the Western Empire would be placed, even a little, on the rise of Christianity during that time. It didn’t seem sensible for two reasons. The first reason is that Jesus Christ, in whom the Christians believed, had been born, lived, and crucified over 400 years before the Empire fe ll. His lifetime spanned only until the second emperor of the Roman Empire, beforeRead MoreThe Fall Of The Roman Empire1419 Words   |  6 PagesThe Roman Empire was a powerful governing body of extensive political and social structures throughout western civilization. How did this empire fall and were internal factories responsible? Slow occurrences in succession to one another led to the fall of the empire rather than one single event. The fall of the Roman Empire was a combination of both internal and external pressures, not just one, leading up to the complete decay of the cities—Rome and Constantinople. However, one could argue how oneRead MoreHow Did Civil War Affect The Fall Of Rome?1761 Words   |  8 Pagesthe following question; how did civil war effect the fall of Rome? The time period of focus will be between 235 and 476 CE. The location will be Rome, Italy, the Mediterranean Sea, and the surrounding areas once held by the Roman Empire. This investigation will a ddress the following issues; what were the effects of civil war and how these effects contributed to the fall of Rome. This topic is important from a historical standpoint because the fall of Rome transformed Italy and surrounding countriesRead MoreEssay on Roman Influence on Byzantine Empire and Islamic Societies1584 Words   |  7 PagesMother of the World â€Å"The mother of the world has been killed,† stated a 5th century historian, bereft and appalled when the news of Rome’s fall had reached ear. Certainly his words hold truth, for Rome - the dauntingly colossal Empire engulfing the Mediterranean and all territories around it; the source of artistic, intellectual, and cultural ascendancy; the influential factor of brilliance in so many of the coexisting societies of the western world - was truly the predecessor and creator of allRead MoreThe Rise of Four Empires in 300 B.C. to 200 B.C. Essay922 Words   |  4 PagesThe great empires that flourished between 300 B.C.E and 200 B.C.E. can all be broken down into the four factors the contributed to their rise. Although each empire faced prolonged periods of conflict, all four empires succeeded in imposing unity and order among the people. The rise of these empires can be attributed to four specific factors crucial to their construction. The factors crucial to the rise of the great empires included having a centralized form of leadership with enforced uniform legalRead MoreAncient Bc : Rome As A Collection Of Small Wooden Huts2725 Words   |  11 PagesRome began as a collection of small wooden huts on a group of 7 hills near the River Tiber in central Italy. Legend says however, that Romulus and his twin brother Remus founded the city of Rome on the 21st of April 753 BC. According to the legend, Rome’s origins can be traced back to Aeneas, who, after the destruction of Troy, approached the coasts of Latium and founded the city of Alba Longa after marrying the daughter of the Latin king. When Proclus, the last king died, he left the reign to hisRead MoreThe Fall Of The Roman Empire1609 Words   |  7 PagesThe Fall of Rome HIST534 A001 Sum 15 American Military University David Provencher (ID# 4358187) July 30, 2015 The fall of the Roman Empire is one of the most discussed and debated events in ancient history. Many historians site the date of 476 A. D. as the day the empire ended, but there are also many that say that the 476 A.D. date is subjective because it took many years of internal problems and neglect for the empire to come to an end. Even from the beginning of the Empire underRead MoreHist10412 Essay1952 Words   |  8 PagesModule title: World History Module code: HIST10412 Module leader: Dr Nicholas Morton Seminar leader: Amy Fuller Assignment title: Essay: To what extent would you agree that economic growth is always the primary factor underpinning the rise of any Empire? Explain your answer with reference to at least two case-studies Word count: I confirm that this is my own work and that I have complied with University Assessment Regulations. Yes To be completed by the marker: 1st marker: 2nd marker: Assessment

Why Is Strategy Important to Business Free Essays

Strategy is determining where you are now, where you want to go, and how to get there. It’s the art of developing and implementing specific actions and decisions that will help a business to achieve goals and objectives as set out by the owners. Through the strategy process the overall direction of the company is set including opportunities and threats in the outside world and the internal strengths and weaknesses of the business. We will write a custom essay sample on Why Is Strategy Important to Business? or any similar topic only for you Order Now The aim of a business strategy is to ensure that the threats posed by the external environment are minimized and also to strengthen or minimize the effects of internal weaknesses. The opportunities and strengths are combined to ensure maximum productivity is achieved. The more the external environment changes the more opportunities there are likely for a company, but the more threats can be a problem if not prepared for. Without a business strategy, it would be difficult for an owner to realize the opportunities available. Strategic management in contrast with business policy is a technical approach having a five step model. Strategic management is a set of managerial decisions and actions that determine the long run performance of a company. Strategic management does not have to be just a part of the top level management. In fact, organizations should focus on strategic management at all levels of the management and the entire hierarchy of the company should be involved both in planning and implementation phases. Strategic management does not have to be just a part of the top level management. Organizations should focus on strategic management such that all levels of the management and the entire hierarchy of the company should be involved in both planning and implementation phases. The basic theory of strategic management involves the action of creating and implementing plans and decisions for the benefit of the organization and to help it achieve its objectives. Strategic management analyzes and scan the environment therefore future problems and opportunities could be well anticipated, allows a firm’s top management to anticipate changes and provide track and control for the enterprise, provides clear cut mission, also gives vision and objectives of enterprise to all the employees, and allows a firm to take decisions on the basis of long range forecast. Your vision must be future-oriented it has to paint a picture that attracts employees through the use of visual imagery. This is what gets people hooked into buy-ins, followership, and implementation of the plan. So it means you just have to think outside the box of today and describe the world of the future. With the current situation of the economy the fact that some business establishments have stopped their operation and closed has caused big drop in small and large corporations. Having back up plan would be the idea should the original plan does not succeed businessmen could have alternative options or backed up plans for the continuity and success of the business. Since businessmen are knowledgeable of the business processes, they know the importance of having back up plans. Without a contingency plan, and should the original plan fail, businessmen and the business could experience a lot of trouble. The Mission statement is important because it describes the reason for the existence of an organization and what it hopes to achieve. While mission statements vary from organization to organization and represent the distinctness of each one, they all share similar components. Before writing a mission statement, leaders in the organization must have an idea of what is in store for the future. This vision is the foundation for the mission statement. Most statements include descriptions of the organization’s target market, the geographic domain, their concern for survival, growth and profitability, the company philosophy, and the organization’s desired public image. In addition, it is a tool that conveys the goal, organizational structure and strategy, legitimacy, values, participation and ownership among employees, leadership, responsibility to the community, ethical priorities, and commitment to the public and stakeholders. The organizational decision making process involves proper and efficient implementation of strategic plans and methods to achieve desired business objective. Often one difficulty facing an organization is that multiple divisions are involved in the overall decision making process. Making a decision can have different implications for each respective division. With the businesses of today facing shortened product lifecycles, organizations are facing intense competitive pressures to build market share to stay ahead of rivals. Process changes, the introduction of new and improved disruptive technologies are forcing companies to adapt new business goals and objectives in shortened timeframes, this alone places stresses on all organization. References Karger (1991). Strategic Management: The Key to Corporate Success Pearce II, J.A., Robinson, Jr., R.B. (2008). Strategic management. (11th ed.). New York, NY: McGraw-Hill. Mission and Vision Statements http://www.referenceforbusiness.com/management/Mar-No/Mission-and-Vision-Statements.html#ixzz1LGZLzvbI How to cite Why Is Strategy Important to Business?, Papers

The Vision Essay Research Paper Most people free essay sample

The Vision Essay, Research Paper Most people are disbelieving about psychics and psychic powers. In the book The Vision by Dean Koontz, there arises a existent convincing psychic Mary, who has visions of slayings that are yet to go on. But, a new turn to the narrative causes Mary to see a different sort of vision. Murders more ghastly than of all time. More hard to see. Harder to prosecute. All these factors cause the reader, and perchance Mary to inquire who are the 1s who truly care for her. Can the liquidator perchance be person she loves? Or possibly a haunting truth about the yesteryear. The narrative takes topographic point in assorted locations of modern twenty-four hours California. Some of the narrative takes topographic point in Los Angeles, but the most momentous portion of the narrative takes topographic point in a small town called King # 8217 ; s Point. The town is on the Pacific Coast Highway, and expensive houses dot the shoreline. Refering to the visions, Dean Koontz vividly describes the scene of each of them, as they take topographic point. For illustration, he takes the reader to one of the scenes of a slaying. A little beauty store in Santa Ana, California. He forces the reader to visualize the assorted facets of a normal beauty store, such as, the outside. The neon visible radiations, the thenar trees, the jade-plant hedges, and the money-scented air. He informs the reader of the aroma of the shampoo, pick rinse, Cologne, and sweat. He tells how the floor was covered in hair, and the violet colour of the walls, and the plush purple rug. He describes the sound of the hair drier and the gunfire in which the liquidator shot the teller. As one can see, the writer exhaustively describes the scene. The chief character is of class, the psychic, Mary Bergen. She is the writer of a syndicated newspaper column about psychic phenomena, and the 1 who pursues the visions in which the liquidator creates. The true individuality of the liquidator is non clear until the terminal of the book. Max Bergen, Mary # 8217 ; s hubby, and Alan Tanner, Mary # 8217 ; s brother, each attempt to assist Mary prosecute her visions to catch the slayer, and to liberate Mary # 8217 ; s life of the atrocious emphasis that encompasses her. But Max and Alan don # 8217 ; t acquire along really good. Alan feels that Mary could hold picked a better adult male to get married, because he believes that all Max is after is Mary # 8217 ; s money, and that Max doesn # 8217 ; t truly recognize how delicate she is. Max knows how Alan feels, but evidently he disagrees. Max is reasonably a strong adult male, six inches taller, and forty lbs heavier than Alan. Although Max had promised Mary that he would neer physica lly fight another individual, he feels a strong demand to contend Alan, but knows that won # 8217 ; t halt him from being so chesty. Alan on the other manus, can easy carry people with his sweet voice, and delighting visual aspect. There is besides Dr. Cauvel, Mary # 8217 ; s head-shrinker, and Lou Pasternak, one of Mary # 8217 ; s old friends. Calcium uvel urgently tries to associate Mary’s visions to the yesteryear. Pasternak, an alcoholic journalist, helps Mary and Max seek to happen the slayer, and halt him. Mary Bergen, the well-known psychic, has unfortunate visions of liquidators killing their victims. One twenty-four hours, a awful vision appears with no warning. And from so on, these visions are even more ghastly than her usual visions, and they ever prevent Mary from seeing the slayer # 8217 ; s face. This puzzles Mary, so she goes to her head-shrinker Dr. Cauvel, to seek some replies. He tries to dig into her yesteryear and unveil some truths. She was abused as a kid by one of her neighbours, who purportedly killed all of her brother Alan # 8217 ; s pets. And her male parent died when she was truly immature. Mary doesn # 8217 ; t clearly recall any of the maltreatment she experienced. All she can truly retrieve is the flutter of a batch of wings, like those of a bird. She frequently has visions of merely the wings, and it is an mystery which badly frightens Mary. All she knows, is the wings relate to her maltreatment. Sing that Mary has blocked this portion of her yesteryear ou t, Cauvel believes that her maltreatment is what caused her to get down holding these visions. That same twenty-four hours, a vision comes to her. As she tries to prosecute the vision and see the slayers face, 100s of glass Canis familiariss that the Doctor had collected, flew of the shelves, and at Mary. Scared and confused, Mary subsequently looks for comfort in Max. He of class amenitiess her, and attempts to assist work out the enigma. He takes her to King # 8217 ; s Point where the following slaying is to take topographic point and to run into with Lou, who helps them by holding a sitting to reply some of Mary # 8217 ; s inquiries. A Ouji board assists in replying these inquiries. But, there are a few inquiries asked by the reader, such as: Is the slayer really person who is near to Mary? The Vision by Dean Koontz, is a really exciting book that will most decidedly maintain one turning the pages. It has a batch of suspense, and most of all, a batch of enigma. The writer does a good occupation in allowing the reader cognize what is traveling on at all times. He does so in such an interesting mode, which keeps one beggary for more. The book itself has a really attractive screen which besides gets one # 8217 ; s attending. This book is recommended to about anyone, but largely to those who like slaying enigmas. In reading this book, one will happen that the chief character Mary, goes through many hazards but neer seems to give up. She persists with her visions until she feels that justness has been served. Even though she has some people against her, chiefly the sceptics, she besides has people who love her assisting. This merely shows that even though one might experience like the universe is against them, they really have friends who love them plenty to assist them work out all their jobs. It merely takes continuity and forbearance. 31a

My Favourite Subject free essay sample

Taste and temperament differ from person to person. The taste of a student is different from that of a teacher. Taste also differs from student to student. Some students like to read fictions while some other students prefer science and mathematics. As a student, I read all kinds of subjects as per the syllabus. There are such subjects as Sanskrit, General Science, Mathematics, Hindi, Oriya and English. I read all these subjects for my high School Examination. But my favorite subject is Sanskrit. My father is respected as a learned Pandit in our locality. He has inspired me to read Sanskrit. I get plenty of inspiration to read Sanskrit at home. My father has a wide knowledge in this subject. I read the original text books in Sanskrit such as Megha Dutam by Kalidas, Panchatantra by Vishnu Sharma and Amar Kosha by Amar Singh. My father says that Sanskrit is an ancient Indo-Aryan language from which many European languages have been born. We will write a custom essay sample on My Favourite Subject or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Sanskrit is also taught in school. I perform better in this subject. The Sanskrit teacher loves me very much for this reason. He tells me to read more and more of Sanskrit Grammar. He says that it is a very interesting subject. I can read this subject in graduation and Post-graduation stage also. I am sure that I can prosper a lot in this subject. I must try to fulfill the wish of my father and be a learned scholar in Sanskrit. At present, majority students are interested in engineering and computers. Very few students want to read Sanskrit. But they should remember that Sanskrit is the original language of India. It is also called Deva Bhasa or divine language. Indias culture is built upon this language. If we neglect this language, India will be neglected. The culture of India will deteriorate. You May Also Like:

Independent and Dependent Variables Which Is Which

Independent and Dependent Variables Which Is Which SAT / ACT Prep Online Guides and Tips Independent and dependent variables areimportant for both math and science. If you don't understand what these two variables are and how they differ, you'll struggle to analyze an experiment or plot equations. Fortunately, we make learning these concepts easy! In this guide, webreak down what independent and dependent variables are, give examples of the variables in actual experiments, explain how to properly graph them, provide a quiz to test your skills, and discuss the one other important variable you need to know. What Is an Independent Variable? What Is a Dependent Variable? A variable is something you’re trying to measure. It can be practically anything, such as objects, amounts of time, feelings, events, or ideas. If you’re studying how people feel about different television shows, the variables in that experiment are television shows and feelings. If you’re studying how different types of fertilizer affect how tall plants grow, the variables are type of fertilizer and plant height. There are two key variables in every experiment: the independent variable and the dependent variable. Independent variable:What the scientist changes or what changes on its own. Dependent variable:What is being studied/measured. The independent variable (sometimes known as the manipulated variable) is the variable whose change isn’t affected by any other variable in the experiment. Either the scientist has to change the independent variable herself or it changes on its own; nothing else in the experiment affects or changes it. Two examples of common independent variables are age and time. There’s nothing you or anything else can do to speed up or slow down time or increase or decrease age. They’re independent of everything else. The dependent variable (sometimes known as the responding variable) is what is being studied and measured in the experiment. It’s what changes as a result of the changes to the independent variable. An example of a dependent variable is how tall you are at different ages. The dependent variable (height) depends on the independent variable (age). An easy way to think of independent and dependent variables is, when you’re conducting an experiment, the independent variable is what you change, and the dependent variable is what changes because of that. You can also think of the independent variable as the cause and the dependent variable as the effect. It can be a lot easier to understand the differences between these two variables with examples, so let’s look at some sample experiments below. Examples of Independent and Dependent Variables in Experiments Below are overviews of three experiments, each with their independent and dependent variables identified. Experiment 1: You want to figure out which brand of microwave popcorn pops the most kernels so you can get the most value for your money. You test different brands of popcorn to see which bag pops the most popcorn kernels. Independent Variable: Brand of popcorn bag (It’s the independent variable because you are actually deciding the popcorn bag brands) Dependent Variable: Number of kernels popped (This is the dependent variable because it's what you measure for each popcorn brand) Experiment 2: You want to see which type of fertilizer helps plants grow fastest, so you add a different brand of fertilizer to each plant and see how tall they grow. Independent Variable: Type of fertilizer given to the plant Dependent Variable: Plant height Experiment 3: You’re interested in how rising sea temperatures impact algae life, so you design an experiment that measures the number of algae in a sample of water taken from a specific ocean site under varying temperatures. Independent Variable: Ocean temperature Dependent Variable: The number of algae in the sample For each of the independent variables above, it’s clear that they can’t be changed by other variables in the experiment. You have to be the one to change the popcorn and fertilizer brands in Experiments 1 and 2, and the ocean temperature in Experiment 3 cannot be significantly changed by other factors. Changes to each of these independent variables cause the dependent variables to change in the experiments. Where Do You Put Independent and Dependent Variables on Graphs? Independent and dependent variables always go on the same places in a graph. This makes it easy for you to quickly see which variable is independent and which is dependent when looking at a graph or chart. The independent variable always goes on the x-axis, or the horizontal axis. The dependent variable goes on the y-axis, or vertical axis. Here’s an example: As you can see, this is a graph showing how the number of hours a student studies affects the score she got on an exam. From the graph, it looks like studying up to six hours helped her raise her score, but as she studied more than that her score dropped slightly. The amount of time studied is the independent variable, because it’s what she changed, so it’s on the x-axis.The score she got on the exam is the dependent variable, because it’s what changed as a result of the independent variable, and it’s on the y-axis. It’s common to put the units in parentheses next to the axis titles, which this graph does. There are different ways to title a graph, but a common way is â€Å"[Independent Variable] vs. [Dependent Variable]† like this graph. Using a standard title like that also makes it easy for others to see what your independent and dependent variables are. Are There Other Important Variables to Know? Independent and dependent variables are the two most important variables to know and understand when conducting or studying an experiment, but there is one other type of variable that you should be aware of: constant variables. Constant variables (also known as â€Å"constants†) are simple to understand: they’re what stay the same during the experiment. Most experiments usually only have one independent variable and one dependent variable, but they will all have multiple constant variables. For example, in Experiment 2 above, some of the constant variables would be the type of plant being grown, the amount of fertilizer each plant is given, the amount of water each plant is given, when each plant is given fertilizer and water, the amount of sunlight the plants receive, the size of the container each plant is grown in, and more. The scientist is changing the type of fertilizer each plant gets which in turn changes how much each plant grows, but every other part of the experiment stays the same. In experiments, you have to test one independent variable at a time in order to accurately understand how it impacts the dependent variable. Constant variables are important because they ensure that the dependent variable is changing because, and only because, of the independent variable so you can accurately measure the relationship between the dependent and independent variables. If you didn’t have any constant variables, you wouldn’t be able to tell if the independent variable was what was really affecting the dependent variable. For example, in the example above, if there were no constants and you used different amounts of water, different types of plants, different amounts of fertilizer and put the plants in windows that got different amounts of sun, you wouldn’t be able to say how fertilizer type affected plant growth because there would be so many other factors potentially affecting how the plants grew. 3 Experiments to Help You Understand Independent and Dependent Variables If you're still having a hard time understanding the relationship between independent and dependent variable, it might help to see them in action. Here are three experiments you can try at home. Experiment 1: Plant Growth Rates One simple way to explore independent and dependent variables is to construct a biology experiment with seeds. Try growing some sunflowers and see how different factors affect their growth. For example, say you have ten sunflower seedlings, and you decide to give each a different amount of water each day to see if that affects their growth.The independent variable here would be the amount of water you give the plants, and the dependent variable is how tall the sunflowers grow. Experiment 2: Chemical Reactions Explore a wide range of chemical reactions with this chemistry kit. It includes 100+ ideas for experiments- pick one that interests you andanalyze what the different variables are in the experiment! Experiment 3: Simple Machines Build and test a range of simple and complex machines with this K'nex kit. How does increasing a vehicle's mass affect its velocity? Can you lift more with a fixed or movable pulley? Remember, the independent variable is what you control/change, and the dependent variable is what changes because of that. Quiz: Test Your Variable Knowledge Can you identify the independent and dependent variables for each of the four scenarios below? The answers are at the bottom of the guide for you to check your work. Scenario 1:You buy your dog multiple brands of food to see which one is her favorite. Scenario 2:Your friends invite you to a party, and you decide to attend, but you're worried that staying out too long will affecthow well you do on your geometry test tomorrow morning. Scenario 3:Your dentist appointment will take 30 minutes from start to finish, but that doesn't include waiting in the lounge before you're called in. The total amount of time you spend in the dentist's office is the amount of time you wait before your appointment, plus the 30 minutes of the actual appointment Scenario 4:You regularly babysit your little cousin who always throws a tantrum when he's asked to eat his vegetables. Over the course of the week, you ask him to eat vegetables four times. Summary: Independent vs Dependent Variable Knowing the independent variable definition and dependent variable definition is key to understanding how experiments work. The independent variable is what you change, and the dependent variable is what changes as a result of that. You can also think of the independent variable as the cause and the dependent variable as the effect. When graphing these variables, the independent variable should go on the x-axis (the horizontal axis), and the dependent variable goes on the y-axis (vertical axis). Constant variables are also important to understand. They are what stay the same throughout the experiment so you can accurately measure the impact of the independent variable on the dependent variable. What's Next? Independent and dependent variables are commonly taught in high school science classes. Read our guide to learn which science classes high school students should be taking. Scoring well on standardized tests is an important part of having a strong college application. Check out our guides on the best study tips for the SAT and ACT. Interested in science? Science Olympiad is a great extracurricular to include on your college applications, and it can help you win big scholarships. Check out our complete guide to winning Science Olympiad competitions. Quiz Answers 1: Independent: dog food brands Dependent: how much you dog eats 2: Independent:how long you spend at the party Dependent:your exam score 3: Independent:Amount of time you spend waiting Dependent:Total time you're at the dentist (the 30 minutes of appointment time is the constant) 4: Independent:Number of times your cousin is asked to eat vegetables Dependent:number of tantrums Want to improve your SAT score by 160 points or your ACT score by 4 points? We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now: These recommendations are based solely on our knowledge and experience. If you purchase an item through one of our links, PrepScholar may receive a commission.

Understanding Delphi Project and Unit Source Files

Understanding Delphi Project and Unit Source Files In short, a Delphi project is just a collection of files that make up an application created by Delphi. DPR is the file extension used for the Delphi Project file format to store all the files related to the project. This includes other Delphi file types like Form files (DFMs) and Unit Source files (.PASs). Since its  quite common for Delphi applications to share code or previously customized forms, Delphi organizes applications into these project files. The project is made up of the visual interface along with the code that activates the interface. Each project can have multiple forms that let you build applications that have multiple windows. The code thats needed for a form is stored in the DFM file, which can also contain general source code information that can be shared by all the applications forms. A Delphi project cannot be compiled unless a Windows Resource file (RES) is used, which holds the programs icon and version information. It might also contain other resources too, like images, tables, cursors, etc. RES files are generated automatically by Delphi. Note: Files that end in the DPR file extension are also Digital InterPlot files used by the Bentley Digital InterPlot program, but they have nothing to do with Delphi projects. DPR Files The DPR file contains directories for building an application. This is normally a set of simple routines which open the main form and any other forms that are set to be opened automatically. It then starts the program by calling the Initialize, CreateForm, and Run methods of the global Application object. The global variable Application, of type TApplication, is in every Delphi Windows application. Application encapsulates your program as well as provides many functions that occur in the background of the software. For example, Application handles how you would call a help file from the menu of your program. DPROJ is another file format for Delphi Project files, but instead, stores project settings in the XML format. PAS Files The PAS file format is reserved for the Delphi Unit Source files. You can view the current projects source code through the Project View Source menu. Although you can read and edit the project file like you would any source code, in most cases, you will let Delphi maintain the DPR file. The main reason to view the project file is to see the units and forms that make up the project, as well as to see which form is specified as the applications main form. Another reason to work with the project file is when youre creating a DLL file rather than a standalone application. Or, if you need some startup code, such as a splash screen before the main form is created by Delphi. This is the default project file source code for a new application that has one form called Form1: program Project1;uses Forms, Unit1 in Unit1.pas {Form1};{$R *.RES}begin Application.Initialize; Application.CreateForm(TForm1, Form1) ; Application.Run; end. Below is an explanation of each of the PAS files components: program This keyword identifies this unit as a programs main source unit. You can see that the unit name, Project1, follows the program keyword. Delphi gives the project a default name until you save it as something different. When you run a project file from the IDE, Delphi uses the name of the Project file for the name of the EXE file that it creates. It reads the uses clause of the project file to determine which units are part of a project. {$R *.RES} The DPR file is linked to the PAS file with the compile directive {$R *.RES}. In this case, the asterisk represents the root of the PAS file name rather than any file. This compiler directive tells Delphi to include this projects resource file, like its icon image. begin and end The begin and end block is the main source code block for the project. Initialize Although Initialize is the first method called in the main source code, it isnt the first code thats executed in an application. The application first executes the initialization section of all the units used by the application. Application.CreateForm The Application.CreateForm statement loads the form specified in its argument. Delphi adds an Application.CreateForm statement to the project file for each form thats included. This codes job is to first allocate memory for the form. The statements are listed in the order that the forms are added to the project. This is the order that the forms will be created in memory at runtime. If you want to change this order, do not edit the project source code. Instead, use the Project Options menu. Application.Run The Application.Run statement starts the application. This instruction tells the pre-declared object called Application, to begin processing the events that occur during the run of a program. Example of Hiding the Main Form/Taskbar Button The Application objects ShowMainForm property determines whether or not a form will show at startup. The only condition for setting this property is that it has to be called before the Application.Run line. //Presume: Form1 is the MAIN FORM Application.CreateForm(TForm1, Form1) ; Application.ShowMainForm : False; Application.Run;

Data life cycles -Compare and contrast IT lifecycle approaches Essay

Data life cycles -Compare and contrast IT lifecycle approaches - Essay Example In this scenario, the option is an extremely disconnected firm with islands of proficiency in a sea of mislaid opportunity (IBM, 2012). However, to help businesses organize these endeavors, a group of IT lifecycle approaches and solutions exists, which is a collection of integrated systems and tools, developments and services to support the collaboration and communication of company, development, functions and stakeholders. Moreover, every forward-thinking is particularly planed to facilitate teams in tackling key cross-lifecycle actions that are most important to offer timely and productive worth to the company (IBM, 2012). In addition, it should be clear that businesses have to make the process of data storage more efficient. The benefit is that ILM/DLM (data and information life cycle management) creates high-quality business sense: actually, that is why it subsists in the primary place. In this scenario, ILM/DLM is a precondition for high-quality business governance; however is a s well a crucial component of high-quality industry conduct. Additionally, it takes care of company’s reputation and deals with risk, and supports a secure and reliable dealing environment. Moreover, it defends worldwide financial marketplace security and stability in addition to tracking doubtful customers' group. As well, it gives importance to clients’ self-assurance. Furthermore, it helps avoid terrorists and money-laundering as well as harmonizes global authoritarian approaches (TechTarget, 2007; Brinkmoller & Fischer, 2007). Basically, the DLM is a policy-based method that is used to handle and organize the flow of data and information system's data all through its life cycle: from configuration and preliminary storage to the time when it turns out to be old-fashioned and is deleted. In addition, data life cycle management products computerize the procedures concerned. Additionally, new data and information that have to be accessed more often, are stored on rapid and more costly storage media, on the other hand less critical data is stored on less costly and slower storage media (TechTarget1, 2004; Enterprise Integration, Inc., 2006). Moreover, HSM (Hierarchical storage management) is also a kind of data life cycle management product. In this scenario, the hierarchy refers to various kinds of data and information storage media, like that RAID (redundant array of independent disks) data and information systems, tape, optical storage, every type demonstrating a specific level of cost as well as speed of data recovery when access is necessary. In addition, HSM product allows data or system administrator to create and implement strategy for how frequently different types of files are to be stored to a backup data and information storage device (TechTarget1, 2004; Enterprise Integration, Inc., 2006). In simple words, ILM is all about understanding the data value with respect to time. The value of data changes with time and various rules are avai lable to administer how long data must be saved for, how secure the data store must be, and when the data must be removed from that store. However, these values will vary for different categories of data. In addition, ILM engages classifying data classes into business importance categories, then creating and

Predictors of Medication Errors in Elderly in Nursing Homes Research Paper

Predictors of Medication Errors in Elderly in Nursing Homes - Research Paper Example The National Coordinating Council for Medication Error Reporting and Prevention (2011) explains that "A medication error is any preventable event that may cause or lead to inappropriate medication use while the medication is in the control of the healthcare professional, patient, or consumer.† This means that medication errors do not only occur at the hands of medical professionals. In this essay, the writer review predictors of medication errors in elderly in nursing homes. This means that the bulk of the writer’s attention shall be based on factors that medical practitioners in nursing homes and taking care of elderly people can use to predict possible medication errors. As seen in the definition of medication errors, the writer’s view of predictors shall be varying and widespread, not centering only on the health practitioner but on all other causative factors including patients and consumers. Predictors of Medication Errors in Elderly This section of the essay reviews five major predictors of medication errors that can take place among elderly people in nursing homes. Number of Home Medications The fact that elder people under consideration are based on nursing homes should not eradicate the possibility of medication error occurring as a result of a number of home medications. Nursing officers and other health professionals taking care of elderly people in nursing homes must predict the fact that once admitted at the home, the history of a number of home medications received by patients before their admission at the nursing home can interfere with the efficacy and functions of medications administered to them at the nursing home. For this reason, it is rightly appropriate that nursing and other health professionals have a fair idea of medications patients on admission might have received at home before being admitted. Over the years, it is because nursing practitioners have been negligent of the need to assess the number of home medicati ons taken by elderly patients admitted at the nursing homes that Prasanatikom and Madigan (2004) concluded in a research that â€Å"incidence of medication error was highest at the first visit (23.5%)† Self-administration of medication Self-administration of medication is something that is common among elderly patients in nursing homes. Pollick explains that self-administration of medication or self-medication is the â€Å"practice of using illicit or legal drugs without proper medical supervision is known as self-medication.† The commonest cause given to the problem of self-administration of medication among elderly patients in nursing homes has been found to be over anxiety among the elderly patients (Akakpo, 2003). As a matter of fact, due to degeneration psychological problems among elderly patients, they tend to be very anxious about their health and always have a feeling that taking medications in overdose or taking extra medications aside what is prescribed for them may lead to a quick recovery of their health. Health practitioners in nursing homes must, therefore, have a forecasted knowledge that if self-administration of medication takes place among their patients, the patients risk the problem of medication error because there is the tendency of self-medicated drugs conflicting with the functions of prescribed drugs.  

Target Private Label Brand Analysis Essay Example for Free

Target Private Label Brand Analysis Essay In this assignment we analyzed Target’s private labels. Target has both value and premium private brands. Target uses â€Å"Up Up† for its value private label products and â€Å"Archer Farms† for its premium private label food products. The three product categories that we picked are household products, health products, and food products. The first household product that we picked is Target’s Up Up body wash. The Up Up’s Delicate Exfoliating Body Wash is compared to the national brand Dove Exfoliating Body Wash. They both are 24 oz and have the same package size and color. The Up Up is $3.24 whereas Dove is $5.49 which is 69% more expensive than the Up Up body wash. In terms of packing, the Up Up body wash has the same packing as the Dove body wash. They are very identical to each other and have the same shape and color. The Up Up body wash is placed on the upper right shelf where other body wash products are placed. In addition, the private brand is placed on the same shelf, but to the right side of the national brand. Next, we picked Target’s Up Up hand soap. The Up Up’s Moisturizing Hand Soap Aloe Vera is compared to Softsoap Soothing Aloe Vera hand soap. They both are 64 oz, have the same package and color. The Up Up is $3.69 while Softsoap is $4.49 which is 22% is more expensive than Target’s private brand. In terms of packaging, the Up Up hand soap has the same packaging as Softsoap hand soap. They both look the same and have a similar package size, shape and color. The Up Up hand soap is placed on the center bottom shelf and is placed to the right of Dove body wash. From the health products we picked Target’s Up Up Probiotic Dietary Supplement. The Up Up’s Probiotic Dietary Supplement is compared to Align Probiotic Dietary Supplement. They both have 26 tablets 4 week supply. The Up Up tablets costs $16.79 where the Align is $28.89 which is 72% more expensive than the Up Up probiotic tablets. In terms of packaging the Up $ Up Probiotic tablets have the same package size and shape as the Align Probiotic tablets, but the Up Up has a blue packaging color. The Up Up tablets are placed on the bottom right corner of the shelf. The national brand Align is to the left of Target’s private label. From the food products we chose Target’s premium private label Archer Farms. Target only has premium private label for its food products. The Archers Farms’ Organic Skim Milk is compared to Horizon Organic Fat-Free Milk. They both are 1.89 L and have the same package size but have different package color. The Archer Farms’ organic milk is $3.59 whereas the Horizon’s organic milk is $3.99. Here we see that the national brand is only 11% more expensive than the premium private brand. In terms of packaging the Archer Farms’ milk has the same package size and shape to the Horizon’s milk but conveys a premium image. Archer Farms’ milk is placed on the middle shelf and on the center of the shelf for milk products. The national brand Horizon is to the left side of Archer Farms premium private brand.

Catcher In The Rye Vs. Don Quixote Essay -- essays research papers

J.D. Salinger’s TheCatcher in the Rye can be compared to Cervantes’ Don Quixote. Both novels feature naive protagonists pining for an ideal world. In Salinger’s novel, Holden Caulfield is a sixteen year old who experiences challenging and questionable events in the mid-stage of his adolescence. Holden wants to protect the innocent children like â€Å"the catcher in the rye† from the immorality and corruptness of the â€Å"phony† adult world. In Cervantes work, Don Quixote is the idealistic protagonist who sets out to transform the world in accordance to his medieval vision. His growing obsession with stories of knighthood and books of chivalry leads him to abandon his former life and become a wandering knight set out to right the world’s wrongs. The title of the book Thr Catcher in the Rye is reflected in the mistaken words of a poem by Robert Burns. Holden thought the words were â€Å"if a body catch a body coming through the rye.† That is what he wanted to be. He feels that he has the responsibility of saving the children from falling off the cliff and losing their innocence. Holden wants to protect the vulnerable from being corrupted by the adult world, an immoral and unscrupulous society tainted by phonies. Unless stopped the children will fall off the cliff and plunge into the evils of adulthood. Although Holden wished to help children retain their innocence perpetually, he realized he couldn’t. There was too much evil in the world, and it would be infeasible to shelter a child fro...

Movie Review of Canterbury Tales

The British film entitled A Canterbury Tale was released in 1944 and directed by Michael Powell and Emeric Pressburger. The movie was successful enough in adapting the themes of Chaucer’s creation. It is a mixture of Comedy Drama which enticed the audience and kept them tuck in their seats. The magnificent genre and plot was performed artistically by actors and actresses in the film.The film depicts the era of the 14th century, giving audience a glimpse of what really happened during that time. The Canterbury Tales (written form) is one of the greatest works done during the 14th century but for a work to be considered â€Å"the work of the century† it must exemplify the major events that happened during that period. Good thing that the directors successfully gave audience a clear representation of the book by Chaucer.The film was set in Britain and deals with the system of locking up young daughters as part of the policy adopted by Thomas Colpepper, J.P. (Erick Portman) in the film. In order to escape from he claws of Portman, Sgt. Peter Gibbs (Dennis Price) who is a British tank sergeant led the troop on a journey towards many discoveries.He traveled with Alison Smith (Sheila Sim) a shopkeeper and American GI Bob Johnson (John Sweet). They traveled towards Canterbury. The journey of the main characters made them discover many things about life. The stereotypical notion about Yankees was reversed by Sweet’s experience as he met his true love along the way to Canterbury. There is magic in every life of the characters and the actors and actresses played their part very well.The movie is also magnificent in terms of cinematography since there are scenes that made it possible for audience to see themselves united with the characters. The camera angles are set in a way that viewers will see the emotion of the characters more clearly.The Canterbury Tales as it were, holds a mirror to the life of the Chaucer’s age and shows it manners and m orals completely, â€Å"not in fragments†. The director of the film replaces effectively the shadowy delineations of the old romantic and allegorical school with the vivid and pulsating pictures of contemporary life that made the film more appealing. Chaucer’s tone as a poet is wonderfully instinct with geniality, tolerance, humor, and freshness which are absent from that of his contemporaries and predecessors who are too dreamy or too serious to be interesting.Another thing that made the film outstanding is the variation of characters in terms of profession, experiences in life and point of views. Although the film was made in black and white, viewers can still enjoy watching because of the plot and the theme. A Canterbury Tale film was adopted from The Canterbury Tales of Geoffrey Chaucer, and loosely uses Chaucer's theme of unconventional characters on a pilgrimage' to highlight the period of war, the experiences of the citizens of Kent and persuade the friendship a nd understanding of Anglo-American.The film was shot in locations like Kent countryside. It is a representation of the real environment were war is rampant and in Canterbury itself. Large participation of people was also utilized since there is a need for crowd performances like river battles and children activities. It creates a dynamic and interactive environment that made viewers enticed.The directors of the film made the characters detailed and true to life-like because he intended to make the viewers of the time reflect on their actions. The film shows clearly the good and bad situations in Canterbury, and it was intended to be easily understood by the audience.

Cooling Drinks

1) What is the specific latent heat of fusion of water?Specific latent heat of fusion is the amount of heat absorbed or released by a substance when changing states. This could be boiling or melting. Latent heat of fusion is the amount of energy needed to melt a substance, while latent heat of vaporisation is the amount of energy needed to boil a substance. The specific latent heat of fusion of water is 334 j/g In the graph, you can see that as the temperature increases more energy is needed to heat the water. When the temperature hits the latent heat of fusion, the temperature stops rising as the energy is being used to change the state of water. This also happens when the latent heat of vaporisation2) What is the specific heat capacity of water?The specific heat capacity is the amount of heat that is needed to raise the temperature of a substance. The specific heat capacity water is 4181 j/kg. This is higher than most metals. Here are some other substances with their specific heat capacity; SubstanceC (J/g oC) Air 1.01 Aluminium 0.902 Copper 0.385 Gold 0.129 Iron 0.450 Mercury 0.140 Sodium Chloride 0.864 Ice 2.03 Water 4.183) Why energy is needed to melt ice and how this is explained by the structures of ice and water The molecules of H20 behave differently in water than in ice. In water they are floating around freely and in ice they are â€Å"stationary†, they only vibrate slowly. This is because they don’t have enough energy to break their intermolecular bonds. So in order to melt ice you need to add energy to give the molecules kinetic energy to move around, becoming less stationary. If enough energy is given to the molecules they break the intermolecular bonds and the ice melts to ice. 4) Why is ice more effective for cooling a drink than cold water The cooling of a drink with a cube of ice is more effective than using cold water because ice can absorbs a lot more heat. This is because it has a higher specific latent heat of fusion.Hypothes isThe greater the amount of ice that melts the bigger the temperature drop of the water This is because when more ice melts more energy is taken from the waterApparatus5 identical beakers which are made of the same materials Thermometers with a suitable range; -10oC to 100oC Measuring with volume above 200cm3 Top-pan balance reading with up to 35g Ice (crushed), not straight form the freezer Suitable insulating material Means of removing water e.g. paper towels Stopwatch to measure time in minutes and secondsMethod1) Pour 200cm3 of water into 4 same sized beakers of the same materials. This is so the materials does not affect the in temperature 2) I’m going to measure the temperature of the water. I’m going to make sure the temperature is the same to make it a fair test. I’m going to leave the water to become room temperature for about 5 minutes 3) I’m going to add 15g of ice to Beaker 1, 25g to Beaker 2, 25g to Beaker 3 and the fourth Beaker will have no ice.The fourth beaker will set the benchmarks. The amount of ice is the independent variable. I will measure the ices mass by using the top-pan balance. I used these certain amount of mass so I have a big range of data and will make a better comparison. 4) I will then measure the temperature of the beakers every minute for three minutes. 5) Then I will put all my results into a table and then into a line graph so I can make easy comparisons Hazards, the risks and how to reduce the risksResults Table1. Describe any patterns or trends in your results. Comment on any unexpected results. After analysing my result I have found some trends in the data. I also saw some anomalies that came up in the experiment. The most obvious trend is in the line graph and the temperature drop. The more mass of ice I put into the beaker to cool the drink, the faster the temperature dropped. For example, in beaker one 2. Compare results of your own investigation (Part 2) with the data from other groups wi thin your class and any data collected in Part 1. Comment on any similarities and differences.Suggest  and explain possible reasons for any differences. 3. Evaluate your results, the method you used and how well you managed the risks. 4. Do your results from Part 2 support the hypothesis suggested by Charlie’s friend? Explain your answer. 5. It is possible to use the equations below to predict the temperature drop of the water when a chosen amount of ice is added to it. Will the actual temperature drop, measured in your experiment, be equal to the predicted value? Use relevant scientific explanations in your answer. Use the results of your experiment, appropriate calculations and your research (Part 1) to provide evidence to support your answer. 1 cm3 of water has a mass of 1 gEnergy = mass Ãâ€" specific heat capacity Ãâ€" temperature change Energy = mass Ãâ€" specific latent heat

Killing Animals Essays

Killing Animals Essays Killing Animals Essay Killing Animals Essay Ever wonder how animals are being processed in the industry? Well I can only tell you that it’s one hell of a disaster, but it’s our way of life being human. We humans have been killing animals for survival since we have been evolved. Long time ago there were no rights or laws for killing a certain animals because the human population was very modest. Killings animals since the Stone Age has been done because we needed the food, fur to survive and sustain life. Nowadays we struggle to keep the animals population abroad, as many species are being extinct. This is a problem because of the global warming, and climate changing all around the world. Also how animals are being hunted down just for the joy or for food. This brings a serious cause because most of the animals are in the endangered species list, and almost being extinct. Most people don’t even know what happing when animals are being hunted down and ignoring the cause, this is why the media should spread the news so people can witness, and see what the hell is going on. This also will encourage some people to fight for stricter laws on animal abuse. Innocent animals are being use for lab experiments, for the safety of new products for us humans to buy later in the future. This brings a lot of confusion why animals are tested for human products as we two species are different in many ways. Another argument is rare breed of animals are being killed for their fur to be used for fashion. Animals are being test in laboratory every day which causes death to most of them or just a defect part of their body. Now, it’s a tradition to humans to ensure the safety of consumer products and drugs around the world, scientist and regulators work together to develop alternative for their use. Animal testing dates back to ancient Greece to research medical experiments. As animals have being used for a long time, people have expressed concerns about animals testing and research. Killing animals have been a top priority when it comes to agriculture. Agriculture has dominated the industrialized facilities that maximize profits and has been treating animals as they are nothing to the world. We go kill, sell, buy, eat, wear every animal on the planet every day; this is how we keep our lives sustainable. It has been reported that we have killed over nine billion chickens, pigs, cattle, turkeys, sheep’s, goats, ducks, and geese annually in the United States. As we all look into it, there are tons of disadvantages that still apply today. Now a days more animals are being scientifically fed to grow fast and meaty, so much for brings the extinction of organically feed. There are very little farms with no contract that offer animals that are naturally fed. As some people say, we live in a strange world, but to me it seems to be sustainable on the things we do. The way we do agriculture is now a culture for the human life. Yes the things we do are sometimes the things we regret. Killing an animal can scar us for life and some people don’t like that, that’s why there are established groups of protest and attack the company’s. Sometimes it works sometimes it doesn’t. For my option on animal torture, there should be an alternative way because I just don’t like to see animals being tested and tortured. On the other hand, killing animals that are raised for food is wrong for a vegetarian because they don’t eat meat. It’s defiantly fine to kill animals and eat them because we actually need to eat meat for protein. It just that we don’t see how they are processed though the factory which most people don’t know. In the essay â€Å"the Evil of Animal Rights† by Alex Epstein and Yaron Boork, the authors explain how scientist are closer than ever to finding the cures for AIDS, cancer, and other deadly diseases. As most people depend on these types of people some people are against like the â€Å"Stop Huntingdon Animal Cruelty† formally known as the SHAC. These people protest against the animals use for laboratory work. They protest outside of businesses and the employees of the Huntingdon employees. When it comes to pathos for this essay, it brings a lot of emotions on how we use innocent animals for everything. However, this is the only way how we can only solve our health problems for us humans and even other animals. A life of an animal butcher can be rough and depressing as Suzanne Winkler explains in her essay â€Å"A Savage Life†. Every few years Winckler butchers chickens with a friend named Chuck. Chuck buys the chicks and matures them for 10 weeks. When they are ready to be butchered, Winckler does her job. Pathos is explained in this essay when Winckler goes into detail on how backbreaking her job is; working from 10pm to 6pm. She also goes into detail on how messy it is, and how it brings a lot of emotions. However she has overcome and knows her duties because it has been passed on generation to generation from her family. Millions of animals are being killed for agriculture and tested for products for us. This is how we live now and there is no going back. Most people don’t know and don’t care and some people do. This is how we live to sustain our lives and it has been mostly successful. If animals test and help cure the worlds deadly diseases, that’s should be fine for the most of us. It just all the animal’s torture is wrong and should be an alternative way of finding it.

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. ). (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