RESPONSE 1 (SR)
Given that Rachel comes from a family with a history of breast cancer, the most appropriate moral and ethical thing would be to contact Kristin. Nevertheless, every physician is bound by the Health Insurance Portability and Accountability Act (HIPAA). As such, as Rachel healthcare provider there may be no grounds contacting Kristin without mentioning Rachel and this would be a breach of the act. Nevertheless, I would strongly advise Rachel to talk to Lisa and see if Lisa is agreeable that they should not contact Kristin. According to Chen and Benusa (2017) the HIPAA Act pronounce the national standards that protects a patient’s medical records or any other personal health information and applies to health care plans. Perhaps Rachel doesn’t not understand what it means to be diagnosed with BRCA1 gene. Therefore, patient education would be essential.
While cancer is as a result of the interaction of several factors such as behavioral, environmental and hereditary. According to Shah, Rosso and Nathanson (2016) hereditary cancer is as a result of the mutations of the high penetrance genes BRCA1 and BRCA2. Breast malignance results from the epithelial elements and are normally categorized as carcinomas. According to McCance and Huether (2014) breast carcinomas are a wide range of lesions that are of difference microscopic appearance and biologic behavior. Nevertheless, Velloso et al. (2017) notes that these disorders are often considered as a single disease. The in situ carcinomas of the breast can either be ductal or lobular. These form of in situ carcinomas are primarily differentiated by their growth pattern and cytological features of the lesions as opposed to their anatomic location within the breast ductal-lobular system. Tumors are constantly evolving. Normal breast tissue and breast tumors share myo-epithelial cells, endothelial cells, macrophages, and ECM molecules, which are major controllers of carcinogenesis (McCance & Heuther, 2014).
When it comes to hereditary cancer, BRCA1 and BRCA2 are the most important genes. A mutation in any of these two increases the risk of a patient developing breast cancer. A family history of breast cancer means that mutation of BRCA1 is a high likelihood hence the need for other forms of preventive care measures. According to Cragun and Pal (2013) BRCA carriers and women at very high risk benefit from multidisciplinary, individualized medical evaluation and risk management.
There are a number of risk factors for breast cancer and possible preventative interventions. Factors such as age, heredity, lifestyle, and family history are some of the known predisposing risk factors. Early screening, prophylactic surgery and chemoprevention are some of the intervention that may significantly delay the onset or occurrence of breast cancer (Cragun & Pal, 2013).
RESPONSE 2 (Andria)
According to statistics published by the Centers for Disease Control and Prevention (CDC) in 2018, breast cancer is the most common malignancy in women and the second leading cause of cancer deaths in women behind lung cancer. As Rachel’s health provider I would encourage her to communicate the new information with Kristin. In the even she remains adamant and refuses, I would seek her permission to contact her sister to inform her of the possible hereditary disease. Another tach as her HP I could employ is to ask her to let her other sister Lisa notify Kristin. Educating Rachel that earlier awareness of the potential disease, according to WHO, is the cornerstone of Brest cancer prevention and control.
Due to the family history of breast disease there is an increased risk for the development of breast cancer. According to McCane & Huether (2014), breast cancer arises from mutation of duct all epithelium. Risk of breast cancer, the second most common cancer found in women in the United States, can be inherited. BRCA1 and BRCA2 are two genes linked directly with susceptibility to developing breast cancer, as well as to developing ovarian, prostate, and other types of cancer. Mutations in these genes can eliminate their ability to control cell growth (Benson, 2019).
The nature of the cellular abnormalities responsible for the development of breast cancer has been the object of intense research for many years. With the variety of risk factors associated with breast cancer there are some interventions that can be applied to address the modifiable factors to prevent or promote health management of women and men. The most common is to encourage lifestyle changes such as becoming more physical active, performing monthly breast self examination, manage other comorbities if any and dietary adjustment.
Patient’s are usually treated in various ways when the BRCA gene has been identified. Management may include early or enhanced screening, prophylactic surgery to remove air risk tissue before getting infected and lastly chemoprevention which entails using such such as tamoxifen and raloxifene to (cancer.gov) which specifically targets the estrogen receptors in breast tissue and blocks the growth-promoting effects of estrogen in positive breast cancer.
provide 1 participation type response for each of the discussions