Among women living in the Western countries, breast cancer is a disease of significance in terms of incidence and mortality. Improvement in therapeutic approaches has improved the survival of breast cancer patients many of who have normal life expectancy. A better understanding of the determinants of this disease has generated eventually an approach where breast cancer care is increasingly being directed toward developing interventions based on risk factors to improve the overall quality of life as well as longevity of the patients.
From a determinant analysis of incident breast cancer cases in a given community, it is clear that physical activity has an important role to play in prevention of incidence of breast cancers. In fact, physical exercise has consistently been identified as a central element of rehabilitation for many chronic diseases and has been successful in improving quality of life and reducing all-cause mortality. Due to reasons of its own, breast cancer patients who undergo therapy may suffer from morbidity that can be reduced considerably with promotion of physical activity in such patients.
Recent observational evidence suggests that moderate levels of physical activity may even reduce the risk of death from breast cancer, and therefore, exercise may prove to be an extremely fruitful intervention to improve not only quality of life in such patients, but also overall survival. Current guidelines for the dietary pattern most likely to prevent breast cancer include high consumption of vegetables and fruits and reduced intake of fat, specially animal fat. This dietary pattern emphasizes decreased intake of fat and increased intake of protective micronutrients and phytochemicals that would prevent breast cancer.
In a given population, therefore, interventions designed on these lines would modify the behaviors of affected population and population at risk. This work represents an intervention plan for the community in question. Introduction: In the community in question, the review of health survey and hospital morbidity data indicate that there is an unusually high prevalence of breast cancer in the community. Like any western community, the population is small, consists of 100,000 people.
Interestingly, recent regional dietary intake data indicates high fat intake and low levels of consumption of fruit and vegetables among adult women in this community. The population is obviously unaware of the fact that risk management approach and interventions designed to influence and modify the determinants of breast cancer can control and reduce the incidence of breast cancer, and an intervention plan designed to influence the dietary and other behaviors in the adult female population in the community can, in fact, be prophylactic.
The recent concern of the community about a local newspaper report about environmental pollution created by a pulp mill in the region is baseless since breast cancer is recognised to have no environmental aetiologic factors promoting its incidence. The campaign against the local pulp mill will lead to its closure with no scientific evidence to back up the propaganda, and that would have gross economic consequences of the region.
The best way would be to frame an intervention plan depending on the dietary data and the other parameters to prevent the incidence of breast cancer. This preventative approach based on behavioural modification of the population at risk would incur costs, but taking into consideration the amount of money that would need to be spent on the treatment of existing cases and investigation of the cases that would be incident later, the amount of days lost in suffering and disease, this cost is worthwhile.
In this work, an intervention plan based on determinant analysis has been proposed that would act factually as a prophylactic in this population to reduce the incidence of breast cancer. Although about 10% of the human breast cancer cases have been linked to genetic causes and familial origin, basically cancer of the breast is hormone dependent. Many cases of breast cancers cluster in a family, and in many cases sisters and daughters are affected (Kipnis, V. , Midthune, D. , Freedman, L. S. et al. , 2001).
Studies have shown that there had been geographical clustering of cases in very many different parts of the world, and the predilection cannot be explained on the basis of genetics because despite anthropometric variations, geographical clustering and predisposition to cancer breast cases seem to be due to some element related to environment of that particular geographic region (Bingham, S. A. , Luben, R. , Welch, A. , Wareham, N. , Khaw, K. T. , and Day, N., 2003).
One would always try to find out the easiest solution, that is, environmental pollution. Fortunately, several researches have been undertaken to demonstrate unequivocally that environmental pollutants have little to do in causation of breast cancer. As a result, in an attempt to answer an apparent paradox of geographical clustering of breast cancer cases, the role of diet has long been investigated (Day, N. , McKeown, N. , Wong, M. , Welch, A. , and Bingham, S. , 2001).