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HM411 Healthcare Management Question The purpose of the essay is to develop skills in essay writing through the exploration and analysis of an issue relevant to the study of Health Sciences using scientific literature. A thesis statement should be clearly stated in the introduction and then supported throughout the essay by providing arguments and evidence from the literature. Answer Research Essay- Breast Cancer Introduction: Breast cancer is the most common malignancy in women of productive age, accounting for approximately 41% of new cases in Canada . Approximately 40% of the women who were diagnosed with breast cancer are younger than 50years . Due to the availability of anticancer treatments such as chemotherapy, although the younger breast cancer patients become disease free and healthy it causes a negative impact on the gonad function, which causes the impaired fertility. However, accumulated evidence suggested adjuvant therapy prior to the chemotherapy resolved the issue of the chemotherapy. This essay will argue adjuvant therapy with combination with chemotherapy is efficient than tradition chemotherapy in females with breast cancer. Therefore, this paper will illustrate the effectiveness of adjuvant therapy over chemotherapy in the following paragraphs. Discussion : Fertility preservation becomes increasingly important for women who survived cancer along with women who are going through chemotherapy. The available evidence suggested the occurrence of congenital abnormalities of infants born to women with the history of breast cancer . There is a higher incidence of the birth complication observed in the women due to previous cancer treatment. Therefore, pregnancy becomes a huge issue even after the survival of breast cancer. The prime reason behind the phenomenon is that the drugs used in chemotherapy interrupted the normal cellular processes and causes Oxidative damage of DNA in somatic and germ line cells that resulted in the loss of fertility in the patient having breast cancer or even after surviving breast cancer. However, the study by Dabrosin ,  most of the women experience fertility loss as well as after undergoing through the chemotherapy process . According to Sparano et al. (2018), The older breast cancer is more susceptible to ovarian loss compared to younger breast cancer patient because of the low ovarian reserve. A quantitative study reported by  Dabrosin  (2015),that early menopause in their life if they menstruated during the session of chemotherapy . A randomized trail control by Dieci et al. (2018), suggested that this loss could be prevented by using adjuvant therapy with combination with chemotherapy. This study reported that administration of hormone-based adjuvant therapy prior to the chemotherapy prevent the loss of fertility . The Hormonal based therapy prevent the loss of ovary by suppressing the function of it during the chemotherapy . The study stated that approximately 85 % of breast cancer patient was benefited by administration the adjuvant chemotherapy of 50 years or younger than 50 years . Two retrospective study was conducted by that suggested that the data accumulated between 2004-2006 and 2014-2016 shows the positive impact of the adjuvant therapy over chemotherapy on a patient with breast cancer .  These two-cohort studies reported that the fertility issues decreased over the time in the patients due to the adjuvant therapy . Therefore, adjuvant therapy resolved the issue related to pregnancy in breast cancer patient . However, to administrate the hormones in the patient with breast cancer, collaboration between oncologists and endocrinologists should be followed  Conclusion: Therefore, it can be concluded that breast cancer is considered as one of the common malignancy in women around the globe that affects the fertility of the women and influenced the menopause. Although, although the younger breast cancer patients become disease free due to chemotherapy it causes the impaired fertility. Therefore, adjuvant therapy prior to the chemotherapy proves to be effective in preventing fertility loss in the patient. References : Burstein, Harold J., Christina Lacchetti, and Jennifer J. Griggs. “Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update on Ovarian Suppression Summary.” Journal of oncology practice12, no. 4 (2016): 390-393. Dabrosin, Charlotta. “An overview of pregnancy and fertility issues in breast cancer patients.” Annals of medicine 47, no. 8 (2015): 673-678. Dieci, Maria Vittoria, Cristina Ghiotto, Caterina Barbieri, Gaia Griguolo, Carlo Saccardi, Michele Gangemi, Alfonso Pluchinotta et al. “Patterns of Fertility Preservation and Pregnancy Outcome After Breast Cancer at a Large Comprehensive Cancer Center.” Journal of Women’s Health(2018). Pavone, M., M. B. Moravek, A. K. Lawson, S. Klock, R. Confino, K. N. Smith, and R. R. Kazer. “Fertility preservation (FP) in breast cancer patients does not delay time to cancer treatment.” Fertility and Sterility 108, no. 3 (2017): e184. Sparano, Joseph A., Robert J. Gray, Della F. Makower, Kathleen I. Pritchard, Kathy S. Albain, Daniel F. Hayes, Charles E. Geyer Jr et al. “Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer.” New England Journal of Medicine (2018).

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