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LIFESTYLE OF OTHER COUNTRIES EFFECT THE INCIDENCE & TREATMENT OF BREAST CANCER
How could the lifestyle of other countries effect the incidence, detection and treatment of Breast
Cancer?
Alecia Wagner
Global Studies and World Languages Academy
Talllwood High School
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ABSTRACT
My name is Alecia Wagner and I am a senior at the Global Studies and World Languages
Academy at Tallwood High School. While in the academy, students have to take four years of
one language, and two years of another. I have taken four years of Spanish and I am currently in
my third year of German. I have had the opportunity to travel to Germany twice before.
Everything is awesome in Germany! After my travels to Germany, I fell in love with it. I love
their culture, lifestyle and of course, the yummy food. This is the reason why I picked Germany
as my other country to compare to America.
Breast cancer is a subject that hits close home to me. My mother was diagnosed with
stage four inflammatory breast cancer my freshman year of high school. It has been a long road
for my family and I, but thankfully my mother is currently in remission, which means her cancer
is not growing nor spreading.
I plan on attending Indiana State University after high school to earn my nursing degree
to become an RN. During my sophomore year, I became especially interesting in the medical
field. Between my mothers development of breast cancer and I myself wanting to become a
nurse, I chose a topic in the medical field. Also, since my mother has had breast cancer, my
chances of possibly developing breast cancer are a bit higher than others. I will admit I do not
live the healthies lifestyle, so with my research question being how lifestyle could affect breast
cancer, I want to see how I can change my lifestyle now to help benefit me later on.
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TABLE OF CONTENTS
Abstract.2
Introduction...4
Limitations5
Methodology.....6
Literature Review.7
Body.10
Conclusion..13
References14
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INTRODUCTION
Breast Cancer is the second most common type of cancer found in women in America. In
general, breast cancer tends to affect women more than men. There are many different types of
breast cancer, although the most typical kind is called ductal carcinoma, which starts in the cells
of the ducts. Breast cancer can also start in other places such as the breast tissue. (Institute, 2015)
In America, about 1 in 8 women will develop breast cancer, which equates to about 12%
of women developing breast cancer. There is an estimate of there being 231,840 new cases in
America in 2015. (BreastCancer.Org, 2015) Surveillance, Epidemiology and End Results, SEER,
which is part of the National Cancer Institute, predicts that there will be about 231,840 new cases
of breast cancer in America in the year 2015. Along with that, SEER also predicts that out of
those 231,840 cases, there will be about 40,290 deaths from breast cancer in 2015. (SEER, 2015)
In Germany, there were about 71,623 cases of breast cancer in 2014, which seems to be the most
common type of cancer as well. Out of 104,300 deaths from six different types of cancer, about
18.8% of women died from breast cancer. (Organization, 2014)
Thankfully for countries such as America and Germany, we have the technology to detect
breast cancer early by using mammograms, which is a X-ray of a womans breast that helps
detect breast cancer. But separate from technology that helps detect it earlier, is there any way
our lifestyle could impact the chances of someone developing breast cancer? I believe that the
life we live now could affect the chances of developing breast cancer later on in life. How could
the lifestyle of women in other countries effect the incidence, detection and treatment of breast
cancer there?
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LIMITATIONS
Since I am a senior in high school working at a minimum -wage job, I will not be able to
travel to Germany. Although I have traveled to Germany a couple of times before, at the time of
my travel, I was not quite sure what I was going to do for my senior project, and therefore, I was
not able to ask my host families their knowledge on breast cancer. Also, since I will not be in
Germany, I will not be able to talk to German doctors. I will not get the chance to ask if they
think lifestyle could affect the chances of people living in their country developing breast cancer.
Another limitation that I will be facing is not being able to see their technology and equipment
that they use to detect and treat breast cancer. I know that America uses many different
techniques and machines to help detect and treat breast cancer. Since my outside advisor is an
oncologist, he showed me some of things we use in America, such as the area where patients
receive chemo, as well as where people receive radiation to help kill their cancer cells. Since
Germany is a wealthy country like America, I am sure they have great pieces of equipment.
However, I will just not be able to personally learn about them and see them myself.
Although I have studied three years and traveled to Germany twice for a total of five
weeks, I am still facing another limitation: the lifestyle. Even though I have had the opportunity
to travel and experience their lifestyle, I did not get to experience it for as long as I would have
wanted to. Thankfully, the little bit of lifestyle that I lived while I was there will be helpful. Since
I was not there for a couple of months, or a couple of years at a time, I still feel like I could be
missing out on key parts of the German lifestyle.
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METHOLOGY
Most of my data for my project will come from three to four different sources. The first
way for me to get information and data will be from the internet and trusted, reliable websites.
Websites such as the National Cancer Institute, Breast Cancer.org, the World Health Organization
(WHO) as well as Surveillance, Epidemiology and End Results Program (SEER) are very helpful
in finding accurate data. Also, since I will not be able to talk face to face with German doctors,
these websites will help me get the same statistics that the doctors would have. I will also be
looking at medical studies that deal with breast cancer.
My inside advisor is also a helpful resource for me. My inside advisor grew up in
Germany and has also traveled there many times, so she will be able to help me with the other
parts of the German lifestyle that I might not have seen or that I missed when I traveled to
Germany. Like I have mentioned before, I have also traveled to Germany and I am currently in
my third year of German. Even though I might have missed some things, my short experience
with the culture and lifestyle will be helpful. Since I have traveled to Germany before, I will be
able to compare and contrast the different lifestyles that Germans and Americans live.
In addition, I have witnessed how breast cancer can be treated in America. During my
freshman year of high school, my mother was diagnosed with stage four inflammatory breast
cancer. These past three, nearly four years have been a roller coaster for my whole family.
However, since my family and I have been faced with this obstacle, I decided to use it to my
advantage. I will be able to look at my mothers lifestyle and compare it to the German lifestyle.
Another helpful source of information is my mothers oncologist, Dr. Morris. Dr. Morris looks at
all different types of cancer except for skin cancer. I recently had an interview with him and he
gave me a lot of helpful information.
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LITERATURE REVIEW
From the National Cancer Institute, the Surveillance, Epidemiology, and End Results
Program, also known as SEER, was a very helpful and up to date source. This site gave me
information mostly from America, but it was everything I was looking for. My outside advisor,
Dr. Morris, recommended this site for me during the interview I had with him. SEER covered
everything from statistics, the type of people who develop breast cancer as well as the death rates
from breast cancer.
The World Health Organization, WHO, was also very helpful. I found a lot of information
on German statistics as well as American for breast cancer. This site was also very useful because
it gave the obesity rate of females in Germany, which helped me compare the two countries. As
well as the National Cancer Institute, this information was within the last couple of years.
An interesting article that I found came from an article from a magazine on BBC. In the
article, it talked about another way that Germans help detect breast cancer. In the article, Dr.
Frank Hoffmann explains how blind people could possibly help detect breast cancer. Dr.
Hoffmann says people trained to read Braille have a highly developed sense of touch
(d'Archy, 2015) Although this is not a real way that Germans detect breast cancer, I found it
very interesting that blind people would be better qualified than anyone else to carry out breast
examinations on his patients. (d'Archy, 2015)
Germans try their best to help a lot of women get screened for breast cancer. In the article
The Mammography Screening Debate in Germany: Yes or No?, it explains what Germany
does different when it comes to mammograms compared to America. In Germany, they try their
best to help the vast majority of women get a mammogram. For starters, German mammograms
are free. In America, most of peoples insurance covers mammograms, but sometimes they do
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not so there is a low price that people have to pay. In Germany, they have mobile screening
busses to drive and give mammograms. These little mobile screening busses go everywhere from
the big cities to the little towns. I think this is a great way to help give mammograms!
Recently, there has been much debate on what age women should go for their first
mammogram. The age range to get your first mammogram was between 40 and 50, which is
pretty broad. The Susan G. Komen website was helpful in describing what age women should
go. On the website, it also a table comparing three different medical sources. It compared the
American Cancer Society, the National Comprehensive Cancer Network as well as the U.S.
Preventive Services Task Force. In the table, each one listed recommendations for breast cancer
screening for women at average risk. Even though the ages were not all the same, it was good to
see what the average was.
Another resource that provided information about breast caner was the World Cancer
Research Fund International. As well as giving statistics about breast cancer in other countries, it
provided a table that had twenty countries. In the table, it ranked them from one to twenty
ranking them from the number of women that were still living five years after their breast cancer
diagnosis. Germany was ranked seventh. The number of women still living after five years was
279,045. America was ranked two spots below at nine. In America, there was 970,693 women
still living after five years. (WCRF, 2015)
Lastly, my interview with Dr. Morris was very informational and helpful. Dr. Morris
helped me understand the many different types of breast cancers that there is. Also, he explained
how the cancer cells can sometimes be stored in fat cells. This was very important fact to include
my paper since my paper focuses on the lifestyle. As well as my interview, my experiences with
both breast cancer and the German lifestyle helped me. With my mothers battle with breast
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cancer, I used how her lifestyle was compared to my German host familys lifestyle. I could
compare how my German host family ate healthier foods more often than my family as well as
how Germans usually ride bikes or walk everywhere. Although my family and I have a healthy
lifestyle, it is not as healthy as the German lifestyle. We have changed our lifestyle after my
mothers diagnoses to help keep her healthy and help her beat off the cancer cells. As well as
changing how much we were active, we also started to eat better. From my experiences, I found
that Germans eat more vegetables as well as fruit. My experiences helped me to not be as bias
towards on country.
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BODY
Is there any difference between Germany and America? They both seem economically
healthy, modern as a whole when it comes to technology, and pretty healthy. The lifestyle might
seem similar to anyone who does not know the difference and has never traveled to the opposite
country. However, if you have never traveled to Germany, you would never know that the
American lifestyle is pretty different than the German lifestyle. Our lifestyle makes us look
relatively lazy compared to the German lifestyle. In America, we rely on cars and busses to get
everywhere. In Germany, however, Germans tend to walk and bike a lot more than Americans. I
myself have traveled to Germany twice before and it is safe to say that the Germans tend to live a
healthier lifestyle than us. To help explain the difference with an example, in America it would
take me the better part of a day to reach my 10,000 step goal on my FitBit. In Germany, however,
it would take me only a three to four hours to reach my 10,000 step goal.
In America, we use mammograms as one of the main ways to detect breast cancer. A
mammogram is when an X-Ray machine is used to take photographs of tissues inside the breast.
Lately, there has been much controversy regarding what age women should get their first
mammogram. The U.S. Preventive Services Task Force, also known as the USPSTF,
recommends women who do not have a high risk of developing breast cancer should get a
mammogram after the age of 50. The USPSTF recommends that women who have a higher
chance of developing breast cancer should get a mammogram at the age of 40. (Boyles & MD
Chang, 2009) Germany is similar to America when it comes to age for mammograms; they also
recommend that women start getting mammograms at the age of 50. Germany and America both
believe that women should get mammograms every two years. Germany spends about 220
million Euros every year for their mammogram screening program. Germany uses busses to
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drive to big cities as well as small cities to help as many women as possible get a mammogram
screening. (Eich-Krohm, 2014) Although the age for women to have their mammograms is the
age is 50, sources say that the the biggest killer of women is between 40-55. (d'Archy, 2015)
Germany has also used a different way to try detect breast cancer. People trained to read Braille
have a highly developed sense of touchblind and visually-impaired women would be better
qualified that anyone else to carry out breast examinations on his patients. (d'Archy, 2015)
The earlier someone is screened, the better chances they have of surviving breast cancer.
The earlier you find it, the faster you can start treatment to help kill the cancer cells. Like I have
mentioned before, there are 231,840 new cases of breast cancer predicted to develop in America
in the year 2015. Out of that 231,840 cases, about 6.8% of the deaths will come from cancer.
(SEER, 2015) There is a 89.4% percent of surviving five years in America. The five year
survival rate has increased a lot from 1975. In 1975, the percent was about 75.2%, in 32 years, it
has risen 16% to a total of 91.0% in 2007. (SEER, 2015) The five year survival rate in Germany
is about the same as America, 83.7%. The highest point from 2002 to 2006 was about a 89.8%
survival rate. (Hiripi, 2012)
A good, healthy lifestyle, could help reduce the possibility of someone developing breast
cancer? I do believe a healthy lifestyle could help someone lower the chances of them
developing breast cancer later on in their life (Morris, 2015) I had an interview with Dr. Todd
Morris, an oncologist. Dr. Morris exams all types of cancers expect for skin. In my interview
with Dr. Morris, I asked him several questions about breast cancer and if peoples lifestyles could
cause them to be more of a risk of developing breast cancer. As I have mentioned before,
Germans are a bit healthier than us Americans. As well as them walking a lot, their food is
healthier, for the most part. Their food does not have as much cholesterol and fatty elements as
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ours. Although alcohol does not have a huge impact (Morris, 2015) on someone developing
breast cancer, Germans start to drink way before Americans drink. The legal age to drink in
Germany is 16, in America it is 21. This is part of the German lifestyle that could end up having
a slight effect of them developing breast cancer. With the Germans being a bit healthier than
America, Germanys obesity rate for females was about 21.4%. (WHO, 2014) In America, about
two-thirds of Americans are overweight. There are fewer opportunities for exercise, and in
many places, no bike paths, sidewalks, or easily accessible stairways. (Marks, 2015)
America has many ways we help treat breast cancer. We use everything from radiation,
chemotherapy and even pills. Just to give a brief explanation of these techniques, radiation helps
damage the cancer cells that way the cancer cells can not grow any bigger or divide anymore.
Chemotherapy is another type of drug that helps attack the cancer cells. Germany is a little
unique when it comes to treat cancers in general. Germany has little clinics that deals with one
sort of cancer. For example, they have breast cancer clinics, bone cancer clinic as well as
pancreatic cancer. Just like America, these clinics use chemotherapy to help fight off breast
cancer. As well as chemotherapy, they use two different types of vaccines, IPT and Dendritic.
(Clinics, 2014)
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CONCLUSION
From the interview I had with an oncologist, the information I found and my own
personal experiences, I believe that other countries lifestyles could effect the incidence of breast
cancer. I will be using my mother as an example to help tie all of this together. Comparing my
mothers lifestyle to my German host familys lifestyle, the Germans lifestyle is healthier than
my mothers. Even though my mothers breast cancer is not the most common type, I believe that
our lifestyle could have effected her. I believe that if someone eats healthy and has an active
lifestyle, their chances of developing breast cancer would decrease. Do not get me wrong, my
mother eats healthy and goes on walks a few times a week, but that has not been her whole
lifestyle growing up. Also, growing up in a small town, my mother had to drive many places
because things were not in walking distance.
With a healthy lifestyle, people can help decrease their chances of developing breast
cancer. Even if a person gets breast cancer, they can help themselves to beat it by creating a
healthy lifestyle. After my mother found out she had breast cancer, my family and I did change
how we did a few things. We stopped eating out as much, we started eating fresh food and started
to do more walking. With those small little changes in our lifestyle, my mom is now in
remission, which means her cancer is not growing or spreading.
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References
World Health Organization
(2014) Cancer Country Profiles
http://www.who.int/cancer/country-profiles/deu_en.pdf?ua=1
American Institute for Cancer Research
(2012) The Weight-Cancer Link
http://www.aicr.org/reduce-your-cancerrisk/weight/reduce_weight_cancer_link.html?referrer=https://www.google.com/?
referrer=http://www.aicr.org/reduce-your-cancerrisk/weight/reduce_weight_cancer_link.html
C. English, N. Scharioth
(2011) Half of Germans Are Obese and Overweight
http://www.gallup.com/poll/150359/half-germans-obese-overweight.aspx
Flegal KM, Carroll MD, American Dieabetes Association
(2003) Obesity in America: Its Getting Worse
http://clinical.diabetesjournals.org/content/22/1/1.full
Susan G. Komen
(October 2015) Breast Cancer Screening for Women at Average Risk
https://ww5.komen.org/BreastCancer/BreastCancerScreeningforWomenatAverageRisk.html
A.Eich-Krohm PHD
(August 2014) The Mammography Screening Debate in Germany: Yes or No?
http://breastcancerconsortium.net/mammography-screening-debate-germany/
E. Hiripi1, A. Gondos, K. Emrich, B. Holleczek, A. Katalinic, S. Luttmann, E. Sirri6, H. Brenner
(March 2011) Survival From Common and Rare Cancers in Germany In The Early 21st
Century
http://annonc.oxfordjournals.org/content/early/2011/05/19/annonc.mdr131.full#sec-5
German Cancer Clinics
(2014) North Americas Gateway to German Cancer Care
http://germancancerclinics.com/
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World Cancer Research Fund International

(2012) Breast Cancer Statistics
http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/breast-cancer-statistics
National Cancer Institute
(2015) SEER
http://seer.cancer.gov/statfacts/html/breast.html
A.dArcy
(2015) The Blind Breast Cancer Detectors
Dr. Morris
(2015) Interview

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