Comparative Health Policy and Outcomes of Breast Cancer Care in The United States versus Germany

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Cancer is a collection of related diseases where some of the body’s cells begin to divide out of control and spread throughout the body. The normally orderly process of cell division becomes unchaperoned, meaning cells can divide and avoid death with nothing to stop them. Cancer can start anywhere in the body, but for the purposes of this paper, I will be focusing on cancer of the breast. This type of cancer normally begins as a lump in the breast tissue of men and women, and if not detected early, it can quickly spread to other tissues of the body (most commonly the lymph nodes).

You can lower your risk for breast cancer through a myriad of lifestyle factors, but while there is no set cure for cancer, breast cancer is a very treatable disease if caught early. Imaging such as X-rays, mammograms, and tomography are all ways to catch breast cancer, followed by treatment options such as radiation, chemotherapy, or the more drastic mastectomy. Specialists typically needed through the stages of screening, diagnostics, and treatment include gynecologists, imaging technicians, radiologists, oncologists, surgeons, and nurses.

Treatments for women with breast cancer vary depending on the stage they are diagnosed in, with higher survival rates the earlier the cancer is found (as well as some genetic factors that I consider too in-depth for this paper). At stage I, the cancer is still contained in the breast tissue and will normally be treated with breast-conserving surgery along with a check of the nearby lymph nodes, followed by some type of radiation therapy to lessen the chance of the cancer returning. At stage II, the cancer is normally larger than stage I and has spread to a few nearby lymph nodes. This stage will normally be treated with surgery and radiation therapy similar to stage I, but with the addition of chemotherapy. At stage III, the tumor is large and has begun spreading to lymph nodes and nearby tissues. The normal treatment at this stage can either be chemotherapy followed by surgery followed by radiation therapy, or surgery first followed by chemotherapy followed by radiation. Finally, at stage IV, the cancer has spread to various parts of the body and is normally treated with various systemic drug therapies along with surgery and radiation (1).

While the level of prevention, screening, and treatment varies slightly from country to country, so do the health care policies that dictate the responsibility of the patient versus the specialist versus the institution. In this paper, I will be discussing the health care organization differences between United States and Germany when it comes to preventing, screening, and treating breast cancer, as well as the associated outcomes when it comes to remission and mortality rates.

United States

In the United States, breast cancer is the most common type of cancer, with over an estimated 266,000 new cases in 2018 so far (which constitutes over 15% of all new cancer cases),

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