2000 words, APA (7th), at least 6 peer- reviewed articles from Pubmed (including their PMID)

Topic: Triple-Negative Breast Cancer (TNBC)

The essay map:

1. Introduction

Purpose: Introduce the cancer subtype and present your thesis.

What to include:

Brief overview of cancer and breast cancer
Introduce Triple-Negative Breast Cancer (TNBC) or your chosen subtype
Explain why this cancer is important to study
Mention Canadian burden and treatment challenges
End with a clear thesis statement

2. Cancer Biology

Origins of cancer

How normal cells become cancerous
DNA mutations and uncontrolled cell growth

Molecular characteristics

Receptor status (ER, PR, HER2 absence in TNBC)
Important mutations (e.g., BRCA1, TP53)
Key signalling pathways (PI3K/AKT/mTOR)

Tumor progression

genomic instability
rapid cell proliferation

Metastasis mechanisms

invasion of surrounding tissue
epithelial-mesenchymal transition (EMT)
angiogenesis
spread to organs such as lung, brain, liver, bone

Include one scientific figure (tumor development or metastasis pathway).

3. Cancer Statistics in CanadaTopics:

Overall breast cancer incidence in Canada
TNBC proportion of breast cancers
mortality rate
survival rates
age groups most affected
disparities in populations

Reliable Canadian sources:

Canadian Cancer Society
Statistics Canada
Public Health Agency of Canada

4. Risk Factors Focus on known carcinogens and risk factors.

Genetic risk

BRCA1 mutation
family history

Environmental and carcinogenic exposures

alcoholic beverages
ionizing radiation
hormonal exposures
diethylstilbestrol (DES)

Lifestyle factors

obesity
physical inactivity
reproductive factors if supported by literature

Use peer-reviewed evidence linking the exposure to breast cancer risk.

5. Treatment Explain the current standard of care.

Include:

Surgery

lumpectomy
mastectomy

Chemotherapy

main treatment for TNBC
neoadjuvant vs adjuvant therapy

Radiation therapyNewer treatments

immunotherapy
PARP inhibitors for BRCA-mutated tumors
antibody-drug conjugates

Explain why treatment options are more limited for TNBC.

6. Knowledge Gaps (higher marks)

Discuss areas where science still lacks answers.

Limitations in Risk Understanding

Explain that some risk factors remain unclear.

Possible points:

Environmental exposures not fully studied
Interaction between genetics and lifestyle
Incomplete data on some populations

Challenges in Early Detection

Explain why screening is difficult.

Key points:

TNBC grows rapidly
It often appears between regular mammograms (interval cancers)
Lack of subtype-specific biomarkers

Explain why this leads to late-stage diagnosis.

Limited Targeted Therapies

Important point.

Explain:

TNBC lacks ER, PR, HER2 receptors
Hormone therapy and HER2 drugs do not work
Chemotherapy remains the primary treatment
Drug resistance can occur

High Metastatic Potential

Explain why mortality remains high.

Points:

aggressive tumor biology
early metastasis to lung and brain
recurrence often occurs within 35 years

Health Disparities

If supported by literature:

Some populations experience higher incidence or worse outcomes
Possible reasons:
genetics
access to screening
socioeconomic factors

7. Future Research Directions (higher marks)

Choose ONE focus as required by the assignment:

Early screening

Explain research on:

Risk-stratified screening

genetic testing
family history models

Advanced imaging

MRI screening for high-risk patients

Biomarker detection

circulating tumor DNA
blood-based screening

Explain how this could detect cancer earlier than mammography alone.

8. Conclusion

Purpose:

Summarize your argument and reinforce the importance of research.