How Movies Portray History

I’ve always watched movies for the sole purpose of entertainment. Thinking about the historical backgrounds they entail never really crossed my mind. The way Hollywood portrays historical events in films isn’t very accurate, which some people see as a problem. After listening to both James Wermers & Dr. Chiltons presentations and reading The Art of War article my train of thought has changed on how films portray history. First, let’s consider the three perspective on the issue of how movies portray history.James Wermers had many opinions on filmography and history. According to him, producers have full rights to using history in fims. He believes that even though history is fair game to the film industry, movies don’t always portray historical events as accurate as they occur. He spoke about film producers use of CGI in movies and how it adds to a movies over all look. Even though CGI is a very clever use of computerized effects, it is not always used as i t should be.He stated, â€Å" CGI is no longer used for a certain effect, it is no longer the question of should we use it but how. † The reality of historical events isn’t always as accurate as it could be says Wermer but it is a good basis to a movie. Dr. Chilton had a political opinion on the matter. She stated that â€Å"filmmakers frequently use films to make statements, whether political or economic, or social, therefore, movies and their makers are protected by the First Amendment. † Whether or not we like how filmmakers are or portraying a specific event. they are entitled to portray it as they please. As Dr. Chilton reminds us, freedom of speech does not only refer to actually speech, it involves writing, sculptures, murals, and of course movies. In the Art of War article we see the artistic aspect of using CGI in films . Even though it states that a lot of the effects in the movie were very unrealistic that is also what made the movie so beautiful. It created this gorgeous scenery that could only be imagined but CGI made it possible to see.Even though the process of filming with CGI is a bit strange and hard to picture until the final product is shown, once you see everything put together it is amazing. After watching 300 and taking in all three of these aspects on movies portrayal of historical events my train of thought has changed immensely. I will now be more cautious as to what I’m actually watching. Is it actually true, is this really how things happened, and is that a real back drop or is it just CGI. I also now question the message movies contain. Instead of just watching to be entertained, I will now watch films with a lot of questions in mind.

SHORT STORY ESSAY

SHORT STORY ESSAY SHORT STORY ESSAY Dhesi 1 Ranvir Dhesi Mr.Depew ENG3U November 10th , 2014 Initiation Symbolism and Conflict In the short story Initiation written by Sylvia Plath the protagonist Millicent Arnold is undergoing a long and difficult set of trials and tribulations with the hopes of being accepted into the most elite sorority at her high school. One of the challenges has Millicent asking people on the bus what they had eaten for breakfast. While doing this she learns about the Heather birds which essentially do whatever they want to. The Heather birds becomes a symbol of freedom and independence that helps develop the internal conflict that Millicent has on whether or not she should join the sorority. Millicent questions whether or not she should be joining the sorority shortly after her conversation with the man on the bus. The man explains to Millicent that Heather birds â€Å"...live on the mythological moors and fly about all day long singing wild and sweet in the sun†¦Ã¢â‚¬ (Vi ewpoints, 205). This quote shows how free and independent the Heather birds are as they are living wild and free with no worries. Millicent now thinks about becoming more like the Heather bird in terms of independance and does not see herself wanting to be a part of the sorority as much as she had previously wanted to. However, her mind is not completely made up yet and she continues to participate in the sororities challenges. She contemplates her future and Dhesi 2 knows that her friendship with her friend Tracy would be put in jeopardy if she joins the sorority because she would be at the top of the high school hierarchy and would not be allowed to associate with people below her. At this point Millicent is completely torn between what she wants to do and has very limited time to make up her mind. She wants to be part of the popular group but at the same time does not want to lose her friend Tracy in the progress. As the day of judgement comes closer and closer Millicent makes up her mind. She realizes that the sorority was not all what she thought it would be like. Millicent now sees the sorority as an exclusive social group that gives girls a false sense of superiority over everybody else and no longer wants anything to do with it. She realizes now that because of this label that was put on her it may have been the only reason Herb even talked to her in the first place. Millicent questions if Herb actually likes her for he rself or if it was just to benefit from her soon being a part of the sorority. This leads Millicent to think about the Heather birds that live care free and far from any drama created by the other birds. She sees the sorority girls as â€Å"...pale grey ­brown birds in a flock , Short Story Essay Short Story Essay Imaginative Text – Short Story Unit: The Gold Watch Hope on the Battlefield By Sarah Ryland As the evening skies embraced hints of aqua and cobalt, Mark strode through the raw deserted grounds and reminisced about what had once been. Not a day below 60, Mark was rather feeble in his stance, with a house full of memoirs as old as the scars upon his skin. Burying his old, nimble fingers into his trouser pockets, he breathed in the fresh, clean air and turned his head towards the wide stretch of ocean accompanying him. Such tranquil, such serenity – it allowed a feeling of gratitude, or even synchronization between what the shallow shores had seen, and what Mark could remember. But his thoughts were stolen. A glimmer had caught his eye, at the moment where the almost-dead grass met the sandy shore. Walking over and carefully uprooting the object from the soil, Mark became enthralled by what resembled a pocket watch - revealing shades of chestnut, and tiny flecks of gold as he scratched off earth from the ornament. There was no clock on the watch – just a circle f ull of dirt and grass. Buried in the middle of the Gallipoli battlefield, the watch brought memories of what had happened in that exact spot on that exact day many years ago, and softly brought a tear to his eye. *** â€Å"Gas! Gas! Quick, boys!† As Mark covered his face, he turned around to see some men still yelling and stumbling – floundering ecstatically through the misty panes and thick olive light. Under a green sea, the brave men choked and drowned. Looking up, the sky was swallowed in shadows of burgundy and copper – or maybe that was just his imagination. War on the Western front had sunk into stalemate. Both sides were peering at each other from fortified trenches as machine guns fired, forced to spill precious blood in futile frontal attacks. The battlefield was a living hell – the inescapable groans were heartrending. The soldiers were constantly the unavoidable victims of the growing fear that they would never see their homes or families again, while fatigue and psychological trauma ruined the brave souls for life just as badly as the mutilation from the gunshot wounds. There were so many gunshots that Mark could not tell where each was coming from. While looking to the left, he could be struck from the right and vice versa. There was a reason they called the ground between trenches ‘No Man’s Land’. A young man who played ‘footer’ was shot when running out. He started trying to crawl back to our lines and was so close, when he was hit again. He was dead within a few minutes. Mark had a gut feeling it was not safe to be where he was. He knew that he had to move. Shouting out to his fellows to stop firing to allow him to travel, he lifted his weapon from his side and prayed to God he would survive. Chaos and confusion menaced his mind as he imagined the possible fate of his actions. Stepping out of his harbor, he made a mad dash to the next trench. As he slid into the dirt and watched dust rise past his face, an excruciating burn encompassed his left side – pulling all thoughts to an abrupt halt as blood spilled out and clung to the material of his uniform. He suffered a splinter of a bullet in the side – deeply slicing his torso. Breathing through the seamless agony, Mark turned around to see he was joined by another solider by the name of Lex. From what Mark could see, he was suffering horribly with open wounds, blood-stained bandages falling from his head, leg and shoulder and a struggle for air. Mark knew he had to help, or else Lex could be just another number for the death count to feast on. No one else was there, and no stretch- bearers of any sort, so he threw the poor soldier’s arm around his neck and helped him down the ridge. With a swollen knee – either another splinter of a bullet, or cut by the rocks, Mark could hardly walk. He passed Lex on, to other soldiers, as he wiped the sweat

Monteverde Cloud Forest Essay Example | Topics and Well Written Essays - 500 words

Monteverde Cloud Forest - Essay Example The Center also makes concerted efforts to create awareness that earth has a finite size and therefore, the organisms residing on it must ensure that the eco system of the earth is not disturbed drastically. The wild life sanctuary is known as Cloud Forest rather than rain forest because of its altitude where clouds can be seen passing through the trees. Situated at a height of 1440 meters, it is also known as green forest and comprises of eight ecological zones and shelters more than 400 species of birds and 100 species of mammals (monteverde.com). It has 120 species of reptilians and amphibians and thousands of insects. The forest with its tall trees help protects the species from natural catastrophes like storms and hurricanes. Many endangered species like Quetzals, Emerald Toucanet, Bellbird, golden toad and rare variety of hummingbirds can be found here. The reserve is a favorite destination for nature lovers across the globe. ‘In 1988, the organization began the International Children’s Rainforest project, which has raised money for the reserve ever since. With the help of children from around the world, the Monteverde Cloud Forest has increased in size to over 26,000 acres. Together with several other forests in the area, it forms almost 70,000 acres of privately owned cloud forest’ (CostaRica). The preserve is an ongoing project for the awareness creation that contributes towards sustainable development. This nature paradise draws more than 70,000 tourists per annum. With its impressive landscape and biodiversity, ‘Monteverde is considered one of the Costa Ricas Seven Wonders, along with Cocos Island, Tortuguero, Arenal Volcano, Chirripo Mountain, Celeste River and Poas Volcano (Monteverde Forest). The sanctuary has more than 2500 species of plants and more than 420 different types of orchids. The stupendous range of biodiversity in the forest makes it one of the most outstanding nature reserves of the

Mid Course Exercise Essay Example | Topics and Well Written Essays - 1250 words

Mid Course Exercise - Essay Example This is the real case in which firms try to differentiate their product or service offerings just to be able to gain considerable market share in the midst of an ongoing competition. The threat of new entrants on the other hand is alarming to the existing firms of the same industry. This is because the new entrants try to remarkably prove themselves and share something new that will create a significant impact in the market (Porter, 1980). Threats of substitute products or services bring forward the opportunity for customers to have various choices. As a result, customers have strong market power because of their chance to choose for the best price, quality and other intrinsic features of a product or service offering (Porter, 1980). Bargaining power of buyers may happen if there are various product or service offerings to choose from. This happens in a highly diversified market where there are existing competition trying to diversify their product or service offerings resulting to b etter substitutes at remarkably lower prices or even higher quality, the bottom line is to extend market power (George, Joll, & Lynk, 1992). Bargaining power of sellers on the other hand can affect the level of competitive intensity within an industry by taking advantage of maximizing their opportunities. They could either monopolize the industry under a monopolistic competition (McEachern, 2011). This is evident in the case of Philippine Petroleum Industry and other third world countries which are under the bargaining power of multinational corporations on petroleum products. Relative power of other stakeholders is also influential on the competitive level of an industry. One basic example is the ability of Apple Incorporated to successfully penetrate the mobile phone industry with its innovative smart phone technology (Apple Incorporated, 2011). This happened because Apple is supported by various stakeholders for the successful promotion of its breakthrough technology. As noticed, the market today is bombarded with different styles and options for smart phone technology. 2. What information is needed for effective strategy formulation? Why? Answer: An organization must be able to measure the level of commitment of its top personnel such as the managers or supervisors in order to be able to understand how well they would want to continue its vision (Ferrell, Fraedrich & Ferrell, 2010; Zanini, 2007; Hitchcock & Willard, 2009). In fact, it is found that a strong commitment among top managers in an organization is associated with effective strategy implementation outside the bound of environmental dynamism (Willauer, 2005). This only implies that an effective strategy formulation does not only ensure finding the right information about the competitors’ strategic moves or the external environment in general, but more so, there is a need to understand the internal environment because it definitely affects how the entire organization would function in great detail in the midst of its entire business operation. For instance, we know how the economic downturn in 2008 affected the United States and the business firms. However, such external factor sometimes may be overlooked but one thing that could not be missed out is the information about employee commitment. In times of crisis like this, employees would most likely to consider many issues and on top of them it might be about their concern on sustainability. How they could feed their family, or ensure making both ends

Failure of Macroeconomic Policy and Decade Long Stagnation Case Study

Failure of Macroeconomic Policy and Decade Long Stagnation - Case Study Example Since 1990 Japan has experienced over a decade of slow growth in real economic activity. Between 1990 and 2000 per capita output raised at an annual rate of 0.68 percent, per capita investment dropped at the rate of 1.4 percent per annum and weekly hours per adult worker declined by 1.18 percent per annum. This period has come to be referred to as "the lost decade." During the same period the inflation rate, as measured by the growth rate of the GDP deflator, fell from 2.3 percent to -1.8 percent and the nominal interest rate fell from 7.4 percent to 0.1 percent. Japan's current experience of sluggish growth coupled by deflation and zero nominal interest rates raises questions about the role of monetary policy in times of deflation. Should monetary policy take actions to avoid the zero nominal interest rate bound and if so, what policies can avoid it and/or ameliorate its negative ejects? This paper deals with a model that accounts for the real and nominal facts from the 1990s and makes use of this model to answer the two questions posed above. We consider an expensive price adjustment model along the lines of Rotemberg (1996) and expand it to allow for capital accumulation. In this economy, monopolistically competitive firms face convex costs of adjusting prices. Households own the capital stock and are subject to convex costs of adjustment. ... Solving for the equilibrium is complicated by the likelihood of a zero nominal interest rate limitation. An algorithm for computing perfect foresight equilibria is developed in situations where the nominal interest rate is zero over some period of time. The model is then solved and replicated using a parameterization that is standardized to Japanese data. An impulse response analysis is used to answer the first question. We find that the dynamic response of the economy to shocks in technology and government purchases is very di.erent depending on whether the zero nominal interest rate constraint binds. When the constraint is not binding output and investment rise in response to improvements in technology under the interest rate targeting rule we mull over. Nevertheless, when the constraint binds, monetary policy cannot respond and output and investment all drop in response to positive technology shocks. A binding constraint also exacerbates the contractionary e.ects of negative government purchase shocks on these same variables. Overview of the Study First, I will analyze what is extent of stagnation and what are its evidences and proofs from economic conditions of the country. Besides this, what went wrong in demand side Second, I will examine the components of GDP which have been stagnant with reference to relevant theories. Third, I will explore the weaknesses of supply side and its relevant issue will be discussed. Background of the study From the beginning of the 1950s to the early 1970s, the Japanese economy experienced dramatic growth. Several institutional structures sustained this rapid growth. First, the stable

Us Policy On Iraq Essay Example for Free

Us Policy On Iraq Essay The war in Iraq has been costly not only to the Iraqis and Americans but to the whole world. Some political analysts say that it is ironical that the war on terrorism has led to increased terrorism activities in defiance and retaliation. Events such as the February 22, 2006 bombing of the Golden Mosque in Samarra, the attack in Mumbai this week and countless suicide attacks in and out of Iraq have been making headlines. In Iraq, such activities are undermining efforts of the current transitional government and the US and her allies to bring peace and stability in the region. Seemingly, terrorists and insurgents are keen to undermine Iraq’s economy, security, and political process. This has led to different quarters asking for a change in the US Iraq policy to one that is based the desire of Iraqis for the speedy formation of an inclusive, national unity government that serves the interests of all Iraqis without drawing so much resentment and hostility from the people and form a sable government. Though the Iraqis themselves produced this key provision (transitional government), the United States throughout helped facilitate agreement on it and other key provisions be it on religion, oil allocation, or federalism. Therefore, looking at the present US Iraq policy helps in understanding the whole process in Iraq as to why these polices are not working and the war continues almost 6 years down the line at the expense of the tax payer’s money. This paper looks at these policies and evaluates how successful or unsuccessful they have been and make recommendations for alternative policies. Policies According to the dossier on US Iraq policy http://www. uspolicy. be/issues/iraq/iraq. asp), the US activities in Iraq are based on †¢ A noble fair and just war †¢ Suppression of the Al-Qaeda and †¢ Reconstruction of Iraq Fairness of the war The underlying policy in the war in Iraq has been that â€Å"the war in Iraq is noble, necessary and fair†. President Bush has been clarifying o n the importance of the war saying that â€Å"Defeating the enemy in Iraq will make it less likely we will face this enemy here at home†¦. † (www. whitehouse. gov/news/releases/2008/03/20080319-3. html). This one single policy locks out all arguments that have been fronted or were fronted even the before the war began. As such, the US feels compelled to attack and occupy Iraq until she feels that her main reason of going to war as to liberate the people of Iraqis fulfilled. But does this bring another definition of freedom into the limelight? Salim 2007 asks. The author says that â€Å"the presence of American and allies troops in Iraq is a threat of the peace and freedom they claim to fight for the people of Iraq†. The Bush administration believes that the war in Iraq is noble in that it is carried out in the right manner in a conscious way. What necessitated the war were the claims by the Bush administration that the government of Sadam Hussein was supporting terror groups and terrorism activities. Now with the man they sought dead, what else could then be the driver to increased instances of terrorism activities? This is one question that the Americans have not paused and addressed it unto themselves according to one online analyst Suppression of the Al-Qaeda As one of the leading terror groups in the world and the one responsible for the terror attacks in the US world trade center, Al-Qaeda is blacklisted by the American government to be denied access to resources that would enable the group to carry out its terrorism activities. With the group based in Iraq, it is feared that it will easily gain access to the numerous oil fields and utilize those resources in undermining global peace efforts. As a result, the targeting of the Al-Qaeda as a group and not Iraq as a country has created a long list of countries that the Bush administration feels deserves action. Among them are Syria, Sudan and Somalia. In light of this view, the American government insists that the idea of attacking Iraq was not for political reasons or economic gains but by a justified reason to protect the globe from terror harm. Continued occupation of Iraq by the US and her allies thus is in pursuance of the denying the terror groups and access to resources. This is accomplished by ensuring that Iraq has a stable government that is capable of handling internal hostilities and insurgencies which are led by the terror groups. Therefore, it would seem irresponsible of the US withdrawing from Iraq without due suppression of the Al-Qaeda. Unfortunately, suppression of the group has not been as successful as such. Countless minor or affiliate terror groups have sprung up and continue to carry out their deadly attacks. This indicates that there is need to change the manner in which the US approaches the terror group. The approach of denying the groups access to oil money does not seem to work as it may be that the terror groups have other sources of resources to finance their activities. Reconstruction of Iraq Two wars against Iraq by the US have crippled the infrastructure of Iraq that is currently an eyesore. The gulf war and the present war have reduced oil production from the world’s third largest oil reserves with 84 billion barrels of oil under her surface. Decreased production has created an oil crisis in the global market leading to skyrocketing petrol and petroleum products. Reconstructing Iraq and maintaining peace and stability in the region is seen as of the ways of bringing down the global oil prices that are hurting very many economies. As the attacker, the US government is bound by moral and humanitarian obligations to correct the effects of the war and reconstruct the economy. Prior to the war, the US had promised to reconstruct the country after the ousting of Saadam. Thus even as the war continues, the US government is committed into helping Iraq find her path to economic prosperity a d realize full democracy. As evidence of this, the US government has been financing almost entirely the transitional government in Iraq either in direct aid o humanitarian aid. Unfortunately, most of the aid forwarded to the country according to Pilisuk and Rountree (2008) is in form of military aid. The future of Iraq The unprecedented length in the Iraq war has called for reevaluation of strategies used in the war. The Bush administration has unveiled six elements it incorporates in its new policy on the Iraq war (http://www. whitehouse. gov/news/releases/2007/01/20070110-3. html). 1. placing leadership on Iraqi people 2. Empowering Iraqi people to defend themselves against terrorism 3. Isolate extremists; 4. Facilitate democracy 5. Diversify political and economic efforts 6. Situate the strategy in a regional approach. By letting the Iraq people lead, then the Iraqis will take responsibility of their own actions and have more responsibility in decision making that will be very critical in stabilizing the region. The second element of helping the Iraq people protect the population has two sides of it. For one, the Iraqi nationals will be involved in fighting terrorism. Secondly, the citizens will keep away from terrorism activities national and international. All these elements are going to be accomplished in four fronts: economic, political, regional and security. Iraq was formerly the leading economy in the Arab world in the late 1980’s. Prior to the Gulf War, the country was using her oil reserves for economic development and prosperity. A series of external attacks have derailed the country from its earlier path and it today relies heavily on foreign aid to run basic government operations. At the moment, the country is just a shell of the former self. Questions have been raised over the effectiveness of the US policies on Iraq and the future of the country. Now that the US economy is facing financial turmoil, the questions on whether the aid assistance to Iraq will continue if of utmost importance. The recent signing of an agreement between the US government and the transitional Iraq government signed an agreement allowing the US troops to remain in Iraq beyond 2008 into the year 2009. Unfortunately, some of the Iraq people are not comfortable with this move. They view that the presence of American troops in their territory infringes on the country’s sovereignty and it is tantamount to total disregard of democracy and independence of one country. They therefore call for the unconditional withdrawal of all foreign troops in the region. The expected coming to power of Barack Obama as the US president provides some hope for a change in policy in how the US handles the situation in Iraq. In his campaign addresses prior to the elections the president elect promised a phased pout withdrawal of American and allied troops from the region that would approximately take 16 months. In addition to this, the fact that the president elect was against the waging of the war from the very word go shows that there is a looming drastic change in the American policy on Iraq once he occupies office. The current economic crisis in America will throw Iraq into further turmoil unless quick strategized withdrawal is put into place. Before the on start of the war, the Bush administration claimed that Iraq had in its possession weapons of mass destruction which were suspect of being used for terrorism purposes. Therefore, the idea behind the war was based on recovery of these weapons and the toppling of the Saddam regime as a supporter of terrorist groups. Unfortunately, only the toppling of Sadaam happened as no weapons of mass destruction were seized. Assuming that the terrorism groups never gained access to the weapons where else could they source such weapons? By adopting such a question, then the US government can have a broader perspective on the fight against terrorism. The resentment by the Iraq people that have fueled increased internal terror activities have resulted from the humanitarian crisis present in the country. US troops have been accused of committing humanitarian atrocities among them killing of innocent civilians and raping of women and young girls. It would seem appropriate then that the US government carries out its operations in Iraq with a lot of caution over the volatility of the region and the sensitivity of the connection between Muslims and terrorism. This is because among the many violations that the troops are accused of, a majority of them have a religious violation connotation. This is very important in that abrupt withdrawal of troops could throw to waste all the efforts made in stabilizing the region and eventually winning the war on terror. In conclusion, it would seem that the best manner in which to carry on the war and formulate polices in handling the war, the involved parties in coalition forces and the US should emphasis on winning the confidence and trust of the Iraqi people. Some of the hostilities meted against sympathizers of presence of foreign troop are not terrorism based but an expression of the anger of the presence of the troops. Unfortunately, the US has not been keen to interpret such incidences as so but is comfortable with the labeling of such activities as terrorism. Therefore, the future of Iraq lies in how strategically America positions itself in the eyes of Iraqis and the success of sanitizing the existing image of America in the eyes of Muslim extremists. Works cited Pilisuk, M. and Rountree, J. Who benefits from global violence and war, New York: Greenwood, 2008 Pillar, P. Terrorism and the US foreign policy, Chicago: Brookings 2004 US policy towards Iraq, Washington: GPO, 2003 Iraq policy at, (www. whitehouse. gov/news/releases/2008/03/20080319-3. html US troops to stay in Iraq beyond 2008 www. arabamericannews. com/news/index. php? mod=articlecat=Iraqarticle=670

Diagnostic Imaging for Breast Cancer Symptoms

Diagnostic Imaging for Breast Cancer Symptoms The role of diagnostic imaging in the initial investigation of female patients symptomatic for breast cancer, and its subsequent application in the staging process. Introduction Breast Cancer is the term used for cancers found within the breast tissue. Usually breast cancer is the result of a small change in the regulatory cycles that the tissue goes through. Any changes in these can result in malignant growths within the breast tissue. As stated by Breast Cancer Now (2016), Breast cancer is the most commonly diagnosed cancer in women in the UK with over 50,000 new cases diagnosed in women each year, in the UK alone, thus approximately 1 in 8 women will be diagnosed with some form of breast malignancy in their lifetime. Furthermore, not all breast cancer occurs in females, in the UK roughly 350 men are also diagnosed with breast cancer each year. The survival rate of breast cancer is quite high at around 90%, states Breast Cancer Care (2016), which highlights how effective treatment currently is. However, it is the most common cause of death in women aged 40-50. Vaidya, J.S. et al (2012a). Per Sestak, I. et al (2012), there are many factors that can predispose a person to the risk of breast cancer. These include: increasing age, geographical variation, breast density, age at first pregnancy, age at menarche and menopause, family history, genes, previous breast disease, radiation, lifestyle, oral contraceptives and hormone replacement therapy. As stated by Vaidya, J.S. et al (2012a), Breast cancer lumps are usually hard and painless, with an irregular shape. They are approximately 2cm before they are palpable and can be felt. Most lumps are found in the upper outer quadrant of the breast. A lump is the most common symptom but there are other signs and symptoms that can be indicative of breast cancer. These other symptoms include: bleeding from the nipple (rare), change in shape or size, ulceration, swelling in breast or arm due to blockage of lymphatic circulation, peau dorange which is usually the result of fluid in the dermis and axillary lumps. These symptoms are not present in all cases and are indicative of the different stages and kinds of breast cancer. Content Discussion People with breast cancer symptoms usually undergo what is known as a Triple Assessment. A triple assessment comprises of a clinical examination, imaging examinations and pathological evaluation. This assessment process is usually able to diagnose 95% of malignant breast cancers. Vaidya, J.S. et al (2012b) Vaidya, J.S. et al (2012b) also states that before a clinical examination occurs, the patients history is taken into consideration, as this can aid the diagnose or other potential causes of the symptoms. Usually the history that is considered includes: the history of the current complaint, family history of breast or ovarian cancers, HRT and oral contraceptives history, previous diseases and surgeries, allergies and smoking history. Clinical Assessment of Breast Cancer As stated before clinical examination is the first step in a triple assessment to diagnose breast cancer. Clinical examination is done to assess dimpling, which is usually an early sign, as it occurs because of the contraction of the ligaments of Cooper. Clinical examination can also distinguish between coarse nodular tissue and an actual lump in the breast tissue. The colour and site of any discharge at the nipple is also recorded and tested for any blood within the discharged fluid. Vaidya, J.S. et al (2012b). Imaging in Diagnosis of Breast Cancer As stated by Vaidya, J.S et al (2012b), Both mammography and ultrasonography have important roles in the diagnosis of breast cancer, but the use of other modalities, such as magnetic resonance and infrared imaging, is being developed. Mammography can detect over 95% of clinically detectable cancers. However, it does not aid the diagnosis of a patient with a discrete lump. In this case diagnosis relies heavier on cytology and histology. It may also be of use in the detection of cancer in patients with coarse nodular breasts and is particularly useful in dense breast tissues. Vaidya, J.S. et al (2012b) Another use for mammography is to accurately assess where the cancer is located. This information can also be used to aid biopsy and surgeries.ÂÂ   Mammography can also reveal that there is an impalpable lump in the other asymptomatic breast which otherwise would have gone undetected. Vaidya, J.S. et al (2012b) If a mass is detected on a mammogram, a range of codes are typically used to determine the potential malignancy of the mass. These are defined by Willet, A. et al, for the Association of Breast Surgery (2010) as: M1 Normal M2 Benign M3 Indeterminate/Likely Benign M4 Suspicion of Malignancy M5 Highly suspicious of Malignancy. Another key imaging technique used in the diagnosis of breast cancer is ultrasonography. Ultrasound shows the difference between a cyst or a more solid mass. Therefore, a mass can be confirmed to be a cyst and can be drained using needle aspiration. However, a blood-stained aspirate may be a result of a cancer within the cyst which was previously unidentified. The sensitivity and specificity of ultrasound in the diagnosis of breast lumps has continued to improve with growing technological advances. Benign lumps appear as well-defined masses with no acoustic shadow. Malignant lumps are ill-defined masses, with a varying echogenicity and/or have evidence of microcalcifications within them. Ultrasound is also the preferred imaging method in women under the age of 30, as their breasts tend to be less dense and are therefore radiosensitive. Vaidya, J.S. et al (2012b). The NICE Guidelines (2015), also state that, ultrasound evaluation of the axilla should be performed for all patients bein g investigated for early invasive breast cancer. Fine-needle aspiration cytology is also used in breast cancer diagnosis by inserting a small needle into a lump which is located during the examination using ultrasound. The aspirate on the needle is then examined under a microscope by a pathologist which can then diagnose a breast cancer with almost 100% specificity depending on their level of skill and training. Vaidya, J.S. et al (2012b) Imaging in Staging of Diagnosed Breast Cancer If the tumour is large and there is extensive lymph-node involvement, preoperative staging is prudent. Vaidya, J.S. et al (2012b) As stated by RCR guidelines (2014), the objectives of staging are to: assess the size of a tumour, assess for other involvement of the skin or chest wall, assess multifocality of tumour, to assess the nodal status and to assess for any metastatic spread. MRI is used in staging any indeterminate lesions. The expense of MRI is now becoming less of an issue as the cost of an MRI breast coil is considered relatively low. The injection of a contrast agent during MRI enables the vascularity of a lesion to be visualised. The downside of this is that a specifically trained team is required to undergo this route of imaging. Vaidya, J.S. et al (2012b) NICE guidelines (2015), state that MRI is not recommended in the preoperative assessment of patients with invasive breast cancer that has been proven by biopsy or ductal carcinoma in-situ. It should only be offered to those where the extent of metastases is indeterminate, breast density has caused mammography to be indefinite or to assess tumour size to aid surgery for invasive lobular cancer. Computed Tomography is stated by the RCR Guidelines (2014), to be used with patients who have advanced symptoms and are suspected to have a further progressed cancer. Reasons for request of a CT to stage breast cancer include: bone pain and breathlessness. If the use of CT for staging is used, intravascular contrast media should be employed during the scan. The scan should include the supraclavicular fossa, the chest and the liver. The RCR Guidelines (2014), state that Photon Emission Tomography should not be used for early stage breast cancer but should be used more to assess metastatic spread. It is also used to assess potentially multi-focal disease or suspected recurrence if a patient has particularly dense breasts. Axially node status is usually assessed by using US, with the use of fine-needle aspiration or biopsy of any suspicious nodes. RCR Guidelines (2014). Vaidya, J.S. et al (2012b) also suggest that routine staging in early breast cancer, as the results are usually less than 4%. Thus, these investigations can slow down the otherwise relatively quick treatment and can cause the patient unnecessary anxiety as they await results. Follow-up and Surveillance after treatment of Breast Cancer It is suggested by Vaidya, J.S. et al (2012b) that patients who have had a mastectomy are at a higher risk of developing cancer in the remaining breast and should therefore undergo regular mammograms for surveillance. They also suggest that colour Doppler ultrasound scanning of a breast that has had a malignant tumour postoperatively is likely to increase the chances of an early diagnosis should there be any recurrence. RCR guidelines (2013) state that women who have been treated for breast cancer under the age of 50 should have a yearly mammogram as surveillance follow up. After 50 the guidelines are unclear but it is currently recommended that surveillance mammograms are routinely performed every 2-3 years. NICE guidelines (2015), also state that an annual mammography should be offered to all those with early breast cancers, including DCIS until they reach the age for screening. These guidelines recommend that patients of the age for screening should have also annual mammograms for 5 years. The NICE guidelines (2015), further suggest that US nor MRI should be offered in post-treatment surveillance for those who have been treated for DCIS or other early stage breast cancers. Conclusion In summary, it is essential that patients presenting symptoms which usually pertain to a breast cancer undergo a thorough assessment, including multiple imaging examinations not just for the diagnosis of the cancer, but also the staging and the follow-up once the cancer has been successfully treated. Mammography and Ultrasound are the two key imaging techniques that are vital in my opinion within diagnosis. They enable a fast and usually efficient result which can then be used for staging. Ultrasound can be seen to have more benefits as it does not use ionising radiation unlike mammography, but mammography is essential is those patients who have highly dense breast tissue. This is usually postmenopausal patients who tend to be the high-risk group of developing breast cancer. CT and Ultrasound are mainly used during staging. This stage is vital in patients with more progressive breast cancer, but if the tumour has been caught in the early stages, staging methods can usually be skipped as it is more efficient to immediately commence treatment methods. Follow-up imaging is also essential as those who have undergone treatment of breast cancer are at higher risk of recurrence in either breast. In conclusion, imaging is one the most essential tools available in the diagnosis, staging and follow-up of breast cancer. Without the current imaging techniques, we have today the 95% survival rate of breast cancer would likely be nowhere near as high. Reference List: Breast Cancer Care. (2016). Prognosis. Available: https://www.breastcancercare.org.uk/information-support/facing-breast-cancer/diagnosed-breast-cancer/diagnosis/prognosis. Last accessed 27th Mar 2017. Breast Cancer Now. (2016). Breast Cancer Statistics. 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