...................................................................................................................................................... 5 INTRODUCTION ............................................................................................................................................ 6 Epidemiology .............................................................................................................................................. 6 Health Disparities in Rural Medicine ....................................................................................................... 6 Breast Development and Cancer ............................................................................................................... 8 Comorbidities Surrounding Breast Cancer ............................................................................................ 12 Breast Cancer in Rural Medicine ............................................................................................................ 12 Examining Breast Cancer in Rural Medicine ......................................................................................... 13 METHODS ..................................................................................................................................................... 14 RESULTS ....................................................................................................................................................... 16 DISCUSSION ................................................................................................................................................ 20 CHAPTER TWO ............................................................................................................................................. 23 ABSTRACT ..................................................................................................................................................... 24.................................................................................................................................................... 24 INTRODUCTION .......................................................................................................................................... 25 Breast Cancer ............................................................................................................................................ 25 Estrogen and its receptors ....................................................................................................................... 25 Menopause ................................................................................................................................................ 26 Phytoestrogens .......................................................................................................................................... 26 Promensil ................................................................................................................................................... 27 Apoptosis ...................................................................................................................................................28 T47D Breast Cancer Cell Line .................................................................................................................. 29 Evaluating the Effects of Promensil on T47D cells ................................................................................. 29 METHODS .................................................................................................................................................... 30 Promensil Extraction ............................................................................................................................... 30 Cell Maintenance ..................................................................................................................................... 30 Cell Plating and Synchronization ........................................................................................................... 30 Cell Harvesting ........................................................................................................................................ 30 Immunoblotting ........................................................................................................................................ 31 RESULTS ....................................................................................................................................................... 33 DISCUSSION ................................................................................................................................................. 35 REFERENCES ................................................................................................................................................... 37 APPENDIX A ..................................................................................................................................................... 42