208 Concept: Cellular regulation; breast assessment Flashcards
Define cellular regulation.
All function carried out within a cell to maintain homeostasis, including its responses to extracellular signals (e.g., hormones, cytokines, and neurotransmitters) and the way it produces an intracellular response.
What is proliferation?
Proliferation refers to the production of new cells through cell growth and cell division.
What is differentiation?
Differentiation refers to the acquisition of a specific cell function, a normal process by which a less specialized cell becomes a more specialized cell type.
What is neoplasia?
An abnormal and progressive multiplication of cells, leading to the formation of a neoplasm (also known as a tumor).
What are the two classifications of neoplasms?
Benign or malignant.
What is the scope of cellular regulation?
Normal Cell Growth —— Dysplasia ——- Malignant Neoplasia
What populations are at risk for cancer?
- certain racial and ethnic minorities appeared to be at higher risk
- it has been shown that these disparities in cancer burden largely reflect obstacles to receiving healthcare services related to cancer prevention, early detection, and high-quality treatment, with poverty as the overriding factor.
In minority groups, communication barriers and provider assumptions can affect interactions between patients and physicians, which further contributes to miscommunication and the delivery of substandard care
What are individual risk factors for cancer?
- Age (risk for developing an invasive cancer increases significantly as a person ages)
- Smoking/Tobacco (At least 30% of all cancer-related deaths and 80% of all lung cancer deaths can be attributed to smoking. In addition, smoking is a known risk factor for 18 different types of cancers
- Infectious Agents (Bacteria and viruses are known to cause cancer and examples include the Helicobacter pylori bacteria (gastric cancer), hepatitis B and hepatitis C viruses (liver cancer), and human papillomavirus (cervical, oropharyngeal, and anal cancer)
- Genetic Risk (Only approximately 5% of all cancers result from an inherited genetic alteration that is associated with an increased risk of developing certain types of cancer. In some cases, a specific gene mutation results in an extraordinarily high risk of cancer, such as women with a BRCA1 gene mutation that confers a 70% lifetime risk of developing either breast or ovarian cancer)
- Radiation ((ultraviolet and ionizing) exposure that are linked to an increased risk of developing certain types of cancer.)
- Carcinogens (Exposure to these carcinogens is often due to lifestyle choices (e.g., smoking), but other carcinogens are present as environmental pollutants in the air, water, soil, or food.)
- Nutrition and physical activity (Combined, more than 20% of all cancer cases are attributed to poor nutrition, a sedentary lifestyle, and excessive weight.)
What are the assessment components associated with cancer and cellular regulation?
- history
- examination findings
- diagnostic tests
- classification: grading and staging
What functions are associated with cellular regulation?
- hormonal control
- neurotransmission
- extracellular response
- intracellular responses (cellular replication and growth, proliferation and differentiation)
True or false: breasts may be enlarged and visible in neonates.
True
What is the white fluid that is secreted by neonates called?
“witch’s milk”
When does adolescent breast development usually begin?
between 8 and 10 years of age
What are the stages of breast development in girls?
Stage 1: preadolescent. Only a small elevated nipple is present.
Stage 2: breast bud stage. A small mound of breast and nipple develops; the areola widens
Stage 3: The breast and areola enlarge; the nipple is flush with the breast surface.
Stage 4: The areola and nipple form a secondary mount over the breast.
Stage 5: mature breast. Only the nipple protrudes; the areola is flush with the breast contour
What is the breast composed of?
a) glandular tissue
b) fibrous tissue
c) adipose tissue
Where does more than 75% of lymph drain into?
The ipsilateral (same side) axillary node.
What are the four groups of axillary nodes?
- central axillary nodes
- pectoral
- subscapular
- lateral
If you divided the breast into sections, what would the five sections be?
- upper inner quadrant
- upper outer quadrant
- lower inner quadrant
- lower outer quadrant
- axillary tail of spence
What is a supernumerary nipple?
An extra nipple that can persist and is visible along the track of the mammary ridge.
Normal or abnormal finding: during adolescents, one breast grows faster than the other.
Normal
In the Tanner staging model of breast development, how long does it normally take for full development from stage 2 to 5?
3 years, though 1.5 to 6 years is the range.
How long after the appearance of pubic hair does axillary hair appear?
2 years
How long does breast development precede menarche?
About 2 years (average age of menarche is 12 years old)
True or false: breasts change with menstrual cycle.
True
What are common changes in breasts during pregnancy?
- early sign of pregnancy for most women
- expansion of the ductal system and supporting fatty tissues
- development of true secretory alveoli
- breasts enlarge and feel more nodular
- Nipples are larger, darker and more erect
- Areolae darken and become larger
- Tubercles become more prominent
- A venous pattern is prominent over the skin surface
- After the fourth month, colostrum may be expressed
- Milk production begins 1 - 3 days postpartum
What changes occur in the breasts in older women?
- after menopause, breast glandular tissue decreases
- breast size decreases, as does elasticity, causing them to droop
- lumps may be more palpable
What is gyneconastia?
Temporary enlargement of breast tissue in adolescent boys, Usually unilateral and temporary.
At what age does the risk of breast cancer increase?
50 y/o +
When does mammography start?
Sometimes 40, but every two years between 50 - 74 y/o
Where do most breast tumours devep?
Tail of Spence and upper outer quadrant
What health history topics are you covering for breast and regional lymphatic assessment?
Breast 1. Pain 2. Lump 3. Discharge 4. Rash 5. Swelling 6. Trauma 7. History of breast disease, and breast cancer risk factors. 8. Surgery 9. Self-care behaviours Axilla 1. Tenderness, lump or swelling? 2. Rash?
Are nodes usually palpable in the axillae?
Not usually, though you may feel a small, soft, non-tender node in the central group.
What are the three patterns of breast palpation?
- Vertical strip pattern
- Spokes-on-a-wheel pattern
- Concentric circles pattern
If you feel a lump or mass, what characteristics should you note?
- Location (use breast like a clock face, describe in distance cm from nipple)
- Size (cm width x length x thickness)
- Shape: oval, round, lobulated or indistinct
- Consistency: soft, firm or hard
- Movable: freely movable or fixed
- Distinctness (solitary or multiple)
- Nipple: displaced or retracted
- Note the skin over the lump: erythmatous, dimpled or retracted
- Tenderness (tender to palpation)
- Lymphadenopathy: any regional lymph nodes palpable)
