Breast Ca Flashcards
which part of the breast is common in breast ca?
upper outer quadrant
when do you start BSE?
- 5 to 7 days after menses
- Start from age 20
most common benign condition that causes tumor for pt. aged 40 and above
fibrocystic breast changes
when do you start mammography?
Annually after the age of 40 years
Clinical Manifestations of Breast Cancer
Lesions are non- tender, fixed, and hard with irregular borders
Advanced signs— skin dimpling, nipple
retraction, skin ulceration
Clinical Manifestations of Breast Cancer
Lesions are non- tender, fixed, and hard with irregular borders
Advanced signs— skin dimpling, nipple
retraction, skin ulceration
Involves removal of
the lump
Lumpectomy/
tylectomy
Involves removal of
the entire breast, pectoralis muscle and
nipple remains intact
Simple Mastectomy
- Involves removal of
the breast, pectoralis
major muscle and
the axiliary lymph
nodes
Modified Radical
Mastectomy
Involves removal of the
entire breast, pectoralis
major and minor
muscles, axiliary and
neck lymph nodes. It is
followed by skin
grafting
Radical mastectomy
(Halsted surgery)
hematoma vs seroma formation
hematoma - blood yung namuo
seroma formation: mixture ng blood and lymph
Surgical site mgt and care of drain usually removed when the output is less than ___ mL in a 24-hour period, approximately _ to 10 days)
30
7
T or F
If immediate reconstruction has been performed, showering may be
contraindicated until the drain is removed
TRUE
Arm exercises on the
affected side 3x a day
for 20 minutes at a time
until full range of
motion is restored
(generally 4 to 6 weeks)
Arm exercises on the
affected side 3x a day
for 20 minutes at a time
until full range of
motion is restored
(generally 4 to 6 weeks)
Heavy lifting (more than
5 to 10 pounds) is
avoided for about 4 to 6
weeks
Heavy lifting (more than
5 to 10 pounds) is
avoided for about 4 to 6
weeks
classic sign of advanced breast ca that results from a neoplasm blocking lymphatic drainage
p’eau d orange
note:
breast tissue of adolescent: firm and lobular
postmenopausal woman: thin and fattier
note:
breast tissue of adolescent: firm and lobular
postmenopausal woman: thin and fattier
BREAST ASSESSMENT
*annually after the age of 40 years
*this aids in early detection and diagnosis of malignant or benign disease
*rarely used because of MRI
*digital and 3d– mas gamit
*contrast
-involves injection of less than 1 mL of radiopaque material
-performed to evaluate an abnormality within the duct when the patient has bloody nipple discharge on expression
*don’t wear deodorant, perfume or powder
-may substance such as talc that interfere with the procedure
-talc can be seen as “dust” through xray
*bukol ‘yong hinahanap
Mammography
BREAST ASSESSMENT
*used as a diagnostic adjunct to mammogram to differentiate fluid-filled cyst from other type of lesion
*cannot rule out malignant lesions
*microcalcifications, which are detectable on mammography. can’t be identified on ultrasonography
*use high frequency sound waves to produce visual pictures
*omit deodorants with aluminum hydroxide or body talc the day of test to avoid artifacts on x-ray film
Ultrasonography
BREAST ASSESSMENT
*highly sensitive test that has become a useful diagnostic adjunct to mammography
* useful for evaluation of contralateral disease, invasive lobular carcinoma, and assessment of chemotherapeutic response
Magnetic Resonance Imaging
Surgical Biopsy
*standard procedure for complete pathologic assessment of a palpable mass
*the entire mass, plus a margin of surrounding tissue, is removed
Excisional Biopsy
Surgical Biopsy
*removes a portion of a mass
*done to confirm the diagnosis
*will aid in determining treatment
Incisional Biopsy
Surgical Biopsy
technique used to locate nonpalpable mass or suspicious calcium deposits detected on mammogram, ultrasound, MRI that require excisional biopsy
Wire Needle Localization
note: dressing covering the incision is usually removed after 48 hours, but the Steri-Strips which are applied directly over the incision should remain in place for approx. 7-10 days until they fall off
note: dressing covering the incision is usually removed after 48 hours, but the Steri-Strips which are applied directly over the incision should remain in place for approx. 7-10 days until they fall off
BENIGN CONDITIONS OF THE BREAST
cysts common among ages 40 and above
fibrocystic breast changes
BENIGN CONDITIONS OF THE BREAST
- atypical hyperplasia
- lobular carcinoma in situ (LCIS)
benign proliferative breast disease
BENIGN CONDITIONS OF THE BREAST
– most common lesion; firm, round, movable, benign tumor
fibroadenomas
*standard of care for the treatment of early-stage breast cancer
*the SLN that receives drainage from the primary tumor in the breast, is identified by injecting radioisotope or blue dye
*patient may discharge the same day after procedure
Sentinel Lymph Node Biopsy
it is done to excise tumor in breast completely and obtain clear margins while achieving an acceptable cosmetic result
Breast Conservation Treatment
BENIGN CONDITIONS OF THE BREAST
breast pain
(mastalgia)
*swelling of the arm, caused by an abnormal collection of too much fluid
*the acute and more painful type of lymphedema can occur about 4 to 6 weeks following surgery
*most common type is slow and painless and may occur 18 to 24 months after surgery
Lymphedema
note: self care
*surgical site mgt and care of drain (usually remove when the output is less than 30mL in a 24-hour period), approximately 7-10 days
*shower on second postop day and wash the incision or drain site with soap and water. if immediate reconstruction has been performed, showering may be contraindicated until the drain is removed
*2nd post-op day encourage to take a bath
*arm exercises on the affected side 3x a day for 20 minutes at a time until full ROM is restored (generally 4 to 6 weeks)
*heavy lifting (more than 5 to 10 pounds) is avoided for about 4 to 6 weeks
note: self care
*surgical site mgt and care of drain (usually remove when the output is less than 30mL in a 24-hour period), approximately 7-10 days
*shower on second postop day and wash the incision or drain site with soap and water. if immediate reconstruction has been performed, showering may be contraindicated until the drain is removed
*2nd post-op day encourage to take a bath
*arm exercises on the affected side 3x a day for 20 minutes at a time until full ROM is restored (generally 4 to 6 weeks)
*heavy lifting (more than 5 to 10 pounds) is avoided for about 4 to 6 weeks
