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z_MS_Primers for Exam 4 > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What are the highest risk factors of breast cancer for women?

A
  • ≥60 years of age
  • Family history
  • Personal history of cancer (breast, colon, endometrial, ovarian)
  • Early menarche or late menopause
  • Full-term pregnancy >30 years of age
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2
Q

True or False
Having any first-degree relative with breast cancer increases a woman’s risk of breast cancer 1.5 to 3 times, depending on age.

A

• True

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3
Q

What are some other risk factors for breast cancer in women?

A
  • Weight gain and obesity after menopause
  • Exposure to ionizing radiation
  • Combined hormone replacement therapy
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4
Q

Women who have BRCA-1 and BRCA-2 mutations have a __% to __% lifetime chance of developing breast cancer.

A

• 40% to 80%

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5
Q

A female patient presents with a persistent lesion of the nipple and areola w/ s/s of itching, burning and bloody nipple discharge. This is indicative of what condition?

A

• Paget’s Disease (of the breast)

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6
Q

What is the treatment for Paget’s Disease?

A

• Simple or modified radical mastectomy.

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7
Q

What indicates a good prognosis w/ Paget’s Disease?

A

• When it is confined to the nipple

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8
Q

What are some common s/s of breast cancer?

A
  • Hard lump, Irregularly shaped, poorly delineated, non-mobile, non-tender
  • Irritation or dimpling of breast skin (peau d’orange)
  • Redness or flaky skin in the nipple area or the breast.
  • Inverted nipple
  • Nipple discharge other than breast milk, including blood.
  • Any change in the size or the shape of the breast.
  • Pain in any area of the breast.
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9
Q

On what location of the breast do most breast cancers occur?

A

• Upper lateral aspect of either breast

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10
Q

What are the clinical manifestations of a local breast cancer reoccurrence in the skin or chest wall?

A

• Firm discrete nodules, occasionally pruritic, usually painless, commonly in or near a scar

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11
Q

What are the clinical manifestations of a regional breast cancer reoccurrence?

A

• Enlarged nodes in axilla, supra clavicular area

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12
Q

Progressive back-pain, bowel and bladder function, and lower sensation loss can indicate distant metastasis in what location?

A

• Spinal cord

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13
Q

Headache described as different, unilateral sensory loss/weakness, ataxia, and N/V can indicate distant metastasis in what location?

A

• Brain

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14
Q

Shortness of breath, tachypnea, and cough can indicate distant metastasis in what location?

A

• Pulmonary

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15
Q

Abdominal distention/ascites Rt lower quadrant pain , nausea/vomiting, weight loss ,jaundice, peripheral edema can indicate distant metastasis in what location?

A

• Liver

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16
Q

Anemia, infection, weakness, increased bleeding and infection risk, petechiae, mild confusion, and dyspnea can indicate distant metastasis in what location?

A

• Bone marrow

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17
Q

Besides physical examination, what are diagnostic studies done for breast cancer?

A
  • Mammography
  • Ultrasound
  • Biopsy
  • MRI, if indicated
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18
Q

Why is lymphatic mapping performed w/ breast cancer?

A

• To see if there is any lymphatic involvement and if so, the extent

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19
Q

Why is a lymph node dissection performed?

A

• To remove any lymph nodes that may contain cancer cells and prevent metastasis

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20
Q

Is a well differentiated breast tumor more or less aggressive?

A

• Less

21
Q

Breast cancer is rated from stage I to Stage IV. Describe stage 1 and stage 4.

A
  • I: Small (<2cm) tumor w/ no lymph node involvement

* IV: Any size tumor w/ nodal involvement and distant metastasis

22
Q

Lymphedema is a result what procedure associated w/ mastectomy?

A

• Axillary node dissection

23
Q

What is lymphedema and what causes it?

A
  • Accumulation of lymph in the soft tissues
  • Cause: When axillary nodes cannot return lymph fluid to central circulation, fluid accumulates in arm, causing obstructive pressure on veins and venous return.
24
Q

Lymphedema causes what other clinical manifestations?

A
  • Pain
  • Impaired motor function in arm
  • Numbness
  • Paresthesia of the fingers
25
Q

What is the treatment for acute lymphedema?

A
  • Complete decongestive therapy
  • Elevation of arm (level with heart)
  • Diuretics
  • Isometric exercises
  • Wearing a fitted elastic pressure gradient sleeve during waking hours
26
Q

True or False

Blood pressure readings, venipunctures, and injections should not be done on an arm with Lymphedema.

A

• True

27
Q

What is the patient education provided re: lymphedema post mastectomy?

A
  • Instruct patient to protect arm from even minor trauma (e.g., sunburn, pinprick).
  • Advise surgeon of all traumas, and observe site for inflammation.
  • Make sure patient understands that there will always be a risk for lymphedema.
28
Q

Breast cancer is treated w/ Chemo/radiation therapy and surgery. What would warrant chemotherapy before radiation?

A

• Evidence of systemic disease

29
Q

What are the goals of combined surgery and radiation for breast cancer?

A
  • Maximize benefits of cancer tx and cosmetic outcome

* Minimize risks

30
Q

A modified radical mastectomy is the removal of breast and axillary lymph nodes but preserves…

A

• The pectoralis major muscle

31
Q

What is Postmastectomy Pain Syndrome?

A

• Unusual pain associated symptoms that last beyond the 3 month mastectomy healing time.

32
Q

What are the s/s of Postmastectomy Pain Syndrome?

A
  • Chest and upper arm pain, tingling down arm
  • Numbness, shooting or prickling pain
  • Unbearable itching
33
Q

Treatment for Postmastectomy Pain Syndrome includes the use of what types of drugs?

A
  • NSAIDS
  • Antidepressants
  • Antiseizure drugs
  • Topical lidocaine patches
34
Q

Restoring arm function on affected side after mastectomy and axillary lymph node dissection is one of the most important goals. What are the associated interventions?

A
  • Place in a semi-Fowler’s position with arm on affected side elevated on a pillow.
  • Flexing and extending fingers should begin in recovery room
  • Postoperative arm and shoulder exercises are instituted gradually at surgeon’s direction
35
Q

Postmastectomy exercises are designed to:

A
  • Prevent contractures and muscle shortening

* Maintain muscle tone, and improve lymph and blood circulation.

36
Q

The goal of all exercise is a gradual return to full range of motion in what time frame

A

• Within 4 to 6 weeks post-mastectomy

37
Q

What is the follow up schedule for a patient that has had breast cancer and mastectomy?

A

• Every 6mos for 2yrs, then annually

38
Q

True or False

Breast cancer is one of the solid tumors that is least responsive to chemotherapy.

A

• False, it is one of the MOST responsive

39
Q

Estrogen can increase growth of breast cancer cells if cells are estrogen receptor positive. How is this addressed with drugs?

A

• Hormonal therapy: removes or blocks source of estrogen, promoting tumor regression

40
Q

Tamoxifen (Nolvadex) is what type of drug and how does it treat breast cancer?

A
  • It is an anti-estrogen

* By blocking estrogen, it starves the tumor of it and the tumor shrinks

41
Q

Fever, inflammation, and erythema at the surgical site. Why should these symptoms be reported?

A

• Possible infection

42
Q

Any unusual swelling. Why should this be reported?

A

• Indicates possible lymphedema, possible metastasis

43
Q

Unusual, persistent back pain. Why should these symptoms be reported?

A

• Possible spinal/bone metastasis

44
Q

Persistent weakness. Why should this be reported?

A

• Could be indicative of anemia through bone metastasis

45
Q

Persistent shortness of breath. Why should this be reported?

A

• Possible metastasis to lungs

46
Q

Episodes of confusion. Why should this be reported?

A

• Possible metastasis to brain.

47
Q

True or False

Major risk for breast cancer is increased age.

A

• True

48
Q

True or False

Less than half of all breast cancers are diagnosed in women age 65 or older.

A

• False, MORE than half are

49
Q

Tolerance to treatment and long-term prognosis are influenced more by patient’s _____ than by age.

A

• Health status

z_MS_Primers for Exam 4 (18 decks)

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