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Nursing Theory IV A- Cindy'S Class > Breast Cancer > Flashcards

Breast Cancer Flashcards

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1
Q

What is fibrocystic breast cancer?

A

Characteristics: generalized breast lumpiness/nodularity with tenderness, Pain, swelling, symptoms may decrease after period
- Lumps/cysts are soft or firm, single or multiple, smooth, round and movable.
- May enlarge and become tender
- Nipple discharge may be present- milky, yellow or greenish discharge

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2
Q

What is the pathophysiology of breast cancer?

A
  • Size
  • Axillary node involvement
  • Tumour differentiation
  • Estrogen and progesterone receptor status
  • Human epidermal growth factor receptor 2 (HER-2) status
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3
Q

What are the three types of breast cancer?

A
  1. invasive/infiltrating lobular carcinoma
  2. noninvasive
  3. invasive/infiltrating ductal carcinoma
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4
Q

What is an invasive/infiltrating lobular carcinoma?

A

Tumors occur as an area of ill defined thickening in breast (1 or both breasts).

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5
Q

What is a noninvasive breast cancer?

A

cancer confined on ducts

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6
Q

What is the two types of noninvasive breast cancer?

A
  1. ductal carcinoma in situ(DCIS)
    2.lobular carcinoma in situ(LCIS)
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7
Q

What is ductal carcinoma in situ(DCIS)?

A

proliferation of malignant cells within the ducts without invasion. Stage 0 breast cancer, simple/total mastectomy 98-99% cure rate.
- unilateral, progresses to invasive if untreated

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8
Q

What is lobular carcinoma in situ(LCIS)?

A
  • premalignant cancer
  • Those with LCIS have a higher risk of developing invasive breast cancer in same or opposite breast
  • Treatment may not be necessary, tamoxifen may be used.
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9
Q

What is invasive (infiltrating) ductal carcinoma?

A
  • Most common type of breast cancer, forms in ducts
    –> Colloid, Inflammatory, Paget’s disease, Medullary, Tubular
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10
Q

what are the complications of breast cancer?

A

Local: skin
Regional: lymph nodes
Distant: skeletal, spinal cord, brain, pulmonary, liver, bone marrow

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11
Q

How often are you suppose to do self exams for breast cancer? Most common site?

A

after each period, upper outer quadrant

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12
Q

What is the diagnostic studies for breast cancer?

A
  • History, including risk factors
  • Physical examination, including breast and lymphatics
  • Mammography, ultrasound, biopsy
  • MRI, if indicated
  • alnd, slnd
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13
Q

What is an axillary lymph node dissection (ALND)?

A

often performed to determine if cancer has spread to the axilla on the side of the breast cancer. The more nodes involved, the greater the risk of recurrence.

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14
Q

What is an sentinel lymph node dissection (SLND)?

A

remove only one node that is most likely to be cancerous

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15
Q

What is a mastectomy?

A

Removal of breast, pectoral muscles, axillary lymph nodes, all fat and adjacent tissue

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16
Q

What is the TNM system?

A

Tumour size (T)
Nodal involvement (N)
Presence of metastasis (M)

17
Q

What are the four stage ranges for tumour size?

A

stage 1: <2 cm
stage 2: <5cm
stage 3: 5-10 axillary nodes
stage 4: any size tumour, any type of nodal involvement, distant metastasis

18
Q

What is surgical therapy for breast cancer?

A
  • Most common options for resectable BC
    –> Breast conservation surgery with radiation therapy
    –> Modified radical mastectomy with or without reconstruction
    –> lumpectomy, axillary node dissection, modified radial mastectomy
19
Q

What is breast conserving procedures(lumpectomy)?

A

removal of entire tumor with a margin of normal surrounding tissue.

20
Q

What is axillary node dissection?

A

removal of 12 – 20 nodes. Was standard of care until early 2000s.

21
Q

What is modified radical mastectomy?

A

removal of breast tissue and an axillary node dissection. Preferred if tumour too large to excise to excise adequate margins. Patients have the option of breast reconstructive surgery.

22
Q

What is lymphedema?

A

Accumulation of lymph in soft tissues
- When axillary nodes cannot return lymph fluid to central circulation, fluid accumulates in arm, causing obstructive pressure on veins and venous return.
- Make sure client understands that there will always be a risk for lymphedema after surgery

23
Q

What is the prevention for lymphedema?

A
  • Frequent and sustained elevation of arms
  • Performing arm exercises daily
  • Avoidance of constrictive clothing
  • NO BP’s or IM’s IN AFFECTED ARM
24
Q

What is post-mastectomy pain syndrome?

A

Can occur following a mastectomy or an axillary node dissection

25
Q

What is the S&S of post-mastectomy pain syndrome?

A
  • Chest and upper arm pain, tingling down arm
  • Numbness, shooting or prickling pain
  • Unbearable itching persisting beyond 
3-month healing time
26
Q

What is the treatment of post-mastectomy pain syndrome?

A
  • Nonsteroidal anti-inflammatory drugs
  • Antidepressants
  • Topical lidocaine patches or EMLA
  • Antiseizure drugs
27
Q

What is adjuvant therapy?

A

Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back.

28
Q

What is an mammoplasty?

A
  • Surgical change in size or shape of breast
  • Cosmetic or reconstructive
  • Possible complications of hematoma, hemorrhage, and infection
29
Q

What is the S&S of breast cancer?

A

hard, irregularly shaped, poorly delineated, non-mobile, and non-tender to palpation

30
Q

What is the late S&S of breast cancer?

A

pain, ulceration, edema, “orange peel skin” due to plugging of dermal lymphatics

31
Q

What are the types of mammoplasty?

A
  • Breast implants and tissue expansion
    -Musculocutaneous Flap Procedure: Client’s own tissue may be used to repair soft tissue defects if there is insufficient muscle after mastectomy (from back or abdomen)
  • Nipple-Areolar Reconstruction
32
Q

How do you restore arm function on? the affected side after a mastectomy

A

Exercising: are designed to prevent contracture and muscle shortening, maintain muscle tone, and improve lymph and blood circulation

33
Q

What drug is used as a hormonal agent of choice in estrogen receptor-positive with breast cancer cells?

A

Tamoxifen (nolvadex)

34
Q

During surgical therapy of axillary node dissection, how do you prevent lymphedema?

A

NO BP, IM, or OV in affected arm

35
Q

What is Pagets disease?

A

AKA nipple cancer, scaly lesion, burning, itching around nipple/areola. bloody nipple discharge

Nursing Theory IV A- Cindy'S Class (17 decks)

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