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ADULT Health > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What is the time recommended for Clinical Breast Exam (CBE)???

A

Every 2-3 years in the 20’s and 30’s!!!
Yearly AFTER age 40

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2
Q

What is the exam for for Clinical Breast Exam (CBE)???

A
  1. Inspection (woman sitting or standing) for symmetry, size, color, contour, skin changes, nipple changes, and lesions.
  2. Palpation while sitting: include axilla AND above and below the clavicle for nodes.
  3. Palpation while laying down: systematic, including Tail of Spence.
  4. Nipple discharge should always be evaluated!!!!!!!
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3
Q

During Clinical Breast Exam (CBE), what is the ACS guidelines for mammography????

A

Mammography (US and MRI can also be used!!!)
1. Age 40: Talk to HCP about when to begin. Women can screen earlier if they choose
2. Age 45: YEARLY screening
3. AGE 55: EVERY OTHER YEAR or u can continue yearly screening if u choose
4. AGE 55+: just have regular screenings for as long as you’re in good health!

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4
Q

What is the Patient teachings for mammography????!!!!**

A

1) RESTRICTIONS:
1. NO pregnancy
2. NO deodorant
3. NO lotion/powder

2) COMFORT:
1. AVOID CAFFEINE**
2. TAKE NSAIDS for pain **
3. TIMING: 1 week AFTER period!!

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5
Q

What does the American Cancer Society (ACS) recommend for Breast Self-Exam (BSE)???!!!!

A

Recommends **MONTHLY BSE by women beginning in their 20’s

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6
Q

What is the method for Breast Self-Exam (BSE)?????

A

1) TIMING for exam:
1. Premenopausal women: 1 week AFTER period!!
2. Women no longer influenced by hormone fluctuations (after BSO or after menopause): PICK A DAY AND STICK WITH IT!!!
3. If Breast feeding: After breast feeding!
2) Allow DEMO and give them FEEDBACK
3) Utilize models

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7
Q

WHAT ARE THE 2 BENIGN BREAST CONDITIONS?????

A
  1. Fibroadenoma!!
  2. Fibrocystic Breast Condition!!
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8
Q

What are the assessments and patient care & teachings for the 2 Benign Breast Condition!??????**

A

1) Fibroadenoma
1. Assessment:
- Firm, smooth, round, rubbery, and movable!
- Tender or Painful ESPECIALLY BEFORE PERIOD!!
2. Patient care/teachings:
1. Surgical excision
2. Know your breast tissue, may shrink after menopause!!!

2) Fibrocystic Breast Condition
1. Assessment:
- Tender or Painful lumps WITH NO DISCHARGE!!
2. Patient care/teachings:
1. Aspirate the fluids, send it to the labs to r/o cancer!
2. ANALGESICS, and hot/cold compresses
3. BRA FOR SUPPORT
4. LIMIT SALT AND CAFFEINE!!

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9
Q

What are the assessment findings and patient care/teachings for FIBROCYSTIC BREAST CONDITION??????!!!!*****

A
  1. Assessment:
    1. Tender or Painful lumps WITH NO DISCHARGE!!
  2. Patient care/teachings:
    1. Aspirate the fluids, send it to the labs to r/o cancer!
    2. ANALGESICS, and hot/cold compresses
    3. BRA FOR SUPPORT
    4. LIMIT SALT AND CAFFEINE!!
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10
Q

What are the assessment findings and patient care/teachings for FIBROADENOMA??????!!!!*****

A
  1. Assessment:
    • Firm, smooth, round, rubbery, and movable!
    • Tender or Painful ESPECIALLY BEFORE PERIOD!!
  2. Patient care/teachings:
    1. Surgical excision
    2. Know your breast tissue, may shrink after menopause!!!
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11
Q

What are the 2 types of Breast cancer and examples???

A

1) Noninvasive:
1. DUCT carcinoma in Situ (DCIS)- Risk for INVASIVE DISEASE
2. LOBULAR carcinoma in Situ (LCIS) - NOT a precursor to cancer, but increases risk for cancer!

2) Invasive:
1. INFILTRATING Duct Carcinoma (MOST COMMON)
2. METASTASIS through blood and lymph!!

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12
Q

Out of the 2 types of non-invasive breast cancer, which one do we prefer and not prefer??? WHY??

A
  1. Duct carcinoma in Situ (DCIS)- PREFERABLE because the cancer cells are still in the lobe/duct system!!!
  2. Lobular carcinoma in Situ (LCIS) - Not as good because the cancer cells have gone out from the lobe/duct system and into the breast tissue!
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13
Q

WHAT ARE THE 3 RISK FACTORS FOR BREAST CANCER????????***** WHICH ONE IS THE PRIMARY RISK FACTOR!!????

A
  1. OLDER WOMEN!!! PRIMARY risk factor!!!!!*****
  2. BRCA 1 & 2 mutations!
  3. Having 1st degree relative!!
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14
Q

What surveillance/treatment options available for women with high risk??????

A
  1. CLOSER surveillance
  2. MRI & Mammograms early in life
  3. PROPHYLACTIC Mastectomy
  4. PROPHYLACTIC Oopherectomy
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15
Q

What are the skin changes of breast cancer???

A
  1. Peau d’orange
  2. Dimpling or pitting
  3. Redness and warmth
  4. Peeling and flaking
  5. Ulceration
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16
Q

What are the psychosocial concerns of pt who have breast cancer???

A
  1. Fear
  2. Body image, sexuality, intimacy
  3. Decisional conflicts
  4. Uncertainty r/t outcomes
17
Q

WHAT ARE THE 3 BIOPSIES FOR BREAST CANCER?????**

A
  1. ER/PR State –> Good! So, we want it POSITIVE!
  2. HER2 Neu –> Not Good! So, we don’t want it positive!!
  3. Staging with TNM system
18
Q

WHAT ARE THR 2 SURGICAL INTERVENTIONS FOR BREAST CANCER??????

A

1) Lumpectomy (Breast conserving) (just taking the mass out):
1. Stage 1 or 2 Cancer
2. Cosmetically and Psychologically beneficial
2) Mastectomy with/without axillary dissection
1. Senile node biopsy
2. With axillary dissection, HIGH RISK FOR LYMPHEDEMA!!

19
Q

What’s the difference between Lumpectomy and Mastectomy?

A

Lumpectomy would just be taking the mass out, while Mastectomy would be cutting off the breast off!!!

20
Q

Which surgical intervention of breast cancer cause increase risk for Lymphedema?????

A

Mastectomy with axillary dissection!!!!!

21
Q

What are the two concerns of Lynphedema????

A

Swelling & Infection!!!!!!

22
Q

What is the Post-op nursing care for breast cancer?

A
  1. Routine post-op care
  2. NO BP or Needle sticks to arm on affected side!!!!***
    - WHY? Because it can increases risk for LYMPHEDEMA!!!
  3. Lymphedema Risk
  4. Post sign at the head of bed
  5. Teach patient to tell providers in the future
  6. Incision protection/assessment:
  7. Surgical bra: they can put gauze on the breast incision and instead of taping it, they can use surgical bra. They can also safety pin JP drain on it!!
  8. Drain care
  9. Empty, record, protect, teach patient!
  10. Positioning
  11. Arm elevated on pillows at heart level
  12. Exercises:
  13. ADLs
  14. Post op exercises
  15. More Extensive exercises AFTER drain is out
  16. Office teaching at post op visits: Avoid overload immediately post op!!!
23
Q

SHOULD PT WITH MASTECTOMY WITH AXILLARY DISSECTION HAVE THEIR BP CHECKED WITH A MACHINE AND GET VACCINES/INJECTIONS???? WHY?????

A

NO BP or NEEDLE Sticks to arm on affected side!!!!!! Because this can increase risk for Lymphedema (swelling & infection) !!!!

24
Q

What should be used to protect their breast incision after surgery???

A

Surgical bra!!!

25
Q

What arm position should breast cancer post-op be in???

A

Arm elevated on pillows AT HEART LEVEL!!!!!

26
Q

What exercises do we encourage for post-op breast cancer patients???

A
  1. Encourage ADLs
  2. Post op exercises
  3. More extensive exercises AFTER DRAIN IS OUT (like hand exercises)
  4. Office teaching at post op visits: AVOID OVERLOAD IMMEDIATELY POST OP!!!!
27
Q

What one discharge teaching stood out for post-op????*** (What should they expect after surgery??))

A
  1. Teach “What to expect”:
    - NUMBNING and Neuropathic pain = NORMAL!!!
28
Q

What are the 2 Meds for the Breast Cancer patients??!!!!!**

A

1) Trastuzumab (Herceptin)- A MONOCLONAL antibody that target HER2-neu!!!
1. Targeted Therapy*
2. Teaching and adverse effects:
1. IV course of treatment
2. Infusion reactions: Fever, chills, nausea, aches, pain, headache, dizziness, and SOB
3. Adverse effects;
1. Birth defects (fake contraceptives bc we don’t want her to be pregnant bc of this)
2. Blood count Concerns!
3. CHF !
4. Rare pulmonary toxicity!

2) Tamuxifen- a SERM, for women with ER Positive breast cancer
1. Hormonal Therapy*
2. Adverse effects:
1. Menopause**
2. Increased risk for Endometrial cancers!!
3. Clot development!!!!***

29
Q

What is Trastuzumab (Herceptin)?

A

a MONOCLONAL antibody

30
Q

What does Trastuzumab (Herceptin) target??

A

Targets the HER2-neu!!!!!

31
Q

What kind of therapy is Trastuzumab (Herceptin)? What about Tamuxifen???

A
  1. Targeted Therapy
  2. Hormonal Therapy
32
Q

What is Tamuxifen???

A

a SERM!

33
Q

What does Tamuxifen target

A

Targets women with ER POSITIVE** breast cancers

34
Q

What are the adverse effects of Tamuxifen???????

A
  1. Menopause
  2. Increase risk for Endometrial cancer
  3. CLOT development

ADULT Health (24 decks)

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