Breast Cancer

Question 0

Who has the highest mortality rate for breast cancer?

Answer 0

african americans

Question 1

Risk reduction for breast cancer

Answer 1

Healthy diet, healthy weight, healthy lifestyle

Question 2

Who has the highest incidence rate for breast cancer?

Answer 2

whites

Question 3

Risk Factors for breast cancer

Answer 3

1. Female
2. Over 50
3. Obesity
4. Exposure to ionizing radiation
5. Genetic mutations (BRCA 1 & BRCA 2)
6. Onset menarche less than or equal to age 12
7. Onset menopause greater than or equal to age 55
8. Full term pregnancy after age 30 or no children (nulliparity)
9. Prolonged hormone replacement therapy
10. Family hisotry breast, colon, endometrial, ovarian cancer

Question 4

Breast Self-Exam

Answer 4

• Not very effective
• Check monthly for lumps after age 20

Question 5

Clinical Breast Exam

Answer 5

1. Every 3 years women 20-40
2. Every year for women over age 40

Question 6

Mammography

Answer 6

1. Baseline at age 35
2. Annually beginning at age 40
3. can detect a breast cancer 5mm in diameter

Question 7

Magnetic Resonance Imaging

Answer 7

• Annually for high-risk women (strong family history of breast and/or ovarian cancer

Question 8

Lymph Nodes

Answer 8

small oval structures that filter the lumph and fight infection

Question 9

Normal & Abnormal Findings Lymph Node Assessment

Answer 9

Normal: generally not palpable

Abnormal:

Infection: round, rubbery, tender and mobile

Malignancy: fixed, hard, and non-tender

Question 10

Diagnosis of Breast Cancer

Answer 10

1. Mammogram
2. Breast Ultrasound
3. Biopsy

Question 11

What is treatment of breast cancer based upon?

Answer 11

• stage and grade of tumor
• menopausal status
• lymph node status (+ or - )
• hormone receptor status (estrogen receptor and progesterone receptor)
• HER-2 new status
• Various additional prognostic indicators (genetic testing)

Question 12

What is the primary treatment for breast cancer?

Answer 12

surgery

Question 13

What are the goals of surgery?

Answer 13

1. Remove whole tumor
2. Assess lymph nodes for presence of cancer cells

Question 14

Surgery options (three types)

Answer 14

1. Modified Radical Mastectomy (MRM)
2. Lumpectomy (Breast Conserving)
3. Axillary Node Dissection (AND)

Question 15

Adjuvant therapy for breast cancer

Answer 15

• Chemotherapy
  
  • may be given prior to surgery to shrink tumor, given after surgery, or both
• Radiation Therapy
  
  • Always given for patients who undergo a lumpectomy. May be given to patients who undergo a MRM
  • Low Density Radiation (LDR): 5 days/week X 4-5 weeks
  • High Density Radiation (HDR): daily X 5 days
• Targeted Therapy
• Hormone Therapy

Question 16

Modified Radical Mastectomy

Answer 16

Removal of entire beast and axillary lymph nodes and lining over pectoralis major muscle

• Patients will have JP drain
• Discharged with drain
• May have reconstruction immediately following surgery or may have a second surgery for reconstruction. Not all women choose to have reconstruction.

Question 17

Lumpectomy

Answer 17

Tumor removed with margin of surrounding healthy tissue

• Major portion of breast is left
• Must receive radiation therapy to remaining tissue to treat undetected cancer

Question 18

Axillary Node Dissection

Answer 18

Performed during a MRM or lumpectomy

• Assess for spread of malignant cells
• Separate incision may be required