Breast Cancer

Question 0

Mesoderm

Answer 0

1. Filler in the middle

- Bone, muscle, fat, lymph, cartilage, bone marrow

Question 1

Ectoderm

Answer 1

1. Exposed layer to the environment

- Skin, GI, lungs, vagin, prostate, bladder, breast, ovary

Question 2

Endoderm

Answer 2

1. Glands

Question 3

Benign Tumors

-Characteristics

Answer 3

1. Slow growing w/ slow cell division
2. Histologically mature cells that stick together
3. Function as normal cells and produce hormones
4. Can be removed and don’t grown back
5. Generally don’t progress to malignancy

Question 4

Benign Brest Problems

Answer 4

1. Fibrocystic Changes

2. Fibroademona

Question 5

Benign Brest Problems

-Fibrocystic Changes

Answer 5

1. No increase cancer risk
2. Most common in 35-50
3. Hyperplasia of epithelial lining of ducts
4. Accompanied by cyclic pain and tenderness
5. Subside w/ menopause

Question 6

Benign Brest Problems

-Fibroademona (Benign breast lumps) COMMON

Answer 6

1. Small, painless, round mobile well defined masses
2. Most common in young women 15-25 (dealing with IDENTITY)
   - Address changes in body image
3. Rarely associated w/ cancer

Question 7

Breast Cancer

-Statistics

Answer 7

1. Most common cancer & most common malignancy in American women
2. 2nd leading cause of cancer deaths

Question 8

Breast Cancer

-Risk factors

Answer 8

1. Age over 40 and women
2. 1st degree relative w/ breast cancer
3. Hormone use greater than 5 years
4. Early menarche and late menopause
5. 1st pregnancy after age 30

Question 9

Breast Cancer

-Epithelium of Lobules Patho

Answer 9

1. Lobular cancer in situ has a higher risk of invasive breast cancer

Question 10

Breast Cancer

-Epithelial lining of Ducts Patho

Answer 10

1. Ductal carcinoma in situ will progress to invasive cancer if untreated

Question 11

Breast Cancer

-Inflammatory Breast Cancer Patho

Answer 11

1. Generalized, fast-growing cancer

Question 12

Breast Cancer

-Prophylactic Mastectomy

Answer 12

1. Reduction of breast cancer risk by 90%

Question 13

Breast Cancer

-Prophylactic Oophorectomy

Answer 13

1. Should be considered in women who are no longer wanting children and who have the BRCA genes
2. Reduces ovarian cancer by 50% and breast cancer by 90%

Question 14

Breast Cancer

-Positive axillary nodes

Answer 14

1. 50 to 75% chance of recurrence of cancer

Question 15

Breast Cancer

-Positive Estrogen Receptors?

Answer 15

1. Estrogen receptor positive most often metastasizes to the bone

Question 16

Breast Cancer

-Negative Estrogen Receptor

Answer 16

1. Estrogen receptor negative breast cancer generally metastasizes to:
   - Soft Tissue… Brain, liver, lungs

Question 17

Breast Cancer

-HER2

Answer 17

1. If result is positive, this gene may be responsible for the rapidly cancerous growing cells
2. Additional chemotherapy may be needed postoperatively

Question 18

Age R/t Risk of Breast Cancer

Answer 18

1. 1/2044 @ 20
2. 1/249 @ 30
3. 1/67 @ 40
4. 1/36 @ 50
5. 1/29 @ 60

Question 19

Breast Cancer

-Risk Factors Ductal CA

Answer 19

1. Combination of estrogen and progesterone increase risk

2. New evidence shows Progesterone may be bigger risk

Question 20

Breast Cancer

-Manifestations

Answer 20

1. Breast mass or thickening (non-moveable, non-tender)
2. Unusual lump in the underarm (upper-outer quadrant)
3. Persistent skin rash near nipple
4. Flaking or eruption near nipple
5. Dimpling, pulling, or retraction in breast area
6. Nipple discharge
7. Change in nipple position
8. Burning, stinging, or pricking sensation

Question 21

Breast Cancer

-Self Breast Exam

Answer 21

1. Pg 109

Question 22

Breast Cancer

-Drugs that inhibit Cancer

Answer 22

1. Celebrex & Low Dose Aspirin (COX-2 Inhibitors)
   - Encourage the breast and colon cancer cells to die
2. Drugs ending w/ “-nibs”
   - Inhibit the enzymes required for cancer cells to grow

Question 23

Breast Cancer

-Radical Mastectomy

Answer 23

1. Removal of the entire affected breast, the underlying chest muscles, and the lymph nodes under the arms

Question 24

Breast Cancer

-Simple Mastectomy

Answer 24

1. Removal of the complete breast only

Question 25

Breast Cancer

-Drugs

Answer 25

1. Pt 866 ATI Book

Question 26

Breast Cancer

-Cachexia Etiology

Answer 26

1. Physical wasting from weight loss and loss of muscle mass from rapid growth and reproduction of cancer cells and their need for increased nutrients

Question 27

Breast Cancer

-Cachexia Clinical Manifestations

Answer 27

1. Weight loss, fatigue & weakness
2. Loss of strength, Activity Intolerance
3. Constipation

Question 28

Breast Cancer

-Cachexia Clinical Therapies

Answer 28

1. Nutritional counseling
2. Increased caloric intake
3. Periods of rest and activity
4. Monitoring weight
5. Monitor I&O

Question 29

Breast Cancer

-Tamoxifen

Answer 29

1. Oral medication that interferes w/ estrogen activity

2. Watch for development of DVT’s

Question 30

Breast Cancer

-Herceptin

Answer 30

1. Immunotherapy used to stop the growth of breast tumors that express the HER2 neuroreceptor

Question 31

Breast Cancer

-Where do Carcinoma’s Arise?

Answer 31

1. Carcinomas arise from the endodermal and ectodermal cells

Question 32

Assessment of the Breasts

Answer 32

1. Lumps
2. Nipple Discharge & retraction
3. Redness, pain or tenderness
4. Dimpling of the skin
5. Edema
6. Menstrual Cycle relationship

Question 33

Breast Cancer

-Avastin

Answer 33

1. Clients who have metastatic cancer may receive a vascular endothelial growth factor inhibitor such as bevacizumab (Avastin)

Question 34

Breast Cancer

-Leuprolide (Lupron)

Answer 34

1. Inhibits estrogen synthesis

2. May be sued in premenopausal women to prevent growth of breast tumors

Question 35

Breast Cancer

-Radiation Therapy

Answer 35

1. Radiation therapy is usually reserved for clients who had a lumpectomy or breast-conserving procedure