Breast Cancer Flashcards
Breast cancer
A 25 year old just got her breast biopsy report and cancerous tcells were seen. counsel her on her diagnosis and management
GRIP LCCC
Greet: Good morning ma/sir, good morning MA
Rapport: how are you doing today
Introduce: my name is “insert name” a candidate of the ongoing exam and for the purpose of the exam I would like to counsel
you
Permission: may I proceed
Language: is English your preferred language of communication
Comfort: are you comfortable here or would you like to go
somewhere alse
Companion: do you want a loved on to be here before we start
Confidentiality : I want to assure you that whatever is said today
remains between us and would only be shared with your permission
ASK
Brief biodata: what is your ? how old are you? What is your highest level of education
Patient understanding: have you been told about your diagnosis? what do you know about breast cancer (empathy) do you have any worries or fear regarding your diagnosis. I don’t want you to be worried, by the end of our counselling, you will know various optioned opened to you for management of this diagnsosis
Tell: definition, aetiology/ risk factors, clinical features and complications
Definition – breast cancer is a type of cancer that forms in the cells of the breast. It is usually starts as a lump or tumor in the breast tissue
Epidemiology – women are mostly affected but men can get it too, although its less common.
In Nigeria, breast cancer is a significant health condition because it is the most common cancer among women
Aetiology/risk factors
There are certain factors that increase a womans risk of breast cancer
1. Genetic: some people have mutation in specific genes like BRCA 1 and BRCA 2, and this increases their risk for breast cancer
2. Family history – having close relatives like the mother, sister or daughter also increases the risk
3. Hormonal factors – early menstruation, late menopause, hormone replacement therapy can increase exposure to estrogen and increase risk for breast cancer
4. Lifestyle – factors like obesity, lack of physical exercise, excessive alcohol consumption and smoking can increase the risk
Clinical features
A person with breast cancer will usually present with a hard lump or mass in the breast which is ually the first noticeable sign. They can also present with skin changes like dimpling, nipple inversion , nipple discharge, breast pain, and changes in the shape or size of the breast
Complications
Dealing with diagnosis of breast cancer and the treatment can be emotionally challenging, it can lead to anxiety and depression and if it’s not treated early it can spread to other parts of the body like bones, lungs, liver, brain and affect the organ functions
Diagnosis and Treatment
Diagnosing breast cancer involves several steps
The clinical examination, imaging tests like ultrasound and mammogram, biopsy and histology of the tissue gotten from the affected area
Treatment
Breast cancer treatment can vary depending on the stage of the cancer, its location and the persons overall health
1. Syrgery – we can do lumpectomy (to remove the tumor and small amount of the surrounding tissue)
We can also do a mastectomy, which can be a total mastectomy – here we remove the entire breast or modified radical mastectomy – here we remove the entire breast and some lymph nodes
2. Radiation therapy – here, high energy rays are used to kill or shrink the cancer, it can be done after surgery to remove the remaining cells
3. Chemotherapy – uses medications to kill cancer cells and stop them from growing. It is often used in combination with surgery or radiotherapy
4. Hormone therapy – if the cancer cells are hormone receptor positive, hormone therapy may be used to block hormones like estrogen and progesterone, which fuels the cancer growth
5. Reconstructive surgery – it can be done to rebuild the breast shape and appearance after surgery has been done
Help
HELP
Your treatment plan will be tailored to your needs and a combination of these treatments may be used. The goal is to remove or destroy cancer, prevent its recurrence and preserve the quality of your life
I would like to advise you to be complaint with your regular follow ups with your doctors as they are essential to monitor your progress, manage side effects and adjust your treatment as needed
Empathy
Empathy (from beginning to the end of your counselling)
Im truly sorry for diagnosis. please know you are not alone, we have a team of good and compansionate professionals who have handled smililar cases with successful outcomes. Your well being will be their priority
Retell
Retell
- Do you understand all I have said so far?
- Do you have any questions for me
- Can you retell in your own words all I have said
- Thank you for listening
I would like to give you this pamphlet so you can read through and make an infeormed decision on your next step
Thank your patient
Thank your examiner
