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Med/Surg 1 Exam 2 > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

Statistics of breast cancer and prevalence?

A
  • More than 200,000 diagnosed with breast cancer every year
  • Prevalent among white women
  • Primarily among older women
  • 2nd most common occurring cancer in women
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2
Q

How is breast cancer classified?

A

Noninvasive (in situ)

Invasive (invades surrounding tissue)

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3
Q

What is breast cancer?

A

Unregulated growth of abnormal cells in the breast tissue

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4
Q

How does breast cancer begin?

A

Begins as a single transformed cell and is often hormone dependent

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5
Q

What are the different categorization of breast cancer?

A
  • Carcinoma of the mammary ducts
  • Carcinoma of the mammary lobules
  • Sarcoma of the breast
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6
Q

What is the most common type of carcinoma of the mammary ducts?

A

Infiltrating ductal carcinoma

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7
Q

What are the three receptors known to fuel most breast cancers?

A
  • Estrogen
  • Progesterone
  • Human Epidermal Growth Factor Receptor 2 (HER2)
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8
Q

What is triple negative breast cancer?

A

A type of breast cancer that is negative to all three receptors that are usually the fuel to most breast cancers

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9
Q

What type of treatment is triple negative breast cancer most responsive to ?

A

Chemotherapy

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10
Q

What are the Atypical types of breast cancer?

A

Paget’s disease

Inflammatory carcinoma

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11
Q

What is Paget’s disease?

A

Rare breast malignancy found in the areola
Most commonly in women
Tumors within the same breast are often found

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12
Q

What are symptoms of pagets disease?

A

Itching, tingling, or redness of areola
Discharge of yellowish/bloody
Flaking, crusty, or thickened of skin around nipple
Flattened of nipple

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13
Q

What is inflammatory carcinoma?

A

Most malignant form of breast cancer
Aggressive and fast growing
High risk for metastasis
Peau d’orange (plugging of the dermal lymphatics)

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14
Q

Cancer growth can be from what?

A

Slow to rapid

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15
Q

What are some of the factors that can affect prognosis?

A 
Tumor size 
Axillary node involvement 
Tumor differentiation 
Estrogen and progesterone receptor status 
HER2 status
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16
Q

Which receptor helps regulate cell growth?

A

HER-2

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17
Q

What are some possible causes of breast cancer?

A

Environmental
Hormonal
Reproductive
Hereditary

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18
Q

What are the breast cancer susceptibility genes?

A

BRCA1

BRCA2

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19
Q

Which gene is responsible for 10% of women with hereditary breast cancer with genetic mutations causing up to 80% in women

A

BRCA2

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20
Q

What are some risk factors of breast cancer?

A 
Gender- women 
Age
Family history (breast cancer- 1 degree)
Personal history (breast cancer)
Previous chest irradiation 
Menstrual history (early menarche, late menpause)
Life style
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21
Q

What is included in lifestyle risk factors?

A 
Oral contraceptives 
Not having children 
Having children after age of 30
Hormone replacement therapy (for more than 5 years)
Alcohol 
Not breastfeeding 
Obesity
High-fat diets
Physical inactivity
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22
Q

What are predisposing risks in men?

A

States of hyperestrogenism
Family Hx of breast cancer
Radiation exposure

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23
Q

What should be enforced as to prevention of breast cancer?

A

Monthly self breast exams

Routine screenings for genetic abnormalities

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24
Q

Early detection helps with what?

A

Reduce mortality

Promote positive outcomes

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25
What does a "lump" feel like?
``` Hard Irregularly shaped Poorly delineated Non mobile Non tender ```
26
Where does breast cancer often occur within the breast?
Upper outer quadrant (location of most glandular tissue)
27
What can women with BRCA1 or BRCA2 mutations do as part of prevention?
Prophylactic bilateral oophorectomy (decrease breast and ovarian cancer) Prophylactic bilateral mastectomy (reduce risk of breast cancer by 90%)
28
What are some of the diagnostic tests performed for breast cancer?
Mammography Aspiration biopsy Excisional biopsy
29
When does ACS recommend getting mammograms?
Annually at age 40 | Every 3yrs for women in 20s and 30s
30
When should an aspiration biopsy be done? | And what sample is taken?
With a cystic mass or fibrocystic changes Fluid or tissue
31
When should an excisional biopsy be done? | And what sample is taken?
Suspicious lump is identified Tissue
32
What are tumor markers?
Protein molecules detected in serum or other body fluids
33
What are some types of tumor markers?
``` CEA HER1 HER2 EGFR CA-15-3 CA-27-29 ```
34
What are some types of treatment for breast cancer?
``` Surgery Radiation Chemotherapy Targeted therapy Hormone therapy ```
35
What types of surgery are available for breast cancer?
Segmental Simple Modified radical Radical
36
What is a segmental mastectomy?
Lumpectomy 'Breast-sparing' Removal of breast cancer and normal, healthy tissue surrounding it
37
What is a simple mastectomy?
Removal of breast tissue, nipple, areola, and skin but not all lymph nodes
38
What is a modified radical mastectomy?
Removal of all entire breast | Tissue, nipple, areola, and most of axillary lymph nodes
39
What is a radical mastectomy?
Removal of breast tissue, along with chest muscle and axilla lymph nodes
40
What is part of breast conservation therapy?
Lumpectomy | Radiation therapy
41
When is a segmental mastectomy an option?
For tumors for 4-5 cm
42
What is an advantage of breast-conservation therapy?
Maximize benefits of both cancer treatments and cosmetic outcome while minimizing risks
43
What is a disadvantage of breast-conservation therapy?
Increased cost of surgery and radiation possible side effects of radiation
44
What are some types of breast reconstruction?
Breast implants and tissue expansion Musculocutaneous flap procedure Nipple-areolar reconstruction
45
What are the indications of breast reconstructions?
Improve self image Regain a sense of normalcy Assist in coping with the loss of a breast
46
What remains a powerful prognostic factor of breast cancer?
The presence or absence of malignant cells in lymph nodes
47
What is the advantage of immediate reconstruction?
One surgery One anesthesia One recovery period Before the development of scar tissue or adhesions
48
What is the standard of care for the majority of breast cancer cases with axillary lymph node involvement?
Chemotherapy
49
What are the benefits of chemotherapy and other pharmacologic agents?
Reduces the rate of reoccurrence and the death rate
50
What is letrazole?
Aromatase inhibitor | Reduces risk of recurrence after surgery
51
What is bevacizumab?
Combined with chemotherapy has extended cancer free survival for meta cancer patients
52
What is radiation therapy used for? Examples
Usually follows surgery to kill any cells that could cause recurrence or metastasis - Shrink the tumor before surgery - Palliative radiation External beam High dose brachytherapy
53
What is intraoperative radiotherapy?
Probe inserted into the cavity created by a lumpectomy | Radiation equivalent to 6 weeks of doses is given in 25mins
54
What are some complications of breast cancer?
Local recurrence (skin and chest wall) Regional recurrence (Lymph nodes) Distant metastasis - (Skeletal-bone, spinal cord, brain, pulmonary, liver, bone marrow)
55
An example of hormone therapy for breast cancer?
Tamoxifen Citrate | -Selective estrogen receptor modulator (SERM)
56
What is the purpose of Tamoxifen Citrate?
- Prevents estrogen from attaching to estrogen receptors on the cancer cells - Inhibits tumor growth and ultimately kills tumor cells
57
When is Tamoxifen Citrate used ?
Treat advanced breast cancer Adjuvant for early stage breast cancer Preventative treatment in women at high risk for developing breast cancer
58
What is targeted therapy used for?
To counteract specific genetic mutations that promote cancer growth
59
What is Trastuzumab? | What is it used for?
Used to stop the growth of breast tumors that express the HER2/ neu receptor (which binds an epidermal growth factor that contributes to cancer cell growth) on their cell surface - This drug is a recombinant DNA-derived monoclonal antibody that binds to the receptor, inhibiting tumor cell proliferation
60
What is lymphedema?
Accumulation of lymph in the soft tissues
61
S/S of lymphedema?
- Pain - Heaviness and impaired motor function in the affected arm - Numbness and paresthesia of the fingers - Cellulitis
62
What are the intervention measures for lymphedema ?
- Administration of analgesics to minimize post-op pain and allow for exercise - Teach measures to prevent lymphedema - Procedures should not be done on affected side - Protect from infection - lymph drainage is altered
63
What should be part of the nurse planning ?
- Client will make informed treatment decisions - Client will express feelings regarding diagnosis, treatment and prognosis - Family and significant others will provide appropriate support for client - Accurate and complete answers - Open communication

Med/Surg 1 Exam 2 (6 decks)

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