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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
Q

What does a “lump” feel like?

A 
Hard
Irregularly shaped 
Poorly delineated 
Non mobile
Non tender
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26
Q

Where does breast cancer often occur within the breast?

A

Upper outer quadrant (location of most glandular tissue)

27
Q

What can women with BRCA1 or BRCA2 mutations do as part of prevention?

A

Prophylactic bilateral oophorectomy (decrease breast and ovarian cancer)
Prophylactic bilateral mastectomy (reduce risk of breast cancer by 90%)

28
Q

What are some of the diagnostic tests performed for breast cancer?

A

Mammography
Aspiration biopsy
Excisional biopsy

29
Q

When does ACS recommend getting mammograms?

A

Annually at age 40

Every 3yrs for women in 20s and 30s

30
Q

When should an aspiration biopsy be done?

And what sample is taken?

A

With a cystic mass or fibrocystic changes

Fluid or tissue

31
Q

When should an excisional biopsy be done?

And what sample is taken?

A

Suspicious lump is identified

Tissue

32
Q

What are tumor markers?

A

Protein molecules detected in serum or other body fluids

33
Q

What are some types of tumor markers?

A 
CEA
HER1
HER2
EGFR
CA-15-3
CA-27-29
34
Q

What are some types of treatment for breast cancer?

A 
Surgery 
Radiation 
Chemotherapy 
Targeted therapy 
Hormone therapy
35
Q

What types of surgery are available for breast cancer?

A

Segmental
Simple
Modified radical
Radical

36
Q

What is a segmental mastectomy?

A

Lumpectomy
‘Breast-sparing’
Removal of breast cancer and normal, healthy tissue surrounding it

37
Q

What is a simple mastectomy?

A

Removal of breast tissue, nipple, areola, and skin but not all lymph nodes

38
Q

What is a modified radical mastectomy?

A

Removal of all entire breast

Tissue, nipple, areola, and most of axillary lymph nodes

39
Q

What is a radical mastectomy?

A

Removal of breast tissue, along with chest muscle and axilla lymph nodes

40
Q

What is part of breast conservation therapy?

A

Lumpectomy

Radiation therapy

41
Q

When is a segmental mastectomy an option?

A

For tumors for 4-5 cm

42
Q

What is an advantage of breast-conservation therapy?

A

Maximize benefits of both cancer treatments and cosmetic outcome while minimizing risks

43
Q

What is a disadvantage of breast-conservation therapy?

A

Increased cost of surgery and radiation possible side effects of radiation

44
Q

What are some types of breast reconstruction?

A

Breast implants and tissue expansion
Musculocutaneous flap procedure
Nipple-areolar reconstruction

45
Q

What are the indications of breast reconstructions?

A

Improve self image
Regain a sense of normalcy
Assist in coping with the loss of a breast

46
Q

What remains a powerful prognostic factor of breast cancer?

A

The presence or absence of malignant cells in lymph nodes

47
Q

What is the advantage of immediate reconstruction?

A

One surgery
One anesthesia
One recovery period
Before the development of scar tissue or adhesions

48
Q

What is the standard of care for the majority of breast cancer cases with axillary lymph node involvement?

A

Chemotherapy

49
Q

What are the benefits of chemotherapy and other pharmacologic agents?

A

Reduces the rate of reoccurrence and the death rate

50
Q

What is letrazole?

A

Aromatase inhibitor

Reduces risk of recurrence after surgery

51
Q

What is bevacizumab?

A

Combined with chemotherapy has extended cancer free survival for meta cancer patients

52
Q

What is radiation therapy used for?

Examples

A

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
Q

What is intraoperative radiotherapy?

A

Probe inserted into the cavity created by a lumpectomy

Radiation equivalent to 6 weeks of doses is given in 25mins

54
Q

What are some complications of breast cancer?

A

Local recurrence (skin and chest wall)
Regional recurrence (Lymph nodes)
Distant metastasis
- (Skeletal-bone, spinal cord, brain, pulmonary, liver, bone marrow)

55
Q

An example of hormone therapy for breast cancer?

A

Tamoxifen Citrate

-Selective estrogen receptor modulator (SERM)

56
Q

What is the purpose of Tamoxifen Citrate?

A
  • Prevents estrogen from attaching to estrogen receptors on the cancer cells
    • Inhibits tumor growth and ultimately kills tumor cells
57
Q

When is Tamoxifen Citrate used ?

A

Treat advanced breast cancer
Adjuvant for early stage breast cancer
Preventative treatment in women at high risk for developing breast cancer

58
Q

What is targeted therapy used for?

A

To counteract specific genetic mutations that promote cancer growth

59
Q

What is Trastuzumab?

What is it used for?

A

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
Q

What is lymphedema?

A

Accumulation of lymph in the soft tissues

61
Q

S/S of lymphedema?

A
  • Pain
  • Heaviness and impaired motor function in the affected arm
  • Numbness and paresthesia of the fingers
  • Cellulitis
62
Q

What are the intervention measures for lymphedema ?

A
  • 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
Q

What should be part of the nurse planning ?

A
  • 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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