Breast Cancer--Jen

Question 1

Risk Factors of Breast Cancer

Answer 1

• age
• BrCA gene
• family history
• dense breasts
• menstruation before 12 yo
• menopause after 55
• first pregnancy after 30
• never having been pregnant
• obesity
• alcohol use

Question 2

Breast Anatomy

Answer 2

• collection of glands and fatty tissues
• clavicle to last few ribs
• over pec major, serratus ant, external obliques
• lobes made of lobules (produce milk)

Question 3

mammograms

Answer 3

-yearly after age 40

Question 4

Pathology of Breast Cancer

Answer 4

• slow growing

- may be present years before detection

Question 5

indications for biopsy of breast

Answer 5

• mass
• bloody nipple discharge
• nipple retraction
• thickening of breast tissue
• palpable mammographic lesions
• non-palpable suspicious mammographic abnormalities

Question 6

Breast Cancer:

Surgery

Answer 6

• modified radical mastectomy
• axillary node dissection
• sentinel node biopsy

Question 7

Modified radical Mastectomy

Answer 7

-remove breast tissue and axillary lymph nodes and pec minor may be removed

Question 8

Breast Cancer:

Radiation

Answer 8

-for lumpectomy and some MRM

Question 9

Side Effects of Radiation

Answer 9

• reddened skin
• thickening/fibrosis of breast tissue
• edema
• fatigue

Question 10

Breast Cancer:

Chemotherapy

Answer 10

-interfere with cellular metabolism/growth

Question 11

Side Effects of Chemo

Answer 11

• bone marrow suppression
• peripheral neuropathy
• joint pain
• alopecia
• GI upset
• Fatigue
• decreased functional capacity

Question 12

Breast Cancer:

Endocrine/Biological Therapy

Answer 12

• positive estrogen/progesterone receptors in tumor tissue
• block estrogen receptors to interfere with cell growth
• side effects like menopause

Question 13

Breast Reconstruction Surgery

Answer 13

• simple implant
• autologous muscle flap
• –rectus abdominis, DIEP, latissimus dorsi, Gracilis (TUG)

Question 14

When using Lat Dorsi for breast reconstruction

Answer 14

-NO shoulder extension in PT

Question 15

Limitations Post Breast Cancer Treatment

Answer 15

• fatigue
• N/T (post arm)
• adhesions/scarring
• cording (tight/scarring down of lymphatic veins)
• shoulder dysfunction (ROM, neck/shdr pn, Mm spasm/imbalances)

Question 16

Cording

Answer 16

• scarring/tight lymphatic veins
• Treatment: median nerve glide positions
• gentle ROM

Question 17

PT Intervention (post breast cancer treatment)

Answer 17

• shoulder/CS/TS assessment
• scar mob
• nerve mob
• Mm imbalances
• restore/improve scap-hum mechanics
• posture/body mechanics
• pt edu
• screen for lymphedema