Breast Disorders Flashcards
Breast Disorders
- Affect both men and women
- Most lumps are benign
- May have affects on one’s self esteem and body image awareness
- Can occur at any age
Benign Breast Disorders
- Fibroadenoma (most common): younger women and adolescents - MASS OF CONNECTIVE TISSUE - movable tumor.
- Fibrocystic breast disease (FBD): involves lobules, ducts; tender breasts, pain; CYSTS ( drain fluid out of cyst); supportive bra to reduce discomfort.
- Ductul ectasia: blockage of ducts : discharge (greenish brown fluid ) from nipple , edema, redness - infectious process; analyze discharge from fluid
- Intraductal ectasia: papiloma (NOT PALPABLE mass)- discharge
Gynecomastia
“female breasts”;Benign Caused by: 1. abnormal growth of the glandular tissue 2. Corticosteroids; medications 3. Aging 4. Obesity 5. Excess estrogen 6. Alcoholism
Breast Cancer
Most commonly diagnosed
2nd highest cause of death by cancer
The earlier it’s found, the better chances for survival
Characterized by one abnormal cell which replicates
Invasive or noninvasive
Noninvasive Breast Cancer
• Cancer cells remain within the duct • Not yet harmful to client • Can lead to invasive breast CA if not treated - Ductal carcinoma in situ (DCIS) - Lobular carcinoma in situ (LCIS)
Invasive Breast Cancer
Infiltrating ductal carcinoma
Most common
Starts in the duct, spreads to breast tissue
Palpable lesion, irregular pattern
Tumor grows fibrosis develops enters lymphatic channelsblockage occurs (edema, redness, warmth)
Cancer metastasizes
S/s: Peau d’ orange (orange peel ) - DIMPLING of the breast ; might see discoloration along with the palpable lesion.
Causes
No one single defined cause
- First-degree relative
- 2 first-degree relatives
- HRT (hormone replacement therapy due to increase of estrogen in the body)
- Alcohol usage
- Obesity
- Men on anti-androgen agents
- Those with dense breasts
More causes
- Radiation exposure
- Childless women
- Early menses
- Oral contraceptives
Detection & Diagnosis
- Mammography
- Begin at age 40 unless high risk
- Existing barriers - Breast Self-examination (BSE)
- Assess client’s knowledge
- Provide education on correct technique and timing
- Perform one week AFTER menstrual period - Clinical Breast examination - performed by clinician
Surgical Treatment
1. Prophylactic Mastectomy Preventative breast removal Given to high risk women 2. Modified radical mastectomy Removes breast tissue, nipple & axillary lymph nodes 3. Lumpectomy with Lymph node dissection ( only portion to see if metastasis has occured) Tumor and lymph nodes removed Examined for presence of cancer cells
Post-op/Home care
- Presence of Jackson Pratt drain
May remain up to 3 weeks
Client measures drainage twice a day and records output
Removed once output <25ml in 24 hrs - Pain management
Keep affected arm elevated and free from needle sticks/BP/invasive measures (to prevent lymphedema)
Observe for excessive bleeding/drainage
Exercises
Most begin immediately following surgery Squeezing soft, round object with affected hand Flexion/extension of elbow Hand wall climbing Pulley exercise Rope turning (see IGGY p. 1675 73-2)
Adjuvant Therapy Radiation
Kill breast cancer cells remaining post-op
Given over 5-6 weeks
Entire breast or affected area
Brachytherapy - pt is radioactive when catheters inserted ; visitors only 30 min
Adjuvant Therapy Chemotherapy
Kill breast cancer cells traveling to other areas
Started after Stage II
Given before or after surgery
May be used in combination with other chemotherapy agents
Adjuvant Therapy cont…
Blocks action of estrogen or inhibits production Tamoxifen most common (SERM) Decreases recurrence up to 50% SE: hot flashes, weight gain Aromatase inhibitors Estrogen receptor down-regulators LH-RH agonists (See IGGY p. 1677 73-5)
