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NU314 OB > Breast Disorders > Flashcards

Breast Disorders Flashcards

1
Q

Breasts

A

modified sweat glands which lie over the pectoralis major muscle
-specialized for milk production

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2
Q

What is a benign breast disorder?

A

any noncancerous breast abnormality

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3
Q

What are the most commonly encountered benign breasts disorders?

A

Fibrocystic disease
Fibroadenomas
Mastitis

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4
Q

Fibrocystic Breast Changes

A

also known as benign breast disease (BBD) represents a variety of changes in the glandular and structural tissue of the breast

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5
Q

Wha causes fibrocystic changes?

A

An overgrowth of fibrous tissues in the connective tissues supporting the breasts

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6
Q

What would you find on your assessment of a patient with Fibrocystic breast changes?

A

Lumpy tender breasts caused by fluid filled cysts
Clear-to-yellow nipple discharge upon manipulation
Dull, aching pain
Feeling of fullness

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7
Q

What is the main cause of concern for women with fibrocystic changes?

A

Breast exams and mammography become more difficult to interpret with multiple cysts present and early cancerous lesions may be overlooked

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8
Q

How can the patient manage the symptoms of fibrocystic changes?

A

SELF CARE: diet and life style changes, wearing a supportive bra, OC pain relievers, limit salt and caffeine consumption

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9
Q

In severe cases of Fibrocystic changes what medications may the patient have to take?

A

Tamoxifen, bromocriptine, or danazol

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10
Q

Tamoxifen

A

used to reduce the influence of estrogen on breast tissues

-Masculinization is a common undesirable side effect

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11
Q

What is a last resort for pain relief and swelling reduction for fibrocystic changes?

A

Aspiration or surgical removal of the breast lumps will reduce pain and swelling by removing the space-occupying mass

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12
Q

When is the best time to exam a woman’s breast?

A

A week after menses, when swelling has subsided

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13
Q

Mammography

A

Can help distinguish fibrocystic changes from breast cancer

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14
Q

Ultrasound

A

Often used w/ mammography to help distinguish a cystic mass from a solid mass

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15
Q

Nursing Management of BBD

A
  • instruct patient to perform monthly self breast exams (triple touch method)
  • Oral contraceptives can help hormones
  • Low fat diet high in fruits, veggies, and grains
  • Heat to reduce pain
  • Thiamine and Vitamin E
  • Decrease salt and avoid caffeine
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16
Q

Fibroadenomas

A

Common benign SOLID breast tumors; usually unilateral but can be bilateral
**PAINFUL

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17
Q

What can stimulate fibroadenomas?

A

External estrogens, progesterones, lactation, and pregnancy

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18
Q

Pituitary tumor = what?

A

spontaneous nipple discharge

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19
Q

Treatment of Fibroadenomas

A
  • Watch and wait-many will shrink on their own
  • Some require surgical removal
  • Cryoablation (RARE)
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20
Q

Cryoablation

A

extremely cold gas is pumped into the tumor using ultrasound guidance; the tumor freezes and dies

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21
Q

Fibroadenoma Lumps

A

firm, rubbery, and well circumscribed, and freely MOBILE

-Usually found in upper/outer quadrant

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22
Q

What is important to remember about a woman with a mass?

A

Should be evaluated and cancer should be excluded

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23
Q

Diagnostic tests for Fibroadenomas

A

Mammography, ultrasound, some form of biopsy

24
Q

Nursing Management for Fibroadenomas

A
  • Advise patient and encourage to return in 6 months for reevaluation
  • Emotional support
  • Allow time to ask questions
25
Q

Mastitis

A

an infection or inflammation of connective breast tissues

26
Q

When does mastitis typically occur in women?

A

When they are lactating

27
Q

What are the two types of Mastitis?

A

Lactational and Non-lactational

28
Q

What are the most common organisms that cause LACTATIONAL Mastitis?

A

Staphylococcus aureus, Haemophilus influenzae, and Haemophilus and streptococcus species

29
Q

Lactating Mastitis

A

Typically occurs in first 2-3 weeks of lactation

-One or more of the ducts becomes blocks resulting in bacterial growth

30
Q

Nursing Assessment of Mastitis

A
  • History of ductal abnormalities of breasts
  • Assess for cracks or fissures in nipples
  • Assess for proper breast emptying w/ feeding
  • Supportive bra
  • Assess breast feeding schedule
31
Q

Symptoms of Mastitis

A
  • Localized, unilateral area of erythema of breast
  • fever
  • flu-like symptoms
  • leukocytosis
  • cracked nipples
  • breast distended w/ milk
32
Q

How is engorgement different then Mastitis?

A

Engorgement means that both breasts will be full of milk while mastitis is only one

33
Q

What can cause Non-lactational Mastitis?

A

Duct ectasia

-milk ducts become clogged w/ secretions and or debris

34
Q

Nursing management for Mastitis

A
  • effective milk removal
  • pain meds (Tylenol)
  • antibiotic therapy
  • heat
  • encourage breast feedings
35
Q

Breast feeding with Mastitis

A
  • Begin w/ affected breast first
  • Massage breast before and during feeding
  • Supportive bra 24/7
  • increase fluid
  • Make sure infant is positioned correctly and change positions
36
Q

Where does breast cancer typically start?

A

the epithelial cells that line the mammary ducts within the breasts

37
Q

What does the growth rate for breast cancer depend on?

A

Hormonal influence-estrogen and progesterone

38
Q

What are the 2 major categories of breast cancer?

A

Invasive and Noninvasive

39
Q

Non-invasive Breast Cancer

A

“In Situ” = localized

Have NOT extended beyond their ducts, lobule, or point of origin into the surrounding tissue

40
Q

Invasive Breast Cancer

A

HAS extended into the surrounding breast tissue with the potential to metastasize

41
Q

Metastasis

A

can take place to almost all organs of the body, but primarily to the lungs, bone, liver, lymph nodes, and brain

42
Q

What are usually the first sites of metastasis?

A

Usually local or regional, involving the chest wall or axillary supraclavicular lymph nodes or bone

43
Q

What is the most common type of breast cancer?

A

Invasive ductal carcinoma

44
Q

Invasive Ductal Carcinoma

A

a malignant tumor that occurs in epithelial tissue; tends to infiltrate and give rise to metastases

  • spreads rapidly to lymph nodes
  • women > 60
45
Q

Invasive Lobular Carcinoma

A

Women 40-50

Does NOT present as a well defined mass-starts as ill defined thickening

46
Q

Where does invasive lobular carcinoma usually originate?

A

terminal lobular units of breast ducts

47
Q

Tubular Carcinoma

A

uncommon

Women 55 years and older

48
Q

Colloid Carcinoma

A

Women 60-70

49
Q

Medullary Carcinoma

A

younger women 50 and younger

grows in large tumor masses

50
Q

Inflammatory Breast Cancer

A

presents with skin edema, redness, and warmth

poor prognosis

51
Q

Paget’s Disease

A

originates in the nipple and typically occurs with invasive ductal carcinoma

52
Q

3 Stages of Breast Cancer

A

Tumor size
Extent of lymph node involvement
Evidence of metastasis

53
Q

What is the purpose of staging breast cancer?

A
  • determine the probability that the tumor has metastasized
  • Determine course of therapy
  • Assess prognosis
54
Q

Non-modifiable risk factors for breast cancer

A
  • gender
  • age
  • genetic mutation
  • personal history
  • increased breast density
  • race/ethnicity
  • previous abnormal biopsy
  • exposure to chest radiation
  • early menarche
55
Q

Modifiable risk factor for breast cancer

A
  • Not having children at all or not having them after age 30
  • Post-menopausal use of estrogen and progesterone
  • Failing to breast feed for 1 year after birth
  • Alcohol consumption
  • Smoking
  • Obesity and high fat diet
  • Sedentary lifestyle
56
Q

Testing for Breast Cancer

A 
Mammography
MRI
Fine-needle aspiration
Stereotactic needle-guided biopsy 
Hormone receptor staus 
Infrared thermal imaging 
DNA status/Genetic markers
57
Q

Surgical Options for Breast cancer

A
  • Breast conserving surgery-lumpectomy w/ radiation
  • Modified radical mastectomy
  • Radical mastectomy
  • Breast implants/augmentation

NU314 OB (21 decks)

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