CT 4.2 Breast Flashcards

Question

Identify the psychosocial impact on patients and their families of the diagnosis and treatment of breast and other cancers and outline the importance of socio cultural background in determining the psychosocial response to diagnosis and treatment (H&S)

Answer 1

Certain factors that can influence a patient’s response to cancer diagnosis include their coping mechanisms, support networks, hobbies, their character, and whether they’re independent or rely on family members. Culture and religion is also a factor in the resilience of a person, and can be seen as a coping mechanism * * * The dual process model to grief states we cope with grief by carrying out loss-orientated behaviours (e.g. grief, breaking ties with people, denial, avoidance etc - usual stuff with grief) and restoration-orientated behaviours (e.g. doing new things, new roles, new relationships - stuff that helps you get over it), with both sides being important Effects grief can have on patients is implications on work and childcare, anxiety about health and wellbeing, social isolation and depression, and impacts on relationships with friends and family. Furthermore, side effects of cancer and its treatment like weight loss/anorexia, fatigue, hair loss etc can impact the patient’s personal image Effects grief can have on families is the increased burden on travel and care for their family member, impact mentally with stress, anxiety and emotions, and stress on the relationship with the patient

Answer 2

There are 3 phases in which delayed diagnosis can occur: ◦ Patient delay = interval between the patient first noticing symptoms and first consulting a doctor. Things that affect this are older age, socioeconomic status, education level, being of non-white ethnic origin, awareness and interpretation of symptoms, a ‘wait and see’ approach (i.e. denial, self-diagnosis, self-medication), fear of cancer diagnosis and further investigation and treatment, and a lack of social support ◦ Practitioner delay = time between the first consultation and referral to breast clinic. Generally younger aged and male patients aren’t referred as quickly, due to reduced likelihood of cancer diagnosis. Also, presentation of symptoms other than a breast lump cause delay in referral due to non-specificity of symptoms ◦ System delay = time between referral and diagnosis. Things that can affect this include misdiagnosis, just treating patients symptomatically, failure to adequately examine patients, and inappropriate requests

Answer 3

Develop from a whole lobule Mobile, firm breast lumps 12% of all breast masses Over a 2 year period up to 30% will get smaller No increase in risk of malignancy

Answer 4

7% of all Western females will present with a breast cyst Usually presents as a smooth discrete lump (may be fluctuant) Small increased risk of breast cancer (especially if younger)

Answer 5

Fibroadenoma – A common, firm, mobile, and painless lump seen in younger women. fibroadenosis/Fibrocystic Changes – Lumpy, tender breasts that fluctuate with the menstrual cycle. Breast Cysts – Fluid-filled sacs that may be tender and fluctuate in size. Lipoma – A soft, movable lump composed of fatty tissue. Intraductal Papilloma – A small, wart-like growth in a milk duct, sometimes causing discharge. Abscess or Mastitis – Infection leading to a painful, red, and swollen lump, more common in breastfeeding women. Fat Necrosis – A firm lump that may develop after breast trauma or surgery.

Answer 6

Invasive Ductal Carcinoma (IDC) – The most common type of breast cancer, often presenting as a hard, irregular lump. Invasive Lobular Carcinoma (ILC) – May present as thickening rather than a distinct lump. Inflammatory Breast Cancer (IBC) – Rare but aggressive, presenting with redness, swelling, and peau d’orange appearance.