Female reproductive disorders Flashcards
Benign Breast disorders:
Breast pain Cysts Fibrocystic Fibroadenomas Atypical ductal hyperplasia Lobular carcinoma in situ
What are the types of cysts?
Simple - require no intervention, can aspirate to relieve discomfort
Complicated - fluid inside, rarely malignant, aspirate to confirm it is complicated
Complex - wall is thick, solid, need biopsy to confirm it is benign
Fibrocystic breast disorder
Transient breast mass - typically r/t hormones
What are fibroadenomas (cause)
usually caused by cell abnormalities – causes a firm, round, movable nodule.
what is a risk atypical ductal hyperplasia
incidental finding, increases risk of cancer and
What is a risk with lobular carcinoma in situ
incidental finding, can indicate risk for cancer
Risk factors for breast cancer
Women, aging, inherited genetic mutation, family history, personal history, history of benign proliferative breast disease, history of high dose radiation to chest, hormonal factors, history of ovarian or endometrial cancer
obesity, alcohol consumption post-menopause, hormone replacement
Examples of screening and prevention of breast cancer
Screening recommendations Prevention strategies in the high-risk patient - long term surveillance - chemoprevention - prophylactic mastectomy
Clinical manifestations of breast cancer
Dimpling Nipple retraction Skin ulceration Nodule Hard/firm breast tissue
What are ways that breast biopsy can be obtained?
Fine needle aspiration Ultrasound guided Stereotactic breast biopsy MRI guided biopsy Surgical biopsy
Types of breast cancer
Ductal carcinoma in situ
Infiltrating ductal carcinoma
Infiltrating lobular carcinoma
Medullary carcinoma
Surgical management of breast cancer
Lumpectomy Simple mastectomy Modified radical mastectomy Radial mastectomy Breast conversion therapy Sentinel lymph node biopsy
What are complications of surgical management of breast cancer
Lymphedema
Hematoma and seroma formation
Infection
Breast cancer: reconstruction surgery
You can can reconstructive surgery for
- lumpectomy
- after mastectomy, this includes
- tissue expander followed by permanent implant
- tissue transfer procedures
- nipple-alveolar reconstruction
- prosthetics
Patient education - hand and arm care after axillary lymph node dissection (ALND)
Avoid blood pressures, injections, blood draws in the affected extremity
Sun screen (at least 15 spf)
Apply insect repellant to avoid insect bites
Wear gloves for gardening
Use cooking mitt for removing objects from oven
Avoid cutting with cuticles - push back instead
Avoid lifting >5-10 lb (increases pressure)
Avoid tight jewelry, clothing, bandages on arm
Avoid chemical hair removers
Observe area or 24 hours
If trauma or break in the skin occurs, wash area with soap and water and apply OTC abx ointment
Systemic therapy for breast cancer
Radiation Neoadjuvant Adjuvant Biologic Endocrine Chemo
What is neoadjuvant for systemic therapy of breast cancer
Give before surgery to help decrease tumor size
What is adjuvant for systemic therapy of breast cancer
Given with surgery to eradicate any residual tissues involved
What is biologic systemic therapy for breast cancer
looking at monoclonal antibodies to target specific protein to reduce the occurence rate of the tumor
What is endocrine systemic therapy for breast cancer
Estrogen is a hormone that is produced by ovaries that can increase breast cancer growth - so tamoxifen can be prescribed to work on blocking the effects of estrogen on the breast tissue
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: hot flashes
Wear breathable, layed clothing Avoid caffeine and spicy food Perform breathing exercises Considered medications (medications, antidepressants) Acupuncture
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: vaginal dryness
Use vaginal moisturizers for everyday dryness
Apply vaginal lubrications during intercourse
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: n/v
Bland diet
Try to take medication in evening
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: Musculoskeletal symptoms
Take NSAIDS
Warm baths
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: risk of endometrial cancer
Report any irregular bleeding
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: Risk for thromoembolic events
Report and redness, swelling, or tenderness in the lower extremities or any unexplained SOB
MANAGING the sfx of adjuvant hormonal therapy in breast cancer: risk for osteoporosis or fractures
Undergo a baseline bone density scan
Perform regular weight bearing exercises
Take calcium supplements with vitamin D
Take biphosphonates (alendronate) or calcium as prescribed
What are examples of reproductive disorders
Amenorrhea
Dysmenorrhea
Abnormal uterine bleeding
PMS