T. Breasts Flashcards
Lobules::
milk-producing glands
Ducts
milk passages that connect lobules and the nip
Breast cancer arises from
Epithelial lining of ducts
Epithelium of lobules
Paget’s Disease
- Persistent lesion of the nipple and areola with or without palpable mass
- Different from Paget’s disease of the bone
- Itching, burning, bloody nipple discharge
Inflammatory Breast Cancer
• Caused by cancer cells blocking lymph channels
• an aggressive cancer because it grows quickly
• Skin of the breast
– Looks red
– Feels warm
– Has a thickened appearance, resembling an orange peel
Breast Cancer
- Detected as lump or mammographic abnormality in breast
- Most often in upper, outer quadrant of breast
- Dense with glandular tissue
Tumour size
- The larger the tumour, poorer the prognosis.
- The more well differentiated the tumour, the less aggressive it is.
- Poorly differentiated tumours appear morphologically disorganized and are more aggressive.
Estrogen and progesterone Receptor-positive tumours
- Well differentiated
- Diploid DNA content and low proliferative indices
- Low chance for recurrence
- Frequently hormone dependent and responsive to hormonal therapy
Estrogen and progesterone Receptor-negative tumours
- Poorly differentiated
- Increased incidence of aneuploidy and higher proliferative indices
- Frequently recur
- Unresponsive to hormonal therapy
Ploidy status
- correlates with tumour aggressiveness.
* Diploid tumours have a significantly lower risk of recurrence than aneuploid tumours.
Mastectomy
- Removal of breast, pectoral muscles, axillary lymph nodes, all fat and adjacent tissue
- Historically, was the standard of care
TNM system
• Staging of breast cancer
- Tumour size (T)
- Nodal involvement (N)
- Presence of metastasis (M)
Axillary Node Dissection
• a procedure to remove these lymph nodes.
on same side as breast cancer is often performed.
• Until recently, was standard of care for invasive breast cancer
Lymphedema
- Accumulation of lymph in soft tissues
- Can occur as a result of excision or radiation of lymph nodes
- When axillary nodes cannot return lymph fluid to central circulation, fluid accumulates in arm, causing obstructive pressure on veins and venous return.
Breast Conservative Therapy
- Involves removal of entire tumour with a margin of normal tissue
- Radiation therapy is delivered to entire breast, ending with a boost to tumour bed.
- Evidence of systemic disease may warrant chemotherapy before radiation.
Modified Radical Mastectomy
- Removal of breast and axillary lymph nodes
- Preserves pectoralis major muscle
- Selected over breast reconstruction surgery if tumour is too large to excise
- Client has best option of breast reconstruction.
Postmastectomy Pain Syndrome
• Can occur following a mastectomy or an axillary node dissection
Symptoms
• Chest and upper arm pain, tingling down arm
• Numbness, shooting or prickling pain
• Unbearable itching persisting beyond 3-month healing time
Radiation Therapy
- Usually performed after local excision of breast mass
* Breast is radiated daily over ~4–6 weeks.
High-dose brachytherapy
- Internal radiation delivered using a multicatheter implant
* After placement, radioactive seed delivered into each catheter to treat target area
Chemotherapy
- Use of cytotoxic drugs to destroy cancer cells
- Breast cancer is one of the solid tumours that is most responsive to chemotherapy.
- Given preoperatively in some clients to decrease size of primary tumour
Hormonal therapy
- Removes or blocks source of estrogen, promoting tumour regression
- Estrogen can increase growth of breast cancer cells if cells are estrogen receptor positive.
Aromatase inhibitors
interfere with the enzyme that synthesizes endogenous estrogen.
