Topic 8: Breast Cancer

Question 1

lobules

Answer 1

milk-producing glands

Question 2

ducts

Answer 2

milk passages that connect the lobules and the nipple

Question 3

Breast cancers can in situ are within the…

Answer 3

duct

Question 4

invasive breast cancers are evading…

Answer 4

through the wall of the duct

Question 5

Metastatic breast cancer has spread to

Answer 5

other organs

Question 6

Risk factors of breast cancer

Answer 6

· Women over the age of 50 (after 60 the incidence increases dramatically)
· Hormone therapy
· Oral contraceptive use
Mutations in the BRCA 1 and BRCA 2 genes

Question 7

Clinical Manifestations of breast cancer

Answer 7

· Usually detected as a lump or thickening of the breast or mammography abnormality
· Nipple discharge (can be clear or bloody)
· Nipple retraction may occur
· Infiltration, induration, dimpling pulling in of the overlying skin

Question 8

where are lumps usually found on the breast

Answer 8

o Often on the upper outer quadrant of the breast

Question 9

Side effects of Lumpectomy

Answer 9

· Breast soreness
· Breast edema
· Skin reactions
· Arm swelling
· Sensory changes in the breast and arm

Question 10

Side effects of Mastectomy

Answer 10

· Chest wall tightness, scar
· Phantom breast sensations
· Lymphedema
· Sensory changes
· Impaired ROM

Question 11

Lymphedema

Answer 11

axillary nodes cannot return lymph back to central circulation, resulting in accumulation of lymph on soft tissue

Question 12

lymphedema often accumulates in

Answer 12

arm, hand, breast

Question 13

s/s of lymphedema

Answer 13

· Patient may have heaviness, impaired motor function, numbness and paresthesia of the fingers

Question 14

when should women undergo regular screening mammography

Answer 14

starting at age 45 then annually after that

Question 15

predignosis tests for breast cancer

Answer 15

· Mammography
· Ultrasound
· Breast MRI
· Biopsy

Question 16

postdiagnosis tests for breast cancer

Answer 16

· Axillary Lymph Node Analysis
· Estrogen and progesterone receptor status
· Cell-proliferative indices
· HER-2 marker
· Genetic assays

Question 17

Axillary Lymph Node Analysis

Answer 17

o Axillary lymph nodes are examined to see int eh cancer has spread to the axilla on the same side of the breast as the cancer

Question 18

Staging

Answer 18

· Uses TNM system, the stages range from 0 to IV
· CBC
· Liver function tests
· Chest x-ray
· CT scan of chest, abdomen and pelvis
· PET/CT, MRI, bone scan

Question 19

health promotion for breast cancer

Answer 19

· Adhere to breast cancer screening guidelines
· Genetic testing for BRCA and other gene mutation
· Prophylactic oophorectomy to reduce risk

Question 20

acute care: what to expect after surgery

Answer 20

o Instructions on pain control like dressing and drain care, turning, coughing, deep breathing
o A review of mobility restrictions and post-op exercises
o Explanation of recovery period

Question 21

acute care and arm and shoulder function

Answer 21

· Arm and shoulder exercises to restore arm function on the affected side
· Give analgesics regularly and 30 minutes before starting exercises

Question 22

Lymphedema interventions

Answer 22

· No BP readings, venipunctures or injections on affected arm if possible
· Arm should not be dependent for long periods
· COMPRESSION bandaging
· Intermittent pneumatic compression sleeve
· Elevating arm at heath level
· Performing isometric exercises

Question 23

what can be done if BRCA1 or BRCA2 mutation is present

Answer 23

· Prophylactic bilateral oophorectomy (removing the ovaries) and mastectomy

Question 24

why does a Prophylactic bilateral oophorectomy reduce the risk

Answer 24

Removing the ovaries lowers the risk because ovaries are the main source of estrogen in premenopausal women

Question 25

breast self examination (BSE)

Answer 25

a) Inspection can be done in front of a mirror. Palpation can be done in a shower.
b) BSE should always be performed following a menstrual cycle.
e) If client is menopausal, BSE should be performed on the same day of each month.