Topic 8: Breast Cancer Flashcards
lobules
milk-producing glands
ducts
milk passages that connect the lobules and the nipple
Breast cancers can in situ are within the…
duct
invasive breast cancers are evading…
through the wall of the duct
Metastatic breast cancer has spread to
other organs
Risk factors of breast cancer
· 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
Clinical Manifestations of breast cancer
· 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
where are lumps usually found on the breast
o Often on the upper outer quadrant of the breast
Side effects of Lumpectomy
· Breast soreness
· Breast edema
· Skin reactions
· Arm swelling
· Sensory changes in the breast and arm
Side effects of Mastectomy
· Chest wall tightness, scar
· Phantom breast sensations
· Lymphedema
· Sensory changes
· Impaired ROM
Lymphedema
axillary nodes cannot return lymph back to central circulation, resulting in accumulation of lymph on soft tissue
lymphedema often accumulates in
arm, hand, breast
s/s of lymphedema
· Patient may have heaviness, impaired motor function, numbness and paresthesia of the fingers
when should women undergo regular screening mammography
starting at age 45 then annually after that
predignosis tests for breast cancer
· Mammography
· Ultrasound
· Breast MRI
· Biopsy
postdiagnosis tests for breast cancer
· Axillary Lymph Node Analysis
· Estrogen and progesterone receptor status
· Cell-proliferative indices
· HER-2 marker
· Genetic assays
Axillary Lymph Node Analysis
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
Staging
· 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
health promotion for breast cancer
· Adhere to breast cancer screening guidelines
· Genetic testing for BRCA and other gene mutation
· Prophylactic oophorectomy to reduce risk
acute care: what to expect after surgery
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
acute care and arm and shoulder function
· Arm and shoulder exercises to restore arm function on the affected side
· Give analgesics regularly and 30 minutes before starting exercises
Lymphedema interventions
· 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
what can be done if BRCA1 or BRCA2 mutation is present
· Prophylactic bilateral oophorectomy (removing the ovaries) and mastectomy
why does a Prophylactic bilateral oophorectomy reduce the risk
Removing the ovaries lowers the risk because ovaries are the main source of estrogen in premenopausal women
breast self examination (BSE)
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.
