Flashcards
Breast Disorders
Cards in this deck (19)
- 1What is the development of excess fibrous tissue (commonly) benign and not cancerous, has a heightened response to estrogen and progesterone with hyperplasia of the endothelia lining of the mammary gland?Fibrocystic breast disease
- 2What are some clinical manifestations of fibrocystic breast disease?1). Palpable lumps that are round, well defined and move freely
2) found throughout the breast
3) tenderness or pain with palpation
4) lumps usually increase with size and tenderness during premenstrual time
5) rare but might have nipple discharge - 3How do you diagnose fibrocystic breast disease?1) biopsy with fine needle aspiration
2) US is preferred over mammogram to diagnose fibrocystic changes due to younger women having denser breast tissue. - 4What to teach the fibrocystic breast disease patient?1) regular breast examinations are needed after menses to avoid discomfort
2) if a women no longer has a period then use the first of the month.
3) * you can expect reoccurrence of a cyst in one or both breasts until menopause - 5What is the priority of care in fibrocystic breast disease patient?1) report any lumps that do not respond clinically to period cycle
2) Reassure, "cysts do not turn into cancer" - 6This breast disorder has a 1 in 8 chance of being diagnosed and is one of the most common forms of malignancy in the US?BREAST CANCER
- 7Who is at risk for breast cancer?1) 99% females
2) > 60 years
3) used hormone replacement therapy for menopause
4) family hx of early period start before age 12
5) late menopause >55
6) null parity or fancy for never pregnant
7) #1 child was after age 30
8) obese (fat cells store more estrogen)
9) exposed to ionized radiation which damages cells (tanning beds?) - 8This type of breast cancer is 20% of breast cancer that is in-situ ( stays in its place) and does not spread?Non-invasive cancer
- 9This type of cancer is 80% of breast cancers that start out in the milk duct then go to the breast wall and then spread?invasive ductal carcinoma
- 10This type of breast cancer is 10-15% of the invasive type cancers but instead of starting out in the milk duct they start in the lobules of the breast?Invasive lobular carcinoma
- 11What are the clinical manifestations of breast cancer?1) most often occur in upper quadrant of the breast because this is the location of most of the glandular tissue
2) is detected as a lump abnormality on the mammography
3) is going to be able to be felt as a hard irregular poorly delineated nonmoving not tender at all but hard nodule. nipple discharge again super rare
4) nipple retraction or peau d'orange skin manifestation - 12What tests diagnose/detect breast cancer?1) #1 digital mammography in a younger woman, regular mammography in the older gal
2) If they find a mass after mammo then they grab the US
3) High risk pop. gets an MRI
4) The biopsy is the definitive to determine which cancer you have
5) DNA testing for BRCA-1 & 2 mutations increase your risk of developing breast or ovarian cx by 40%
6) SLNB Sentinel lymph Node Biopsy helps the surgeon identify lymph nodes that the tumor site drains into first sentinel lymph nodes radioisotope and or/blue dye is injected into tumor site and drains into SLN's. - 13What treatment to we provide for breast cancer?1). We stage the cancer first to determine the treatment:
2) Then the TNM system is used to determine the TUMOR SIZE, NODULE involvement, and Metastasis (0-4)
3) breast conservation therapy (lumpectomy) with radiation involvement to avoid risk of reoccurrence.
4) mastectomy with or without reconstruction is total or simple
5) a type of modified radical mastectomy:
6) with radiation therapy externally and then a primary tx to prevent local & lymph recurrences after sx
7) Internal radiation brachytherapy is delivered directly to boob
8) Palliative radiation is used to shrink (not cure) metastatic lesion in sites such as bone, soft tissue organs, brain, or chest
9) chemo-is cytotoxic drug used to destroy cx cell can be used pre or post op
10) hormonal therapy estrogen receptor blocker tamoxifen/Nova
11) Aromatase inhibitor Anastrozole/femara an enzyme needed for synthesis of estrogen - 14What teaching can be applied to a patient with breast cancer?1) BSE should be done monthly when the breasts are not tender right after menses
2) when doing breast conservation-it is a removal of tumor and the surrounding tissue.
3) When doing a mastectomy-it is a removal of entire breast tissue and DOES NOT REMOVE axilla nodes or pectoralis muscle
4) modified radical mastectomy-it is a removal of breast, axilla nodes, & DOES NOT remove pectoralis muscle
5) radiation therapy external-primary lesions are radiated 5 days/week over 5-7 weeks
6) brachytherapy tx only takes 5 days because it is concentrated and focused
7) palliative radiation therapy-is successful in controlling recurrent or mets, prolongs life, & relieves pain
8) estrogen therapy-means less estrogen avail for tumor=tumor regression=SE of hot flashes, mood swings, vaginal discharge, or dryness, decreased visual acuity, & blood clots - 15What is the priority care for patients with breast cancer?1) The radiation SE's: 24 hr after tx is fatigue, skin changes, & breast swell so keep boob dry
2) chemo drug SE's: N/V/Anorexia, Anemia, Hair loss, difficulty concentrating & focusing, "chemobrain"
3) Assist to develop a + but realistic attitude to help identify sources of support & strength
4) tissue expander-goes in place after mastecto-fill w/ water weekly to stretch the skin and muscles, fitting usually takes 5-8 weeks. - 16The patient will have unilateral swelling of the arm/hand due to damaged lymph nodes and complications?lymphedema
- 17What are the clinical manifestations of lymphedema?1) Impaired motor fx
2) numbness
3) paresthesia of the fingers
4) slow wound healing
5) cellulitis - 18What is the teaching for the patient with lymphedema?1) Hug deal is positioning the affected arm elevated
2) exercise by flexing and extending fingers ASAP
3) massage
4) decongestive therapy with lymphedema therapist
5) compression with compression sleeves during waking hours - 19What is the teaching for the patient with lymphedema?1) on affected side No blood pressure readings, venipuncture, injections, avoid insect bites, use bug repellent spray, avoid burns, use a cooking mitt, avoid cuts, avoid cutting cuticles, use electric razor to shave axilla, no heavy lifting, and NO SUN exposure.
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