AH ppt. 5 breast cancer – Flashcards
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is the key to effective treatment and survival
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early detection
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five year survival rate
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- lower for women diagnosed wit advnaced stage --98.6 for localized -83.8 when cancer has spred to regional lymph node -surival drops dramatically when it metastic/spreads
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Catagories of Breast Cancer: Noninvasive (20%)
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DCIS: cells in duct, not invated fatty breast tissue. if untreated 14-53% become invasive and spread to breast surroundings over 10 yrs. LCIS: rare; ocurs as abnml cell growt in lobules (milk producing glands); treated with close observation, women with breast cancer risk factors may consider prophylactic treatment
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Invasive (80%)
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Inflitrating ductal carcinoma -most common -orginate in mammary ducts -enedma of breast skin "peu d' orange (orange peel skin) Inflam breast cancer (IBC) -rare/agressive -swelling, redness, pain -dioagnosed at later stage -harder to treat
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breast cancer in men
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-rare, less than 1% -68 onset -sym: hard, painless, subareolar mass gynecomastia may be present -diagnosis frew delated
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breast cancer in young women
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-4.6% occur in women younger than 40 -genetic presispotion stronger factor for younger women than older -screening tools less effective cuz breast are denser
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etiology
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-older women or man high risk for -65+ -genetic factors BRCA1/2 -history of previous breast cancer -dense breasts (contain more glandular and connective tissue) -atpical hyperplasia (increased cell and organ)
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Modifiable risk factors for B.C
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-avoid weight gain/obseity -enage in acitivty -minimize alchoal
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Mammogrpahy
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-annualy 40+ -MRI for those with genetic mutations or high risk factors. -ultrasound sometimes used
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Breast self wareness/self exam
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-done in premenopausal women 1 week after their period - others, same day each month.
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Clinical Breast Exam
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performed by advance practice nurses
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options for high risk women
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-annual mommogrpahy -clincial breast exam -annual breast MRI screening -prophylactic mastectomy (preventive surgial removal of one or both brest) -prophalactic oophorectomy (removal of overies) Anti estrogen chomoprevetive drugs
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after cancer diagnosis is made ->
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posssible metases is investigated
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only definativ way to diagnose breast cancer
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breast bioposy
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Nursing diagnosis
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ineffective coping related to breast cancer diagnosis potenial for metasis of caner to other body parts
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Interventions
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-develop coping stratgies --decrease anxity --outside resources --assess need for knowledge -decrease risk for metasists --nonsurgialmanagement --therpies, chemo...pallativ care...diet...vitamins...CAm etc... 80% use some form during breast treatment
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surgical maangement - preopertive
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preopertive care -relieve anxity -provide info -increase knowlege -include spouse/partner -address body image issues before surgery
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Opertive procedures
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lumpectomy - tumor / small amt of tissue removed partial mastectomy - part tissue/breast total (simple) mastecomy - removal of entire breast modified radical mastectmy - some breast lymph nodes and part of chest wall removed.
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post op care
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-avoid using affected arm for mearuing bp, injections, drawing blood -ss of infection -wound care -drainage tube care -HOB 30 -elevate arm of affected side on a pillow while awake (promotes lympathic fluid return) -repositiong -analgsics -breast reconstruction
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Intervention- adjuvant therpay
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-stage -age -menopausal -preferncfe -patho exam -hormon recpetor status -presense of known gentic predispositon (radiation and drug)
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pt family teaching
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look at notes
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prevention of lymphedema - abnormal accumulation of protein flud in sucutatnous tissue of the affected limb after mastectomy
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-difficult to manage/ life long (can be) -sym: sensation of heaviness, aching, fatigue, numbness, tinglling, swelling of affected arm, and upper chest. -avoid bp, injection, blood drawn form site -mitt when using oven -govles in gardening -treat cuts/scrapes -elevate arm when possible -referal to specailist ma be necesary
