question

signs and symptoms (4)

answer

lump anywhere in breast (usually in upper outer quadrant), usually nontender, fixed, hard with irregular borders (advanced signs- skin dimpling, nipple retraction, skin ulceration)

question

dx tests (9)

answer

biopsy, tumor staging, TNM (tumor, nodes, metastasis), xray, ct, mri, pet, bone scans, blood work

question

most important prognosis are ____ ____ and whether the tumor has _____ to lymph nodes under the arm

answer

tumor size and spread

question

most common route of spread

answer

axillary nodes

question

potential complication- infection of breast cancer surgery (5)

answer

higher in diabetes, immune disorders, advanced age, poor hygiene, foul smelling discharge

question

potential complication- lymphedema

answer

chronic swelling of extremity due to interrupted lymph circulation

question

s/s of lymphedema (5)

answer

affects both breasts and ipsilateral limbs, painful swelling, weakness, shoulder pain, tingling sensation in arms and shoulders

question

lymphedema tx (7)

answer

exercises, elevate arm above head, gentle muscle pumping, antibiotics, rehab, compression sleeve/glove, manual lymph draining

question

potential complication- hematoma or seroma formation

answer

swelling, tightness, pain, bruising- call dr

question

tx for hematoma/seroma formation

answer

compression for 12 hours, return to or and identify source of bleeding, warm showers, warm compresses

question

potential complication- seroma w/ s/s

answer

collection of serous fluid under breast incision- swelling, heaviness, discomfort, sloshing of fluid, temp when drain is removed

question

risk factors (7)

answer

increased age, personal/family hx, genetic- brca1 and 2, obesity, hight fat diet, alcohol, hx of benign proliferative breast disease

question

hormonal risk factors (6)

answer

early menarche (before 12yr), late menopause (after 55), nulliparity (no fullterm pregnancies), late age at 1st full term pregnancy (after 30yrs), hormone therapy (long term use)

question

teaching (9)

answer

BSE (breast self exam) preop education, reduce fear, anxiety, coping, post op- relieve pain, promote body image, coping, improve sexual function

question

pt hand adn arm care after axillary lymph dissection

answer

avoid bp, injections, and blood draws in affected extremity, avoid lifter more than 5-10lb

question

if immediate reconstruction

answer

shower is contraindicated until drain removed, decreased sensation, heal in 4-6 weeks

question

assessments (13)

answer

health/family hx, previous surgeries, meds, use of hormonal contraceptives, fertility tx, social habits, marital status, occupation, resources/support, palpable masses, swelling, redness, nipple discharge

question

prevention strategies- long term surveillance (3)

answer

focus on early detection, additional screening w/ mri and yearly mammogram, breast exams 2x/yr starting at 25

question

prevention strategies- chemoprevention

answer

main modality that aims to prevent disease- tamoxifen and raloxifene

question

prevention strategies- prophylactic mastectomy

answer

can reduce risk by 90%, total mastectomy, extensive counseling before

question

hematopoietic growth factors

answer

minimize effects of chemo induced neutropenia and anemia

question

hematopoietic growth factors short acting

answer

filgrastim (neupgen) 7-10 days after chemo epoetin/epogen- weekly

question

hematopoietic growth factors long acting

answer

pegilgrastim (neulast) once no earlier than 24 hours after chemo

question

treatments- modified radical mastectomy (4)

answer

invasive breast cancer, removal of breast tissue, nipple areola complex, and axillary nodes

question

tx- total mastecotmy

answer

removal of breast and nipple, arreola complex, does not include alnd, performed in pts with noninvasive breast cancer, prophylactically

question

tx- axillary lymph node dissection (alnd)

answer

prognostic procedure performed to determine if chemo is indicated, helps prevent metastasis, but not the reason it is performed**

question

tx- sentinel lymph node biopsy (slnb)

answer

1st node that receives drainage from primary tumor, setn to lab, if + surgeon procedes with alnd

question

tx- radiation

answer

s/e management- mild soap w/ minimal rubbing, avoid perfumed soaps and deodorants, use hydrophilic lotions, nondrying antipruritc soap, avoid tight clothes, underwire bras, excessive temps, uv lights

question

tx- chemo

answer

s/e management- ease mucositis, rinse w/ ns and sodium bicarb, avoid hot and spicy foods, use soft toothbrush

question

tx- SERM tamifoxen

answer

tx of premenopausal breast cancer, estrogen antagonist, may lead to high risk of endometrial cancer and thromboembolic events

question

s/e's of SERM tamifoxen

answer

hot flashes, vaginal dryness/discharge/bleeding, irregular menses, nausea, mood disturbances, rashes; increased risk for endometrial cancer and thromboembolic events

question

tx- aromatase inhibitors

answer

anastrozole, letrozole, exemestane- manage post menopausal women- decreases estrogen, SUPERIOR TO TAMIFOXEN

question

tx- targeted therapy- trastuzumab (herceptin)

answer

slows tumor growth, spares normal cells and limits adverse reactions (fever, chills, n/v/d, h/a)

question

tx- hormonal therapy

answer

estrogen and progesterone receptor assay- test to determine whether the breast is nourished

question

tx- erythropoietin

answer

increased rbcs, epoetin, epogen

question

contraindications of surgery and radiation

answer

first/second trimester of pregnancy, presence of multicentric disease in breast, prior radiation to the breast or chest region, large tumor to breast ratio, tumor beneath nipple

question

managing s/e of hot flashes (6)

answer

breathable layered clothing, avoid caffeine/spicy food, breathing exercises, vit. e, antidepressants, tylenol

question

managing s/e of vaginal dryness (2)

answer

vag moisturizers (replens, vit. e), apply vaginal lube during sex

question

managing s/e of n/v (2)

answer

bland nutritional diet, take meds in evening

question

managing s/e of musculoskeletal system (2)

answer

take nsaids, warm sitz

question

managing s/e of risk for endometrial cancer (2)

answer

report any irregular bleeding to gynocologic for evaluation, report- redness, swelling, tenderness in lower extremities, or any unexplained sob

question

managing s/e of risk for osteoporosis or fractures (4)

answer

undergo baseline bone density scan, perform regular wt bearing exercises, take ca and vit.d, take bisphophonate (alendronate/calcitonin)

breast cancer- concept map/blueprint – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards