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Breast Disorders
N/A
48
Nursing
Undergraduate 1
07/02/2011

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Cards

Term
What is fibrocystic breast changes (FBC)?
Definition
It is a benign condition (not a disease) in which there is a bilateral increase in fibrous tissue, hyperplasia, and proliferation of mammary ducts.
Term
The 2 main features of FBC are what?
Definition
1. Fibrosis. 2. Cysts.
Term
What age group of women does FBC primarily affect?
Definition
35-50 (usually when they are still having menstrual periods).
Term
What is FBC caused by?
Definition
It is an increased response of breast parenchyma (tissue) to the hormones estrogen & progesterone.
Term
What are the chances of a cyst from FBC to turn into cancer?
Definition
Rare.
Term
Can you tell if a lump or mass in the breast is cancerous or not by feeling it?
Definition
No you can only tell by having a biopsy done.
Term
In FBC how many lumps are there usually?
Definition
By rule of thumb there is usually more than 1 lump bilaterally. However, there can be just one lump in certain cases.
Term
FBC usually occurs when there is an increase in tenderness & size prior to what?
Definition
Menstruation.
Term
The nipple discharge that occurs with FBC is usually described as what?
Definition
Milky or watery-milky.
Term
Symptoms of FBC usually increase in what phase of menstruation?
Definition
Premenstrual.
Term
What are the 8 things for collaborative care in regards to FBC?
Definition
1. Diagnostic studies.
2. Surgical removal.
3. Supportive undergarments.
4. OTC pain relievers.
5. Caffeine.
6. Vitamins.
7. Low Na+ diet or diuretics.
8. Hormones.
Term
When do you do surgical removal of FBC?
Definition
1. When the client thinks the changes are too painful.
2. If the doctor thinks the masses are too big and need to be removed.
Term
What are the best OTC meds for FBC?
Definition
1. NSAIDS are best due to its anti-inflammatory effects. 2. Acetominiphine when NSAIDS are not able to be used. *Can't use NSAIDS if patient has h/o bleeding.
Term
What is the most common malignancy in women?
Definition
Breast cancer.
Term
What are the 2 types of breast cancer?
Definition
1. Lobular.
2. Ductal.
Term
Which type of breast cancer is more common and invasive?
Definition
Ductal.
Term
Why is axillary node involvement important in terms of long term prognosis?
Definition
Because if the cancer gets into the lymphatic system its easy for it to spread and metastasize.
Term
What is the name of a aggressive type of breast cancer?
Definition
HER2/neu gene positive breast cancer.
Term
50% of breast tumors occur where in the breast and what type of tissue are they?
Definition
They occur in the upper outer quadrant and most are glandular tissue.
Term
Why is early menarche (< age 12) a risk factor for developing breast cancer?
Definition
There is a higher level of hormones of over a longer period of time therefore it increases the risk of breast cancer.
Term
What are the 10 risk factors for breast cancer that cannot change?
Definition
1. Gender.
2. Age 55 or older.
3. Inherited mutations BRCA 1 or 2.
4. Family hx.
5. Race ethnicity.
6. Dense breast tissue.
7. Previous hx of breast cancer.
8. Early menarche/late menopause.
9. Previous chest radiation.
10. DES exposure.
Term
What is the ratio of breast cancers that are invasive/aggressive after the age of 55?
Definition
2 out of 3 breast cancers are invasive/aggressive.
Term
What are the chances of getting breast/ovarian cancer if a person has a mutated BRCA 1 or 2 gene?
Definition
80% lifetime risk.
Term
In regards to family hx what is the risk of getting breast cancer with a 1st degree relative? How about two 1st degree relatives?
Definition
2x risk for 1st degree relative.
5x risk for two 1st degree relatives.
Term
What group of people are at the most risk for developing breast cancer?
Definition
Whites.
Term
What group of people are the most risk for dying from breast cancer?
Definition
Blacks.
Term
What are the 11 lifestyle risk factors for breast cancer?
Definition
1. Nulliparous or 1st child after 30 yrs of age.
2. Recent birth control pill usage.
3. Current or recent long term combined hormone replacement therapy.
4. Long term (> 10 years) estrogen only increases risk for ovarian and breast cancers.
5. Not breast feeding.
6. Alcohol.
7. Obesity.
8. Lack of physical activity.
9. High fat diet.
10. Environment.
11. Night work.
Term
What are the 10 clinical manifestations of breast cancer?
Definition
1. Single lump, mass, or mammographic abnormality.
2. Painless, hard, irregular edges > likely to be cancerous.
3. Can also be tender, soft or rounded.
4. Orange peel appearance.
5. Swelling of all or part of a breast.
6. Skin irritation or dimpling.
7. Breast or nipple pain.
8. Nipple retraction (turning inward).
9. Redness, scaliness, or thickening of nipple or breast skin.
10. A discharge other than breast milk, e.g., clear or bloody.
Term
The diagnostic studies used in breast cancer are the same ones used in what?
Definition
Same as the ones used in fibrocystic breast disease.
Term
What is axillary lymph node dissection?
Definition
All of the lymph nodes in that area are removed.
Term
What is sentinel lymph node dissection?
Definition
A dye is used before surgery to determine where the tumor is and then it is checked to see if there is anything abnormal and if there is only those nodes are taken out.
Term
The larger the breast tumor, the poorer the what?
Definition
Prognosis.
Term
What is the usual treatment for breast cancer?
Definition
Surgery.
Term
What are the 2 types of surgical therapy for breast cancer?
Definition
1. Lumpectomy.
2. Modified radical mastectomy.
Term
When surgical therapy is used for breast cancer why is a drainage system such as Jackson-Pratt used?
Definition
To remove excess fluid/swelling.
Term
Do most women have radical mastectomy?
Definition
No they usually opt for simple mastectomy or some other treatment.
Term
What is lumpectomy?
Definition
It is a surgical therapy for breast cancer that:
1. Conserves the breast, nipple.
2. Removes tumor with small amounts of normal tissue.
3. Radiation is used post removal.
4. ALND or SLND used depending on the condition.
Term
What is modified radical mastectomy?
Definition
It is removal of breast & axillary nodes but conserves the pectoralis muscle.
Term
What 4 ways can radiation therapy be used to treat breast cancer?
Definition
It can be used as:
1. Primary treatment (5-6 weeks).
2. To shrink the tumor size to operable size.
3. Palliative tx for pain where the tumor is shrunken to a smaller size which reduces pain and increases comfort level.
4. Brachytherapy where radiation seeds are planted inside breast.
Term
What is used in chemotherapy?
Definition
Cytotoxic drugs which destroy cancer cells.
Term
How is chemotherapy administered in breast cancer?
Definition
It is administered pre & post-op:
1. In pre-op it used as a neoadjuvant where it used to shrink the tumor to operable size.
2. In post-op it is used as an adjuvant to kill all the remaining cancer cells.
Term
What are the 6 collaborative cares used for breast cancer?
Definition
1. Diagnostic studies.
2. Surgical therapy.
3. Radiation therapy.
4. Chemotherapy.
5. Prophylactic oophorectomy.
6. Hormonal therapy.
Term
What is prophylactic oophorectomy and when do you do it?
Definition
It is the removal of the ovaries to prevent cancer and it is used when a woman has BRCA gene mutation which puts the person at high risk of developing breast and ovarian cancer.
Term
What drug is used in hormonal therapy of breast cancer and what does it do?
Definition
Tamoxifen citrate (Novaldex) it blocks estrogen and puts women in a post menopausal state.
Term
What are the side effects of Tamoxifen citrate (Novaldex)?
Definition
Hot flashes, nausea, vomiting, blood clots, and endometrial cancer.
Term
What are 3 nursing diagnoses for breast cancer?
Definition
1. Anxiety.
2. Ineffective coping.
3. Disturbed body image.
Term
What are 2 collaborative problems for breast cancer?
Definition
1. Potential for metastasis.
2. Potential for lymphedema.
Term
What are the 8 post op nursing managments for breast cancer?
Definition
1. LOC, V/S.
2. Bleeding (dsg, drains).
3. Infection.
4. Avoid checking BP, giving injections and phlebotomy on affected arm.
5. Ambulation & diet.
6. Postmastectomy exercises.
7. Breast reconstruction.
8. Adjuvant therapy.
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