Term
| What is fibrocystic breast changes (FBC)? |
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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. |
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Term
| The 2 main features of FBC are what? |
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Definition
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Term
| What age group of women does FBC primarily affect? |
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Definition
| 35-50 (usually when they are still having menstrual periods). |
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Term
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Definition
| It is an increased response of breast parenchyma (tissue) to the hormones estrogen & progesterone. |
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Term
| What are the chances of a cyst from FBC to turn into cancer? |
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Definition
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Term
| Can you tell if a lump or mass in the breast is cancerous or not by feeling it? |
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Definition
| No you can only tell by having a biopsy done. |
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Term
| In FBC how many lumps are there usually? |
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Definition
| By rule of thumb there is usually more than 1 lump bilaterally. However, there can be just one lump in certain cases. |
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Term
| FBC usually occurs when there is an increase in tenderness & size prior to what? |
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Definition
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Term
| The nipple discharge that occurs with FBC is usually described as what? |
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Definition
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Term
| Symptoms of FBC usually increase in what phase of menstruation? |
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Definition
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Term
| What are the 8 things for collaborative care in regards to FBC? |
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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. |
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Term
| When do you do surgical removal of FBC? |
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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. |
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Term
| What are the best OTC meds for FBC? |
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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. |
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Term
| What is the most common malignancy in women? |
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Definition
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Term
| What are the 2 types of breast cancer? |
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Definition
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Term
| Which type of breast cancer is more common and invasive? |
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Definition
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Term
| Why is axillary node involvement important in terms of long term prognosis? |
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Definition
| Because if the cancer gets into the lymphatic system its easy for it to spread and metastasize. |
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Term
| What is the name of a aggressive type of breast cancer? |
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Definition
| HER2/neu gene positive breast cancer. |
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Term
| 50% of breast tumors occur where in the breast and what type of tissue are they? |
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Definition
| They occur in the upper outer quadrant and most are glandular tissue. |
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Term
| Why is early menarche (< age 12) a risk factor for developing breast cancer? |
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Definition
| There is a higher level of hormones of over a longer period of time therefore it increases the risk of breast cancer. |
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Term
| What are the 10 risk factors for breast cancer that cannot change? |
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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. |
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Term
| What is the ratio of breast cancers that are invasive/aggressive after the age of 55? |
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Definition
| 2 out of 3 breast cancers are invasive/aggressive. |
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Term
| What are the chances of getting breast/ovarian cancer if a person has a mutated BRCA 1 or 2 gene? |
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Definition
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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? |
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Definition
2x risk for 1st degree relative.
5x risk for two 1st degree relatives. |
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Term
| What group of people are at the most risk for developing breast cancer? |
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Definition
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Term
| What group of people are the most risk for dying from breast cancer? |
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Definition
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Term
| What are the 11 lifestyle risk factors for breast cancer? |
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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. |
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Term
| What are the 10 clinical manifestations of breast cancer? |
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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. |
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Term
| The diagnostic studies used in breast cancer are the same ones used in what? |
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Definition
| Same as the ones used in fibrocystic breast disease. |
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Term
| What is axillary lymph node dissection? |
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Definition
| All of the lymph nodes in that area are removed. |
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Term
| What is sentinel lymph node dissection? |
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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. |
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Term
| The larger the breast tumor, the poorer the what? |
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Definition
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Term
| What is the usual treatment for breast cancer? |
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Definition
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Term
| What are the 2 types of surgical therapy for breast cancer? |
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Definition
1. Lumpectomy.
2. Modified radical mastectomy. |
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Term
| When surgical therapy is used for breast cancer why is a drainage system such as Jackson-Pratt used? |
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Definition
| To remove excess fluid/swelling. |
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Term
| Do most women have radical mastectomy? |
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Definition
| No they usually opt for simple mastectomy or some other treatment. |
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Term
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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. |
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Term
| What is modified radical mastectomy? |
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Definition
| It is removal of breast & axillary nodes but conserves the pectoralis muscle. |
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Term
| What 4 ways can radiation therapy be used to treat breast cancer? |
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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. |
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Term
| What is used in chemotherapy? |
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Definition
| Cytotoxic drugs which destroy cancer cells. |
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Term
| How is chemotherapy administered in breast cancer? |
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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. |
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Term
| What are the 6 collaborative cares used for breast cancer? |
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Definition
1. Diagnostic studies.
2. Surgical therapy.
3. Radiation therapy.
4. Chemotherapy.
5. Prophylactic oophorectomy.
6. Hormonal therapy. |
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Term
| What is prophylactic oophorectomy and when do you do it? |
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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. |
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Term
| What drug is used in hormonal therapy of breast cancer and what does it do? |
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Definition
| Tamoxifen citrate (Novaldex) it blocks estrogen and puts women in a post menopausal state. |
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Term
| What are the side effects of Tamoxifen citrate (Novaldex)? |
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Definition
| Hot flashes, nausea, vomiting, blood clots, and endometrial cancer. |
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Term
| What are 3 nursing diagnoses for breast cancer? |
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Definition
1. Anxiety.
2. Ineffective coping.
3. Disturbed body image. |
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Term
| What are 2 collaborative problems for breast cancer? |
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Definition
1. Potential for metastasis.
2. Potential for lymphedema. |
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Term
| What are the 8 post op nursing managments for breast cancer? |
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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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