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UM - Integumentary > Breast Cancer > Flashcards

Breast Cancer Flashcards

(51 cards)

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1
Q

What type of tumor accounts for 85% of all cancers

A

Carcinoma

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2
Q

What is the most common invasive breast cancer?

A

Invasive Ductal

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3
Q

What is the most aggressive type of breast cancer?

A

inflammatory

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4
Q

What are the primary ways cancer can spread?

A
  • blood
  • lymph
  • direct extension
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5
Q

Differentiate T1-T4 for the TNM Staging System

A

T1: <= 2 cm
T2: 2-5 cm
T3: > 5 cm
T4: Direct extension into the chest wall and/or skin

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6
Q

Differentiate N1-N3 for the TNM Staging System

A

N1: metastasis to ipsi, movable, axillary LN
N2: metastasis to ipsi fixed axillary or IM LNs
N3: Metastasis to infraclavicular/supraclavicular LN or to axillary and IM LNs

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7
Q

What is a PET Scan

A

a computerized radiographic technique that employs radioactive substances to examine the metabolic activity of body structures

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8
Q

List the types of biopsy

A
  • fine needle aspiration
  • incisional biopsy
  • excisional biopsy
  • stereotactic biopsy
  • sentinel lymph node biopsy
  • axillary dissection
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9
Q

What is a fine needle aspiration?

A

Dx procedure where a thin, hollow needle is inserted into a mass to extract cells - the most common initial dx for breast cancer

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10
Q

What is an incisional vs excisional biopsy

A

Incisional is just a section of tumor is removed (Not common breast cancer) vs excisional is the whole thing

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11
Q

What is a stereotactic biopsy?

A

Procedure that uses a computer and imaging performed in at least two planes to localize a tumor in 3-D space and guide the removal of tissue

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12
Q

what is a sentinel lymph node biopsy?

A

Finding the first node that drains the tumor bed via blue dye and completing a biopsy to see if it has spread to the lymph nodes or not

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13
Q

What is an axillary dissection

A

Removal of level I and II LN - typically 10-20 nodes

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14
Q

What is a lumpectomy?

A

Removal of a tumor and clean margin to conserve some breast tissue

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15
Q

What is a mastectomy?

A
  • removal of all breast tissue and possibly the fascia over the chest muscle
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16
Q

What are the two types of muscle-flap reconstruction surgeries?

A
  • Latissimus + Implant (not done often)
  • Transverse Rectus Abdominus Myocutaneous
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17
Q

What are the post-sx precautions/contraindications

A
  • Surgical drains: no flexion/abd over 90 degrees
  • open incisions
  • seroma: a pocket of clear serous fluid that occurs 30-90% of the time post breast cancer sx
  • undiagnosed swelling
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18
Q

What are dysfunctions commonly seen post breast cancer sx

A
  • postural changes (scap retraction & elevation, winging, & fwd head posture)
  • pain
  • postoperative vascular and pulmonary complications
  • swelling
  • ST restrictions
  • dec ROM and strength
  • loss of function
  • increased risk for infections and lymphedema
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19
Q

When is radiation done for breast cancer?

A
  • almost all lumpectomies & some mastectomies
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20
Q

T or F: Only the tumor site is radiated w/breast cancer

A

FALSE - the entire chest wall is radiated, just at an angle to try and be direct

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21
Q

Side effects of radiation?

Study These Flashcards
A
  • fatigue
  • dec RBC, WBC, and Platelets
  • N/V
  • Skin changes (burns, cording)
  • fibrosis (6-36 mo post)
  • increased risk for lymphedema
22
Q

When is it appropriate to do manual therapy to the incisional site if pt has had radiation?

Study These Flashcards
A

first 2-3 weeks before skin changes occur and then following radiation when skin returns to normal

23
Q

How do you manage fibrosis post radiation?

Study These Flashcards
A
  • Deep tissue work/MFR in subacute state of healing
  • manual stretching
  • manual lymphatic drainage
  • maintenance of ROM
24
Q

Importance of scar tissue mgt post sx

Study These Flashcards
A
  • improved lymph circulation
  • improved UE & trunk ROM
  • improved cosmesis
  • desensitization
  • prevent adhesion of tissue
25
Side effects of chemo
- fatigue - dec WBC - hair loss - N/V - neuropathies - pulm fibrosis - renal dysfunct - arrythmias or ataxia
26
T or F: Hormonal therapy is a short term treatment
False - it is usually done for a long period of time (ex 5 years) to help prevent recurrence of cancer
27
What is the goal of PT during chemo?
- minimize fatigue - maintain weight & mm - independent strength & flexibility program - avg 20 mins aerobic exercise 3-5x a week - promote sense of active role in recovery
28
Chemo exercise contra/precautions
- first 24 hrs post chemo - fever - infection - severe fatigue - low blood counts
29
List the 7 breast cancer shoulder impairment syndromes
- neuromuscular coordination syndrome - pain syndrome - muscular force production syndrome - peripheral neuropathic syndrome - myofascial restriction syndrome - glenohumeral capsular restriction syndrome - lymphedema syndrome
30
What is neuromuscular coordination syndrome
- poor quality of movement in the absence of joint or peri-articular restrictions from disuse or nonuse - full PROM
31
What is pain syndrome
- primary limiting factor is the presence of pain upon movement - resting pain, empty end feel, pain t/o & @ end ROM, dec AROM and full PROM - perceived mm weakness
32
What is muscular force production syndrome
- presents w/AROM < PROM (normal + NORMAL EF) & no observable atrophy - diminished MMT strength but good contractility
33
What is peripheral neuropathic syndrome
- of one or several nn that innervate the mm of the shoulder joint complex - <2/5 strength w/poor contractility - mm atrophy and jt deformity - AROM < PROM
34
What is myofascial restriction syndrome?
- ST fibrosis, mm trigger points, or axillary web syndrome - AROM = PROM - palpable fibrosis - "cording"
35
What is glenohumeral capsular restriction syndrome
- limits in ROM w/ significant limits in accessory mvmts - Capsular end feel + capsular pattern - isolated GH limitations & poor SH rhythm
36
What is lymphedema syndrome
- pain upon movement or due to the appreciable increased weight of the limb
37
What is axillary web syndrome?
- Set of tense cords (nerves & LN) that are palpable/visible under the skin as a direct result of sx from breast cancer - limited shoulder abduction ROM
38
Risk factors for developing axillary web syndrome?
- age - extent of sx - lymph node involvement - complications during healing - lower BMI
39
Impairments/Limitations w/AWS
- pain - visible/palpable cords - loss of shldr and elbow ROM - dec arm strength & function - dec ADLs, vocational & social function
40
Cording interventions
- stretches - skin traction - STM - ROM - Strengthening - MFR - Cardiopulmonary
41
What interventions are used for neuromuscular coordination syndrome?
- neuro reed w/tactile and verbal cues, repetition & full & partial task practice
42
What interventions are used for pain syndrome
- modalities (NOT US) - meds
43
What interventions are used for muscular force production syndrome
- strengthening regimen - inc muscular force prod - restore length-tension rlns
44
What interventions are used for peripheral neuropathic syndrome
- monitor reinnervation - reduce postural effects - protect jts - bracing & splinting
45
What interventions are used for myofascial restriction syndrome
- myofascial stretching - home stretching - TPR - scar massage
46
What interventions are used for glenohumeral capsular restriction syndrome
joint mobs
47
What interventions are used for lymphedema syndrome
- complete decongestive therapy - vasopneumatic pumping
48
T or F: PT cannot help with the complications post breast cancer
False - PT can treat all complications (reduced function & ROM, pain, lymphedema, AWS) to improve function and QOL
49
What is a significant difference for lymphedema measures?
> 10 % diff in volume, > 200 mL diff in volume, or > 2cm
50
If PROM > AROM.... If PROM = AROM ...
PROM > : Syndrome (neuromuscular coordination, pain, muscular force production, or peripheral neuropathic) PROM = : Lymphedema, Myofascial restriction, or Glenohumeral capsular restriction
51
Pt education to avoid blocking the flow of fluids through the body
- don't cross legs - change positions every 30 mins in sitting - don't carry handbags or use a BP cuff on arm w/lymphedema - avoid extremes of heat - try and maintain a normal weight for your height

UM - Integumentary (6 decks)

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