Breast Cancer Flashcards Preview

Med/Surg 1 Exam 2 > Breast Cancer > Flashcards

Flashcards in Breast Cancer Deck (63):
1

Statistics of breast cancer and prevalence?

- More than 200,000 diagnosed with breast cancer every year
- Prevalent among white women
- Primarily among older women
- 2nd most common occurring cancer in women

2

How is breast cancer classified?

Noninvasive (in situ)
Invasive (invades surrounding tissue)

3

What is breast cancer?

Unregulated growth of abnormal cells in the breast tissue

4

How does breast cancer begin?

Begins as a single transformed cell and is often hormone dependent

5

What are the different categorization of breast cancer?

- Carcinoma of the mammary ducts
- Carcinoma of the mammary lobules
- Sarcoma of the breast

6

What is the most common type of carcinoma of the mammary ducts?

Infiltrating ductal carcinoma

7

What are the three receptors known to fuel most breast cancers?

- Estrogen
- Progesterone
- Human Epidermal Growth Factor Receptor 2 (HER2)

8

What is triple negative breast cancer?

A type of breast cancer that is negative to all three receptors that are usually the fuel to most breast cancers

9

What type of treatment is triple negative breast cancer most responsive to ?

Chemotherapy

10

What are the Atypical types of breast cancer?

Paget's disease
Inflammatory carcinoma

11

What is Paget's disease?

Rare breast malignancy found in the areola
Most commonly in women
Tumors within the same breast are often found

12

What are symptoms of pagets disease?

Itching, tingling, or redness of areola
Discharge of yellowish/bloody
Flaking, crusty, or thickened of skin around nipple
Flattened of nipple

13

What is inflammatory carcinoma?

Most malignant form of breast cancer
Aggressive and fast growing
High risk for metastasis
Peau d'orange (plugging of the dermal lymphatics)

14

Cancer growth can be from what?

Slow to rapid

15

What are some of the factors that can affect prognosis?

Tumor size
Axillary node involvement
Tumor differentiation
Estrogen and progesterone receptor status
HER2 status

16

Which receptor helps regulate cell growth?

HER-2

17

What are some possible causes of breast cancer?

Environmental
Hormonal
Reproductive
Hereditary

18

What are the breast cancer susceptibility genes?

BRCA1
BRCA2

19

Which gene is responsible for 10% of women with hereditary breast cancer with genetic mutations causing up to 80% in women

BRCA2

20

What are some risk factors of breast cancer?

Gender- women
Age
Family history (breast cancer- 1 degree)
Personal history (breast cancer)
Previous chest irradiation
Menstrual history (early menarche, late menpause)
Life style

21

What is included in lifestyle risk factors?

Oral contraceptives
Not having children
Having children after age of 30
Hormone replacement therapy (for more than 5 years)
Alcohol
Not breastfeeding
Obesity
High-fat diets
Physical inactivity

22

What are predisposing risks in men?

States of hyperestrogenism
Family Hx of breast cancer
Radiation exposure

23

What should be enforced as to prevention of breast cancer?

Monthly self breast exams
Routine screenings for genetic abnormalities

24

Early detection helps with what?

Reduce mortality
Promote positive outcomes

25

What does a "lump" feel like?

Hard
Irregularly shaped
Poorly delineated
Non mobile
Non tender

26

Where does breast cancer often occur within the breast?

Upper outer quadrant (location of most glandular tissue)

27

What can women with BRCA1 or BRCA2 mutations do as part of prevention?

Prophylactic bilateral oophorectomy (decrease breast and ovarian cancer)
Prophylactic bilateral mastectomy (reduce risk of breast cancer by 90%)

28

What are some of the diagnostic tests performed for breast cancer?

Mammography
Aspiration biopsy
Excisional biopsy

29

When does ACS recommend getting mammograms?

Annually at age 40
Every 3yrs for women in 20s and 30s

30

When should an aspiration biopsy be done?
And what sample is taken?

With a cystic mass or fibrocystic changes

Fluid or tissue

31

When should an excisional biopsy be done?
And what sample is taken?

Suspicious lump is identified

Tissue

32

What are tumor markers?

Protein molecules detected in serum or other body fluids

33

What are some types of tumor markers?

CEA
HER1
HER2
EGFR
CA-15-3
CA-27-29

34

What are some types of treatment for breast cancer?

Surgery
Radiation
Chemotherapy
Targeted therapy
Hormone therapy

35

What types of surgery are available for breast cancer?

Segmental
Simple
Modified radical
Radical

36

What is a segmental mastectomy?

Lumpectomy
'Breast-sparing'
Removal of breast cancer and normal, healthy tissue surrounding it

37

What is a simple mastectomy?

Removal of breast tissue, nipple, areola, and skin but not all lymph nodes

38

What is a modified radical mastectomy?

Removal of all entire breast
Tissue, nipple, areola, and most of axillary lymph nodes

39

What is a radical mastectomy?

Removal of breast tissue, along with chest muscle and axilla lymph nodes

40

What is part of breast conservation therapy?

Lumpectomy
Radiation therapy

41

When is a segmental mastectomy an option?

For tumors for 4-5 cm

42

What is an advantage of breast-conservation therapy?

Maximize benefits of both cancer treatments and cosmetic outcome while minimizing risks

43

What is a disadvantage of breast-conservation therapy?

Increased cost of surgery and radiation possible side effects of radiation

44

What are some types of breast reconstruction?

Breast implants and tissue expansion
Musculocutaneous flap procedure
Nipple-areolar reconstruction

45

What are the indications of breast reconstructions?

Improve self image
Regain a sense of normalcy
Assist in coping with the loss of a breast

46

What remains a powerful prognostic factor of breast cancer?

The presence or absence of malignant cells in lymph nodes

47

What is the advantage of immediate reconstruction?

One surgery
One anesthesia
One recovery period
Before the development of scar tissue or adhesions

48

What is the standard of care for the majority of breast cancer cases with axillary lymph node involvement?

Chemotherapy

49

What are the benefits of chemotherapy and other pharmacologic agents?

Reduces the rate of reoccurrence and the death rate

50

What is letrazole?

Aromatase inhibitor
Reduces risk of recurrence after surgery

51

What is bevacizumab?

Combined with chemotherapy has extended cancer free survival for meta cancer patients

52

What is radiation therapy used for?

Examples

Usually follows surgery to kill any cells that could cause recurrence or metastasis
- Shrink the tumor before surgery
- Palliative radiation

External beam
High dose brachytherapy

53

What is intraoperative radiotherapy?

Probe inserted into the cavity created by a lumpectomy
Radiation equivalent to 6 weeks of doses is given in 25mins

54

What are some complications of breast cancer?

Local recurrence (skin and chest wall)
Regional recurrence (Lymph nodes)
Distant metastasis
- (Skeletal-bone, spinal cord, brain, pulmonary, liver, bone marrow)

55

An example of hormone therapy for breast cancer?

Tamoxifen Citrate
-Selective estrogen receptor modulator (SERM)

56

What is the purpose of Tamoxifen Citrate?

- Prevents estrogen from attaching to estrogen receptors on the cancer cells
- Inhibits tumor growth and ultimately kills tumor cells

57

When is Tamoxifen Citrate used ?

Treat advanced breast cancer
Adjuvant for early stage breast cancer
Preventative treatment in women at high risk for developing breast cancer

58

What is targeted therapy used for?

To counteract specific genetic mutations that promote cancer growth

59

What is Trastuzumab?
What is it used for?

Used to stop the growth of breast tumors that express the HER2/ neu receptor (which binds an epidermal growth factor that contributes to cancer cell growth) on their cell surface

- This drug is a recombinant DNA-derived monoclonal antibody that binds to the receptor, inhibiting tumor cell proliferation

60

What is lymphedema?

Accumulation of lymph in the soft tissues

61

S/S of lymphedema?

- Pain
- Heaviness and impaired motor function in the affected arm
- Numbness and paresthesia of the fingers
- Cellulitis

62

What are the intervention measures for lymphedema ?

- Administration of analgesics to minimize post-op pain and allow for exercise
- Teach measures to prevent lymphedema
- Procedures should not be done on affected side
- Protect from infection
- lymph drainage is altered

63

What should be part of the nurse planning ?

- Client will make informed treatment decisions
- Client will express feelings regarding diagnosis, treatment and prognosis
- Family and significant others will provide appropriate support for client
- Accurate and complete answers
- Open communication