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Flashcards in Breast Disorders Deck (18):
1

Breast Disorders

- Affect both men and women
- Most lumps are benign
- May have affects on one’s self esteem and body image awareness
- Can occur at any age

2

Benign Breast Disorders

1. Fibroadenoma (most common): younger women and adolescents - MASS OF CONNECTIVE TISSUE - movable tumor.
2. Fibrocystic breast disease (FBD): involves lobules, ducts; tender breasts, pain; CYSTS ( drain fluid out of cyst); supportive bra to reduce discomfort.
3. Ductul ectasia: blockage of ducts : discharge (greenish brown fluid ) from nipple , edema, redness - infectious process; analyze discharge from fluid
4. Intraductal ectasia: papiloma (NOT PALPABLE mass)- discharge

3

Gynecomastia

“female breasts”;Benign
Caused by:
1. abnormal growth of the glandular tissue
2. Corticosteroids; medications
3. Aging
4. Obesity
5. Excess estrogen
6. Alcoholism

4

Breast Cancer

Most commonly diagnosed
2nd highest cause of death by cancer
The earlier it’s found, the better chances for survival
Characterized by one abnormal cell which replicates
Invasive or noninvasive

5

Noninvasive Breast Cancer

• Cancer cells remain within the duct
• Not yet harmful to client
• Can lead to invasive breast CA if not treated
- Ductal carcinoma in situ (DCIS)
- Lobular carcinoma in situ (LCIS)

6

Invasive Breast Cancer

Infiltrating ductal carcinoma
 Most common
 Starts in the duct, spreads to breast tissue
 Palpable lesion, irregular pattern
 Tumor grows fibrosis develops enters lymphatic channelsblockage occurs (edema, redness, warmth)
 Cancer metastasizes
S/s: Peau d' orange (orange peel ) - DIMPLING of the breast ; might see discoloration along with the palpable lesion.

7

Causes

No one single defined cause
1. First-degree relative
2. 2 first-degree relatives
3. HRT (hormone replacement therapy due to increase of estrogen in the body)
4. Alcohol usage
5. Obesity
6. Men on anti-androgen agents
7. Those with dense breasts

8

More causes

8. Radiation exposure
9. Childless women
10. Early menses
11.Oral contraceptives

9

Detection & Diagnosis

1. Mammography
- Begin at age 40 unless high risk
- Existing barriers
2. Breast Self-examination (BSE)
- Assess client’s knowledge
- Provide education on correct technique and timing
- Perform one week AFTER menstrual period
3. Clinical Breast examination - performed by clinician

10

Surgical Treatment

1. Prophylactic Mastectomy
Preventative breast removal
Given to high risk women
2. Modified radical mastectomy
Removes breast tissue, nipple & axillary lymph nodes
3. Lumpectomy with Lymph node dissection ( only portion to see if metastasis has occured)
Tumor and lymph nodes removed
Examined for presence of cancer cells


11

Post-op/Home care

1. Presence of Jackson Pratt drain
May remain up to 3 weeks
Client measures drainage twice a day and records output
Removed once output <25ml in 24 hrs
2. Pain management
Keep affected arm elevated and free from needle sticks/BP/invasive measures (to prevent lymphedema)
Observe for excessive bleeding/drainage

12

Exercises

Most begin immediately following surgery
Squeezing soft, round object with affected hand
Flexion/extension of elbow
Hand wall climbing
Pulley exercise
Rope turning
(see IGGY p. 1675 73-2)

13

Adjuvant Therapy Radiation

Kill breast cancer cells remaining post-op
Given over 5-6 weeks
Entire breast or affected area
Brachytherapy - pt is radioactive when catheters inserted ; visitors only 30 min


14

Adjuvant Therapy Chemotherapy

Kill breast cancer cells traveling to other areas
Started after Stage II
Given before or after surgery
May be used in combination with other chemotherapy agents

15

Adjuvant Therapy cont…

Blocks action of estrogen or inhibits production
Tamoxifen most common (SERM)
Decreases recurrence up to 50%
SE: hot flashes, weight gain
Aromatase inhibitors
Estrogen receptor down-regulators
LH-RH agonists
(See IGGY p. 1677 73-5)

16

Nursing Care: Diagnoses

Anxiety
Ineffective coping
Disturbed body image
Acute pain
Sexual dysfunction

17

Interventions

Education, support, complementary & alternative medicine (yoga, meditation, etc)

18

Community Resources

1. American Cancer Society
www.cancer.org
2. BreastCancer.org
www.breastcancer.org
3. Susan G. Komen Foundation
www.komenohio.org
And many many more!