Breast Cancer

Breast CancerJeorge Kristoffer R. Duldulao, RNBreast CancerA rapid, unregulated growth of abnormal cells originating from the breast tissue.1. Chest Wall2. Muscle3. Lobules4. Nipple5. Areola6. Lactiferous Ducts7. Fat Tissues8. Skin

ONCOGENESOnco CancerGene Genetic MaterialOncogene : Suppressor Gene Ratio 1:1

In CancerOncogene > Suppressor GeneCauses of Breast CancerCausative factors have not yet been identified by experts, but instead, they have provided factors that increase a persons RISK in developing cancer. RISK FACTORSOld AgeGeneticsHistory of breast cancerHaving a certain types of breast lumpsDense breast tissueEstrogen exposureObesityHeightAlcohol consumptionRadiation exposure Use of HRTJob relatedCosmetic ImplantsTypesDuctal VS Lobular(Based on tissue origin of cancer cells)

Invasive VS Non-Invasive(Based on tissue involvement of cancer cells)Signs and SymptomsSigns are those that are felt by patient (subjective).

A lump in a breastA pain in the armpits or breast that does not seem to be related to the woman's menstrual periodPitting or redness of the skin of the breast; like the skin of an orangeA rash around (or on) one of the nipplesA swelling (lump) in one of the armpits

SIGNS AND SYMPTOMSSigns are those that are felt by patient (subjective).

An area of thickened tissue in a breastOne of the nipples has a discharge; sometimes it may contain bloodThe nipple changes in appearance; it may become sunken or invertedThe size or the shape of the breast changesThe nipple-skin or breast-skin may have started to peel, scale or flake

Diagnostic proceduresBreast Exam (Initial assessment)Mammogram X-ray2D + 3DBreast Ultrasound (solid mass vs fluid-filled)Biopsy (Confirmatory procedure)Breast MRI (determine extent of cancer)Breast self exam

Breast self exam

Breast self examSTAGINGBlood Tests:Tumor Marker Test:CA 15-3Bone ScanPET Scan

T - TumorN Nodal InvolvementM Metastasis

ManagementOncologistSpecialist cancer surgeonSpecialist nursePathologistRadiologistRadiographer

Reconstructive surgeonOccupational therapistPsychologistDietitianPhysical therapistThe TEAMManagement and the Nurses roleSurgery Radiotherapy ChemotherapyHormone TherapyBiological TreatmentSURGERY- Lumpectomy- Mastectomy- Reconstructive Surgery

Nurses focus:Post-Operative CareWound CareRehabilitation plan to achieve optimum level of functioning (OLOF)Psychological care for clients towards changes in body image

RADIOTHERAPY- Brachytherapy- Tele-therapy- Linear accelerator

Nurses focus:Skin CarePrevent fatigue

CHEMOTHERAPY- Single agent- Multiple agent

Nurses focus:Alleviate most common side effects: nausea/ vomiting, diarrhea/ constipationPrevent extravasation/ phlebitisEncourage adherence to treatment plan and schedule

Hormone Therapy- Endocrine receptor- HER2 receptor- Triple negative/ positive

Nurses focus:Clients adherence to treatment schedule and duration

Biological TherapyAlso known as Targeted Therapy-Monoclonal antibodies- -umab, -inib suffixes of medicines

Nurses focus:Allergic reactionPrevent extravasation/ phlebitisAdherence to treatment schedule

Prevention of breast cancerLifestyle ModificationAlcohol consumptionPhysical ExerciseDietPostmenopausal Hormone therapyBodyweightBreast Cancer ScreeningBreastfeeding

How much have you learned?Give one characteristic of a cancer cell!Provide one risk factor of developing breast cancer.The procedure an individual can perform to herself as an initial assessment of breast cancer is called: _____________________Give one management of breast cancer.A patient is undergoing radiotherapy. What should a nurse teach to her client? Give at least 1 (one) focus.