Breast Cancer

Presented By: ACOSTA, Keith AGTARAP, Princess Diana Mae ASUNCION, Pio Justin BISCOCHO, Clarence Rico BONUS, Mary Grace

OVERVIEW OF CANCER PROCESS

WHAT IS BREAST CANCER?

Malignant tumors that typically begin in the

ductal-lobular epithelial cells of the breast and spread via the lympathic system to the axillary lymph nodes Carcinoma In Situ Malignant appearing cells confined to the ductal lobular units without permeation of the basement membrane Ductal carcinoma in situ is a precursor of infiltrating carcinoma

ETIOLOGY AND RISK FACTORS

The cause of breast ca is unknown

Risk factors:
Age and ethnicity: risk increases with age Ovarian and hormonal function Benign breast disease Family history Environmental and dietary factors

CLINICAL MANIFESTATIONS

Source: NursingCrib.com

BREAST CANCER IN MEN

Risk Factors:

A first degree male or female relative with breast

cancer Presence of the BRCA 2 gene Klinefelters Syndrome Caused by a chromosomal anomaly with 47, XXY chromosome constitution Hepatic Schistosomiasis Exposure to ionizing radiation Prolonged heat exposure

Laboratory Procedures and Findings

Digital mammography and computer assisted

diagnosis used to evaluate lesion and allow more variations in exposure and show the differences in tissue contrast Fine-needle aspiration used to determine whether a solid lump is a cyst or to confirm a clinically apparent diagnosis Stereotactic Needle Guided Biopsy Used mainly to target and identify non-palpable lesions in the breast that have been detected with mammography Ultrasound Core Biopsy Used when the lesion can be seen on ultrasound Open Biopsy Chosen when the lesion is determined to be solid and indeterminatein nature, when results of cytologic or histologic analysis are insufficient

TUMOR STAGING AND GRADING

Resource:

Resource: http://www.swicancer.org/healthcare/breastcancer/manifestations.aspx

NURSING DIAGNOSIS
Risk for impaired skin integrity

Fluid and electrolyte imbalance

Risk for injury Disturbed body image Risk for ineffective individual coping

Health Management & Education

Resource: McKesson Health

SURGICAL INTERVENTIONS
Surgeries include lumpectomy (breast-preventing

procedure), mastectomy (breast removal), and mammoplasty (reconstructive surgery). Endocrine related surgeries to reduce endogenous estrogen as a palliative measure. Bone marrow transplantation may be combined with chemotherapy. AXILLARY NODE DISSECTION BREAST CONSERVATION SURGERY RECONSTRUCTIVE SURGERY MAMMAPLASTY

MEDICATIONS
Arimidex (anastrozole) 1 mg tablets (AU)
Nolvadex (tamoxifen) 20 mg tablets (UK)

NURSING INTERVENTIONS

Monitor for adverse effects of radiation therapy such as fatigue, sore throat, dry cough, nausea, anorexia. Monitor for adverse effects of chemotherapy; bone marrow suppression, nausea and vomiting, alopecia, weight gain or loss, fatigue, stomatitis, anxiety, and depression. Realize that a diagnosis of breast cancer is a devastating emotional shock to the woman. Provide psychological support to the patient throughout the diagnostic and treatment process. Involve the patient in planning and treatment. Describe surgical procedures to alleviate fear. Prepare the patient for the effects of chemotherapy, and plan ahead for alopecia, fatigue. Administer antiemetics prophylactically, as directed, for patients receiving chemotherapy. Administer I.V. fluids and hyperalimentation as indicated. Help patient identify and use support persons or family or community. Suggest to the patient the psychological interventions may be necessary for anxiety, depression, or sexual problems. Teach all women the recommended cancer-screening procedures.