Breast Cancer Awareness and Risk Factors

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is true about hormone receptor-positive breast cancers?

They can be treated with hormone therapy drugs. (correct)

They have no estrogen or progesterone receptors.

They are more likely to grow rapidly.

They tend to have a poorer prognosis.

What distinguishes triple negative breast cancer from other types?

It has a better short-term outlook.

Hormone therapy is ineffective. (correct)

It has both estrogen and progesterone receptors.

It is more common in women over 40.

Which receptor status is associated with a poor short-term prognosis for breast cancer?

Triple negative

Hormone receptor-positive

Hormone receptor-negative (correct)

Triple positive

What is a characteristic of hormone receptor-negative breast cancers?

They often return within the first few years after treatment. Signup and view all the answers

What does it mean for breast cancer to be triple positive?

It is positive for estrogen, progesterone, and HER2. Signup and view all the answers

Which group is more likely to develop triple negative breast cancer?

Women under 40 years of age. Signup and view all the answers

Which option correctly describes the growth rate of hormone receptor-positive cancers compared to hormone receptor-negative cancers?

Hormone receptor-negative cancers tend to grow faster. Signup and view all the answers

What is the significance of HER2 status in triple positive breast cancers?

It helps identify suitable treatments targeting HER2. Signup and view all the answers

What characterizes hormone receptor-positive breast cancer?

Presence of one or both estrogen or progesterone receptors Signup and view all the answers

What is the primary aim of keeping estrogen and progesterone from attaching to receptors in breast cancer treatment?

To prevent cancer from growing and spreading Signup and view all the answers

Which type of radiation therapy is administered after local excision of the breast mass?

Primary Radiation Therapy Signup and view all the answers

What defines hormone receptor-negative breast cancer?

Absence of estrogen and progesterone receptors Signup and view all the answers

What system is used in high-dose brachytherapy to focus radiation on the tumor site?

Balloon Catheter System Signup and view all the answers

What is a common adverse effect of external beam radiation therapy?

Fatigue and skin changes Signup and view all the answers

Which type of therapy aims to destroy tumor cells that may have spread to distant sites?

Systemic Therapy Signup and view all the answers

What describes the use of chemotherapy in breast cancer treatment?

Use of cytotoxic drugs to destroy cancer cells Signup and view all the answers

What is an overall goal for clients with breast cancer during their treatment process?

Verbalize acceptance of physical changes and engage in self-care activities Signup and view all the answers

Which of the following is NOT a nursing intervention when caring for clients undergoing breast cancer treatment?

Encourage clients to ignore their pain during recovery Signup and view all the answers

What should nurses emphasize when preparing clients for surgery?

What to expect during the surgery and post-operative care Signup and view all the answers

How should nurses approach the client's need for information regarding their treatment?

Be sensitive to the individual's need for and type of information Signup and view all the answers

What is a critical aspect of the therapeutic plan for clients with breast cancer?

To ensure adherence and management of therapy side effects Signup and view all the answers

What is the primary purpose of preoperative (neoadjuvant) chemotherapy in breast cancer treatment?

To decrease the size of the primary tumor Signup and view all the answers

Which of the following is NOT a common adverse effect of hormonal therapy with tamoxifen?

Increased hair growth Signup and view all the answers

Which patient history factor is considered a significant risk for breast cancer?

Menstrual history of early menarche Signup and view all the answers

What is a possible symptom indicative of metastasis in breast cancer patients?

Cognitive disorientation Signup and view all the answers

What psychological impact may be experienced by breast cancer patients due to their condition?

Disturbed body image Signup and view all the answers

Tamoxifen is primarily effective against which type of breast cancer cells?

Estrogen receptor-positive cells Signup and view all the answers

Which lifestyle factor can increase the risk for breast cancer?

Nulliparity or late first full-term pregnancy Signup and view all the answers

What nursing diagnosis may be associated with a breast cancer patient's treatment decisions?

Decisional conflict related to insufficient information Signup and view all the answers

Which of the following is a common side effect of chemotherapy impacting the gastrointestinal tract?

Nausea Signup and view all the answers

Which factor is associated with an increased risk of breast cancer based on past medical history?

History of benign breast disorders with atypical changes Signup and view all the answers

What is the role of acetaldehyde in cancer development?

It damages DNA and hinders the repair process. Signup and view all the answers

Which hereditary factor increases the risk of developing breast cancer the most?

Having a first-degree relative with breast cancer. Signup and view all the answers

What characteristic is often associated with inflammatory breast cancer?

Orange-peel skin (Peau d’orange). Signup and view all the answers

What does a mammography primarily help to detect?

Lumps less than 1 cm in diameter. Signup and view all the answers

What is one primary purpose of a fine-needle aspiration biopsy?

To confirm the diagnosis of a lesion. Signup and view all the answers

What should clients avoid before undergoing a biopsy?

Blood-thinning agents. Signup and view all the answers

Which screening method is recommended for high-risk patients aged 30-69 in Ontario?

Regular mammograms and breast MRIs. Signup and view all the answers

What is a significant risk factor for men regarding breast cancer?

Hyperestrogenism. Signup and view all the answers

Which surgical procedure often preserves the breast, including the nipple?

Lumpectomy. Signup and view all the answers

How often should eligible women in Ontario schedule a mammogram after 40 years of age?

Every 2 years. Signup and view all the answers

What indicates the need for a chest radiograph in diagnostic studies?

Investigation of potential metastasis. Signup and view all the answers

Which statement about breast cancer surgery is correct?

Radiation therapy is often used in conjunction with surgery. Signup and view all the answers

What is the primary goal of using local anesthesia during biopsy procedures?

To ensure the patient feels no pain during the procedure. Signup and view all the answers

What should be monitored after a lumpectomy procedure regarding the incision site?

Skin color and presence of any unusual swelling. Signup and view all the answers

What primary need does the ABC program address for cancer survivors?

Psychological, physical, and cosmetic needs Signup and view all the answers

Who founded the after BREAST CANCER organization?

Alicia Vianga Signup and view all the answers

Which type of support does the ABC Care KITS! not include?

Financial counseling services Signup and view all the answers

What significant issue did Alicia identify while reviewing the Bra and Breast Prosthesis Guide?

Absence of a program providing breast prostheses in Toronto Signup and view all the answers

What item is included in the ABC Care KITS! to offer comfort during recovery?

Handmade knitted blanket Signup and view all the answers

Which organization can assist healthcare professionals in addressing the needs of breast cancer patients?

Canadian Cancer Society Signup and view all the answers

What does ABC provide to clients at no cost?

Breast prostheses and bras Signup and view all the answers

Which item in the ABC Care KITS! assists with post-surgery recovery?

Front Closure Mastectomy Bra Signup and view all the answers

What lifestyle factor is associated with a higher risk of breast cancer following menopause?

Increased alcohol intake Signup and view all the answers

Which risk factor significantly increases the likelihood of developing breast cancer if a person has a family history of the disease?

Smoking before age 17 Signup and view all the answers

What is a potential effect of smoking on breast cancer development besides directly increasing risk?

Raises the incidence of hormone receptor-positive breast cancer Signup and view all the answers

Which of the following is a common characteristic of individuals who are at higher risk of breast cancer?

Having a high body mass index (BMI) after menopause Signup and view all the answers

When considering the modifiable risk factors for breast cancer, which of the following has a significant impact?

Reducing alcohol consumption Signup and view all the answers

What is the role of BRCA1 and BRCA2 genes in breast cancer prevention?

They are involved in inhibiting tumor development. Signup and view all the answers

Which of the following clinical manifestations is most commonly associated with Paget's Breast Cancer?

Abnormal nipple discharge Signup and view all the answers

What is the most accurate statement regarding mammography for breast cancer screening?

It can show lumps less than 1 cm in diameter. Signup and view all the answers

Which factor distinguishes individuals who should consider genetic testing for BRCA mutations?

Family history of ovarian cancer in first-degree relatives. Signup and view all the answers

What is a significant nursing intervention post-lumpectomy?

Inspecting the incision site for signs of infection. Signup and view all the answers

What is the primary therapeutic approach of hormone receptor-positive breast cancer?

Keeping hormones from attaching to the receptors Signup and view all the answers

Which statement accurately describes high-dose brachytherapy?

Balloon catheter insertion with radioactive seeds is a common technique. Signup and view all the answers

What defines palliative radiation therapy in the context of breast cancer?

It stabilizes symptomatic metastatic lesions. Signup and view all the answers

What is the purpose of adjuvant therapy in breast cancer treatment?

To prevent the spread of cancer after primary treatment. Signup and view all the answers

What distinguishes systemic therapy from other types of treatments for breast cancer?

It destroys tumor cells that may have metastasized. Signup and view all the answers

Which of the following adverse effects is NOT commonly associated with external beam radiation therapy?

Severe hair loss on the scalp Signup and view all the answers

Which aspect is NOT a characteristic of chemotherapy in breast cancer treatment?

It focuses solely on hormone receptor-negative tumors. Signup and view all the answers

What is a primary benefit of skin-sparing mastectomy compared to traditional mastectomy?

Less scar tissue and a more natural appearance Signup and view all the answers

Which procedure involves using a woman's own tissue to reconstruct the breast mound?

Tissue flap procedures Signup and view all the answers

During nipple–areolar reconstruction, which of the following materials can be used to create an areola?

Tattooing with pigmented dye Signup and view all the answers

Sentinel lymph node biopsy is primarily performed to assess what aspect of breast cancer?

If cancer has spread to nearby lymph nodes Signup and view all the answers

What is one purpose of using a tissue expander in breast reconstruction?

To stretch the skin and muscle for future implant placement Signup and view all the answers

In what way does hormone receptor status affect breast cancer treatment planning?

It indicates the need for hormone therapy Signup and view all the answers

Which type of surgical procedure typically includes the use of a tissue expander?

Breast reconstruction post-mastectomy Signup and view all the answers

What is a significant advantage of reconstructing the nipple–areolar complex after breast reconstruction?

It helps restore a natural appearance to the breast Signup and view all the answers

Which risk factor is NOT commonly associated with an increased likelihood of developing breast cancer?

Having a family history of diabetes Signup and view all the answers

Which lifestyle factor is most associated with an increased risk of hormone receptor-positive breast cancer?

Daily alcohol consumption Signup and view all the answers

What significant impact does starting to smoke before age 17 have on breast cancer risk?

It raises the risk for at least twenty years after quitting Signup and view all the answers

Which factor related to reproductive history is considered a significant risk in developing breast cancer?

Delayed first pregnancy after age 30 Signup and view all the answers

Which non-reproductive factor has been correlated with an increased incidence of breast cancer in individuals working night shifts?

Disruption of circadian rhythms Signup and view all the answers

What is the role of BRCA1 and BRCA2 genes in relation to cancer development?

They inhibit tumor development when functioning normally. Signup and view all the answers

Which symptom is often characteristic of Paget’s breast cancer?

Blood-stained nipple discharge Signup and view all the answers

What effect does acetaldehyde have on DNA?

It damages DNA and hinders repair processes. Signup and view all the answers

How is mammography effective for early cancer detection?

It can show lumps smaller than 1cm in diameter. Signup and view all the answers

What is the purpose of performing an axillary node dissection during breast cancer surgery?

To assess and remove potentially cancerous lymph nodes. Signup and view all the answers

Study Notes

Female Reproductive Cancers: Breast Cancer

Breast cancer refers to individuals assigned female at birth (AFAB), even if the term "female" is used.
Symptoms may include nipple changes (turning inward, discharge), lumps in the underarm area, swelling of part or all of the breast, skin dimpling, and breast or nipple pain/irritation.

Risk Factors

Female and AFAB: Account for 99% of cases.
Increasing age: (over 50)
Early menstrual period: (before age 12)
Late or no pregnancy: (first pregnancy after age 30)
Starting menopause after age 55:
Dense breasts:
Combination hormone therapy:
Oral contraceptives:
Personal history of breast cancer: Breast cancer is more common in those with a prior diagnosis.
Personal history of certain non-cancerous breast diseases:
Higher income:
Working night shifts:
Overweight or obese after menopause: (BMI >31.1)
Lack of physical activity:
Alcohol intake:

Simple Modifiable Risk Factors and Cancer Connection

Smoking: Higher risk if started before age 17, and risk remains elevated for at least 20 years after quitting. A 35% increased risk with a family history of breast cancer. Associated with hormone receptor-positive breast cancer.
Physical activity: Related to lower sex hormone levels and growth factors (e.g., breast, colon).
Alcohol: Alcohol breaks down into acetaldehyde, damaging DNA and preventing repair. Damaged DNA can lead to uncontrolled cell growth that forms a tumor.

Genetic Factors

Family history: A first-degree relative (mother, sister, daughter) with ovarian cancer and/or bilateral breast cancer significantly increases risk. BRCA1 and BRCA2 gene mutations have a high risk (~85% lifetime chance) of breast and ovarian cancer.
BRCA genes: Located on chromosomes 17 (BRCA1) and 11 (BRCA2), these are tumor suppressor genes.

Clinical Manifestations

Nontender lump: Frequently located in the upper outer quadrant of the breast.
Firm (fixed), hard mass: Embedded in surrounding tissue.
Dimpling of skin:
Asymmetrical shape:
Irregular shape (not round):
Inflammatory breast cancer: Orange-peel skin, nipple discharge, rash, nipple retraction, flaking or eruption near nipple, burning, stinging, or prickly sensation.
Paget's breast cancer: Abnormal nipple discharge (blood), rash around nipple area.

Diagnostic Studies

Health history: Including family history.
Biopsy:
Fine-needle aspiration:
Surgical biopsy:
Breast MRI: (if indicated)
Mammography:
Physical examination: Including breast and lymph nodes.
Ultrasonography:
Metastasis assessment (if suspected): Bone scan, chest radiograph, complete blood count, platelet count, liver function tests, CT scan of chest, abdomen, and pelvis.

Fine-Needle Aspiration

A needle used to collect fluid or tissue for examination.
Best for confirming a diagnosis.
A few minutes procedure, often as an outpatient.
Collected tissue sent for histological examination.
Clients should avoid NSAIDs, Vitamin E supplements, herbal supplements (e.g., ginkgo biloba, garlic), and warfarin (Coumadin) before the procedure.

Screening

Mammography: Canadian Cancer Society recommends every 2 years for women aged 50-69.
X-ray with compression: 2 views to detect lumps (<1cm). Low radiation (equivalent to 1 hour in the sun). High accuracy for detection (~90.05%).
Stages: Stage I (<2cm, no nodes), Stage II (2–5cm, 1–3 nodes), Stage III (>5cm, 4–9 nodes), Stage IV (any size, any nodal involvement).
Ultrasonography: Helpful to differentiate between solid and fluid-filled masses.

Breast Cancer Update for Ontario (2023)

Eligible women, non-binary, trans, and two-spirit people ages 40–74 can self-refer for mammograms every two years.
Eligible people may get regular mammograms and breast MRIs between the ages of 30 and 69.

Collaborative Care

Surgery: Breast-conserving (lumpectomy) with or without sentinel lymph node dissection (SNLD), axillary lymph node dissection (ALND). Modified radical mastectomy (may include reconstruction).
Radiation Therapy: Primary (after local excision), adjuvant (following surgery), high-dose brachytherapy, palliative.
Chemotherapy:

Breast-Conserving Surgery

Lumpectomy: Breast tissue and nipple preserved. Radiation therapy often part of this treatment.
Axillary Node Dissection: Removal of lymph nodes on the same side. Complications may include lymphedema.

Post-Mastectomy Surgical Therapy

Breast Reconstruction:
- Breast implants and tissue expansion.
- Tissue flaps: autologous tissue to re-create a breast mound.
- Nipple-areolar reconstruction: gives a more natural appearance.

Hormone Receptor Status

Breast cancer cells are tested for estrogen (ER) and progesterone (PR) receptor status and HER2 status.
- ER+: Treatment with hormone therapy
- PR+: Treatment with hormone therapy
- Negative: Treatment with chemotherapy
- Triple-negative cancers: tend to be more aggressive and respond to chemotherapy.
Receptors are proteins on cells that attach to blood substances. If the receptors for hormones are present, the hormones stimulate cancer growth.

Other Therapies

Adjuvant Therapy: Includes local radiation and systemic treatments like chemotherapy or hormone therapy.
Primary Radiation Therapy: After local excision of a mass.
High-Dose Brachytherapy: Radioactive seeds placed in the breast after tumor removal.
Palliative Radiation Therapy: Addresses symptomatic metastatic disease in bone, soft tissues, or the brain.
Systemic Therapy: For cancers that have spread to distant sites.

Assessment

Past Health History: Family history of breast cancer (especially mother or sister), age at diagnosis, history of abnormal mammograms/biopsies, any benign breast disorders, menstrual/pregnancy history, previous cancers, dietary habits, alcohol usage, level of physical activity, and medications (hormones, oral contraceptives).
Symptoms: Palpable breast changes, obesity/weight loss, cognitive changes, neurological symptoms, headache, bone pain, unilateral nipple discharge (bloody or milky), change in breast size/contour or symmetry, psychological stress, and anxiety.

Nursing Diagnoses

Decisional conflict related to treatment options or their effects.
Anxiety related to cancer diagnosis and treatment.
Disturbed body image from breast surgery or scars.

Planning

Client will verbalize acceptance of physical changes, improve body image, engage in self-care, and active participation in decision-making process.
Adherence to therapeutic plans, management of treatment side effects, access to support systems.

Nursing Interventions

Review treatment options, arm/shoulder mobility, range-of-motion exercises, pain/medication management, turning and positioning, good communication with client, realistic expectations, support for coping with pain and uncertainty, providing supportive resources, informing clients about postoperative sensations/pain relief, maintaining privacy, providing bras or breast forms, monitoring for potential complications (infection, hematoma, drainage), assessing the drainage, and assessing affected arm for tingling or numbness.
Hand/arm care: restoring arm function, prevention, no blood pressure/injections/draws, elevated arm positioning, gentle exercises; avoidance of pressure/heavy items and restrictive actions.

Follow-Up and Survivorship Care

Continued monitoring for recurrence, regular professional examinations, monthly self-breast examinations, close monitoring of the surgical site after surgery, appropriate breast imaging, and encouragement of clients to process their feelings.

References

(All references listed in the uploaded document should be included in a formal study guide)

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz explores essential information about breast cancer, specifically focusing on symptoms and various risk factors associated with the disease. Learn how age, reproductive history, and lifestyle choices can influence the likelihood of developing breast cancer. Empower yourself with knowledge to promote awareness and early detection.