Podcast
Questions and Answers
What is true about hormone receptor-positive breast cancers?
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?
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?
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?
What is a characteristic of hormone receptor-negative breast cancers?
What does it mean for breast cancer to be triple positive?
What does it mean for breast cancer to be triple positive?
Which group is more likely to develop triple negative breast cancer?
Which group is more likely to develop triple negative breast cancer?
Which option correctly describes the growth rate of hormone receptor-positive cancers compared to hormone receptor-negative cancers?
Which option correctly describes the growth rate of hormone receptor-positive cancers compared to hormone receptor-negative cancers?
What is the significance of HER2 status in triple positive breast cancers?
What is the significance of HER2 status in triple positive breast cancers?
What characterizes hormone receptor-positive breast cancer?
What characterizes hormone receptor-positive breast cancer?
What is the primary aim of keeping estrogen and progesterone from attaching to receptors in breast cancer treatment?
What is the primary aim of keeping estrogen and progesterone from attaching to receptors in breast cancer treatment?
Which type of radiation therapy is administered after local excision of the breast mass?
Which type of radiation therapy is administered after local excision of the breast mass?
What defines hormone receptor-negative breast cancer?
What defines hormone receptor-negative breast cancer?
What system is used in high-dose brachytherapy to focus radiation on the tumor site?
What system is used in high-dose brachytherapy to focus radiation on the tumor site?
What is a common adverse effect of external beam radiation therapy?
What is a common adverse effect of external beam radiation therapy?
Which type of therapy aims to destroy tumor cells that may have spread to distant sites?
Which type of therapy aims to destroy tumor cells that may have spread to distant sites?
What describes the use of chemotherapy in breast cancer treatment?
What describes the use of chemotherapy in breast cancer treatment?
What is an overall goal for clients with breast cancer during their treatment process?
What is an overall goal for clients with breast cancer during their treatment process?
Which of the following is NOT a nursing intervention when caring for clients undergoing breast cancer treatment?
Which of the following is NOT a nursing intervention when caring for clients undergoing breast cancer treatment?
What should nurses emphasize when preparing clients for surgery?
What should nurses emphasize when preparing clients for surgery?
How should nurses approach the client's need for information regarding their treatment?
How should nurses approach the client's need for information regarding their treatment?
What is a critical aspect of the therapeutic plan for clients with breast cancer?
What is a critical aspect of the therapeutic plan for clients with breast cancer?
What is the primary purpose of preoperative (neoadjuvant) chemotherapy in breast cancer treatment?
What is the primary purpose of preoperative (neoadjuvant) chemotherapy in breast cancer treatment?
Which of the following is NOT a common adverse effect of hormonal therapy with tamoxifen?
Which of the following is NOT a common adverse effect of hormonal therapy with tamoxifen?
Which patient history factor is considered a significant risk for breast cancer?
Which patient history factor is considered a significant risk for breast cancer?
What is a possible symptom indicative of metastasis in breast cancer patients?
What is a possible symptom indicative of metastasis in breast cancer patients?
What psychological impact may be experienced by breast cancer patients due to their condition?
What psychological impact may be experienced by breast cancer patients due to their condition?
Tamoxifen is primarily effective against which type of breast cancer cells?
Tamoxifen is primarily effective against which type of breast cancer cells?
Which lifestyle factor can increase the risk for breast cancer?
Which lifestyle factor can increase the risk for breast cancer?
What nursing diagnosis may be associated with a breast cancer patient's treatment decisions?
What nursing diagnosis may be associated with a breast cancer patient's treatment decisions?
Which of the following is a common side effect of chemotherapy impacting the gastrointestinal tract?
Which of the following is a common side effect of chemotherapy impacting the gastrointestinal tract?
Which factor is associated with an increased risk of breast cancer based on past medical history?
Which factor is associated with an increased risk of breast cancer based on past medical history?
What is the role of acetaldehyde in cancer development?
What is the role of acetaldehyde in cancer development?
Which hereditary factor increases the risk of developing breast cancer the most?
Which hereditary factor increases the risk of developing breast cancer the most?
What characteristic is often associated with inflammatory breast cancer?
What characteristic is often associated with inflammatory breast cancer?
What does a mammography primarily help to detect?
What does a mammography primarily help to detect?
What is one primary purpose of a fine-needle aspiration biopsy?
What is one primary purpose of a fine-needle aspiration biopsy?
What should clients avoid before undergoing a biopsy?
What should clients avoid before undergoing a biopsy?
Which screening method is recommended for high-risk patients aged 30-69 in Ontario?
Which screening method is recommended for high-risk patients aged 30-69 in Ontario?
What is a significant risk factor for men regarding breast cancer?
What is a significant risk factor for men regarding breast cancer?
Which surgical procedure often preserves the breast, including the nipple?
Which surgical procedure often preserves the breast, including the nipple?
How often should eligible women in Ontario schedule a mammogram after 40 years of age?
How often should eligible women in Ontario schedule a mammogram after 40 years of age?
What indicates the need for a chest radiograph in diagnostic studies?
What indicates the need for a chest radiograph in diagnostic studies?
Which statement about breast cancer surgery is correct?
Which statement about breast cancer surgery is correct?
What is the primary goal of using local anesthesia during biopsy procedures?
What is the primary goal of using local anesthesia during biopsy procedures?
What should be monitored after a lumpectomy procedure regarding the incision site?
What should be monitored after a lumpectomy procedure regarding the incision site?
What primary need does the ABC program address for cancer survivors?
What primary need does the ABC program address for cancer survivors?
Who founded the after BREAST CANCER organization?
Who founded the after BREAST CANCER organization?
Which type of support does the ABC Care KITS! not include?
Which type of support does the ABC Care KITS! not include?
What significant issue did Alicia identify while reviewing the Bra and Breast Prosthesis Guide?
What significant issue did Alicia identify while reviewing the Bra and Breast Prosthesis Guide?
What item is included in the ABC Care KITS! to offer comfort during recovery?
What item is included in the ABC Care KITS! to offer comfort during recovery?
Which organization can assist healthcare professionals in addressing the needs of breast cancer patients?
Which organization can assist healthcare professionals in addressing the needs of breast cancer patients?
What does ABC provide to clients at no cost?
What does ABC provide to clients at no cost?
Which item in the ABC Care KITS! assists with post-surgery recovery?
Which item in the ABC Care KITS! assists with post-surgery recovery?
What lifestyle factor is associated with a higher risk of breast cancer following menopause?
What lifestyle factor is associated with a higher risk of breast cancer following menopause?
Which risk factor significantly increases the likelihood of developing breast cancer if a person has a family history of the disease?
Which risk factor significantly increases the likelihood of developing breast cancer if a person has a family history of the disease?
What is a potential effect of smoking on breast cancer development besides directly increasing risk?
What is a potential effect of smoking on breast cancer development besides directly increasing risk?
Which of the following is a common characteristic of individuals who are at higher risk of breast cancer?
Which of the following is a common characteristic of individuals who are at higher risk of breast cancer?
When considering the modifiable risk factors for breast cancer, which of the following has a significant impact?
When considering the modifiable risk factors for breast cancer, which of the following has a significant impact?
What is the role of BRCA1 and BRCA2 genes in breast cancer prevention?
What is the role of BRCA1 and BRCA2 genes in breast cancer prevention?
Which of the following clinical manifestations is most commonly associated with Paget's Breast Cancer?
Which of the following clinical manifestations is most commonly associated with Paget's Breast Cancer?
What is the most accurate statement regarding mammography for breast cancer screening?
What is the most accurate statement regarding mammography for breast cancer screening?
Which factor distinguishes individuals who should consider genetic testing for BRCA mutations?
Which factor distinguishes individuals who should consider genetic testing for BRCA mutations?
What is a significant nursing intervention post-lumpectomy?
What is a significant nursing intervention post-lumpectomy?
What is the primary therapeutic approach of hormone receptor-positive breast cancer?
What is the primary therapeutic approach of hormone receptor-positive breast cancer?
Which statement accurately describes high-dose brachytherapy?
Which statement accurately describes high-dose brachytherapy?
What defines palliative radiation therapy in the context of breast cancer?
What defines palliative radiation therapy in the context of breast cancer?
What is the purpose of adjuvant therapy in breast cancer treatment?
What is the purpose of adjuvant therapy in breast cancer treatment?
What distinguishes systemic therapy from other types of treatments for breast cancer?
What distinguishes systemic therapy from other types of treatments for breast cancer?
Which of the following adverse effects is NOT commonly associated with external beam radiation therapy?
Which of the following adverse effects is NOT commonly associated with external beam radiation therapy?
Which aspect is NOT a characteristic of chemotherapy in breast cancer treatment?
Which aspect is NOT a characteristic of chemotherapy in breast cancer treatment?
What is a primary benefit of skin-sparing mastectomy compared to traditional mastectomy?
What is a primary benefit of skin-sparing mastectomy compared to traditional mastectomy?
Which procedure involves using a woman's own tissue to reconstruct the breast mound?
Which procedure involves using a woman's own tissue to reconstruct the breast mound?
During nipple–areolar reconstruction, which of the following materials can be used to create an areola?
During nipple–areolar reconstruction, which of the following materials can be used to create an areola?
Sentinel lymph node biopsy is primarily performed to assess what aspect of breast cancer?
Sentinel lymph node biopsy is primarily performed to assess what aspect of breast cancer?
What is one purpose of using a tissue expander in breast reconstruction?
What is one purpose of using a tissue expander in breast reconstruction?
In what way does hormone receptor status affect breast cancer treatment planning?
In what way does hormone receptor status affect breast cancer treatment planning?
Which type of surgical procedure typically includes the use of a tissue expander?
Which type of surgical procedure typically includes the use of a tissue expander?
What is a significant advantage of reconstructing the nipple–areolar complex after breast reconstruction?
What is a significant advantage of reconstructing the nipple–areolar complex after breast reconstruction?
Which risk factor is NOT commonly associated with an increased likelihood of developing breast cancer?
Which risk factor is NOT commonly associated with an increased likelihood of developing breast cancer?
Which lifestyle factor is most associated with an increased risk of hormone receptor-positive breast cancer?
Which lifestyle factor is most associated with an increased risk of hormone receptor-positive breast cancer?
What significant impact does starting to smoke before age 17 have on breast cancer risk?
What significant impact does starting to smoke before age 17 have on breast cancer risk?
Which factor related to reproductive history is considered a significant risk in developing breast cancer?
Which factor related to reproductive history is considered a significant risk in developing breast cancer?
Which non-reproductive factor has been correlated with an increased incidence of breast cancer in individuals working night shifts?
Which non-reproductive factor has been correlated with an increased incidence of breast cancer in individuals working night shifts?
What is the role of BRCA1 and BRCA2 genes in relation to cancer development?
What is the role of BRCA1 and BRCA2 genes in relation to cancer development?
Which symptom is often characteristic of Paget’s breast cancer?
Which symptom is often characteristic of Paget’s breast cancer?
What effect does acetaldehyde have on DNA?
What effect does acetaldehyde have on DNA?
How is mammography effective for early cancer detection?
How is mammography effective for early cancer detection?
What is the purpose of performing an axillary node dissection during breast cancer surgery?
What is the purpose of performing an axillary node dissection during breast cancer surgery?
Flashcards
Hormone Receptor-Positive Breast Cancer
Hormone Receptor-Positive Breast Cancer
Breast cancer cells that have estrogen (ER) and/or progesterone (PR) receptors.
Hormone Receptor-Negative Breast Cancer
Hormone Receptor-Negative Breast Cancer
Breast cancer cells lacking estrogen and progesterone receptors.
Triple-Negative Breast Cancer
Triple-Negative Breast Cancer
Breast cancer cells lacking estrogen, progesterone, and HER2 receptors.
Estrogen Receptor (ER)
Estrogen Receptor (ER)
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Progesterone Receptor (PR)
Progesterone Receptor (PR)
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HER2 Receptor
HER2 Receptor
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Hormone Therapy
Hormone Therapy
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Triple-Positive Breast Cancer
Triple-Positive Breast Cancer
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Alcohol's impact on DNA
Alcohol's impact on DNA
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BRCA genes
BRCA genes
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Hyperestrogenism
Hyperestrogenism
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Breast cancer risk factors (family)
Breast cancer risk factors (family)
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Mammography screening
Mammography screening
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Fine-needle aspiration (FNA)
Fine-needle aspiration (FNA)
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Breast-conserving surgery
Breast-conserving surgery
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Modified radical mastectomy
Modified radical mastectomy
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Total/Simple Mastectomy
Total/Simple Mastectomy
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Lymphedema
Lymphedema
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Ultrasonography
Ultrasonography
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Biopsy
Biopsy
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Breast Cancer Manifestations
Breast Cancer Manifestations
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Diagnostic Studies (Breast Cancer)
Diagnostic Studies (Breast Cancer)
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Post-Biopsy Nursing Interventions
Post-Biopsy Nursing Interventions
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Breast Cancer Treatment Goals
Breast Cancer Treatment Goals
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Preparing for Breast Surgery
Preparing for Breast Surgery
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Maintaining Communication
Maintaining Communication
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Individualized Information Needs
Individualized Information Needs
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Coping with Uncertain Future
Coping with Uncertain Future
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ER-positive breast cancer
ER-positive breast cancer
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PR-positive breast cancer
PR-positive breast cancer
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Hormone receptor-positive cancer
Hormone receptor-positive cancer
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Hormone receptor-negative cancer
Hormone receptor-negative cancer
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Adjuvant therapy
Adjuvant therapy
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Primary radiation therapy
Primary radiation therapy
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Chemotherapy
Chemotherapy
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Palliative radiation therapy
Palliative radiation therapy
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after BREAST CANCER (ABC)
after BREAST CANCER (ABC)
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ABC Care KITs
ABC Care KITs
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What was the gap Alicia identified in healthcare?
What was the gap Alicia identified in healthcare?
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What is the purpose of after BREAST CANCER (ABC)?
What is the purpose of after BREAST CANCER (ABC)?
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What kind of support do ABC Care KITs provide?
What kind of support do ABC Care KITs provide?
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What is the unique value proposition of after BREAST CANCER (ABC)?
What is the unique value proposition of after BREAST CANCER (ABC)?
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Who are the volunteers at after BREAST CANCER (ABC)?
Who are the volunteers at after BREAST CANCER (ABC)?
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What is the website address for after BREAST CANCER (ABC) for more information?
What is the website address for after BREAST CANCER (ABC) for more information?
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Neoadjuvant Chemotherapy
Neoadjuvant Chemotherapy
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Adverse Effects of Chemotherapy
Adverse Effects of Chemotherapy
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Hormonal Therapy for Breast Cancer
Hormonal Therapy for Breast Cancer
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Estrogen Receptor Blockers
Estrogen Receptor Blockers
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Tamoxifen
Tamoxifen
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Adverse Effects of Tamoxifen
Adverse Effects of Tamoxifen
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Family History of Breast Cancer
Family History of Breast Cancer
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Abnormal Mammogram Findings
Abnormal Mammogram Findings
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Benign Breast Disorders with Atypical Changes
Benign Breast Disorders with Atypical Changes
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Psychological Stress and Breast Cancer
Psychological Stress and Breast Cancer
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Breast Cancer Risk: Age
Breast Cancer Risk: Age
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Breast Cancer Risk: Early Menstrual Period
Breast Cancer Risk: Early Menstrual Period
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Breast Cancer Risk: Late or No Pregnancy
Breast Cancer Risk: Late or No Pregnancy
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Breast Cancer Risk: Menopause
Breast Cancer Risk: Menopause
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Breast Cancer Risk: Dense Breasts
Breast Cancer Risk: Dense Breasts
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Alcohol and Cancer
Alcohol and Cancer
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Sentinel Lymph Node Biopsy
Sentinel Lymph Node Biopsy
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Tissue Expander
Tissue Expander
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Tissue Flap Procedures
Tissue Flap Procedures
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Nipple–Areolar Reconstruction
Nipple–Areolar Reconstruction
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Hormone Receptor Status
Hormone Receptor Status
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Breast Implants
Breast Implants
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Skin-sparing Mastectomy
Skin-sparing Mastectomy
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Autologous Tissue
Autologous Tissue
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What is Adjuvant Therapy?
What is Adjuvant Therapy?
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What is Primary Radiation Therapy?
What is Primary Radiation Therapy?
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What is Palliative Radiation Therapy?
What is Palliative Radiation Therapy?
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What is Breast Cancer?
What is Breast Cancer?
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Breast Cancer Risk Factor: Age
Breast Cancer Risk Factor: Age
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Breast Cancer Risk: Late Pregnancy
Breast Cancer Risk: Late Pregnancy
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Breast Cancer Screening: Mammography
Breast Cancer Screening: Mammography
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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)
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