Podcast
Questions and Answers
What is a common non-invasive type of breast cancer?
Which treatment option may involve the decision between mastectomy and reconstruction?
What is a key consideration when assessing the stages of breast cancer?
Which type of therapy is not typically included under drug therapy for breast cancer?
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Post-mastectomy care should primarily focus on which of the following?
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Radiation therapy for breast cancer can be utilized to:
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Which diagnostic study is least invasive for confirming a breast cancer diagnosis?
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Which statement about inflammatory breast cancer is true?
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What is a possible treatment option to alleviate post-mastectomy pain syndrome (PBTPS)?
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Which type of breast reconstruction can be performed using the patient's own tissue?
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What is the purpose of adjuvant radiation therapy after surgery?
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Which are the two main types of drug therapy included in systemic therapy?
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What symptom may indicate the presence of a breast disorder based on nursing assessment?
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What is a common side effect of external radiation therapy?
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What is the primary goal of nursing assessments post-mastectomy?
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What characterizes lymphedema after axillary node dissection?
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Which action should a nurse take to help prevent lymphedema on the affected side after surgery?
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What can be a treatment option for post-mastectomy pain besides medication?
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What is an important aspect of drug therapy in acute care after a surgical procedure?
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How should a nurse support decision-making for a patient awaiting biopsy results?
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Which of the following should be included in pre- and postop education for a patient?
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What does effective postoperative care focus on regarding a patient's recovery?
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In terms of nursing diagnoses, which concern is often assessed before establishing a treatment plan?
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What approach should nurses take to manage postoperative pain effectively?
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Study Notes
Surgical Therapy
- Breast-conserving surgery involves lumpectomy, radiation therapy after the surgery, and chemotherapy before radiation therapy.
- Mastectomy can be performed with immediate or delayed reconstruction.
- Breast reconstruction after mastectomy is optional, and there are two main types: implant reconstruction and tissue flap.
Post-Mastectomy Pain
- Post-breast therapy pain syndrome (PBTPS) can be caused by nerve injury during surgery.
- Common symptoms of PBTPS include pain, tingling, aching, burning, numbness, edema, and itching.
- Treatments for PBTPS include NSAIDs, low-dose antidepressants, EMLA, and antiseizure drugs.
- Phantom pain is equivalent to PBTPS.
- Feeling pain in the breast after a mastectomy occurs because the brain continues to send signals to the nerves in the breast area that were cut during surgery.
Axillary Node Dissection
- Axillary node dissection can lead to lymphedema, which is the accumulation of lymph in soft tissues.
Radiation Therapy
- Radiation therapy is used as an adjuvant therapy to prevent recurrence and as a palliative therapy for pain caused by cancer spread.
- External radiation is administered after surgery based on the probability of residual cancer cells.
- Side effects of radiation therapy include fatigue, skin changes, and breast edema.
MammoSite
- MammoSite is a type of radiation therapy.
Drug Therapy
- Systemic therapy includes chemotherapy, hormone therapy, immunotherapy, and targeted therapy.
- Systemic therapy is used for patients at an increased risk for recurrent or metastatic disease.
Nursing Assessment
- A history of breast disorders assists in establishing a diagnosis.
- Key aspects of a breast disorder history include:
- Presence of nipple discharge, including color, consistency, and origin (one or both breasts).
- Pain.
- Rate of growth of a lump.
- Breast asymmetry.
- Correlation with the menstrual cycle.
Breast Cancer
- Breast cancer can be detected as a lump, thickening, or mammography abnormality in the breast.
- Other potential signs of breast cancer include nipple retraction, peau d’orange (orange peel-like skin), and dimpling.
- The rate of lesion growth varies, with slow-growing lesions having lower mortality rates.
Breast Cancer: Where it Occurs
- Breast cancer originates in the breast.
Diagnostic Studies
- Biopsy is a diagnostic study to confirm breast cancer diagnosis.
- Types of biopsies include:
- Fine-needle aspiration (FNA).
- Core needle biopsy.
- Vacuum-assisted biopsy.
- Excisional biopsy.
Types of Breast Cancer based on Invasiveness
-
Ductal Carcinomas are the most common type of breast cancer.
- Noninvasive (in situ) ductal carcinomas are localized, while invasive ductal carcinomas have spread to other locations.
Inflammatory Breast Cancer
- Inflammatory breast cancer is aggressive and fast-growing.
- It poses a high risk of metastasis.
- Cancer cells block the lymph channels in the skin of the breast, resulting in a red, warm, thickened breast.
- The thickened skin resembles an orange peel.
Diagnostic Studies
- Axillary lymph node analysis is conducted to determine the extent of cancer spread. More lymph nodes involved correlate with a higher risk of recurrence.
- Tumor size is a prognostic indicator. Larger tumors have a poorer prognosis and a greater chance of metastasis to other organs.
Treatment Options
- Treatment options should be discussed and considered for each patient individually.
- Options include surgical intervention, radiation therapy, drug therapy (including chemotherapy, hormone therapy, immunotherapy, and targeted therapy).
Treatment Options
- Advanced age considerations should be factored into treatment plan discussions.
Breast Cancer Surgery
-
Operable CA Surgery includes:
- Breast conservation surgery, which involves lumpectomy and segmental mastectomy.
- Mastectomy, which involves removal of the breast, with or without reconstruction.
Nursing Diagnoses
- Nursing diagnoses are determined after a medical diagnosis and before a treatment plan is selected.
- Common nursing diagnoses in breast cancer include:
- Decisional conflict (related to pain and life impact).
- Fear and/or anxiety.
- Disturbed body image.
Planning
- Overall goals for breast cancer care include:
- Participation in decision-making.
- Adherence to the therapeutic plan.
- Communication and management of side effects of adjuvant therapy.
- Access and benefit from support systems.
- Compliance with recommended follow-up.
Nursing Implementation: Acute Care
- Waiting for biopsy results and treatment recommendations is stressful.
- Clarify and expand on treatment options provided by the healthcare provider.
- Assess coping levels and strategies.
- Support decision-making.
- Provide sufficient information to ensure informed consent and a signed consent form.
- Be sensitive to patient needs regarding information type and preferences.
- Educate about pre- and post-operative pain control and care, mobility restrictions/post-operative exercises, and recovery period.
- Regularly administer analgesics for post-operative pain.
- Pre-medicate patients before exercises.
- Teach drain care if necessary.
- Restoring arm function on the affected side after breast cancer surgery is a key nursing goal.
- Use and teach patients measures to prevent or decrease lymphedema on the affected side.
- Avoid BP readings, venipunctures, or injections on the affected arm, as they can cause lymphedema.
- Keep the affected arm elevated to prevent lymphedema.
- Prevent infection, burns, and compromised circulation on the affected arm.
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Description
This quiz covers important aspects of surgical therapy related to breast cancer, including breast-conserving surgery, mastectomy options, and the management of post-mastectomy pain syndrome. It also addresses the complications that may arise, such as lymphedema from axillary node dissection. Test your knowledge on these critical topics in breast cancer treatment.
