Podcast
Questions and Answers
What is a common non-invasive type of breast cancer?
What is a common non-invasive type of breast cancer?
Which treatment option may involve the decision between mastectomy and reconstruction?
Which treatment option may involve the decision between mastectomy and reconstruction?
What is a key consideration when assessing the stages of breast cancer?
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?
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?
Post-mastectomy care should primarily focus on which of the following?
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Radiation therapy for breast cancer can be utilized to:
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?
Which diagnostic study is least invasive for confirming a breast cancer diagnosis?
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Which statement about inflammatory breast cancer is true?
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)?
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?
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?
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?
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?
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?
What is a common side effect of external radiation therapy?
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What is the primary goal of nursing assessments post-mastectomy?
What is the primary goal of nursing assessments post-mastectomy?
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What characterizes lymphedema after axillary node dissection?
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?
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?
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?
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?
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?
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?
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?
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?
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.
