Definition | Types |Causes | Risk Factors | Incidence | Pathophysiology | Breast cancer Stages | Sign and Symptoms | Diagnostic Evaluation | Surgical Management | Medical Management | Nursing Management |
- Breast cancer is cancer that forms in the cells of the breast.
- After skin cancer breast cancer is the most common cancer diagnosed in women.
*What is the definition of breast cancer?
Breast cancer Definition:-
- “Breast cancer is a disease that occurs when cells in breast tissue change or mutate and keep reproducing, these abnormal cells usually cluster together to form a tumor.”
- A tumor is cancerous or malignant when these abnormal cells invade other parts of the breast.
*Enlist the breast cancer types ? Give a brief explanation of breast cancer types?
Breast Cancer Types:-
four breast cancer types are as follows:-
- Ductal carcinoma in situ:- DCTS is a non-invasive condition. The cancer cells are confined to the ducts in the breast have not invaded.
- Lobular carcinoma in situ:– Lobular carcinoma in situ is cancer that grows in the milk-producing glands of the breast, has not invaded.
- Invasive ductal carcinoma:- IDC is the most common type. This type of breast cancer begins in the breast milk duct and then invade nearby tissue in the breast.
- Invasive Lobular carcinoma:– ILC first develops in breast lobules then invade nearby tissue.
*What are the breast cancer causes? Or What are the breast cancer causes and risk factors of breast cancer?
Etiology or breast cancer causes:–
- Breast cancer is caused by a genetic mutation in the DNA of breast cells.
- Inherited mutated genes known are breast cancer Gene 1 (BRCA 1), Breast cancer gene 2 (BRCA 2).
Breast Cancer Risk Factors:-
- Gender and Age:- the risk begin after 40 years in women.
- family history.
- Inherited genes:- the most well-known gene mutation -BRCA 1, BRCA 2.
- Radiation therapy.
- The beginning period at a younger age (before age 12).
- Beginning menopause at an older age.
- Have never been pregnant.
- Postmenopausal hormone therapy (estrogen and progesterone).
- Alcohol Consumption.
*What is the incidence rate of breast cancer?
Incidence of Breast cancer:-
- Most common malignancy in women.
- Only 1% of breast cancer occurs in men.
- 1/8 postmenopausal women or at rest.
- The occurrence of breast cancer according to the location.
*Explain the pathophysiology of breast cancer?
Breast cancer Pathophysiology:-
- Majority of breast cancer are adenocarcinomas. They are classified as ductal or lobular.
- Intralobular ( lobe or part or portion of an organ).
- Invasive ductal.
- Invasive lobular.
*Enlist and describe the stages of breast cancer?
Breast cancer Stages:-
- Breast cancer Stage 1:-
- tumor less than 2 cm.
- Confined to the breast.
- No positive symptoms.
- No metastasis present.
- Breast cancer Stage 2:- Tumors less than 2 cm with positive lymph-node.No metastasis evident. or tumor 2-5 cm with or without positive lymph node, not metastasis evident or tumor greater than 5 cm with lymph nodes, not metastasis evident.
- Breast cancer Stage 3:- Tumor >5 cm with a positive lymph node, no metastasis present.
- Breast cancer stage 4:- Any distend metastasis to brain, lung, liver, or bone with or without positive lymph node.
*What are the sign and symptoms of breast cancer?
Breast cancer sign and symptoms:-
- A breast lumps or tissue thickening that feel different than surrounding tissue.
- Breast pain.
- Red, pitted skin over the entire breast.
- Swelling in all or part of the breast.
- Nipple discharge other than breast milk.
- Bloody discharge from the nipple.
- A sudden change in the shape and size of the breast.
- Inverted nipple.
- A lump or swelling in the arm.
- Peeling, scaling, or blacking of skin on the nipple.
*Describe the diagnostic evaluation of breast cancer?
Breast cancer Diagnostic evaluation:-
- Mammography:- It is the process of using low energy X-ray to examine the breast for diagnosis.during the procedure the breast is compressed using a dedicated mammography unit. Parallel plate compression evens out the thickness of breast tissue to increase image quality by reducing the thickness of tissue that X-ray penetrates.
- Breast biopsy:-During this test doctor will remove a tissue sample from the suspicious area to have it tested. The doctor uses a needle to take the tissue sample. then send it to the laboratory to test the sample.
- Ultrasound:- A breast ultrasound uses sound waves to create a picture of the tissue deep in the breast. An ultrasound distinguishes between a solid mass or a tumor.
- Breast self-examination:- Breast self-exam or regularly examining your breast on your own.there are following steps :-(done before warm bath)
- Step 1:-Begin by looking at your breast in the mirror with your shoulders straight an arm on your hips. (breast that is their usual size, shape, and color) (Dimpling, bulging of skin, redness, rashes or swelling, a nipple that has changed position or an inverted nipple)
- Step 2:-Now raise your arm and look for the same changes.
- Step 3:- While you are at the mirror look for any sign of fluid come out of one or both nipples. (this could be a watery, milky or yellow fluid or blood).
- Step 4:- Next fell your breast while lying down using your right hand to feel your left breast and then left-hand feels right breast.use a firm, smooth touch with the first few fingers pads of your hand, keeping the fingers flat and together. Use a circular motion about the size of a quarter.
- Finally, feel breast while you are standing or sitting.
*Describe the management or surgical, medical, and Nursing management?
Breast cancer Management:-
Breast cancer Surgical management:-
- Lumpectomy:-This procedure remove the tumor and surrounding tissue.
- Mastectomy:- In this procedure, a surgeon removes an entire breast.
- Sentinel node biopsy:- This surgery remove a few of the lymph node.
- Contralateral prophylactic mastectomy:- Even though breast cancer may be present in only one breast this surgery remove healthy breast to reduce the risk of developing breast cancer again.
Breast cancer Medical management:-
- Medication used after and in addition to surgery are adjuvant therapy.
- Hormone blocking therapy:- some breast cancers require estrogen to continue growing. they can be identified by the presence of estrogen receptors (ER+) and progesterone receptors (PR+) on their surface. this ER+ cancer can be treated with drugs that either block the receptors. Example:- Tamoxifen, Toremifene (Prevent estrogen from binding to estrogen receptors), Aromatase Inhibitor (stop estrogen production).
- Chemotherapy:- The chemotherapy medication is administered in combinations. Usually for periods of 3-6 months. Example:- Cyclophosphamide with Doxorubicin.
- Radiation therapy:-Radiation is given after surgery to the region of the tumor bed and regional lymph node to destroy microscopic tumor cells. Radiation therapy can be delivered as external beam radiotherapy or as brachytherapy (internal radiotherapy).
*Write the pre and post-operative care of Nursing care or complete nursing management?
Breast cancer Nursing management:-
Pre-operative Nursing care:-
- Knowledge deficit about breast cancer and treatment.
- An anxiety-related cancer diagnosis.
- Fear related to a specific treatment, body images change, or possible death.
- Decisional conflict-related treatment option.
- The risk for ineffective coping related diagnosis of breast cancer.
Postoperative nursing diagnosis:-
- Pain-related to surgical incision and the manifestation of tissue.
- Impaired skin integrity due to surgical incision.
- The risk for the infection-related presence of surgical drain.
- Body image disturbance related loss or alteration of the breast-related surgical procedure.
- the risk for sexual dysfunction related loss of body part, changes in self-image.
- Self-care deficit related partial immobility of upper extremity on the operative side.