MS1 - Breast CA (#8)

Breast CA most commonly arises from

grandular epithelial cells lining breast ducts and lobules

Ductus carcinoma in situ (DCIS) involves

ABN cell growth the ducts

that has NOT invaded surrounding tissue (stage 0)

Invasive ductal carcinoma (IDC) involves

CA cells that break thru duct wall and invade surr tissue

Invasive lobular carcinoma (ILC) involves

CA cells in milk prod lobules and invade surr tissue

______ is the most common form of breast CA, and _____ is the second most common form.

IDC; ILC

ABN cells in breast cancer multiply from

hyperplasia

_______ INC ABN cell growth.

estrogen

MOST cases are NOT directly linked to

inherited mutations

Risk factors from breast CA include all of the following EXCEPT:

minmal radiation exposure

What inherieted genes are risk factors for breast CA?

BRCA1 and BRCA2 mutations.

Modified radical mastectomy removes

entire breast and axillary lymph node

Radical mastectomy removes

entire breast, axillary lymph nodes, and pectoral muscles

Which surgical procedure preserves pectoral m. but may affect s.ROM, strength, sensation, and lymphatic drainage?

Modified radical mastectomy

Other surgical options include

breast-conserving surgery, lymph node procedures, and breast reconstruction

What other interventions are used for breast cancer?

radiation, chemo (pre-/post-op)

What intervention is used for hormone receptor-positive breast cancer, in which cancer cells have receptors that allow hormones such as estrogen to promote growth?

hormone therapy

Selective estrogen receptor modulators (SERMs) bind to

estrogen receptors and block estrogen

ex. tamoxifen (nolvadex)

Aromatase inhibitors (AIs):

Block the aromatase enzyme, reducing estrogen prod in body.

exs: Anastrozole, Letrozole

Selective estrogen receptor degraders (SERDs)

Bind to estrogen receptors and promote their breakdown, reducing estrogen signaling. ex: Fulvestrant

What does primary prevention involve?

self breast exam (women = monthly / men = prn)

Targeted Therapy targets specific ft of CA cells such as

HER2

Screen for cognitive changes associated with chemotherapy such as

memory, attention, executive function, and daily activities

Consider the ________________ questionnaire to assess patient-reported cognitive difficulties

Functional Assessment of Cancer Therapy–Cognitive Function (FACT-Cog)

Post op consideration includes axillary web syndrome (AWS) that involves

cord-like tissue tightness that may limit shoulder movement

Breast(s) may be reconstructed and/or

prosthesis worn with bra.

If reconstruction has occurred or is planned, the PT needs to understand the surgical specifics as many approaches can temporarily compromise muscle groups

pec maj/minor, lats, transverse abd