Breast Cancer-3.Recorded

Breast Disorders Overview

• Breast disorders are prevalent in the population.

• Approximately 80% of breast lumps are non-cancerous.

• Breast tissue undergoes changes due to hormones, nutrition, and environmental factors.

• Common premenstrual symptoms include tenderness and lumpiness of breasts.

Objectives

• Understand benign breast conditions, their causes, and treatments.

• Explore causes of breast cancer, recognizing multiple types.

• Learn recommended screening for breast cancer in normal and high-risk individuals.

• Identify risk factors for breast cancer.

• Discuss treatment options for breast cancer.

• Review nursing care and patient education post-surgical procedures for breast cancer.

Benign Conditions of the Breast

• Common benign conditions include:

  • Fibrocystic breast changes

  • Fibroadenomas

  • Atypical hyperplasia

  • Lobular carcinoma in situ (LCIS)

Fibrocystic Breast Changes

• Characterized by fibrotic tissue and cysts.

• Cysts are non-cancerous, fluid-filled sacs in the breast ducts.

• Changes mainly due to hormonal fluctuations, particularly estrogen.

• Common symptoms include pain, swelling, and tenderness, particularly premenstrual.

Fibrocystic Breast Changes Age Considerations

• Common in women aged 30-55, rare after menopause.

• Possible occurrence among menopausal women using hormone replacement therapy.

• Ceasing hormone therapy can reduce cyst formation.

• Any cyst fluid should be tested for cancer cells, especially if formation is atypical.

Interdisciplinary Care for Fibrocystic Changes

• Evaluations include history and physical examination, ultrasound, and mammography.

• Needle biopsy may be required to rule out malignancy.

• Recommendations:

  • Avoid caffeine and chocolate.

  • Quit smoking.

  • Consider Vitamin E supplementation.

  • Cysts may be aspirated to relieve pain.

  • Utilize mild analgesics and apply cold and heat therapy.

Fibroadenomas

• Solid benign tumors that are round, firm, and non-tender.

• Characterized as movable masses.

• Definitive diagnosis is obtained through biopsy.

• Treatment may not be necessary as they are typically benign.

Atypical Hyperplasia

• Denotes increased cell reproduction leading to a premalignant lesion.

• Generally not detectable upon physical examination but identified via mammogram.

• Confirmed through biopsy, with increased cancer risk requiring prophylactic treatment and high-risk screening.A

Lobular Carcinoma in Situ (LCIS)

• A rare condition featuring abnormal cell growth within lobules.

• Management includes observation, hormone therapy, and preventive measures.

• Associated with a heightened risk of invasive cancer.

Breast Cancer

• Second leading cause of cancer-related deaths in women, following lung cancer.

• Characterized by unregulated growth of abnormal breast cells.

• Various types exist, with men also susceptible (less than 1% prevalence).

Noninvasive Breast Cancer

• Includes cases where cancer cells have not spread, notably Ductal Carcinoma in Situ (DCIS).

• Accounts for 20% of new breast cancer diagnoses.

• Primary treatment involves lumpectomy in conjunction with radiation.

Invasive Breast Cancer

• Defined as cancer that spreads to adjacent tissues and potentially to lymphatic or circulatory systems.

• Common forms include Infiltrating Ductal Carcinoma and Inflammatory Breast Cancer.

Inflammatory Carcinoma

• Characterized by the obstruction of lymph vessels in breast skin leading to edema, warmth, and redness.

• Considered a malignant form of breast cancer with a poor prognosis.

Breast Cancer Risk Factors

• Genetic predispositions, especially with family history (first-degree relative).

• Hormonal factors: obesity, high-fat diets, alcohol use, and hormone replacements.

• Age is a significant risk factor with lower incidence in women under 40 years.

Genetic Considerations

• BRCA1 and BRCA2 mutations linked to hereditary breast and ovarian cancer.

• BRCA1 can indicate up to an 80% risk of developing breast cancer; BRCA2 can indicate 45%.

• Specific receptors facilitate cancer cell growth (e.g., HER2) and can be targeted with therapies like Trastuzumab.

Disease Prevention Strategies

• Emphasize healthy weight maintenance and diet.

• Routine screenings include self and clinical examinations, mammograms.

• Recommendations to breastfeed for extended periods and avoid hormone replacement therapies.

• Consideration of chemoprevention strategies for high-risk women.

Breast Cancer Screening Guidelines

• Monthly self-breast exams starting at age 20.

• Clinical breast exams every 3 years from age 20 to 39, annually post 40.

• Annual mammograms starting at age 45, biennial screenings from 55 onward.

Diagnostics

• Various imaging and biopsy techniques such as mammograms, ultrasounds, PET scans, and cytological exams of nipple fluid are utilized in diagnosis.

Surgical Interventions

• Surgical options range from lumpectomies to mastectomies, including reconstructive options.

  • Lumpectomy focuses on tumor excision with conservation of breast tissue.

  • Mastectomy options include total, modified radical, and radical procedures.

Postoperative Considerations

• Key postoperative care includes monitoring for lymphedema and supporting rehabilitation.

• Addressing body image issues post-surgery is crucial, especially for younger women.

Nursing Responsibilities

• Assess emotional responses, including feelings of loss, fear, and depression post-diagnosis.

• Provide education on managing physical and psychological aspects following mastectomy.

Mastectomy Considerations Post-Operative Care

• Monitoring for Lymphedema: Regular assessments to detect swelling in the arms or chest due to lymph fluid accumulation. Early interventions can help manage symptoms and improve quality of life.

• Rehabilitation Support: Encourage participation in physical therapy to regain strength and mobility, and to address any limitations in arm movement post-surgery.

• Body Image Issues: Address emotional and psychological impacts, particularly for younger women. Provide resources for counseling and support groups.

• Emotional Responses: Assess emotional reactions such as feelings of loss, fear, and depression following diagnosis and surgery. Offer supportive communication and referral to mental health services as needed.

• Education: Inform patients about postoperative care, including wound management, pain relief measures, and signs of complications. Provide guidance on self-examinations and future screening recommendations.