Comprehensive Study Notes on Breast Cancer, Menstrual Disorders, and Women's Health
Replacement and Menopause
Estrogen and Breast Cancer
Many breast cancers are estrogen-dependent; they require estrogen to grow.
If an individual does not have estrogen due to menopause, breast cancers are less likely to grow.
Administering estrogen to someone with breast cancer is akin to providing nourishment for the cancer to thrive.
Risk Factors for Breast Cancer:
Early Menarche: Starting menstruation at a younger age increases breast cancer risk.
Late Menopause: Extended menstruation time elevates risk factors.
First Pregnancy After Age 30: Delaying first pregnancy can increase risk, though it's not a definitive cause.
The link between pregnancy hormone changes and breast cancer risk is significant.
Hormonal shifts during pregnancy, postpartum, and breastfeeding are critical.
Controllable Risk Factors:
Weight control, alcohol intake, smoking, estrogen levels, birth control types, vitamin D levels, and diet (low fruit/veggie intake, exposure to garden chemicals).
Emphasizing the importance of managing controllable risk factors if other factors are uncontrollable (e.g., age, ethnicity, history).
BRCAGene and Mastectomy:
The BRCA gene is a significant risk factor for breast cancer.
A case discussion:
A friend underwent prophylactic bilateral mastectomy and full hysterectomy at age 39 after having her last baby due to BRCA positivity.
This choice led to early menopause and raised questions about the psychosocial aspects of such a decision.
Emotional impacts of undergoing mastectomy and changes in body image are significant.
Signs and Symptoms of Breast Cancer:
Focal thickening in breast tissue.
Dimpling of the skin resembling orange peel.
Discharge from the nipple (clear or bloody).
Unilateral swelling in one breast not typically aligned with menstrual cycle changes, unexpected tenderness, or discoloration of the skin.
Breast Cancer Prevention Strategies:
Breastfeeding is associated with reduced breast cancer risk.
Regular exercise and early identification are crucial.
Breast Self-Examination:
Best performed weekly after menstruation, or if post-menopausal, at the same time every month.
Types of Mastectomies:
Partial mastectomy: removal of some breast tissue.
Simple mastectomy: removal of breast tissue from one or both breasts.
Radical mastectomy: includes removal of breast tissue and lymph nodes, significant for cancer staging.
Characteristics of Cancerous Masses:
Tends to be harder and less mobile, compared to cysts, which may shift position upon palpation.
Irregular shape and margins are common indicators of malignancy.
Cancer Diagnosis and Biopsy:
A biopsy is required to confirm a cancer diagnosis despite indications from imaging and palpation.
Earlier detection typically correlates with better prognosis outcomes.
Mastectomy Reconstruction:
Involves serious surgery, including harvesting muscles and skin from various body parts for reconstruction.
Procedures can include adjustments post-mastectomy like mammoplasty (reshaping) and reduction.
Menstrual Disorders:
PMS and PMDD:
Acknowledges existence of PMS, with PMDD being a severe form leading to debilitating symptoms.
Treatment options include NSAIDs, hormonal contraceptives, and antidepressants among others.
Amenorrhea:
Defined as absence of menstruation for six months or three cycles in a row among irregular individuals.
Primary amenorrhea occurs when a person hasn't started menstruating by age 17, while secondary occurs after previous regular menstruation.
Hyper- and Hypomenorrhea:
Hypermenorrhea: periods longer than seven days.
Hypomenorrhea: very short periods lasting a day or two, indicating potential hormonal imbalance.
Can also indicate issues like fibroids or other structural abnormalities.
Menorrhagia:
Characterized by excessive menstrual bleeding, often linked to fibroids or endometriosis.
Treatment Options for menorrhagia may include D&C, hormone regulation, or surgical intervention.
Endometriosis:
Defined as the presence of endometrial tissue outside the uterus leading to scar tissue, pain, and potential infertility.
Symptoms include severe pain, swelling, and often require surgical interventions for treatment.
Perimenopause:
Defined as the gradual hormonal decline before menopause with persistent menstruation, presenting conflicting symptoms of both hormone decrease and menstrual changes.
Symptoms include hot flashes, memory changes, irritability, and increased risk of health conditions.
Importance of acknowledging symptoms to control impacts on daily living is highlighted.
Menopause and Health Management:
Complications: Any post-menopausal bleeding should be investigated due to associations with serious conditions.
Access to Contraception: Awareness that women may still become pregnant during perimenopause despite irregular cycles.
Vaginal Health and Infections:
Understanding inflammation causes due to overgrowth organisms leads us to treatments that might include antifungal medications or antibiotics.
Recognizing that vaginal pH changes can influence susceptibility to infections, alongside external factors like diet and stress.
Toxic Shock Syndrome:
Associated with prolonged use of tampons and other medical devices leading to severe bacterial infection.
Signs include fever and potential multi-organ failure, emphasizing the necessity of prompt recognition and treatment.
Reproductive Life Planning:
Understanding contraceptive options, including hormonal methods and natural family planning, alongside discussions of reproductive health challenges.
Legal considerations and ethical discussions surrounding in vitro fertilization, including decisions about excess embryos and fertility treatment intricacies.