In-Depth Notes on Breast Cancer

  • Overview of Breast Cancer

    • Two main categories:
    • Invasive Breast Cancer: Cancer that invades surrounding breast tissue.
    • Non-Invasive Breast Cancer: Cancer that remains in the ducts, not spreading.

  • Common Sites of Metastasis

    • Most common locations include:
    • Brain
    • Bone
    • Liver
    • Lung

  • Types of Breast Cancer

    • Non-invasive:
    • Ductal Carcinoma In Situ (DCIS):
      • Early form of breast cancer, detected via screening, generally curable.
    • Invasive:
    • Invasive Ductal Carcinoma (IDC):
      • The most common type of breast cancer, characterized by irregular lumps.
    • Inflammatory Breast Cancer (IBC):
      • Less common but aggressive form of invasive breast cancer.

  • Symptoms of Invasive Breast Cancer

    • Irregular, poorly defined lumps.
    • Breast dimpling, resembling skin texture of an orange.
    • Nipple pitting (a late sign, indicating possible advanced disease).
    • Skin changes, including hyperpigmentation and thickening.

  • Genetic Factors

    • Significant genetic components:
    • BRCA mutations (BRCA1 and BRCA2): Major risk factors.
    • Other mutations: ATM, and others.
    • Family history increases risk.
    • Statistics:
    • 1 in 8 women will develop breast cancer in their lifetime.

  • Risk Factors

    • Increased age.
    • Early menarche and late menopause.
    • Obesity and physical inactivity.
    • Hormone Replacement Therapy (HRT) post-menopause.
    • Alcohol consumption.
    • Mortality rates are higher in Black women compared to White women (40% increase).

  • Screening and Early Detection

    • Importance of screenings for both men and women, especially those with genetic predispositions.
    • Self Breast Exams (SBE):
    • Should be done monthly, ideally on the same day.
    • Clinical Breast Exams (CBE):
    • Conducted by a qualified healthcare provider.
    • Mammography:
    • Typically starts at age 40, with annual screenings at 45 for average risk.
    • High-risk individuals may start earlier and may require additional imaging like MRI.

  • Pathologic Studies and Diagnosis

    • The only definitive diagnosis of breast cancer requires a biopsy.
    • Assessment of lymph nodes to check for metastasis.

  • Chemotherapy Management

    • Administration methods: oral and IV.
    • Precautions include wearing chemotherapy gloves and being aware of extravasation risks.
    • Care during treatment includes avoiding procedures (blood pressure checks, IVs) on the affected side post-mastectomy to prevent lymphedema.

  • Treatment Options

    • Surgical Treatments:
    • Options include lumpectomy, mastectomy (single or double), focusing on complete removal of cancerous tissue.
    • Radiation Therapy:
    • Types include teletherapy (external) and brachytherapy (internal).
    • Brachytherapy requires precautions due to radioactivity.
    • Complementary Therapies:
    • Techniques may include meditation, acupuncture, and other supportive therapies.

  • Psychosocial Considerations

    • High levels of anxiety and panic attacks upon diagnosis are common; emotional support is crucial.
    • Importance of counseling and community resources.

  • Care Coordination and Ongoing Management

    • Home care needs assessed, particularly post-surgery with potential drains.
    • Patients monitored for lymphedema, ensuring precautions in handling the affected side.

  • Outcome Goals

    • Aim for no recurrence or metastasis.
    • Supportive care through palliative and hospice services if metastasis occurs.

  • Conclusion

    • Continuous education and awareness about breast cancer are key in reducing risks and improving outcomes.
    • Engage patients in discussions about feelings and impact on life, including body image concerns post-treatment.