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Name 2 types of Non-invasive breast cancer. (2)
- 1) Ductal carcinoma in situ (DCIS)
- 2) Lobular carcinoma in situ (LCIS)
These are what types of breast cancer?
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This type of non-invasive breast cancer is unilateral, and would progress to invasive breast cancer if untreated.
Discribe ductal carcinoma in situ (DCIS).
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This type of non-invasie breast cancer is not known to be a pre-malignant condition, is a risk factor for developing breast cancer, and can be treated with the estrogen-receptor blocker Tamoxifen, but otherwise there is no other treatment.
Discribe lobular carcinoma in situ (LCIS).
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Discribe inflammatory breast cancer. (7)
- 1) Aggressive, fast growing
- 2) Early, wide metastasis
- 3) Rare
- 4) Skin on the breast is warm, red, thickened (orange peel or peau d’orange) appearance
- 5) May develop hive like bumps and ridges
- 6) Often mistaken for infection
- 7) Treated with radiation, chemo, and hormone therapy rather than surgery
These all discribe what type of breast cancer?
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Breast cancer is most commonly found in what area of the breast?
______ cancer is most commonly found in the upper, outer quadrant of the breast.
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Characteristically breast cancer is
1) hard or soft
2) fixed or moveable
3) round or irregularly-shaped
4) easily or poorly delineated
5) tender or non-tender lump
- _____ _____ is characteristically
- 1) hard
- 2) fixed
- 3) irrregularly-shaped
- 4) poorly delineated
- 5) non-tender lump
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Nipple retraction, Peau d’orange skin appearance of breast and occasionally unilateral clear or bloody nipple discharge would be clinical findings of what.
What would be some clinical findings with breast cancer?
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Name some breast cancer diagnostic workups to help predict risk or recurrence or metastatic disease. (5)
- 1) Lymph node dissection
- 2) Tumor size
- 3) Estrogen and progesterone receptor status
- 4) Cell proliferative indices
- 5) HER-2 receptor status
These are all used as what?
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What are the lab workups that a patient with breast cancer would have done? (6)
- 1) CBC, platelets
- 2) Calcium and phosphorus levels
- 3) Liver function tests
- 4) Chest x-ray
- 5) Bone scan (if indicated)
- 6) CT scan of chest, abdomen, pelvic (if indicated)MRI (if indicated)
These would be done in a patient with ____ ____.
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Name the two types of breast cancer surgery that are the standered of care.
- 1) Modified radical mastectomy
- 2) Breast conservation surgery (lumpectomy)
These are the two types of ____ ____ surgery that are the standered of care.
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What does modified radical mastectomy involve? (3)
- 1) Removal of the breast
- 2) Axillary node dissection
- 3) Preservation of pectoralis muscle
These would be done in what surgical breast cancer procedure?
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What are the side effects of modified radical mastectomy? (4)
- 1) Chest wall tightness
- 2) Phantom breast sensation
- 3) Arm swelling
- 4) Sensory changes
These are all side effect of what surgical breast cancer treatment?
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Discribe breast conservation surgery (lumpectomy) (3)
- 1) Wide excision of tumor
- 2) Sentinel or axillary node dissection
- 3) Radiation Therapy
These would be done in what breast cancer surgical procedure?
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What are the side effects of breast conservation surgery? (6)
- 1) Breast soreness
- 2) Breast edema
- 3) Skin reactions
- 4) Arm swelling
- 5) Sensory changes in breast and arm
- 6) Fatigue
These are all side effects of what breast cancer surgical procedure?
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Name three types of radiation therapy for the treatment of breast cancer. (3)
- 1) Primary treatment with lumpectomy
- 2) High-dose branchytherapy (internal radiation)
- 3) Pallative radiation therapy
These are all what kind of treatments for breast cancer?
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Name some systemic therapies for breast cancer. (3)
- 1) Chemotherapy
- 2) Hormone therapy
- 3) Biologic and targeted therapy
These are all ______ therapies for breast cancer.
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This type of radiation therapy is
1) Used in early-stage breast cancer
2) Radioactive seed is implanted (5-6 weeks)
3) Or balloon is used (5 days)
Discribe High-dose branchytherapy. (3)
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In this type of radiation therapy for breast cancer the affected breast and nodes are irradiated daily for 5-6 weeks, may also be given a “boost” dose to tumor location (10 extra treatments).
Discribe primary treatment with lumpectomy.
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This type of radiation therapy is used to stabilize symptomatic metastatic lesions.
Palliative radiation therapy is use to stabilize what?
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This type of systemic therapy for breast cancer uses a cytotoxic drug to destroy cancer cells.
Discribe chemotherapy.
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In this type of systemic therapy for breast cancern
1) Can be given preoperatively to decrease tumor size
2) Best response to combination of agents
3) Normal cells affected as well- dosing needs to be large enough to kill tumor without killing patient
Discribe how chemotherapy can be used. (1)
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In this type of systimic therapy for breast cancer the bodies estrogen supply is decreased to inhibit ER/PR positive tumor growth.
Discribe Hormone therapy.
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What is the drug of Choice for hormone therapy?
Tamoxifen (Nolvadex) is the drug of choice for what type of cancer therapy?
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What are some side effects of hormone therapy with Tamoxifen (Nolvadex)? (4)
- 1) Hot flashes
- 2) Night sweats
- 3) Mood changes
- 4) Risk for edometrial cance, blood clots, and cateracts
These are all side effects of what hormone therapy drug?
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How does Herceptin (Trastuzumab) work in targeted therapy of cancer.
- It's a monoclonal antibody to HER-2
- It attaches to the antigen and ultimately causes cell destruction
- Has a big effect on prognosis for patients with HER-2 positive breast cancer
This is how what drug works in targeted therapy of cancer?
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How do angiotensin inhibitors work in targeted therapy of breast cancer?
______ ______ work in by preventing formation of blood vessels into newly developing tumors.
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Regular interval follow up visits after completion of treatment of breast cancer include: (2)
- 1) Professional exams every six months X 2 years, then annually thereafter.
- 2) BSE teaching/surgical site inspection monthly.
NOQ
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List support and teachings after initial diagnosis of breast cancer: (3)
- 1) Clarifying information and answering questions
- 2) Assessing decision-making patterns and helping patient evaluate advantages and disadvantages of options
- 3) Offer support for treatment decisions
NOQ
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What's the preop education for breast cancer patients? (4)
- 1) TCDB
- 2) post op exercises
- 3) pain management plan
- 4) explanation of recovery plan
These are _______ ________ for breast cancer patients.
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The goal is to restore function on affected side after mastectomy and/or node dissection by __ to __ weeks post op?
The goal is to restore function on affected side after mastectomy and/or node dissection by 4 to 6 weeks post op.
NOQ
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Name some nursing managements to restore function after mastecomy and/or node dissection. (4)
- 1) Semi-fowlers position with affected arm elevated
- 2) Flexing and extending fingers should begin in recovery
- 3) Post op shoulder and arm exercises increase gradually
- 4) Analgesics 30 minutes before starting exercises.
These are nursing managements to restore function after what?
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Define Lymphedema.
This is the accumulation of lymph in soft tissues.
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Lymphedema can cause what to happen when the lymph nodes are excised or radiated in the treatment of breast cancer. (3)
- 1) ______ can cause heaviness, pain and impaired function of the arm.
- 2) It can cause paresthesia of the fingers.
- 3) It can cause cellulitis and progressive fibrosis
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What are some measures to use and teach in a patient with lymphedema. (4)
- 1) Affected arm should never be dependent
- 2) Blood pressure readings, venipunctures, and injections should be avoided on the affected arm
- 3) Elastic bandages should be avoided in the early post-op period
- 4) Instruct patient to protect affected arm from even minor trauma
These are measures and teaching for patient with _________
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What should you do if a patient with lymphedema has a trauma to the effected side?
If a patient with _______ has a trauma to the effected side you should wash the area thoroughly, apply antibiotic ointment, and sterile dressings should be applied.
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