Breast Cancer Jeorge Kristoffer R. Duldulao, RN

Breast Cancer A rapid, unregulated growth of abnormal cells originating from the breast tissue.

1. Chest Wall 2. Muscle 3. Lobules 4. Nipple 5. Areola 6. Lactiferous Ducts 7. Fat Tissues 8. Skin

ONCOGENES  Onco – CancerGene – Genetic Material Oncogene : Suppressor Gene Ratio 1:1 In Cancer Oncogene > Suppressor Gene

Causes of Breast Cancer  Causative factors have not yet been identified by experts, but instead, they have provided factors that increase a person’s RISK in developing cancer.

RISK FACTORS  Old Age  Genetics  History of breast cancer  Having a certain types of breast lumps  Dense breast tissue  Estrogen exposure  Obesity  Height  Alcohol consumption  Radiation exposure  Use of HRT  Job – related  Cosmetic Implants

Types  Ductal VS Lobular  (Based on tissue origin of cancer cells)  Invasive VS Non-Invasive  (Based on tissue involvement of cancer cells)

Signs and Symptoms  Signs are those that are felt by patient (subjective).  A lump in a breast  A pain in the armpits or breast that does not seem to be related to the woman's menstrual period  Pitting or redness of the skin of the breast; like the skin of an orange  A rash around (or on) one of the nipples  A swelling (lump) in one of the armpits

SIGNS AND SYMPTOMS  Signs are those that are felt by patient (subjective).  An area of thickened tissue in a breast  One of the nipples has a discharge ; sometimes it may contain blood  The nipple changes in appearance ; it may become sunken or inverted  The size or the shape of the breast changes  The nipple-skin or breast-skin may have started to peel, scale or flake

Diagnostic procedures  Breast Exam (Initial assessment)  Mammogram  X-ray  2D + 3D  Breast Ultrasound (solid mass vs fluid- filled)  Biopsy (Confirmatory procedure)  Breast MRI (determine extent of cancer)

Breast self exam

STAGING  Blood Tests:  Tumor Marker Test:  CA 15-3  Bone Scan  PET Scan  T - Tumor  N – Nodal Involvement  M – Metastasis

Management  Oncologist  Specialist cancer surgeon  Specialist nurse  Pathologist  Radiologist  Radiographer  Reconstructive surgeon  Occupational therapist  Psychologist  Dietitian  Physical therapist The TEAM

Management and the Nurse’s role  Surgery  Radiotherapy  Chemotherapy  Hormone Therapy  Biological Treatment

SURGERY  - Lumpectomy  - Mastectomy  - Reconstructive Surgery  Nurse’s focus:  Post-Operative Care  Wound Care  Rehabilitation plan to achieve optimum level of functioning (OLOF)  Psychological care for clients towards changes in body image

RADIOTHERAPY  - Brachytherapy  - Tele-therapy  - Linear accelerator  Nurse’s focus:  Skin Care  Prevent fatigue

CHEMOTHERAPY  - Single agent  - Multiple agent  Nurse’s focus:  Alleviate most common side effects:  nausea/ vomiting,  diarrhea/ constipation  Prevent extravasation/ phlebitis  Encourage adherence to treatment plan and schedule

Hormone Therapy  - Endocrine receptor  - HER2 receptor  - Triple negative/ positive  Nurse’s focus:  Client’s adherence to treatment schedule and duration

Biological Therapy  Also known as Targeted Therapy  -Monoclonal antibodies  - -umab, -inib suffixes of medicines  Nurse’s focus:  Allergic reaction  Prevent extravasation/ phlebitis  Adherence to treatment schedule

Prevention of breast cancer  Lifestyle Modification  Alcohol consumption  Physical Exercise  Diet  Postmenopausal Hormone therapy  Bodyweight  Breast Cancer Screening  Breastfeeding

How much have you learned?  Give one characteristic of a cancer cell!  Provide one risk factor of developing breast cancer.  The procedure an individual can perform to herself as an initial assessment of breast cancer is called: _____________________  Give one management of breast cancer.  A patient is undergoing radiotherapy. What should a nurse teach to her client? Give at least 1 (one) focus.