1. Role of the Community Specialist Breast Care Nurse

2. Role of the Breast Care Nurse
Free service - public or private health system
A central contact point throughout your cancer experience
Provide up-to-date information
Provide practical and emotional support
Act as a ‘sounding board’ to discuss options
Referral to other services as required
Act as a link with support groups and other support networks

3. How to Refer to Breast Care Nurse
Self
General Practitioner
Surgeon
Medical/ Radiation Oncologist
Nurses
Hospital
Breast Screen NSW
MDT

4. What happens next? Phone client to arrange possible meeting.
Face to face meeting at place of client choosing.
In-patient contact
Post discharge
Pre adjuvant treatment
Post completion of active treatment
Ongoing support as required

5. Multidisciplinary Team Meetings
Local Medical Officers
Pathologist
Surgeons
Specialist Breast Care Nurses
Radiologists
Genetic Counsellor
Radiation Oncologist
Physiotherapist
Medical Oncologist
Social Worker

6. Support Services Prosthesis -Medicare Funded up to $400, every 2 years
Breast Cancer Network- My Journey Kit & My Care Kit
Social Workers- case conference, financial and legal concerns, counselling
The Cancer Council NSW
Genetic Counselling
Breast cancer support groups in Ballina, Byron Bay, Casino, Kyogle, Lismore and Murwillumbah.
Look Good Feel Better Workshops
Wig Library - NNSWCI

7. Even more support services…
Encore- gentle exercise program after breast cancer
Lymphoedema Therapists (public and private). Located in Lismore, Ballina, Casino and Byron Bay
Patient Assisted Travel (IPTAAS). For patients who need to access specialist services 70km or more from home or >200km in a week.
Volunteer (community) transport
Rainbow Dragons Abreast – Lennox & Mount Warning groups
CanTEEN- support to 12 to 24 year olds
Knockers, bags, pillows, beanies……..
Even more support services…

8. Anatomy Of the breast A - Ducts B – Lobule
C – Lactiferous Duct (holds milk)
D – Nipple
E – Fat
F – Pectoralis major muscle
G – Chest wall / rib cage
A – Normal Duct
B – Basement membrane
C – Lumen
(BreastCancer.org, 2012)

9. Triple Test Clinical examination & history Mammogram
Ultrasound +/- stereotactic core biopsy
9 out of 10 lumps are benign in Pre-Menopausal women
3 out of 4 lumps are benign in Post- Menopausal women

10. Types of breast cancer
An abnormal cell growth that begins & remains within or insitu (non- invasive) is called:
Duct = DCIS or Ductal Carcinoma Insitu
Lobule = LCIS or Lobular Carcinoma Insitu
(AIHW & Cancer Australia, 2012)

11. Types of breast cancer continued
An abnormal cell growth that NO longer remains within the duct/lobe is called invasive or infiltrating;
IDC = Infiltrating Ductal Carcinoma (most common breast cancer)
ILC = Infiltrating Lobular Carcinoma
(AIHW & Cancer Australia, 2012)

12. Less common breast cancers
Inflammatory breast cancer
A rare form of invasive breast cancer which affects the lymphatic vessels in the skin of the breast making the skin become red & inflamed.
often thought to be cellulitis/mastitis
(Yarbro, Wujcik & Gobel, 2011)

13. Paget’s Disease –
affects the nipple and the areola & often associated with invasive cancer elsewhere in the breast.

14. Surgical Options for Breast Cancer
Wide Local Excision (WLE) - the removal of the breast lump with good clear tissue margins while conserving the breast
Simple Mastectomy - the removal of the breast

15. Lymph Node status
Is necessary for diagnostic, prognostic and therapeutic purposes in order to;
Classify the extent of disease
Planning adjuvant treatment such as chemotherapy, radiotherapy, endocrine treatment

16. Breast area lymph nodes
A- Pectoralis major muscle
B- Axillary lymph nodes Level l
C – Axillary lymph nodes level ll
D – Axillary lymph nodes level lll
E – Supraclavicular lymph nodes
F internal mammary lymph nodes
(BreastCancer.org, 2012)

17. Sentinel lymph node biopsy

18. Axillary lymph node dissection
Standard surgical practice when:
Lymph nodes are clinically palpable
Depending on level of clearance, approximately lymph nodes may be removed

21. THANK YOU