1. Interventions for Clients with Lung Cancer

2. Benign Breast Disorders
• Fibroadenoma, most common cause of breast
masses during adolescence; may occur in
clients in their 30s
• Solid, slowly enlarging, benign mass; round,
firm, easily movable, nontender, and clearly
delineated from the surrounding tissue
• Usually located in the upper outer quadrant of
the breast

3. Fibrocystic Breast Disease
• Physiologic nodularity of the breast, most
common breast problem of women between 20
and 30 years of age
• Stage 1: premenstrual fullness and tenderness,
symptoms occur on menstrual cycle
• Stage 2: multiple nodular areas in both breasts
(Continued)

4. Fibrocystic Breast Disease (Continued)
• Stage 3: microscopic or macroscopic cysts
associated with pain, tenderness, or burning
occurring in women between 35 and 55 years of
age

5. Collaborative Management
• Symptomatic management
• Hormonal manipulation
• Drug therapy: vitamins C, E, and B complex
• Diuretics
• Avoidance of caffeine
• Mild analgesics
(Continued)

6. Collaborative Management (Continued)
• Limited salt intake before menses
• Well-padded supportive bra
• Local application of heat or ice for pain relief

7. Ductal Ectasia • Benign breast problem of women approaching
menopause caused by dilation and thickening of
the collecting ducts in the subareolar area
• Mass that is hard with irregular borders, tender
• Greenish brown nipple discharge, enlarged
axillary nodes and edema over the site of the
mass

8. Intraductal Papilloma
• Occurs most often in women 40 to 55 years of
age
• Benign process in the epithelial lining of the
duct, forming an outgrowth of tissue
(Continued)

9. Intraductal Papilloma (Continued)
• Trauma and erosion within the duct, resulting in
bloody or serous nipple discharge
• Diagnosis aimed first at ruling out breast cancer

10. Gynecomastia • Benign condition of breast enlargement in men
• Can be a result of primary cancer such as lung
cancer
• Causes include:
– Drugs
– Aging
– Obesity
(Continued)

11. Gynecomastia (Continued)
– Underlying disease causing estrogen excess
– Androgen deficiency
– Breast cancer

12. Breast Cancer • Types of breast cancer • Complications include:
– Invasion of lymph channels causing skin
edema
– Metastasis to lymph nodes
– Bone, lungs, brain, and liver—sites of
metastatic disease from breast cancer
– Ulceration of overlying skin

13. Breast Cancer in Men • Of all breast cancers, only 1% occurs in men.
• Breast cancer in men usually presents as a hard, nonpainful subareolar mass.
• Breast cancer in men is often a widely spread disease because it is usually detected at a later stage than in women.

14. Mammography • Baseline screening mammography yearly at age
40 is recommended.
• Barriers to mammography compliance can
involve factors such as fear.
• Increase compliance through education.

15. Breast Self-Examination
• The goal of screening for breast cancer is early
detection because breast self-examination
cannot prevent breast cancer.
• Early detection reduces mortality rate.
• Teach breast self-examination.

16. Breast Care • Clinical breast examination • Cancer surveillance
• Prophylactic mastectomy
• Chemoprevention

17. Pathologic Examination
• Key to diagnosis of breast cancer
• Presence or absence of estrogen receptors or
progesterone receptors
• S-phase index, or growth rate
• DNA ploidy
• Histologic or nuclear grade
• HER2/neu gene expression

18. Anxiety • Interventions: – Anxiety for the woman with breast cancer
begins the moment the lump is discovered.
– Level of anxiety may be related to past
experiences and personal associations with
the disease.
– Allow the client to ventilate feelings.
– Flexibility is the key to nursing care.

19. Potential for Metastasis
• For clients with late-stage breast cancer,
nonsurgical treatment may be the only
alternative; tumor may be removed with local
anesthetic, follow-up treatment with hormonal
therapy, chemotherapy, and sometimes
radiation.
(Continued)

20. Potential for Metastasis (Continued)
• For breast cancer at a stage for which surgery is
the main treatment, follow-up with adjuvant
radiation, chemotherapy, hormone therapy, or
targeted therapy is commonly prescribed.

21. Surgical Management • Mass should be removed to reduce risk for local
recurrence; but controversy exists concerning
the best treatment.
• Axillary lymph nodes (dissection or removal)
• Sentinel lymph node biopsy
• Preoperative care
• Operative procedure

22. Postoperative Care • Avoidance of using the affected arm for blood
pressure measurement, giving injections, or
drawing blood
• Monitoring of vital signs
• Care of drainage tubes
• Comfort measures
• Mobility and diet
• Breast reconstruction

23. Adjuvanat Therapy
• To decrease the risk of recurrence, adjuvant therapy consists of:
– Radiation therapy
– Chemotherapy
– Hormonal therapy
– Stem cell transplantation
– Targeted therapy