1. Breast Cancer Jeorge Kristoffer R. Duldulao, RN

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

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

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

5. 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.

6. 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

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

8. 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

9. 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

11. 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)

12. Breast self exam

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

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

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

18. 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

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

20. 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

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

22. 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

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

26. 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.