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48 Cards in this Set
- Front
- Back
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breast anatomy
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mammary glands
milk ducts areola nipple fatty tissue |
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What should you use to examine breasts?
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pads of middle 3 fingers
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breast self-exam
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manual inspection (reclining)
With fingertips close together, gently probe each breast in 1 of 3 patterns (up, down, circular, clock) |
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What are the quadrants of the breast?
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Right Upper Quadrant
Left Upper Quadrant Right Lower Quadrant Left Lower Quadrant |
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How else can the breast be "divided up"?
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"clock" positions
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breast cancer statistics
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2012, American Cancer Society
232,400 newly diagnosed 50k additional cases of in situ (1,970 males) deaths - 40k females & 440 males |
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warning signs
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lump,
swelling, thickening, dimpling/skin irritation, nipple discharge, retraction, or scaliness, pain/tenderness, something other than normal for pt |
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breast cancer risk factors
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age,
female, previous breast cancer, family hx, genetic factors (BRAC 1 & 2), late pregnancy, early menarche/late menopause |
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more breast cancer risk factors
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estrogen replacement,
oral contraceptives, obesity/diet, alcohol consumption, radiation exposure, environmental factors |
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What are key factors in breast health?
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early detection:
annual mammograms (age 40) clinical breast exams monthly breast self-exams investigate breast lumps promptly |
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mammography - digital
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baseline by age 40
over age 40 - every year |
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detected on mammogram
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microcalcifications
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breast ultrasound
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used to determine is lesion is solid/fluid filled
aids in dx of breast cancer |
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magnetic resonance imaging (MRI)
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women at high risk for breast cancer
extremely dense or unevenly dense breast prior radiation to chest between ages of 10-30 years of age very expensive insurance issues |
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What are types of biopsy procedures?
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fine needle aspiration,
core needle, stereotactice core needle, surgical (open), sentinel node |
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fine needle aspiration biopsy
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performed on palpable lump
small 22 gauge needle inserted into lesion inexpensive determines if benign or malignant immediate results minimal pt discomfort infection/bleeding, potential side effects |
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core needle biopsy
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performed on palpable lesions
performed in breast center determines if malignant lesion infection/bleeding |
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surgical (open) biopsy
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operative procedure
general/local anesthesia increased recovery time additional surgical procedures provides definitive diagnosis |
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stereotactic core needle biopsy
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performed on lesions identified on mammography
several specimens increased accuracy larger tissue sample infection/bleeding |
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sentinel node biopsy
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used when lesion ≤ 2cm
used to detect spread to lymph nodes radioactive dye injected to detect if node/s are involved prevent lymph edema treatment options |
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1890s
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William S. Halsted - radical mestectomy
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1950s
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studies began on modified radical mastectomy
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1970s
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Women's Health Movement
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1980s
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modified radical mastectomies & lumpectomies common practice
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1990s
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sentinel node biopsy
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stages of breast cancer
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diagnosed according to stages (0 - IV) under TNM classification
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factors used in staging of breast cancer
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T - tumor size - size of primary tumor
N - nodal status - indicates presence/absence of cancer cells in lymph nodes M - metastasis - indicates if cancer cells have spread from affected breast to other areas of body, i.e., skin, liver, lungs, bone |
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progressive stages of breast cancer
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early stage - node negative
locally advanced stage - node positive distant spread - metastases |
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ductal carcinoma in situ (DCIS)
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presence of abnormal cells inside milk duct in breast
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staging of breast cancer
stage I |
primary tumor < 2 cm
no lymph node involvement |
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staging of breast cancer
stage II |
tumor size < 5cm
limited lymph node involvement |
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staging of breast cancer
stage III |
tumor size > 5cm
lymph node involvement possible distant metastasis includes inflammatory breast cancer |
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staging of breast cancer
stage IV |
tumor = any size w/ invasion to chest wall or skin
lymph node involvement and/or distant metastasis |
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lumpectomy or breast conservation
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removes tumor & surrounding tissue
axillary lymph node dissection radiation therapy |
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radial mastectomy
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removal of breast & skin, tumor, petoralis major & minor muscles
complete axillary lymph node dissection |
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modified radical mastectomy
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removal of breast & skin, tumor
axillary lymph node dissection DOES NOT REMOVE MUSCLES |
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breast reconstruction
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rebuilding of a breast
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breast implants - post mastectomy
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medical prosthesis used to augment, reconstruct, or create the physical form of breasts
tissue expander |
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autologous reconstruction
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breast reconstruction using own skin & fat
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Transverse Rectus Abdominus Myocutaneous (TRAM) flap
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an autogenous myocutaneous flap that uses transverse rectus abdominal muscle (TRAM) to carry lower abdominal skin and fat to the breast for reconstruction
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nipple/areola reconstruction & tattooing
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nipple reconstruction w/ areola tattoo
nipple & areola reconstruction w/ tattoo nipple reconstruction w/ skin graft to areola |
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lymph node status
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lymph node involvement
metastasis appropriate treatment options prognostic indicator |
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types of chemotherapy
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neo-adjuvant
adjuvant combination chemo: multiple agents, bio-therapy |
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SE of breast cancer treatment - surgery
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weight imbalance
tightness of skin muscle stiffness & weakness lymphedema numbness, tingling pain |
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SE of breast cancer treatment - radiation therapy
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tiredness
skin changes change in breast size |
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radiation therapy
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lumpectomy
post mastectomy treatment pathologic fractures |
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radiation SE
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skin discoloration
skin irritation fatigue bone marrow suppression |
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# of breast cancer survivors
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2.5 mil
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