Breast Assessment

Front 1

breast anatomy

Back 1

mammary glands
milk ducts
areola
nipple
fatty tissue

Front 2

What should you use to examine breasts?

Back 2

pads of middle 3 fingers

Front 3

breast self-exam

Back 3

manual inspection (reclining)
With fingertips close together, gently probe each breast in 1 of 3 patterns
(up, down, circular, clock)

Front 4

What are the quadrants of the breast?

Back 4

Right Upper Quadrant
Left Upper Quadrant
Right Lower Quadrant
Left Lower Quadrant

Front 5

How else can the breast be "divided up"?

Back 5

"clock" positions

Front 6

breast cancer statistics

Back 6

2012, American Cancer Society
232,400 newly diagnosed
50k additional cases of in situ (1,970 males)
deaths - 40k females & 440 males

Front 7

warning signs

Back 7

lump,
swelling,
thickening,
dimpling/skin irritation,
nipple discharge, retraction, or scaliness,
pain/tenderness,
something other than normal for pt

Front 8

breast cancer risk factors

Back 8

age,
female,
previous breast cancer,
family hx,
genetic factors (BRAC 1 & 2),
late pregnancy,
early menarche/late menopause

Front 9

more breast cancer risk factors

Back 9

estrogen replacement,
oral contraceptives,
obesity/diet,
alcohol consumption,
radiation exposure,
environmental factors

Front 10

What are key factors in breast health?

Back 10

early detection:
annual mammograms (age 40)
clinical breast exams
monthly breast self-exams
investigate breast lumps promptly

Front 11

mammography - digital

Back 11

baseline by age 40
over age 40 - every year

Front 12

detected on mammogram

Back 12

microcalcifications

Front 13

breast ultrasound

Back 13

used to determine is lesion is solid/fluid filled
aids in dx of breast cancer

Front 14

magnetic resonance imaging (MRI)

Back 14

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

Front 15

What are types of biopsy procedures?

Back 15

fine needle aspiration,
core needle,
stereotactice core needle,
surgical (open),
sentinel node

Front 16

fine needle aspiration biopsy

Back 16

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

Front 17

core needle biopsy

Back 17

performed on palpable lesions
performed in breast center
determines if malignant lesion
infection/bleeding

Front 18

surgical (open) biopsy

Back 18

operative procedure
general/local anesthesia
increased recovery time
additional surgical procedures
provides definitive diagnosis

Front 19

stereotactic core needle biopsy

Back 19

performed on lesions identified on mammography
several specimens
increased accuracy
larger tissue sample
infection/bleeding

Front 20

sentinel node biopsy

Back 20

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

Front 21

1890s

Back 21

William S. Halsted - radical mestectomy

Front 22

1950s

Back 22

studies began on modified radical mastectomy

Front 23

1970s

Back 23

Women's Health Movement

Front 24

1980s

Back 24

modified radical mastectomies & lumpectomies common practice

Front 25

1990s

Back 25

sentinel node biopsy

Front 26

stages of breast cancer

Back 26

diagnosed according to stages (0 - IV) under TNM classification

Front 27

factors used in staging of breast cancer

Back 27

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

Front 28

progressive stages of breast cancer

Back 28

early stage - node negative
locally advanced stage - node positive
distant spread - metastases

Front 29

ductal carcinoma in situ (DCIS)

Back 29

presence of abnormal cells inside milk duct in breast

Front 30

staging of breast cancer
stage I

Back 30

primary tumor < 2 cm
no lymph node involvement

Front 31

staging of breast cancer
stage II

Back 31

tumor size < 5cm
limited lymph node involvement

Front 32

staging of breast cancer
stage III

Back 32

tumor size > 5cm
lymph node involvement
possible distant metastasis
includes inflammatory breast cancer

Front 33

staging of breast cancer
stage IV

Back 33

tumor = any size w/ invasion to chest wall or skin
lymph node involvement and/or distant metastasis

Front 34

lumpectomy or breast conservation

Back 34

removes tumor & surrounding tissue
axillary lymph node dissection
radiation therapy

Front 35

radial mastectomy

Back 35

removal of breast & skin, tumor, petoralis major & minor muscles
complete axillary lymph node dissection

Front 36

modified radical mastectomy

Back 36

removal of breast & skin, tumor
axillary lymph node dissection
DOES NOT REMOVE MUSCLES

Front 37

breast reconstruction

Back 37

rebuilding of a breast

Front 38

breast implants - post mastectomy

Back 38

medical prosthesis used to augment, reconstruct, or create the physical form of breasts
tissue expander

Front 39

autologous reconstruction

Back 39

breast reconstruction using own skin & fat

Front 40

Transverse Rectus Abdominus Myocutaneous (TRAM) flap

Back 40

an autogenous myocutaneous flap that uses transverse rectus abdominal muscle (TRAM) to carry lower abdominal skin and fat to the breast for reconstruction

Front 41

nipple/areola reconstruction & tattooing

Back 41

nipple reconstruction w/ areola tattoo
nipple & areola reconstruction w/ tattoo
nipple reconstruction w/ skin graft to areola

Front 42

lymph node status

Back 42

lymph node involvement
metastasis
appropriate treatment options
prognostic indicator

Front 43

types of chemotherapy

Back 43

neo-adjuvant
adjuvant
combination chemo: multiple agents, bio-therapy

Front 44

SE of breast cancer treatment - surgery

Back 44

weight imbalance
tightness of skin
muscle stiffness & weakness
lymphedema
numbness, tingling
pain

Front 45

SE of breast cancer treatment - radiation therapy

Back 45

tiredness
skin changes
change in breast size

Front 46

radiation therapy

Back 46

lumpectomy
post mastectomy
treatment pathologic fractures

Front 47

radiation SE

Back 47

skin discoloration
skin irritation
fatigue
bone marrow
suppression

Front 48

# of breast cancer survivors

Back 48

2.5 mil