Final Presentation Breast Cancer
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Transcript of Final Presentation Breast Cancer
8/8/2019 Final Presentation Breast Cancer
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INTRODUCTIONBreast cancer occurs when a malignant (cancerous) tumor originates in
the breast. As breast cancer tumors mature, they may metastasize (spread) toother parts of the body. The primary route of metastasis is the lymphatic system which, ironically enough, is also the body's primary system for producing andtransporting white blood cells and other cancer-fighting immune system cellsthroughout the body. Metastasized cancer cells that aren't destroyed by thelymphatic system's white blood cells move through the lymphatic vessels andsettle in remote body locations, forming new tumors and perpetuating thedisease process.
Breast cancer is fairly common. Because of its well publicized nature, andpotential for lethality, breast cancer is arguably the most frightening type of cancer diagnosis someone can receive. However, it is important to keep in mindthat, if identified and properly treated while still in its early stages, breast
cancer can be cured.Breast cancer is not just a woman's disease. It is quite possible for men toget breast cancer, although it occurs less frequently in men than in women. Ourdiscussion will focus primarily on breast cancer as it relates to women but itshould be noted that much of the information is also applicable for men.
y
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functions:
yBreastfeeding
ySexual role
y milk glands (lobules) that
produce milky ducts that transport milk
from the milk glands(lobules) to the nipple
y nipple
y areola (pink or brownpigmented region
surrounding the nipple)y connective (fibrous) tissue
that surrounds the lobulesand ducts
y fat
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Two hormones responsible
for milk production
Prolactin ="mothering hormone
Oxytocin = deliversthe milk that prolactinhas produced.
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Predisposing Factors:Age
GenderRace
Family History
Hormonal factors:
Early menarch
Late menopause
ETIOLOGY:
Unknown
Precipitating Factors:exposure to radiation and
certain chemicalsobesity
alcohol intake
SmokingLifestyleLate child bearing
Somatic mutations inthe DNA
Activate oncogene/deactivate tumor-
supppresor gene
s/sx:
Lump ( in breast or under the armpits)Change in breast size or shape
Skin dimplingNipple inversion
Spontaneous single nipple discharge
Cells become cancerous, ³Tumor size is up to
2 cm´ (Mutation destroy their ability to stop
dividing, to attach other cells and stay in placewhere they belong)
Uncontrolled Cell divisions with DNA
copied with mistakes ( can also betriggered with hormonal imbalance) : progesterone and estrogen binds with
their respective receptors stimulates the production of protein that increase cell
division
Tumor size is upto 5cm ; with
axillary lymphnode invlovement
Mass of cancer cellsdevelop or a tumor
Diagnostic Test:
BSEMAMMOGRAPHY
GALACTOGRAPHY
ULTRASONOGRAPHYMRI
BIOPSY
Treatment:
TAMOXIFEN
Adriomycin
Tumor size is up to 5cm ;with axillary and neck
lymph node invlovement
Pathophysiology
STAGE 1
STAGE 2
STAGE3
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STAGE 1 STAGE 2
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STAGE 3
STAGE 3A (INFLAMMATORY BC)
STAGE 4
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METASTASIS
Different parts of the body:- Brain
- lungs- liver
- boneFailure of immune surveillance, a
theory in which the immune system
removes malignant cells throughout
one's life.
Types of Breast Cancer: According to its location
Ductal carcinoma in situInvasive cancer:
Infiltrating Ductal carcinomaInfiltrating lobular carcinoma
Medullary carcinomaMucinous carcinoma
Tubular ductal carcinomaInflammatory Carcinoma
Paget Disease
Inherited defects in DNA repair
genes, such as ''BRCA1'', ''BRCA2''
and ''TP53''
Abnormal growth factor signaling
in the interaction between
stromal cells and epithelial cells
can facilitate malignant cellgrow
Proliferation of Cancer cells
STAGE 4
Normal cell will
commit suicide when
they are no longer
needed (apoptosis)
Normally, the PTEN protein turns off the PI3K/AKT
pathway when the cell is ready for cell suicide.
In breast cancers, the gene for the PTEN protein is
mutated, so the PI3K/AKT pathway is stuck in the "on"
position, and the cancer cell does not commit suicide.
Treatment:
-MASTECTOMY
-RADICAL MASTECTOMY
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Ca cells produce anorexogenicsubstances that act in satiety
center of the hypothalamus,causing anorexia
Tumors revert to anaerobic metabolism:
Consume glucose, deplete glycogen stored in the
liver, and convert glucose to lactate (lactic acid)
Deprived normal cells from
nutrition
Tumors take Na. water retention masks malnutrition
All Body cells becomeweak and die
Person¶s Death
yPressure on thesite of neoplastic
growth
yObstruction caused bytumors
PainNecrosis
Ischemia
Tissue damage
High risk for
infection
Tumorsproduces
abnormalcoagulation
factors that
increasesclotting (e.g.Pulmonary
Emboli- lifethreatening)
PARANEOPLASTIC
SYNDROME
y ANEMIA
yHYPERCALCEMEA
ANOREXIA-CACHEXIASYNDROME
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BREAST MAMMOGRAM BREAST ULTRASOUND
BREAST MRI BIOPSY
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Medical Managementy Chemotherapy Chemotherapy medicines to kill cancer
cells
y Radiation therapy Radiation therapy to destroy cancerous tissue
y Hormonal therapy is prescribed to women with ER-positive breast cancer to block certain hormones that
fuel cancer growth.
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TYPES OF PROCEDURE y LUMPECTOMY - is a surgical procedure that
involves removing a
suspected malignant(cancerous) tumor, or lump,and a small portion of the surrounding tissue
from a woman's breast.
y MASTECTOMY - is an operation in which theentire breast, usually including the nipple and the
areola, is removed. Mastectomy is usually
performed as a treatment of breast cancer.
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y MODIFIED RADICAL MASTECTOMY - is the removal
of breast cancer (abnormal cells in the breast
that grow rapidly and replace normal healthytissue).
y RADICAL MASTECTOMY- The breast, lymph
nodes, muscles under the breast, and some of the surrounding fatty tissue are removed.
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MANAGEMENT
Patient Support
«Prior to Surgery
Time and Place to Report
Who will be doing the
procedure
Expected side effects
Need of anesthesia
Follow-up care
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Post operation care. Place the client in semi fowler position with arm
elevated on pillows, abducted to promote venous
return and prevent edema. Monitor HEMOVAC output (serosanguinous for the
first 24 hrs). Check behind patient for bleeding. Blood flows to the
back for gravity . Post sign warning taking against taking blood
pressure, starling IVs, or drawing blood on affectedside.
. Initiate exercise to prevent stiffness and contracturesof shoulder girdle
. Reinforce special mastectomy exercise as prescribed. Provide adequate anesthesia to promote ambulation
and exercise
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9. Prepare client for size and appearance of theincision and provide support when incision is
viewed for the first time.10.Provide client with detailed information
concerning breast prosthesis11.Fitting is not possible for 4-6 weeks
12.A temporary prosthesis or lightly padded bras worn until healing is complete
13.Teach patient to avoid constrictive clothing andreport persistent edema, redness, or infectionof incision
14.Teach patient the importance of continuingmonthly breast examination on remainingbreast
15.Prevention of LYMPHEDEMA
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AVOIDS
1.Cuts
2. Scratches
3. Pinpricks
4. Hangnails
5. Insect bites
6. Burns
7.Strong detergent
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DONTs (on the arm on the affectedside)
1. Carry purse/anything heavy
2. Wear wristwatch/jewelry
3. Pick at/ cut cuticles
4. Work near thorny plants/digin garden
5. Reach into hot oven
6. Hold the cigarette
7.Injections, withdrawal of blood, BP-taking
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DOs
Wear loose rubber gloves when
washing dishes
Wear a thimble when doing sewing
Apply lanolin hand cream to prevent
dryness
Contact AMD if arm gets, red, warm,
or hard/swollen
Return for check up
Wear Life Guard Med. Aid tag
Caution -LYMPHEDEMA
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Nursing Diagnosisy KNOWLEDGE DEFICITR ELATED TO
INEXPER IENCE AND NEW INFORM ATION R EGA R DING AVAILA BLE OPTIONS FOR TR EATMENT
y BODY IM AGE DISTURB ANCER ELATED TO
IMPENDING CHANGES IN BR EA ST AND SEXUALITY
y R ISK FOR INJUR Y R ELATED TO INCR EA SEDR ISK OF INFECTION AND LY MPHEDEM A SECONDA R Y
TO AXILLA R Y NODE DISECTION
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CELEBRITES: BREAST CANCER
SURVIVORS
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