Predisposing factors: -Family history of breast cancer -Personal history of breast cancer. -Age: 42 yo.

-Early menarche: Before age 12 -G0P0A0

Precipitating factors: - High fat diet - Low fiber diet - History of smoking - History of drinking alcoholic beverages - History of taking in illegal drugs (shabu)

Carcinogens damage the cells in the breast

Chronic cell injury Failure of the DNA to repair

LEGEND Diagnostic Exam Significant Laboratory Results Medical Management

Genetic Mutation Diagnostic Exam Breast Self Exam: palpated movable breast mass on upper outer quadrant of Right breast Ultrasound of the Breast: breast mass found in outer upper quadrant of Right Breast Replication of Mutated genes through: -Activation of growth promoting oncogenes -Inactivation of tumor suppressor genes -Alteration in genes that control apoptosis Medications Nursing Dxs and Nursing Management Interventions Done

Beginning of oncogenesis

Inflammation & irritation

Medical Management Excision of Tumor Breast Mass on March 23, 2010 at 8:00 AM

Macrophage phagocytize pathogen & present it as antigen to T lymphocytes & B lymphocytes

Hyperplasia Medications Pre-Op Metochlopramide 10mg slow IVTT en route to OR Ranitidine 50mg IVTT en route to OR Post-Op Cefuroxime 750mg IVTT q 8 Ketorolac 30mg IVTT q 8 Ranitidine 50mg IVTT q 8 Tramadol drip (TDL) 300mg in D5W 500 ml @ 22ml/hr Nubain 5mg IVTT q 8 PRN for pain

Dyplasia

Metaplasia

Secretion of cytokines

Produce antibodies

Neoplasm formation

Regulate activation of immune system against cancer cells

Formation of Fibroadenoma

Failure of T cell recognition of cancer cells as abnormal

Nursing Diagnosis Pre-op Moderate Anxiety Knowledge Deficit Disturbed Body Image Nursing Management Identify patients misconceptions about the procedure Explain information to the patient and family in simple terms Provide opportunities for patient to ask questions and verbalize concerns Teach patient relaxation techniques to be performed at least every 4 hours, such as deep breathing, guided imagery, and meditation.

Failure of immune defense

Significant Laboratory Results WBC= 41,900