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What is breast cancer?

Happens when cells in the breast begin to grow out of control and can then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors. However, some tumors are not really cancer because they cannot spread or threaten someone s life. These are called benign tumors. The tumors that can spread throughout the body or invade nearby tissues are considered cancer and are called malignant tumors. What are the signs of breast cancer? Unfortunately, the early stages of breast cancer may not have any symptoms. This is why it is important to follow screening recommendations. As a tumor grows in size, it can produce a variety of symptoms including: y y y y y Lump or thickening in the breast or underarm. Change in size or shape of the breast. Nipple discharge or nipple turning inward Readness or scaling of the skin or nipple Ridges or pitting of the breast skin

If you experience these symptoms, it doesn t necessarily mean you have breast cancer, but you need to be examined by the doctor. Is the leading type of cancer in women. Most breast cancer begins in the lining of the milk ducts, sometimes the lobule. The cancer grows through the wall of the duct and into the fatty tissue. Breast cancer metastasizes most commonly to auxiliary nodes, lung, bone, liver, and the brain. The most significant risk factors for breast cancer are gender (being a woman) and age (growing older). Other probable factors include nulliparity, first child after age 30, late menopause, early menarche, long term estrogen replacement therapy, and benign breast disease. Controversial risk factors include oral contraceptive use, alcohol use, obesity, and increased dietary fat intake. About 90% of breast cancers are due not to heredity, but to genetic abnormalities that happen as a result of the aging process and life in general. A woman s risk of breast cancer approximately doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. About 20-30% of women diagnosed with breast cancer have a family history of breast cancer. STAGES OF BREAST CANCER STAGE DEFINITION Stage 0 Cancer cells remain inside the breast duct, without invasion into normal adjacent breast tissue. Stage I Cancer is 2 centimeters or less and is confined to the breast (lymph nodes are clear).

Cancer has spread to the axillary lymph nodes. Stage IIIA No tumor is found in the breast. or cancer may have spread to lymph nodes near the breastbone. Stage IIIC There may either be no sign of cancer in the breast or a tumor may be any size and may have spread to the chest wall and/or the skin of the breast AND the cancer has spread to lymph nodes either above or below the collarbone AND the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone. . Stage IIB The tumor is larger than 2 but no larger than 5 centimeters and has spread to the axillary lymph nodes OR the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes. Stage IIIB The tumor may be any size and has spread to the chest wall and/or skin of the breast AND may have spread to axillary lymph nodes that are clumped together or sticking to other structures. Inflammatory breast cancer is considered at least stage IIIB. or cancer may be found in lymph nodes near the breastbone.Stage IIA No tumor can be found in the breast. which are sticking together or to other structures. Cancer is found in axillary lymph nodes that are sticking together or to other structures. but cancer cells are found in the axillary lymph nodes (the lymph nodes under the arm) OR the tumor measures 2 centimeters or smaller and has spread to the axillary lymph nodes OR the tumor is larger than 2 but no larger than 5 centimeters and has not spread to the axillary lymph nodes. or cancer may be found in lymph nodes near the breastbone OR the tumor is any size.

proliferation or S phase study (tumor aggressive). Additional agents for advanced breast cancer include docetaxel. Asymmetry of the breast may be noted as the woman changes positions. clear or serous. may be effective for patients who express this gene Indications for chemotherapy include large tumors. Chest x-rays. doxorubicin. PHARMACOLOGIC INTERVENTIONS Chemotherapy is the primary used as adjuvant treatment postoperatively . compare one breast with the other. fluorouracil. Enlargement of auxiliary or supraclavicular lymph nodes may indicate metastasis. Anti-estrogens. and poor prognostic factors. . Chemotheraphy is also used as primary treatment in inflammatory breast cancer and as palliative treatment in metastatic disease or recurrence. methotrexate. Ultrasonography may be used to distinguish cysts from solid masses. such as microcalcification. such as tamoxifen.Stage IV The cancer has spread ASSESSMENT A firm lump or thickness in breast. Nipple retraction or scalliness. are used as adjuvant systemic therapy after surgery. especially in Paget s disease. Estrogen or progesterone receptor assays. and paclitaxel. or metastasized to other parts of the body. Hormonal agents may be used in advanced disease to induce remissions that last for months to several years. DIAGNOSTIC EVALUATION Mammography (most accurate method of detecting non-palpable lesions) shows lesions and cancerous changes. Principal breast cancer drugs include cyclosphosphamide. bone scans. or possible brain and chest CT scans detect matastasis. Because the drugs differ in their mechanisms of action. usually painless. Biopsy or aspiration confirms diagnosis and determines the type of breast cancer. usually begins 4 weeks after surgery (very stressful for a patient who just finished major surgery). Spontaneous nipple discharge. Treatments are given every 3 to 4 weeks for 6 to 9 months. various combinations are used to treat cancer. positive lymph nodes. may be bloody. premenopausal women. 50% are located in the upper outer quadrant of the breast. mitoxantrone. vinorelbine. Blood testing detects metastasis. and other test of tumor cells determine appropriate treatment and prognosis. and fluorouracil. Herceptin is a monoclonal antibody directed against Her-2/neu oncogene. this includes liver function tests to detect liver metastasis and calcium and alkaline phosphatase levels to detect bony metastasis.

nausea and vomiting. 4. anxiety. 3. 5.Nagging cough and hoarseness. 9. Breast lumps can be cysts that are normal in the course of your menstrual cycle. and depression. have a mammogram to see if there is something there other than fluid. It can also be a sign of lung and other cancers. but sores that do not heal within a usual amount of time need to be checked. 7.SURGICAL INTERVENTIONS Surgeries include lumpectomy (breast-preventing procedure). or they can be the beginnings of breast tumors. fatigue. bone marrow suppression. N .Obvious changes in moles or warts. Realize that a diagnosis of breast cancer is a devastating emotional shock to the woman. Other unusual draining issues should be checked out as well. This can be anything from changes in the bowel movements (watery or too hard) to frequency (going more often or infrequently). dry cough. Administer I. weight gain or loss. Indigestion can come from many things. Moles and freckles should not bleed or drain. 11. anorexia. 6. Describe surgical procedures to alleviate fear. Suggest to the patient the psychological interventions may be necessary for anxiety.Changes in bathroom habits. or sexual problems. Involve the patient in planning and treatment. fatigue. 2. sore throat. NURSING INTERVENTIONS 1. and mammoplasty (reconstructive surgery). Monitor for adverse effects of chemotherapy. Warts and moles shouldn't change shapes or colors or thickness. as directed. T . Administer antiemetics prophylactically. Provide psychological support to the patient throughout the diagnostic and treatment process. even very frequent indigestion can be a sign of acid reflux or other normal conditions. Bone marrow transplantation may be combined with chemotherapy.Unusual discharge and bleeding.A sore that does not heal. Monitor for adverse effects of radiation therapy such as fatigue. C .Indigestion and difficulty in swallowing. Endocrine related surgeries to reduce endogenous estrogen as a palliative measure. Help patient identify and use support persons or family or community. and plan ahead for alopecia. Teach all women the recommended cancer-screening procedures. Any long term changes in bathroom habits should be told to your doctor. If you notice a lump. alopecia. . nausea. U . O .V. for patients receiving chemotherapy. I . A . 10.Thickness or lumps in the breast or other places. it can also be a sign of some cancers. depression. stomatitis. fluids and hyperalimentation as indicated. This can go along with the difficulty in swallowing. Prepare the patient for the effects of chemotherapy. However. This can also be a sign of diabetes. Any of these changes can signal a chance of skin cancer. 8. mastectomy (breast removal).