1

Carcinoma

Morgan Burke

Sault College
 2

Carcinoma

Description of Carcinoma

It is estimated by the Skin Cancer Foundation (2020) that more than 9,500 people are diagnosed

with carcinoma every day, and more than two people die of the disease every hour. Carcinoma

begins in the epithelial tissue of the skin, or in the tissue that lines internal organs, such as the

liver or kidneys and is capable of spreading to other parts of the body (Cancer Center, n.d). Like

other types of cancer, carcinomas are abnormal cells that divide without control. They are able to

spread to other parts of the body, but don't always and the way healthcare providers identify

them is with the following terms carcinoma in situ, invasive carcinoma, and metastatic

carcinoma (Cancer Center, n.d). Carcinoma in situ refers to cancer in which abnormal cells have

not spread beyond where they first formed (Medical News, n.d). Invasive carcinoma is cancer

that has spread beyond the primary tissue layer to surrounding tissue (Cancer Center, n.d), and

metastatic carcinoma is cancer that has spread throughout the body to other tissues and organs

(National Cancer Institute, 2020). It is unspecified on S.P’s chart as to which type of carcinoma

she has other than it was located in her right breast. It could be either Ductal carcinoma in situ

which is a condition where the cancer cells are found inside the ducts of the breast (Breast

Cancer.org, 2019) In ductal carcinoma the cancer has not fully developed or spread into nearby

areas. Or S.P could have invasive ductal carcinoma where the breast cancer starts in a milk duct

but spreads into the fatty tissue of the breast (Breastcancer.org, 2019). This type of cancer is able

to spread to other parts of the body through the bloodstream.

Clinical Manifestations

Carcinoma in the breast can vary for each individual but the most common signs are a new lump

in the breast or underarm, thickening or swelling of part of the breast, irritation or dimpling of
 3

breast skin, redness or flaky skin in the nipple area or the breast, nipple discharge other than

breast milk, including blood, any change in the size or the shape of the breast, and pain in any

area of the breast (Center for Disease Control and Prevention, 2020). It is unclear of the

symptoms that S.P was showing inorder to be diagnosed, but there is a high chance that she

showed some of the symptoms above in her right breast.

Diagnostic Test

Tests and procedures used to diagnose carcinoma of the breast include a breast exam,

mammogram, breast ultrasound, or biopsy (Mayo Clinic). Once it is determined that an

individual does have breast cancer the doctor will establish the stage of cancer with

different tests and procedures. Knowing the stage of cancer an individual has helps

healthcare providers determine the best treatment options available (Mayo Clinic).Tests

and procedures used to stage breast cancer may include blood tests, such as a

complete blood count, mammogram of the other breast to look for signs of cancer,

breast MRI, bone scan, computerized tomography (CT) scan, positron emission

tomography (PET) scan. Tests are ordered based on your specific circumstances and

take into account new symptoms you may be experiencing (Canadian Cancer Society,

n.d). The stages of breast cancer vary from 0 to IV with 0 indicating cancer that is

noninvasive or contained within the milk ducts. Stage IV breast cancer, also called

metastatic breast cancer, indicates cancer that has spread to other areas of the body

(Mayo Clinic, 2020).

Medical Treatment

The treatment plan of breast cancer is determined based on an individuals health and information

provided through the tests conducted. When deciding treatments the healthcare providers may
 4

consider the stage, if you have reached menopause, the hormone receptor status of the cancer, the

HER2 status of the cancer and the risk that the cancer will come back, or recur (Canadian Cancer

Society, n.d) Surgery, radiation therapy, chemotherapy, and hormonal therapy are all options

available once diagnosed. In S.P’s case, her method of treatment was a lumpectomy and

radiation. A lumpectomy Lumpectomy is surgery that removes cancerous breast tissue along

with a rim of normal tissue surrounding it called a surgical margin and the procedure preserves

the rest of the breast as well as sensation in the breast (Memorial Sloan Kettering Cancer Center,

n.d). Radiation therapy is a treatment that uses high-energy radiation to kill cancer cells and

shrink tumors (Breastcancer.org, 2021). The radiation treatment procedure is painless, but it may

cause some skin discomfort over time. When treating early-stage breast cancer, radiation therapy

is often given after a lumpectomy is done (Breastcancer.org, 2021). Due to the radiation therapy

it was noted in S.P’s care plan that blood pressure is not to be taken from the right arm.

Nursing Diagnosis

If carcinoma were to emerge again, a nursing diagnosis that can be applied to the resident’s

nursing care is fear related to diagnosis of cancer, or fear related to potential for diagnosis of

cancer (Ackley & Ladwig, 2008, p. 33). Some interventions could include scheduled skin

assessments to ensure that there are no changes to the skin, and education to both the client and

family members. S.P resides in a nursing home where resources are available to both her and her

family if questions or concerns are brought up, as well as she is under the care of healthcare

providers where they are able to consistently monitor changes in her skin.
 5

References

Cancer Center. (n.d.). Carcinoma. Cancer Treatment Centers of America.

https://www.cancercenter.com/carcinoma

Center for Disease Control and Prevention. (2020, September 14). Breast cancer symptoms.

https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm#:~:text=Irritation%20or

%20dimpling%20of%20breast,than%20breast%20milk%2C%20including%20blood

Mayo Clinic. (2020, December 24). Diagnosing breast carcinoma.

https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-

20352475#:~:text=A%20mammogram%20is%20an%20X,Breast%20ultrasound

Medical News. (n.d.). Carcinoma in situ: What is stage 0 cancer?

https://www.medicalnewstoday.com/articles/319530

Memorial Sloan Kettering Cancer Center. (n.d.). Lumpectomy. https://www.mskcc.org/cancer-

care/types/breast/treatment/lumpectomy

National Cancer Institute. (2020, November). Metastatic Cancer: When Cancer Spreads.

https://www.cancer.gov/types/metastatic-cancer#:~:text=In%20metastasis%2C%20cancer

%20cells%20break,cancer%20as%20the%20primary%20tumor
 6

Skin Cancer Foundation. (2020, July 10). Skin cancer facts & statistics. The Skin Cancer Foundation.

https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/