PAMANTASAN NG LUNGSOD NG MAYNILA

NUTRITION AND DIET THERAPY (LABORATORY)

Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER

● It occurs when abnormal

cells in the breast grow
GROUP
uncontrollably and form a
TABLE OF CONTENTS tumor.
● Breast cancer can affect
I. Breast Cancer
A. Definition/Description both women and men,
B. Etiology although it is much more
C. Assessment Findings common in women.
D. Signs and Symptoms
● Breast cancer can begin in
E. Diagnostic Findings
F. Medical Treatment different parts of the breast.
G. Nursing Management The three main parts of the
breast are:
II. Breast Disorders
○ Lobules -
A. Mastitis
B. Breast Abscess ○ Ducts -
C. Fibrocystic Breast Diseases ○ Connective tissue -
D. Fibroadenoma ● Breast cancer's type is
determined by the specific
cells in the breast that
Breast Cancer become cancer. Most
common type are:
○ ductal carcinoma
in situ - Breast
disorder known as
ductal carcinoma in
situ (DCIS) has the
potential to progress
to invasive breast
cancer. The cancer
cells have not
spread to other
breast tissues; they
are restricted to the
ducts' lining.
○ invasive ductal
carcinoma - The
cancerous cells start
off in the ducts
A. DEFINITION before spreading to
● Breast cancer is a disease in other areas of the
which cells in the breast breast tissue.
grow out of control. Moreover, invasive
cancer cells have the
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER

ability to migrate, or ○ Genetic mutations:

metastasis, to other Certain inherited
bodily regions. genetic mutations,
○ invasive lobular such as BRCA1 and
carcinoma - The BRCA2, can
lobules are where increase the risk of
cancer cells first breast cancer.
start, then they ○ Hormonal factors:
travel from the Exposure to
lobules to the estrogen and
nearby breast progesterone over a
tissues. These long period of time,
invasive cancer cells such as through
can also invade early onset of
different body menstruation, late
regions. menopause, or
hormone
B. ETIOLOGY replacement
● Studies have shown that therapy, can
your risk for breast cancer increase the risk of
is due to a combination of breast cancer.
factors. These include: ○ Lifestyle factors:
○ Age: The risk of Certain lifestyle
breast cancer factors, such as
increases as a alcohol
person gets older. consumption,
○ Gender: Breast tobacco use, lack of
cancer is much more physical activity,
common in women and obesity, can also
than in men. increase the risk of
○ Family history: breast cancer.
Women with a ○ Environmental
family history of factors: Exposure to
breast cancer, certain chemicals,
especially in a such as pesticides
first-degree relative and industrial
(mother, sister, pollutants, may
daughter), have a increase the risk of
higher risk of breast cancer.
developing the
disease.
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER

C. ASSESSMENT FINDINGS D. SIGNS AND SYMPTOMS

● Assessment of the breast ● The most common
can be done through symptom of breast cancer is
physical examination or a new lump or mass
diagnostic tests. Physical (although most breast
examination of the breast is lumps are not cancer). A
done through inspection painless, hard mass that has
and palpation. irregular edges is more
likely to be cancer, but
Normal Findings breast cancers can be also
● Breast has firm elasticity in soft, round, tender, or even
young. In older women, painful.
breasts feel stringy ● Other possible symptoms of
● Glandular tissue may feel breast cancer include:
lobulated, granular, ○ Swelling of all or
irregular ("tapioca"). part of a breast
● Slight tenderness and (even if no lumps is
fullness can be anticipated felt).
in premenstrual period. ○ Skin dimpling
● No lumps or masses are (sometimes looking
palpable. like an orange peel).
● No tenderness upon ○ Breast or nipple
palpation. pain
● No discharges from the ○ Nipple retraction
nipples (turning inward).
● No “orange peel” skin is ○ Nipple or breast
noted which is present in skin that is red, dry,
edema. flaking, or
● Nipples point downward thickened.
and outwards ○ Nipple discharge
(other than breast
Abnormal Findings milk).
● Lumps or masses are ○ Swollen lymph
palpable nodes under the arm
● Tenderness is felt upon or near the collar
palpation bone (sometimes
● Discharge from the nipples this can be a sign of
is observed breast cancer spread
● Retraction and dipping is even before the
noted original tumor in the
● Orange peel skin is present breast is large
enough to be felt).
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER
E. DIAGNOSTIC FINDINGS
● Mammography (most
accurate method of
detecting non-palpable
lesions) shows lesions and
cancerous changes, such as
microcalcification.
Ultrasonography may be
used to distinguish cysts
from solid masses.
● Biopsy or aspiration
confirms diagnosis and
determines the type of
breast cancer.
● Estrogen or progesterone
receptor assays,
proliferation or S phase
study (tumor aggressive),
and other test of tumor cells
determine appropriate
treatment and prognosis.
● Blood testing detects
metastasis; this includes
liver function tests to detect
liver metastasis and calcium
and alkaline phosphatase
levels to detect bony
metastasis.
● Chest x-rays, bone scans, or
possible brain and chest CT
scans detect metastasis
● Primary Nursing Diagnosis:
Body Image disturbance
related to significance of
loss of part or all of the
breast.
F. MEDICAL MANAGEMENT
Pharmacological Intervention
1. Chemotherapy is the primary used
as adjuvant treatment
postoperatively ; usually begins 4
weeks after surgery (very stressful
for a patient who just finished
major surgery).
2. Indications for chemotherapy
include large tumors, positive
lymph nodes, premenopausal
women, and poor prognostic
factors.
3. Chemotheraphy is also used as
primary treatment in inflammatory
breast cancer and as palliative
treatment in metastatic disease or
recurrence.
4. Anti-estrogens, such as tamoxifen,
are used as adjuvant systemic
therapy after surgery.
5. Hormonal agents may be used in
advanced disease to induce
remissions that last for months to
several years.
Surgical Intervention
1. Surgeries include lumpectomy
(breast-preventing procedure),
mastectomy (breast removal), and
mammoplasty (reconstructive
surgery).
2. Endocrine related surgeries to
reduce endogenous estrogen as a
palliative measure.
3. Bone marrow transplantation may
be combined with chemotherapy.
G. NURSING MANAGEMENT
1. Monitor for adverse effects
of radiation therapy such as
fatigue, sore throat, dry
cough, nausea, anorexia.
2. Monitor for adverse effects
of chemotherapy; bone
marrow suppression, nausea
and vomiting, alopecia,
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER

weight gain or loss, fatigue, Breast Disorder

stomatitis, anxiety, and
depression. Breast Disorders Common Signs and
3. Realize that a diagnosis of Symptoms:
breast cancer is a ● Breast Tenderness or Pain
devastating emotional ● Breast Mass
shock to the woman. ● Nipple Discharge
Provide psychological ● Changes in appearance
support to the patient
throughout the diagnostic MASTITIS
and treatment process.
4. Involve the patient in
planning and treatment.
5. Describe surgical
procedures to alleviate fear.
6. Prepare the patient for the
effects of chemotherapy,
and plan ahead for alopecia,
fatigue.
7. Administer antiemetics
prophylactically, as
directed, for patients
receiving chemotherapy.
8. Administer I.V. fluids and
hyperalimentation as Mastitis refers to a condition where there
indicated. is an infection of the breast, resulting in an
9. Help patient identify and inflammation of breast tissues. It may
use support persons or occur as soon as the 7th day after
family or community. childbirth or before the baby is weeks of
10. Suggest to the patient the age. According to Landon (2021) this
psychological interventions occurs in about 2 out of 10 mothers within
may be necessary for 6 months. It especially occurs within the
anxiety, depression, or first 2 months of breastfeeding as the
sexual problems. regularity of the baby’s latching pattern
11. Teach all women the helps prevent mastitis.
recommended
cancer-screening ETIOLOGY
procedures.
What causes mastitis?

The microorganism causing

infection of the breast usually originates
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER
from the nasal-oral cavity of the infant.
For instance, an infant may usually acquire
Staphylococcus aureus while in the
hospital. In the same way, candidiasis can
also be spread. While the infant sucks on
the nipple, the infectant enters through
fissures and cracks in the nipples and into
the milk duct. The microorganisms
multiply in the milk ducts since milk is an
excellent source of nutrients needed for
bacterial growth. Hence, the prevention of
cracked and fissured nipples help prevent
mastitis.
Note: This is potentially an epidemic
breast abscess; when it happens, there are
typically similar cases occurring with
several other breastfeeding mothers at the
same time.
SIGNS AND SYMPTOMS
The following are possible signs and
symptoms of mastitis:
● Affected breast would mainly
possess the following
characteristics:
○ Painful. Some experience
too much pain when
breastfeeding. It can leave a
new, breastfeeding mother
feeling very exhausted.
○ Swollen. Infection is
commonly unilateral but
could be bilateral since it
originates with the infant
○ Reddened. It is possible for
erythema to appear. The
breast may be warm to
touch.
● Fever follows the onset of these
symptoms within hours; this results
in low breast milk supply.
● Chills, aches, flu-like symptoms
Therapeutic Management
● Take antibiotics that are effective
against penicillin-resistant
staphylococci (e.g. dicloxacillin
and cephalosporin).
● Continue breastfeeding to keep the
breast emptied of milk.
○ Doing this can help prevent
the growth of bacteria.
● Use cold or ice compress for pain
relief.
● Supportive bra can also help
relieve pain. It is used until the
process improves.
● Use warm, wet compresses to
reduce swelling and edema.
● Treatment is administered soon as
the symptoms arise in order to
reduce the duration in about 2-3
days.
● Discontinue breastfeeding on an
affected breast if it has abscess.
○ Incision and drainage of the
abscess may be required.
○ Advise the mother to pump
breast milk until the abscess
has resolved, in order to
continue breastfeeding.
○ Reassure the mother that
formula feeding is an
acceptable alternative for
her child, in case she finds
her breast too tender for
pumping.
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER
NURSING MANAGEMENT
Here are some preventive measures:
● During breastfeeding, position the
baby correctly, grasping the nipple
properly, including the areola.
● Before putting the baby away from
the breast, release the baby’s
attachment/grasp on the nipple.
● Sanitize the hands after handling
soiled perineal pads and before
touching the breast.
● Allow the nipples to be exposed to
air for at least part of every day.
● Apply vitamin E ointment every
day to keep the nipples soft.
● Advise the breastfeeding mother to
always begin breastfeeding on the
unaffected nipple, in case the other
is unwell/cracked.
Note: Untreated infection in the breast can
result into localized abscess, possibly
affecting a big area of the breast and
rupture through the dermis. Breastfeeding
on the breast with formed abscess should
be discontinued.
BREAST ABSCESS
Breast abscess refers to a build-up of pus
in the breast, which mainly affects
lactating/breastfeeding women. The
growth of pus underneath the skin is a
result of infection, and it forms a lump.
ETIOLOGY
What causes breast abscess?
As mentioned above, mastitis or infection
in the breast can cause breast abscesses.
However, other conditions unrelated to
breastfeeding (e.g. obesity, being a
smoker) can also be a cause of breast
abscess. Lactational breast abscesses, on
the other side, are commonly caused by
Staphylococcus aureus and other species.
Pathophysiology
Etiological factors (e.g. obesity) or
infections (Staphylococcus species)
↓
Epidermalization of lactiferous ducts
↓
Keratin production
↓
Obstruction of lactiferous ducts
↓
Formation of breast abscess
SIGNS AND SYMPTOMS
● Breast pain
● Increased warmth
● Erythema
● Induration or thickening/hardening
of soft tissue
● Possible edema
● The breast may be warm to touch.
● Chills
● Fever
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER

● Nausea treatment even after the

● Vomiting symptoms have ceased.
● Purulent drainage from nipple b. Pain relief. Painkillers
● Tenderness at the site of palpation; especially the
palpable mass or area of fluctuance anti-inflammatory ones can
● Axillary adenopathy (large, help ease the symptoms
swollen lymph glands) associated with the abscess.
● Tachycardia c. Advice the patient to
continue breastfeeding (if
NURSING MANAGEMENT due to lactational abscess);
make sure that infant
1. Inform the patient that they might latches properly while
undergo the following procedures: feeding, as incorrect
● Incision and drainage. It is positions can cause
the primary option for cracking of skin and
treating breast abscess. inadequate emptying of
● If the patient is not breast.
comfortable with the d. Apply warm cloth over the
above-stated procedures, breast for easier emptying
the patient may be advised of milk when breastfeeding.
to start taking antibiotics e. Massage breast during
and referred to a general breastfeeding for easier
surgeon for immediate flow of milk.
treatment. f. Breastfeed on the
● Needle aspiration. It may unaffected side first as
be done for abscesses infants tend to suck
smaller than 3 centimetres. stronger when hungry.
● Non-lactational abscesses
have higher chances of FIBROCYSTIC BREAST DISEASES
recurring and might need
several drainage operations.
● Incision and drainage
should be performed if
there is a recurrence of
abscess after needle
drainage.
2. Nurses may provide the following
for women with breast abscess:
● Fibrocystic Breast Disease is a
a. Antibiotic therapy. The
painful, lumpy breasts. This
patient is advised to
common condition is not
complete the full course of
considered a disease and not
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER

cancerous. These are not harmful
or dangerous, but may be
bothersome or uncomfortable for
some women.
● It is most common between 20-50
years of age, it is rare in
menopause women unless they are
taking estrogen. Breast change
occurs when thickening of breast
tissue (fibrosis) and fluid-filled
cyst develop. It is thought that
hormones made in the ovaries
during menstruation can trigger
these breast changes.
Etiology
Fibrocystic breast changes is
undetermined. these are the proposed
causes includes'
● Tissue response, exaggerate normal
response of the breasts to the
fluctuating hormones.
● Hereditary (familial occurrence)
● Dietary modification
● Hormones, the alterations in the
estrogen to progesterone ratio
● Alterations in muscle tone
● Postural and life-style habits.
Signs and Symptoms
It's more often worse right before your
menstrual period. Including:
● pain or discomfort in breast and
arms
● breasts that feel full, swollen, or
heavy
● breast lumps. These lumps in
fibrocystic breast tend to fluctuate
in size throughout the month and
are usually movable,
sometimes there's a lot of fibrous
tissue, the lumps may be more
fixed in one place.
● Nipple "zingers" or itching
Nursing Management
There are some recommended self care
measures such as:
● take over-the-counter medicine,
such as acetaminophen (Tylenol) or
ibuprofen (Advil) for pain
● applying heat or ice pressure on the
breast
● wear a well-fitting bra or a sports
bra.
● Regular breast self-examinations
should be performed.
Procedures
Range of tests in a breast clinic. These
may include:
● mammogram (breast x-ray)
● ultrasound scan (using sound
waves to produced image)
● core biopsy (using hollow needle to
take a sample of breast tissue to be
looked under the microscope) fine
needle aspirations (using a fine
needle and syringe to take a sample
of cells to be looked at under a
microscope)
FIBROADENOMA
but
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER
● Fibroadenoma is a very common
benign breast tumors condition
made up of both glandular tissue
and stromal (connective) tissue and
this is not considered as cancer.
● It is often developed during
puberty or ranges between 15-35
years of age. meaning it is
commonly found in young women,
but it can occur in any age. men
can also get fibroadenomas but it's
very rare.
Etiology
● It is thought that it probably occurs
because of increased sensitivity to
hormone estrogen. Fibroadenoma
develops from a lobule. The
glandular tissue and ducts grow
over the lobule and form a solid
lump.
● In most cases you'll not need any
treatment or follow-up. Some
Fibroadenoma increase in size
particularly in teenage girls and
during pregnancy, breastfeeding or
while taking hormone replacement
therapy (HRT), some get smaller,
disappear, or stay the same in size.
Signs and Symptoms
● felt as a lump in the breast which is
smooth to touch and moves easily
under the skin.
● They were painless, but sometimes
they may feel tender or even
painful particularly just before a
period or menstruation.
Nursing Management
● Self-care assessment
● Foods to avoid with Fibroadenoma;
saturated fats, including meat eggs,
cheese, full fat yogurt and high-fat
dairy products. Also avoid
consuming alcohol and caffeinated
foods. However, there are no
randomized controlled studies that
show that these or any dietary
changes are effective at relieving
symptoms.
Procedures
During a range of tests in a breast clinic.
These may include:
● mammogram (breast x-ray)
● ultrasound scan (using sound
waves to produced image)
● core biopsy (using hollow needle to
take a sample of breast tissue to be
looked under the microscope)
● fine needle aspirations (using a fine
needle and syringe to take a sample
of cells to be looked at under a
microscope)
● Cryoablation uses a gas to freeze
the nearby tissue which destroys
fibroadenoma without surgery.
References
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Breastfeeding. Alberta. Retrieved from
https://myhealth.alberta.ca/Health/Pages/c
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER
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20352752
 PAMANTASAN NG LUNGSOD NG MAYNILA
NUTRITION AND DIET THERAPY (LABORATORY)
Prof. Ma. Cecilia O. Martinez
BREAST CANCER + BREAST DISORDER