BREAST CANCER as an area of ill-defined thickening in

the breast. They are often multicentric

Breast cancer is cancer that forms in
and can be bilateral.
the cells of the breasts. It can start in one or
both breasts.
DISEASE PROCESS
It is second to the most common
cancer diagnosed in women in the United
States, after skin cancer. Breast cancer can
occur in both men and women, but it's far more
common in women.

TYPES OF BREAST CANCERS

1. In situ cancers - haven’t spread past the

duct or lobule where they started.

a. Ductal carcinoma in situ (DCIS) -

characterized by the proliferation of
malignant cells inside the milk ducts
without invasion into the surrounding
tissue. It is a noninvasive form of
cancer, but if left untreated, there is an
increased likelihood that it will progress
to invasive cancer.
b. Lobular carcinoma in situ (LCIS) -
found only in the lobules, which SIGNS AND SYMPTOMS
produce breast milk. Technically not
Breast cancer symptoms vary from person
considered cancer, but a change in the
to person and there is no exact definition of
breast that puts one at an increased
what a lump or mass feels like.
risk for invasive breast cancer.
Breast cancer signs and symptoms may
2. Invasive cancers - have spread or include:
invaded the surrounding breast tissue.
• Lump or mass in the breast
• Lump or mass in the armpit
a. Invasive Ductal Carcinoma (IDC) -
• Breast skin changes, including skin
most common histologic type of breast
redness and thickening of the breast
cancer, accounts for 80% of all cases.
skin, resulting in an orange-peel
The tumors arise from the duct system
texture
and invade the surrounding tissues.
• Dimpling or puckering on the breast
They often form a solid irregular mass
• Discharge from the nipple aside from
in the breast.
breastmilk, including blood
b. Invasive Lobular Carcinoma (ILC) -
accounts for 10% to 15% of breast • Scaliness on nipple, which sometimes
cancers. The tumors arise from the extends to the areola
lobular epithelium and typically occur
 • Nipple changes, including the nipple
turning inward, pulling to one side or
changing direction
• An ulcer on the breast or nipple,
sometimes extending to the areola
• Swelling of the breast
These symptoms do not directly mean a
person has breast cancer. However, it is
important to discuss any symptoms with a
physician, since they may also signal other
health problems.
ASSESSMENT AND DIAGNOSTIC
METHODS
1. Biopsy (percutaneous, surgical) and
histologic examination of cancer cells –
A biopsy is the only definitive way to make
a diagnosis of breast cancer. It is a
procedure done to collect cells or a tissue
sample for testing.
• Percutaneous needle Biopsy -
insertion of a needle into a
suspected lesion or an organ with
the aim of obtaining cells or tissue
for diagnosis.
• Surgical Biopsy – a.k.a open
biopsy, is a procedure that involves
the surgical removal of tissue from
a lump or mass for examination.
2. Tumor staging and analysis - additional
prognostic factors used to determine the
prognosis and optimal treatment regimen.
3. Imaging and Lab test
Preoperative Nursing Interventions:
Imaging
• Chest x-rays – Used to check and
see whether the cancer has spread
to the lungs.
• CT scan – Computerized
Tomography, can detect totally
unsuspected very small breast
cancers that were unable to be
identified by conventional
mammography or physical exams.
• MRI scan – Magnetic Resonance
imaging or MRI is a test that uses
radio waves and strong magnets to
make detailed pictures of the inside
of the breast.
• PET scan – Positron Emission
Tomography scan, is an imaging
test that uses a radioactive
substance called a tracer to look for
potential spread of breast cancer.
• Bone scans – needed to figure out
if the breast cancer has
metastasized to the bones.
Lab test
• Comprehensive metabolic panel –
gives information about protein and
electrolyte levels, blood sugar, and
kidney and liver function which can be
useful to help diagnose certain types of
cancer.
• Tumor markers – are proteins
produced by cancer cells many of
which can be found in the blood, like
Carcinoembryonic antigen(CEA), and
CA15-3.
• Complete blood count – a blood test
that measure many different parts and
features of the blood.
NURSING MANAGEMENT
1. Providing Education and Preparation
about Surgical Treatments.
2. Reducing Fear and Anxiety and
Improving Coping Ability.
3. Promoting Decision-Making Ability.
4. Instruct the patient to discontinue any
agents that can increase the risk of
bleeding, including products containing
aspirin, nonsteroidal anti-inflammatory
drugs (NSAIDs), vitamin E
 supplements, herbal substances (such REFERENCES
as ginkgo biloba and garlic
supplements), and warfarin City of Hope. (n.d.). Most common breast cancer
(Coumadin). types: carcinomas.
5. Instruct the patient to not to eat or drink https://www.cancercenter.com/cancer-
types/breast-cancer/types/common-breast-
for several hours or after midnight the
cancer-types
night before the procedure, depending
on the type of biopsy planned. Joyce Young Johnson. (2010). Handbook for Brunner
6. Follow-up after the biopsy. & Suddarth’s textbook of medical-surgical
nursing. (12th ed.). Wolters Kluwer/Lippincott
Postoperative Nursing Interventions: Williams & Wilkins.

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2. Promoting Positive Body Image symptoms, management. We Care.
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4. Improving Sexual Function
Mayo Clinic. (2022, December 14). Breast cancer -
5. Monitoring and Managing Potential
Diagnosis and treatment - Mayo Clinic.
Complications Mayoclinic.org.
6. Teaching patient self-care https://www.mayoclinic.org/diseases-
7. Continuing care. conditions/breast-cancer/diagnosis-
8. Monitor the effects of the anesthesia treatment/drc-20352475
and inspect the surgical dressing for
MD Anderson Cancer Center (2023). Breast cancer
any signs of bleeding.
symptoms.
9. Review care of the biopsy site, pain https://www.mdanderson.org/cancer-
management, and activity restrictions types/breast-cancer/breast-cancer-
with the patient once the sedation has symptoms.html
worn off.
10. The dressing covering the incision is
Shaban, D. (2005, July 31). Breast cancer: symptoms,
usually removed after 48 hours, but the
causes, treatment. WebMD.
Steri-Strips, which are applied directly https://www.webmd.com/breast-
over the incision, should remain in cancer/understanding-breast-cancer-basics
place for approximately 7 to 10 days.
11. Encourage the use of a supportive bra
following surgery to limit movement of
the breast and reduce discomfort.
12. Do a follow-up telephone call 24 to 48
hours after the procedure to provide Prepared by:
the patient with the opportunity to ask
any questions and can be a source of ABDULMALIK, Hamdane S.
great comfort and reassurance.
13. Encourage to avoid jarring or high- ADMAIN, Heba O.
impact activities for 1 week to promote
healing of the biopsy site. ALI, Aljerah D.
14. Encourage to take acetaminophen
(Tylenol) for pain relief; a mild opioid ALIPONTO, Sittie Nor-ashya A.
may be prescribed if needed.