Breast disorders

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Breast disorders
2011-12-09 12:22:05
breast disorders

breast disorders
Show Answers:

  1. Benign breast disorders
  2. S/S of fibroadenoma
    • solid, slowly enlarging benign mass
    • round, firm, easily moveable
    • nontender
    • clearly delineated from surrounding tissue
  3. Fibrocystic breast condition
    fibrocystic changes of the breast that include a range of changes involving lobules, ducts, and stromal tissues of the breast
  4. Risk factors and S/S of fibrocystic breast condition
    • premenoupausal women between 20 and 50 years of age
    • Imbalance in normal estrogen-to-progesterone ratio
    • at least 1/2 of all women
    • pain, tender lumps, upper outer quadrant
    • symptoms increase week prior to menstruation and then fade
  5. Collaborative management of fibrocystic breast condition
    • Symptomatic management
    • Hormonal manipulation -oral contraceptives
    • Drug therapy—vitamins C, E, and B complex
    • Diuretics
    • Avoidance of caffeine
    • Reduction of dietary fat
    • Mild analgesics -Tylenol, Ibuprofen
    • Limited salt intake before menses
    • Well-padded supportive bra
    • Local application of heat or ice for pain relief
  6. What is ductal ectasia?
    • benign breast problem of women approaching menopause
    • caused by dilation and thickening of collecting ducts in the subareolar area
  7. S/S of ductal ectasia
    • mass that is hard with irregular borders and tender
    • greenish brown nipple discharge
    • enlarged axillary nodes
    • edema over site of mass
    • doesn't effect breast cancer risk but it is hard to distinguish between cancer and ductal ectasia
  8. What is intraductal papilloma?
    • benign process in the epithelial lining of the duct, forming an outgrowth of tissue
    • trauma and erosion within the duct, resulting in bloody/serous nipple discharge
    • occurs most often in women 40-55 years old
    • Dx to rule out breast cancer - microscopic exam of discharge
  9. What is gynecomastia?
    • benign condition of breast enlargement in men
    • can be result of primary cancer such as lung cancer
  10. Causes of gynecomastia
    • drugs - estrogen for prostate cancer
    • aging
    • obesity
    • underlying disease causing estrogen excess
    • androgen deficiency
  11. What cancer is the most commonly diagnosed cancer in women (excluding skin cancer)?
    Breast cancer
  12. Types of breast cancer
    • non-invasive = remains in duct; 20% of cases
    • invasive = penetrates tissue surrounding the duct; 80% of cases
  13. What does shortening of the Kuper's ligaments cause?
    Skin dimpling with advanced disease
  14. How does invasive breast cancer grow?
    into surrounding tissues in irregular patterns
  15. Complications of breast cancer
    • invasion of lymph channels causing skin edema
    • metastasis to lymph nodes
    • bones, lungs, brain and liver - metastasis sites
    • ulceration of overlying skin
    • nipple retraction
    • Peau d'orange
  16. What is Peau d'orange?
    • Caused by blocked lymphatics
    • causes skin edema, redness, warmth, orange peel appearance
    • in inflammatory breast cancer - most malignant - into blood through lymphatic channels
  17. Breast cancer in men
    • 1% of men
    • hard, painless, subareolar mass
    • widely spread disease because it's usually detected at a later state than in women
  18. High Risk factors for breast cancer
    • female
    • age > 65
    • BRCA1 and BRCA2 genetic mutations
    • family history - 2 or more 1st degree relatives
    • Hx of previous breast cancer
    • dense breasts
  19. Moderate risk factors for breast cancer
    • family history - one 1st degree relative
    • biopsy confirmed atypical hyperplasia
    • ionizing radiation
    • high postmenopausal bone density
  20. Low risk factors for breast cancer
    • never had kids or had first kid after 30
    • early menarche/late menopause or both
    • oral contraceptives
    • Hormone Replacement Therapy
    • postmenopausal obesity
    • 2 alcoholic drinks per day
    • high socioeconomic status
    • Jews
  21. What is a mammography for?
    baseline screening yearly beginning at 40
  22. What are some barriers to mammography?
    • cost
    • pain
    • embarrassment
    • access
  23. BSE
    • early detection reduces mortality rate
    • teach BSE to all women
  24. Breast care for women
    • clinical breast exam
    • cancer surveillance
    • prophylactic mastectomy
    • chemoprevention - removing ovaries
  25. If there is a potential for breast cancer metastasis, what is done?
    • in late stage they may use nonsurgical treatment
    • tumor removed with local anesthetic
    • hormone therapy
    • chemotherapy
    • radiation
    • if surgery is the main treatment follow-up with radiation, chemo, hormone or targeted therapy
  26. When removing breast cancer surgically, why do they sometimes take the nodes?
    • for staging
    • also sometimes just inject dye into the nodes to detect presence of cancer cells in them
  27. Post-op care after mastectomy
    • don't use affected arm for blood pressure, injections or drawing blood
    • monitor VS
    • elevate HOB with affected arm on pillow
    • care of drainage tubes
    • comfort measures
    • mobility and diet
    • breast reconstruction possible
    • adjuvant therapy
  28. What are adjuvant therapies for post-op care after mastectomy?
    • squeezing rubber ball
    • ROM in arm
    • pulley exercises
    • rope turning
    • radiation, chemo, hormone, stem cell transplants, targeted therapy