BREAST CANCER MOST COMMON NEOPLASM IN WOMEN A CANCER ORIGINATING FROM BREAST TISSUE, MOST COMMONLY FROM THE

HE LININGS OF THE MILK DUCTS OR THE LOBULES THAT SUPPLY DUCTS THE MILK METASTASIS OCCURS VIA LYMPH NODES. COMMON SITES ARE THE BONES AND LUNGS, ALSO MAY OCCUR IN BRAIN AND LIVER LOCAL HAS INVADED SURROUNDING TISSUES BUT IT IS CONFINED WITH BREAST REGIONAL INVADED TISSUES NEAR THE BREAST INCLUDING THE CHEST WALL & THE LYMPH NODES DISTANT SPREAD FROM THE BREAST TO THE PARTS OF THE BODY.

PREVENTION IS THROUGH MONTHLY BSE, STARTING FROM AGE 20 YEARS & DONE 7-10 DAYS AFTER MENSTRUATION DIAGNOSIS IS MADE BY BREAST BIOPSY THROUGH A NEEDLE ASPIRATION OR BY SURGICAL REMOVAL OF THE TUMOR WITH MICROSCOPIC EXAMINATOIN FOR MALIGNANT CELLS OTHER DX TESTS: MAMMOGRAPHY GALACTOGRAPHY ULTRASONOGRAPHY MRI PERCUTANEOUS BIOPSY CANCER STAGE IS BASED ON 4 CHARACTERISTICS 1. SITE OF THE CANCER 2. WETHER THE CANCER IS INVASIVE OR NON-INVASIVE 3. WETHER THE CANCER IS IN LYMPH NODES 4. WETHER THE CANCER HAS SPREAD TO THE PARTS OF THE BODY BEYOND THE BREAST. STAGES OF CANCER STAGE 1 - TUMOR SIZE IS UP TO 2 CM STAGE 2 TUMOR SIZE IS UP TO 5 CM WITH AXILLARY LYMPH NODE INVOLVEMENT STAGE 3 TUMOR SIZE IS MORE THAN 2 CM WITH AXILLARY AND NECK LYMPH NODE INVOLVEMENT STAGE 4 METASTASIS TO DISTANT ORGANS (LIVER, LUNGS, BRAIN, BONE) ASSESSMENT FINDINGS 1. A MASS IS FELT DURING BSE 2. USUALLY FELT IN THE UPPER OUTER QUADRANT, BENEATH THE NIPPLE OR IN THE AXILLA

3. A FIXED, IRREGULAR NONENCAPSULATED MASS; TYPICALLY PAINLESS EXCEPT IN LATE STAGES 4. NIPPLE RETRACTION OR ELEVATION 5. ASSYMETRY, WITH THE AFFECTED BREAST BEING HIGHER 6. BLOODY OR CLEAR NIPPLE DISCHARGE 7. SKIN DIMPLING, RETRACTION OR ULCERATION 8. SKIN EDEMA OR PEAU d ORANGE SKIN 9. AXILLARY LYMPHADENOPATHY 10. LYMPHEDEMA OF THE AFFECTED ARM 11. SYMPTOMS OF BONE OR LUNG METASTASIS IN LATE STAGE 12. PRESENCE OF THE LESSION ON MAMMOGRAPHY NURSING INTERVENTION ASSESS BREAST EARLY FOR EARLY DETECTION & SCREENING COPING OF SELF PREPARATION OF MATESTECTOMY NONSURGICAL INTERVENTION 1. CHEMOTHERAPY 2. RT 3. HORMONAL MANIPULATION VIA THE USE OF MEDICATIONS FOR ESTROGEN RECEPTIVE POSITIVE TUMORS SURGICAL INTERVENTION SURGICAL BREAST RECONSTRUCTION

PROCEDURES,

WITH

POSSIBLE

BREAST

PRE-OPERATIVE CARE 1. PSYCHOSOCIAL SUPPORT 2. TEACH ARM EXERCISES 3. INFORM ABOUT WOUND SUCTION DRAINAGE POST-OPERATIVE CARE 1. MONITOR V/S 2. SEMI-FOWLERS POSITION, TURN FROM THE BACK TO THE UNAFFECTED SIDE WITH THE AFFECTED ARM ELEVATED ABOVE THE LEVEL OF THE HEART TO PROMOTE DRAINAGE & PREVENT LYMPHEDEMA 3. ENCOURAGE COUGHING AND DEEP BREATHING 4. IF A DRAIN IS IN PLACE, MAINTAIN SUCTION, RECORD AMT. & CHARAC. TEACH CLIENT ABOUT HOME MGT. OF DRAIN 5. ASSESS OPERATIVE SITE FOR COLLECTION UNDER THE SKIN FLOPS OR IN THE ARMS 6. MONITOR INCISION SITE FOR RESTRICTION OF DRESSING, IMPAIRED SENSATION OR COLOR CHANGES OF THE SKIN 7. IF BREAST RECONSTRUCTION WAS PERFORMED, THE CLIENT WILL RETURN FROM SURGERY WITH A SURGICAL BRASSIERE & A PROSTHESIS IN PLACE 8. PROVIDE THE USE OF A PRESSURE SLEEVE AS PRESCIBED IF EDEMA IS SEVERE

9. MAINTAIN FLUID & ELECTROLYTE BALANCE; ADMINISTRATION DIURETICS & PROVIDE A LOW SALT DIET AS PRESCRIBED IF FOR SEVERE LYMPHEDEMA 10. CONSULT WITH THE PHYSICIAN & PHYSICAL THERAPIST REGARDING THE APPROPRIATE EXERCISE PROGRAM & ASSIST CLIENT WITH PRESCRIBED EXERCISE 11. INSTRUCT THE CLIENT ABOUT HOME CARE MEASURES POST-OPERATIVE COMPLICATIONS LYMPHEDEMA CHRONIC SWELLING OF THE AFFECTED EXTREMITY AVOIDs - CUTS - SCRATCHES - PINPRICKS - INSECT BITES - BURNS - STRONG DETERGENTS DOs - WEAR LOSE RUBBER GLOVES WHEN WASHING DISHES - WEAR A THIMBLE WHEN SEWING - APLLY LANOLIN HAND CREAM TO PREVENT DRYNESS - CONTACT ATTENDING PHYSICIAN IF ARM GETS RED, WARM OR HARD & SWOLLEN - RETURN FOR CHECK UP - WEAR LIFE GUARD MED. AID TAG: CAUTION - LYMPHEDEMA