By: Kristine Charisse V.

Tanedo
BSN3 MSU-IIT
What is Breast Cancer?
Common sites of
metastases:
 Risk factors:
– Age
– Family history
– Early menarche, late menopause
– Previous cancer of the breast, uterus,
ovaries
– Nulliparity, late first birth
– Obesity
– High – dose radiation exposure to the
breast

Signs and Symptoms:

• -mass/lump felt
• -upper quadrant
beneath nipple
or axilla
• -fixed, irregular
noncapsulated
mass; typically
painless except in
later stage
Signs and Symptoms:
 Signs and Symptoms:

• Skin edema or A xilla ry

Peau ‘d orange lym p h a d e n o p a th y
skin 
 Signs and Symptoms:

• Symptoms of bone or • lesion on

lung metastases in mammography
late stage
•
Normal Physiology:

• The breast is
composed of:
– milk glands
(lobules)
– Milk ducts
– nipple
– areola
– connective (fibrous)
– fat

 Pathophysiology:
• Predisposing • Precipitating
factors factors:
– Age – History
– Gender – of abnormal
– Late breast
Menopausal – biopsies
Neoplasm formation in the breast

Primary tumor begins in the breast

Tumor becomes invasive

Travel to other organ systems Progressed beyond breast to regional

lymph nodes

It Becomes systemic
 Pathophysiology:
• Primary cancer
spreads
• if treated: If not treated:
– surgery
Breast cancer spreads to major
– radiotherapy organs
– chemotherapy
– Interstitial laser
thermotherapy Compromise
the functions
Removal ofBreast Tissure of the major
organs

Cancer Cell
Destroyed DEATH
 Diagnostic Test

• Breast biopsy • Mammography

 Treatment

• Chemotherapy • Radiation therapy

 Treatment

• Medications: Tamoxifen
(Nolvadex)
• for estrogen receptor-positive
tumors

•
•
• exogenous administration of  
steroid hormones, which
inhibit the production or
• Hormonal manipulation activity of such hormones
therapy • Changes the levels or activity
– Use of medication in that causes certain cancers
postmenstrual to cease growing
women
 Surgical interventions:

• Lumpectomy • Simple
mastectomy
•
 Surgical interventions:

• Modified radical • Jackson - Pratt device

mastectomy
•
 Nursing Management:
• POSTOPERATIVE
– Pulse rate and BP
– Do not perform BP, injections, IV on
affected side
– Inspect dressings
– Monitor drainage
– Deep breathing exercises
– Asses graft area
 Nursing Management:
• PREOPERATIVE
– Assess
– Get health history
– Ask coping skills, support systems,
knowledge deficit, presence of
discomfort
– Physical assessment
 Instructions after
mastectomy:
• Avoid overuse of arm (first few
months)
• Keep affected arm elevated to
prevent lyphadema
• Provide incision care with Lanolin to
soften and prevent wound
contracture
• Encourage BSE on remaining breast
• Avoid strong sunlight on affected arm
•
 Instructions after
mastectomy:
• Do not let affected arm hang
dependent
• Do not carry pocketbook or heavy
objects on affected arm
• Avoid trauma, cuts, bruises, burns,
on affected site
• Avoid wearing constrictive clothing or
jewelry on affected side
•
 Instructions after
mastectomy:
• Wear gloves when gardening
• Use thick oven mitts when cooking
• Use a thimble when sewing
• Apply lanolin hand cream several
times a day
• Use cream cuticle remover
•
 Instructions after
mastectomy:
• Call physician if signs of
inflammation occur on affected arm
• Wear medic-alert bracelet stating
which arm is lyphademotous
•