Final Presentation Breast Cancer

8/8/2019 Final Presentation Breast Cancer

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INTRODUCTIONBreast cancer occurs when a malignant (cancerous) tumor originates in

the breast. As breast cancer tumors mature, they may metastasize (spread) toother parts of the body. The primary route of metastasis is the lymphatic system which, ironically enough, is also the body's primary system for producing andtransporting white blood cells and other cancer-fighting immune system cellsthroughout the body. Metastasized cancer cells that aren't destroyed by thelymphatic system's white blood cells move through the lymphatic vessels andsettle in remote body locations, forming new tumors and perpetuating thedisease process.

Breast cancer is fairly common. Because of its well publicized nature, andpotential for lethality, breast cancer is arguably the most frightening type of cancer diagnosis someone can receive. However, it is important to keep in mindthat, if identified and properly treated while still in its early stages, breast

cancer can be cured.Breast cancer is not just a woman's disease. It is quite possible for men toget breast cancer, although it occurs less frequently in men than in women. Ourdiscussion will focus primarily on breast cancer as it relates to women but itshould be noted that much of the information is also applicable for men.

y



functions:

yBreastfeeding

ySexual role

y milk glands (lobules) that

produce milky ducts that transport milk

from the milk glands(lobules) to the nipple

y nipple

y areola (pink or brownpigmented region

surrounding the nipple)y connective (fibrous) tissue

that surrounds the lobulesand ducts

y fat



Two hormones responsible

for milk production

Prolactin ="mothering hormone

Oxytocin = deliversthe milk that prolactinhas produced.







Predisposing Factors:Age

GenderRace

Family History

Hormonal factors:

Early menarch

Late menopause

ETIOLOGY:

Unknown

Precipitating Factors:exposure to radiation and

certain chemicalsobesity

alcohol intake

SmokingLifestyleLate child bearing

Somatic mutations inthe DNA

Activate oncogene/deactivate tumor-

supppresor gene

s/sx:

Lump ( in breast or under the armpits)Change in breast size or shape

Skin dimplingNipple inversion

Spontaneous single nipple discharge

Cells become cancerous, ³Tumor size is up to

2 cm´ (Mutation destroy their ability to stop

dividing, to attach other cells and stay in placewhere they belong)

Uncontrolled Cell divisions with DNA

copied with mistakes ( can also betriggered with hormonal imbalance) : progesterone and estrogen binds with

their respective receptors stimulates the production of protein that increase cell

division

Tumor size is upto 5cm ; with

axillary lymphnode invlovement

Mass of cancer cellsdevelop or a tumor

Diagnostic Test:

BSEMAMMOGRAPHY

GALACTOGRAPHY

ULTRASONOGRAPHYMRI

BIOPSY

Treatment:

TAMOXIFEN

Adriomycin

Tumor size is up to 5cm ;with axillary and neck

lymph node invlovement

Pathophysiology

STAGE 1

STAGE 2

STAGE3



STAGE 1 STAGE 2



STAGE 3

STAGE 3A (INFLAMMATORY BC)

STAGE 4



METASTASIS

Different parts of the body:- Brain

- lungs- liver

- boneFailure of immune surveillance, a

theory in which the immune system

removes malignant cells throughout

one's life.

Types of Breast Cancer: According to its location

Ductal carcinoma in situInvasive cancer:

Infiltrating Ductal carcinomaInfiltrating lobular carcinoma

Medullary carcinomaMucinous carcinoma

Tubular ductal carcinomaInflammatory Carcinoma

Paget Disease

Inherited defects in DNA repair

genes, such as ''BRCA1'', ''BRCA2''

and ''TP53''

Abnormal growth factor signaling

in the interaction between

stromal cells and epithelial cells

can facilitate malignant cellgrow

Proliferation of Cancer cells

STAGE 4

Normal cell will

commit suicide when

they are no longer

needed (apoptosis)

Normally, the PTEN protein turns off the PI3K/AKT

pathway when the cell is ready for cell suicide.

In breast cancers, the gene for the PTEN protein is

mutated, so the PI3K/AKT pathway is stuck in the "on"

position, and the cancer cell does not commit suicide.

Treatment:

-MASTECTOMY

-RADICAL MASTECTOMY



Ca cells produce anorexogenicsubstances that act in satiety

center of the hypothalamus,causing anorexia

Tumors revert to anaerobic metabolism:

Consume glucose, deplete glycogen stored in the

liver, and convert glucose to lactate (lactic acid)

Deprived normal cells from

nutrition

Tumors take Na. water retention masks malnutrition

All Body cells becomeweak and die

Person¶s Death

yPressure on thesite of neoplastic

growth

yObstruction caused bytumors

PainNecrosis

Ischemia

Tissue damage

High risk for

infection

Tumorsproduces

abnormalcoagulation

factors that

increasesclotting (e.g.Pulmonary

Emboli- lifethreatening)

PARANEOPLASTIC

SYNDROME

y ANEMIA

yHYPERCALCEMEA

ANOREXIA-CACHEXIASYNDROME



BREAST MAMMOGRAM BREAST ULTRASOUND

BREAST MRI BIOPSY





Medical Managementy Chemotherapy Chemotherapy medicines to kill cancer

cells

y Radiation therapy Radiation therapy to destroy cancerous tissue

y Hormonal therapy is prescribed to women with ER-positive breast cancer to block certain hormones that

fuel cancer growth.





TYPES OF PROCEDURE y LUMPECTOMY - is a surgical procedure that

involves removing a

suspected malignant(cancerous) tumor, or lump,and a small portion of the surrounding tissue

from a woman's breast.

y MASTECTOMY - is an operation in which theentire breast, usually including the nipple and the

areola, is removed. Mastectomy is usually

performed as a treatment of breast cancer.



y MODIFIED RADICAL MASTECTOMY - is the removal

of breast cancer (abnormal cells in the breast

that grow rapidly and replace normal healthytissue).

y RADICAL MASTECTOMY- The breast, lymph

nodes, muscles under the breast, and some of the surrounding fatty tissue are removed.



MANAGEMENT

Patient Support

«Prior to Surgery

Time and Place to Report

Who will be doing the

procedure

Expected side effects

Need of anesthesia

Follow-up care



Post operation care. Place the client in semi fowler position with arm

elevated on pillows, abducted to promote venous

return and prevent edema. Monitor HEMOVAC output (serosanguinous for the

first 24 hrs). Check behind patient for bleeding. Blood flows to the

back for gravity . Post sign warning taking against taking blood

pressure, starling IVs, or drawing blood on affectedside.

. Initiate exercise to prevent stiffness and contracturesof shoulder girdle

. Reinforce special mastectomy exercise as prescribed. Provide adequate anesthesia to promote ambulation

and exercise



9. Prepare client for size and appearance of theincision and provide support when incision is

viewed for the first time.10.Provide client with detailed information

concerning breast prosthesis11.Fitting is not possible for 4-6 weeks

12.A temporary prosthesis or lightly padded bras worn until healing is complete

13.Teach patient to avoid constrictive clothing andreport persistent edema, redness, or infectionof incision

14.Teach patient the importance of continuingmonthly breast examination on remainingbreast

15.Prevention of LYMPHEDEMA



AVOIDS

1.Cuts

2. Scratches

3. Pinpricks

4. Hangnails

5. Insect bites

6. Burns

7.Strong detergent



DONTs (on the arm on the affectedside)

1. Carry purse/anything heavy

2. Wear wristwatch/jewelry

3. Pick at/ cut cuticles

4. Work near thorny plants/digin garden

5. Reach into hot oven

6. Hold the cigarette

7.Injections, withdrawal of blood, BP-taking



DOs

Wear loose rubber gloves when

washing dishes

Wear a thimble when doing sewing

Apply lanolin hand cream to prevent

dryness

Contact AMD if arm gets, red, warm,

or hard/swollen

Return for check up

Wear Life Guard Med. Aid tag

Caution -LYMPHEDEMA



Nursing Diagnosisy KNOWLEDGE DEFICITR ELATED TO

INEXPER IENCE AND NEW INFORM ATION R EGA R DING AVAILA BLE OPTIONS FOR TR EATMENT

y BODY IM AGE DISTURB ANCER ELATED TO

IMPENDING CHANGES IN BR EA ST AND SEXUALITY

y R ISK FOR INJUR Y R ELATED TO INCR EA SEDR ISK OF INFECTION AND LY MPHEDEM A SECONDA R Y

TO AXILLA R Y NODE DISECTION



CELEBRITES: BREAST CANCER

SURVIVORS











THANK YOU

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Final Presentation Breast Cancer