Breast Cancer Case Study
Breast Cancer Case Study
Breast Cancer Case Study
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Breast cancer is the second leading cause of cancer
death in women, exceeded only by lung cancer. The chance that
breast cancer will be responsible for a woman's death is
about 1 in 35(about 3%). In 2008, about 40,480 women will die
from breast cancer in the United States. Death rates from
breast cancer have been declining since about 1990, with
larger decreases in women younger than 50. These decreases
are believed to be the result of earlier detection through
screening and increased awareness, as well as improved
treatment.
The risk of developing most types of cancer can be
reduced by changes in a person's lifestyle, for example, by
quitting smoking and eating a better diet. The sooner a
cancer is found and treatment begins, the better are the
chances for living for many years.
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P A T I E N T S P R O F I L E
Biographical Data
Present Illness
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lifestyle established during her younger years. Her aunt had
breast cancer and survived and her cousin died due to cancer.
Social/Environmental History
Gynecological History
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P H Y S I C A L A S S E S S M E N T
13 AREAS OF ASSESSMENT
A. Psychosocial Status
C. Environmental Status
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the hallway of the ward which is managed by the Hospital
Janitor.
D. Sensory Status
1. Visual Status
2. Auditory Status
3. Olfactory Status
4. Gustatory Status
5. Tactile Status
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6. Language Perception and Formation
A. Motor Status
Patient can move all her extremities very well. She has
no limited movement from her bed and can barely stand on her
own. She could ambulate around the ward and walks to the
comfort room to refresh herself without no assistance.
B. Nutritional Status
C. Elimination Status
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E. Circulatory Status
Her pulse rate ranges from 62-95 beats per minute which
is within the normal limits. However, her blood pressure
ranges from 100/60- 130/70 which also her normal BP. She has
a history of hypertension. Her capillary refill is about 2-3
seconds which is normal.
F. Respiratory Status
G. Temperature Status
H. Integumentary Status
Skin was moist. Lips and buccal mucosa were not dry.
There is normal Skin turgor which goes back normally. There
were noted incision on the left breast due to her mastectomy
operation last 2008 at Cagayan de Oro.
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L A B O R A T O R Y F I N D I N G S A N D I M P L I C A T I O N S
H e m a t o l o g y R e s u l t F o r m
N a m e : x A g e : 3 6 / f H o s p : 3 9 1 0 5 3
W a r d : s u r g T i m e : 9 : 1 5 a m L a b # : W H 1 2 2
R E F . R A N G E R E S U L T
l / l
Hemoglobin 1 0 2 F 1 2 0 - 1 6 0 7 8
Hematocrit 0 . 3 0 F 0 . 3 7 - 0 . 2 3
l / l
0 . 4 7
g / L
WBC Count 5 . 0 - 1 0 . 0 x 1 0 2 1 . 1
D I F F E R E N T I A L C O U N T
Neutrophils 0 . 5 0 - 0 . 7 0 0 . 8 4
Lymphocytes 0 . 2 0 - 0 . 4 0 0 . 1 5
Midcell 0 . 0 3 - 0 . 0 9
Eosinophil 0 . 0 0 - 0 . 0 7 0 . 0 1
Monocyte 0 . 0 0 - 0 . 0 7
10
Band 0 . 0 0 - 0 . 0 5 1 . 0 0
T O T A L 1 . 0 0
Red Cell Count F 4 . 0 4 - 5 . 4 8 x
1 2 / L
1 0
g / l
Platelet Count 1 5 0 - 4 0 0 x 1 0 M a r k e d l y
i n c r e a s e d
LE Cell Prep.
Malarial Smear
Bleeding Time 1 - 5 m i n u t e s
Clotting Time 2 - 6 m i n u t e s
Lee & white C.T 5 - 1 0 m i n u t e s
P R O T H R O M B I N T I M E ( P T )
Patient 1 0 - 1 4 s e c o n d s
Control 1 0 . 8 - 1 3 . 8
s e c o n d s
INR
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% Activity
P A R T I A L P R O T H R O M B I N T I M E ( P T T )
Patient 2 6 - 3 6 s e c o n d s
Control 2 9 . 6 - 3 7 . 6
s e c o n d s
E R Y T H R O C Y T E S E D I M E N T A T I O N R A T E
Wintrobe Method F 0 - 2 0 m m / H r
Westergren Method A d u l t 0 - 1 0 m m / H r
Retailocyte Count 0 . 5 - 1 . 5 %
R E M A R K S :
Midcells may include less frequently occurring and rare correlating to monotype, eosinophils, basophils,
blast and other precursor.
Rh: “Positive”
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I M P L I C A T I O N :
Chemotherapy affects production of white blood cells in the bone marrow. Normally white blood cells
help fight off infection. After chemotherapy, if your white blood cells are low, you are more likely to get
infections. Any infection can also worsen more quickly – a trivial infection could become life threatening
within hours if it isn’t treated.
When your white blood cell count is at its lowest you can feel very tired (fatigued). Some people also
say they feel depressed. This can be really hard to deal with and make you wonder if you really want to go
on with your treatment. Try to hang in there. Things should improve and you will start to feel better again
before your next treatment, as your blood counts rise. Unfortunately, they'll go down again after each
treatment. But once your treatment is finished your blood cell counts will remain at normal levels.
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A N A T O M Y A N D P H Y S I O L O G Y
T h e B r e a s t s
T h e L y m p h a t i c s y s t e m
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Knowing if the cancer cells have spread to lymph nodes
is important because if it has, there is a higher chance that
the cells could have also gotten into the bloodstream and
spread (metastasized) to other sites in the body.
The more lymph nodes that have breast cancer, the more
likely it is that the cancer may be found in other organs as
well. This is important to know because it could affect your
treatment plan. Still, not all women with cancer cells in
their lymph nodes develop metastases, and in some cases a
woman can have negative lymph nodes and later develop
metastases.
F i b r o c y s t i c c h a n g e s
Most lumps turn out to be fibrocystic changes. The term
"fibrocystic" refers to fibrosis and cysts. Fibrosis is the
formation of fibrous (scar-like) tissue, and cysts are fluid-
filled sacs.
B e n i g n B r e a s t L u m p s
Benign breast tumors such as fibroadenomas or
intraductal papillomas are abnormal growths, but they are not
cancerous and do not spread outside of the breast to other
organs.They are not life threatening. Still, some benign
breast conditions are important because women with these
conditions have a higher risk of developing breast cancer.
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P A T H O P H Y S I O L O G Y O F T H E D I S E A S E
Malignant transformation
of lymphoid stem cells
s/sx:
Uncontrolled proliferation Treatment:
of lymphoblast in the bone bone pain
marrow Analgesic
joint pain
Diagnostic Treatment:
Lymphoblast replace the
Test:
normal marrow elements ✔ Remission
BM aspiration Induction
Therapy
Decreased production ✔ Consolidation
and
of normal blood cells
Maintenance
Therapy
✔ BM
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P A T H O P H Y S I O L O G Y O F T H E
D I S E A S E
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Acquired gene mutations
Most DNA mutations related to breast cancer, however,
occur in single breast cells during a woman's life rather
than having been inherited. These acquired mutations of
oncogenes and/or tumor suppressor genes may result from other
factors, such as radiation or cancer(22 of 121) causing
chemicals. But so far, the causes of most acquired mutations
that could lead to breast cancer remain unknown. Most breast
cancers have several gene mutations that are acquired.
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N U R S I N G C A R E A N D
M A N A G E M E N T
ACTUAL PROBLEMS
POTENTIAL PROBLEMS
PRIORITIZED PROBLEMS
1. Fatigue (due to low red blood cell counts and other
reasons)
Fatigue is a common health complaint. It is, however,
one of the hardest terms to define, and a symptom of
many different conditions.
Fatigue, also known as weariness, tiredness, exhaustion,
or lethargy, is generally defined as a feeling of lack
of energy. Fatigue is not the same as drowsiness, but
the desire to sleep may accompany fatigue. Apathy is a
feeling of indifference that may accompany fatigue or
exist independently.
2. Hair Loss Leading Disturbed Body Image
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and influenced by age and developmental level. As an
important part of one’s self-concept, body image
disturbance can have profound impact on how individuals
view their overall selves.
3. loss of appetite
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N U R S I N G C A R E P L A N S
ACTUAL
ASSESSMENT EXPLANATION OF PLANNING IMPLEMENATION RATIONALE EVALUATION
THE PROBLEM
S> “Medyo The length of STO> After 8 hours DX> Monitor Vital ➢ For baseline STO> Goal is met
nanghihina pa ako” Chemotherapy of Nursing Signs and Record data. if the patient
treatment depends Intervention the ➢ To determine will be able to
O> Appears weak on whether the patient will be ➢ Assess activity identify
cancer shrinks, able to identify Ability to intolerance techniques to
➢ Slow ambulate
Movements how much it techniques to ➢ To determine enhance activity
shrinks, and how a enhance activity ➢ Assess circulatory tolerance such as:
noted capillary
➢ Good Skin woman tolerates tolerance such as: problems.
length of Refill ➢ To determine - gradual increase
Turgor - gradual increase ➢ Assess skin in activity level
➢ Coherent and treatment. Some of hydration.
the most common in activity level turgor. ➢ To enhance as tolerated
Conversant as tolerated TX> Promote
➢ Needs possible side ability to - rest in between
effect is fatigue Adequate Rest participate
assistance in - rest in between activities
performing (due to low red activities with
ADL’s blood cell counts activities
A> Activity and other reasons) ➢ To protect
➢ Assist with LTO> Goal is met
Intolerance client from
LTO> After 8 days activities if the patient
Related to injury
of Nursing will be able to
Weakness ➢ To promote
Intervention, the ➢ Anticipate report an increase
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patient will be Needs wellness in activity
able to report an EDX> Encourage ➢ To determine intolerance.
increase in expression of contributing
activity feelings factors
intolerance. ➢ Suggest Use ➢ To Enhance
of Relaxation Ability to
Techniques participate
such as in activities
visualization
and guided
imagery.
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ASSESSMENT EXPLANATION PLANNING IMPLEMENATION RATIONALE EVALUATION
OF THE
PROBLEM
S> “Nakakahiya The length of STO> After 8 DX> Monitor vital ➢ For baseline STO> Goal is met
makakalbo ako” Chemotherapy hours of Nursing signs and record data if patient will
treatment depends Intervention the ➢ Aids in be able to
O> on whether the patient will be ➢ Determine identification verbalize
cancer shrinks, able to verbalize patient’s of ideas, understanding of
➢ Coherent and perception of
Conversant how much it understanding of attitudes and body changes.
shrinks, and how a body changes cancer and fears,
➢ Submits self cancer
to Nursing woman tolerates misconception
length of treatments. ➢ Misconceptions
Procedure and TX> Ask for LTO> Goal is met
Care done treatment. Some of LTO> After 1 day about cancer may if patient will
the most common patient for verbal be more
A> Disturbed of Nursing feedback, and be able to
Body Image possible side Intervention, the disturbing than verbalize
effect is hair correct facts and can
realted to patient will be misconception acceptance of
illness loss. able to verbalize interfere with self in situation
about individual’s treatments/
treatment. acceptance of type of cancer and in the effects of
self in situation delay healing. therapeutic
treatment. ➢ Accurate and
in the effects of ➢ Provide regimen.
therapeutic concise
anticipatory information
regimen. guidance with helps dispel
patient fears and
regarding anxiety, helps
treatment clarify the
Protocol, expected
27 length of routine.
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ASSESSMENT EXPLANATION PLANNING IMPLEMENATION RATIONALE EVALUATION
OF THE
PROBLEM
S> This can often STO> After 8 DX> Monitor Vital ➢ For baseline STO> Goal is met
have a major hours of Nursing Signs and record. Data. if patient will
O> Coherent and effect on the Intervention the ➢ Temperature be able to
Conversant immune system and patient will be ➢ Monitor elevation may verbalize
may reduce the able to verbalize Temperature occur because understanding of
➢ Submits self
to Nursing body's defenses understanding of of various Having cancer or
against infection Having cancer or factors such treatment for cancer
Procedure and
for some months, treatment for cancer as can weaken your
Care done
both during and can weaken your chemotherapy immune system. This
A> Risk for makes it more likely
after treatment. immune system. This side effects.
Infection makes it more likely that you will pick
related to This is because ➢ Early
that you will pick up an infection and
inadequate chemotherapy recognition develop a fever.
up an infection and
secondary reduces the develop a fever. and
defenses and production of intervention
immunosuppress white blood cells may prevent
TX> Assess all LTO> Goal is met
ion secondary by the bone progression
LTO> After 1 day systems for signs if patient will be
to dose- marrow. People to more
of Nursing and symptoms of able to
limiting side having serious
Intervention, the infection on a demonstrate proper
effect of chemotherapy are situation.
patient will be continual basis. aseptic techniques
chemotherapy. particularly at ➢ Limits
able to preventing further
risk of picking up fatigue, yet
demonstrate proper infection such as
infections between encourages
aseptic techniques proper hand
7–14 days after sufficient
preventing further washing.
the chemotherapy, movement to
infection such as 30 ➢ Promote
when the level of prevent
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D R U G S T U D Y
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Generic name/brand name/ Action and Indication Route/Dosage/Date prescribe Nursing consideration
classification
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C O N C L U S I O N
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R E C O M M E N D A T I O N
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A P P E N D I C E S
S t a g e s o f B r e a s t C a n c e r
Stage Definition
Stage Cancer cells remain inside the breast duct, without
0 invasion into normal adjacent breast tissue.
Stage Cancer is 2 centimeters or less and is confined to the
I breast (lymph nodes are clear).
No tumor can be found in the breast, but cancer cells
are found in the axillary lymph nodes (the lymph nodes
under the arm)
OR
Stage the tumor measures 2 centimeters or smaller and has
IIA spread to the axillary lymph nodes
OR
the tumor is larger than 2 but no larger than 5
centimeters and has not spread to the axillary lymph
nodes.
The tumor is larger than 2 but no larger than 5
centimeters and has spread to the axillary lymph nodes
Stage
OR
IIB
the tumor is larger than 5 centimeters but has not
spread to the axillary lymph nodes.
No tumor is found in the breast. Cancer is found in
axillary lymph nodes that are sticking together or to
other structures, or cancer may be found in lymph nodes
near the breastbone
Stage
OR
IIIA
the tumor is any size. Cancer has spread to the
axillary lymph nodes, which are sticking together or to
other structures, or cancer may be found in lymph nodes
near the breastbone.
The tumor may be any size and has spread to the chest
wall and/or skin of the breast
AND
may have spread to axillary lymph nodes that are
Stage clumped together or sticking to other structures, or
IIIB cancer may have spread to lymph nodes near the
breastbone.
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B r e a s t C a n c e r R i s k F a c t o r s
A “risk factor” is anything that increases your risk of
developing breast cancer. Many of the most important risk
factors for breast cancer are beyond your control, such as
age, family history, and medical history. However, there are
some risk factors you can control, such as weight, physical
activity, and alcohol consumption.
Be sure to talk with your doctor about all of your
possible risk factors for breast cancer. There may be steps
you can take to lower your risk of breast cancer, and your
doctor can help you come up with a plan. Your doctor also
needs to be aware of any other risk factors beyond your
control, so that he or she has an accurate understanding of
your level of breast cancer risk. This can influence
recommendations about breast cancer screening — what tests to
have and when to start having them.
I. Risk factors you can control
Weight. Being overweight is associated with increased risk of
breast cancer, especially for women after menopause. Fat
tissue is the body’s main source of estrogen after menopause,
when the ovaries stop producing the hormone. Having more fat
tissue means having higher estrogen levels, which can
increase breast cancer risk.
Diet. Diet is a suspected risk factor for many types of
cancer, including breast cancer, but studies have yet to show
for sure which types of foods increase risk. It’s a good idea
to restrict sources of red meat and other animal fats
(including dairy fat in cheese, milk, and ice cream), because
they may contain hormones, other growth factors, antibiotics,
and pesticides. Some researchers believe that eating too much
cholesterol and other fats are risk factors for cancer, and
studies show that eating a lot of red and/or processed meats
is associated with a higher risk of breast cancer. A low-fat
diet rich in fruits and vegetables is generally recommended.
For more information, visit our page on healthy eating to
reduce cancer risk in the Nutrition section.
Exercise. Evidence is growing that exercise can reduce breast
cancer risk. The American Cancer Society recommends engaging
in 45-60 minutes of physical exercise 5 or more days a week.
Alcohol consumption. Studies have shown that breast cancer
risk increases with the amount of alcohol a woman drinks.
Alcohol can limit your liver’s ability to control blood
levels of the hormone estrogen, which in turn can increase
risk.
Smoking. Smoking is associated with a small increase in
breast cancer risk.
Exposure to estrogen. Because the female hormone estrogen
stimulates breast cell growth, exposure to estrogen over long
periods of time, without any breaks, can increase the risk of
breast cancer. Some of these risk factors are under your
control, such as:
• taking combined hormone replacement therapy (estrogen
and progesterone; HRT) for several years or more, or
taking estrogen alone for more than 10 years
• being overweight
• regularly drinking alcohol
Recent oral contraceptive use. Using oral contraceptives
(birth control pills) appears to slightly increase a woman’s
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risk for breast cancer, but only for a limited period of
time. Women who stopped using oral contraceptives more than
10 years ago do not appear to have any increased breast
cancer risk.
Stress and anxiety. There is no clear proof that stress and
anxiety can increase breast cancer risk. However, anything
you can do to reduce your stress and to enhance your comfort,
joy, and satisfaction can have a major effect on your quality
of life. So-called “mindful measures” (such as meditation,
yoga, visualization exercises, and prayer) may be valuable
additions to your daily or weekly routine. Some research
suggests that these practices can strengthen the immune
system.
I . R i s k f a c t o r s y o u c a n ’ t
c o n t r o l
Gender. Being a woman is the most significant risk factor for
developing breast cancer. Although men can get breast cancer,
too, women’s breast cells are constantly changing and
growing, mainly due to the activity of the female hormones
estrogen and progesterone. This activity puts them at much
greater risk for breast cancer.
Age. Simply growing older is the second biggest risk factor
for breast cancer. From age 30 to 39, the risk is 1 in 233,
or .43%. That jumps to 1 in 27, or almost 4%, by the time you
are in your 60s.
Family history of breast cancer. If you have a first-degree
relative (mother, daughter, sister) who has had breast
cancer, or you have multiple relatives affected by breast or
ovarian cancer (especially before they turned age 50), you
could be at higher risk of getting breast cancer.
Personal history of breast cancer. If you have already been
diagnosed with breast cancer, your risk of developing it
again, either in the same breast or the other breast, is
higher than if you never had the disease.
Race. White women are slightly more likely to develop breast
cancer than are African American women. Asian, Hispanic, and
Native American women have a lower risk of developing and
dying from breast cancer.
Radiation therapy to the chest. Having radiation therapy to
the chest area as a child or young adult as treatment for
another cancer significantly increases breast cancer risk.
The increase in risk seems to be highest if the radiation was
given while the breasts were still developing (during the
teen years).
Breast cellular changes. Unusual changes in breast cells
found during a breast biopsy (removal of suspicious tissue
for examination under a microscope) can be a risk factor for
developing breast cancer. These changes include overgrowth of
cells (called hyperplasia) or abnormal (atypical) appearance.
Exposure to estrogen. Because the female hormone estrogen
stimulates breast cell growth, exposure to estrogen over long
periods of time, without any breaks, can increase the risk of
breast cancer. Some of these risk factors are not under your
control, such as:
• starting menstruation (monthly periods) at a young age
(before age 12)
• going through menopause (end of monthly cycles) at a
late age (after 55)
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• exposure to estrogens in the environment (such as
hormones in meat or pesticides such as DDT, which
produce estrogen-like substances when broken down by the
body)
Pregnancy and breastfeeding. Pregnancy and breastfeeding
reduce the overall number of menstrual cycles in a woman’s
lifetime, and this appears to reduce future breast cancer
risk. Women who have never had a full-term pregnancy, or had
their first full-term pregnancy after age 30, have an
increased risk of breast cancer. For women who do have
children, breastfeeding may slightly lower their breast
cancer risk, especially if they continue breastfeeding for 1
1/2 to 2 years. For many women, however, breastfeeding for
this long is neither possible nor practical.
DES exposure. Women who took a medication called
diethylstilbestrol (DES), used to prevent miscarriage from
the 1940s through the 1960s, have a slightly increased risk
of breast cancer. Women whose mothers took DES during
pregnancy may have a higher risk of breast cancer as well.
For more detailed information about risk factors for breast
cancer, visit our Lower Your Risk section.
S y m p t o m s & D i a g n o s i s
Breast cancer symptoms vary widely — from lumps to
swelling to skin changes — and many breast cancers have no
obvious symptoms at all. Symptoms that are similar to those
of breast cancer may be the result of non-cancerous
conditions like infection or a cyst.
Breast self-exam should be part of your monthly health care
routine, and you should visit your doctor if you experience
breast changes.
R i s k o f D e v e l o p i n g B r e a s t
C a n c e r
The term “risk” is used to refer to a number or
percentage that describes how likely a certain event is to
occur. When we talk about factors that can increase or
decrease the risk of developing breast cancer, either for the
first time or as a recurrence, we often talk about two
different types of risk: absolute risk and relative risk.
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I . A b s o l u t e r i s k
Absolute risk is used to describe an individual’s
likelihood of developing breast cancer. It is based on the
number of people who will develop breast cancer within a
certain time period. Absolute risk also can be stated as a
percentage.
The absolute risk of developing breast cancer during a
particular decade of life is lower than 1 in 8. The younger
you are, the lower the risk. For example:
• From age 30 to 39, absolute risk is 1 in 233, or 0.43%. This
means that 1 in 233 women in this age group can expect to
develop breast cancer. Put another way, your odds of
developing breast cancer if you are in this age range are 1 in
233.
• From age 40 to 49, absolute risk is 1 in 69, or 1.4%.
• From age 50 to 59, absolute risk is 1 in 38, or 2.6%.
• From age 60 to 69, absolute risk is 1 in 27, or 3.7%.
I . R e l a t i v e r i s k
Relative risk is a number or percentage that compares
one group’s risk of developing breast cancer to another’s.
This is the type of risk frequently reported by research
studies, which often compare groups of women with different
characteristics or behaviors to determine whether one group
has a higher or lower risk of breast cancer than the other
(either as a first-time diagnosis or recurrence).
E n d - o f - L i f e I s s u e s
Palliative care, which provides physical, emotional, and
spiritual relief, must be provided with attempts for curative
therapy and becomes the exclusive goal when cure cannot be
expected. At all stages of breast cancer, treatment needs to
be modified for life expectancy.
Chemotherapy
Chemotherapy is treatment with cancer-killing drugs that may
be given intravenously (injected into a vein) or by mouth.
The drugs travel through the bloodstream to reach cancer
cells in most parts of the body. The chemotherapy is given in
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cycles, with each period of treatment followed by a recovery
period. Treatment usually lasts for several months.
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D E F I N I T I O N O F T E R M S
Breast cancer general terms
It is important to understand some of the key words used to
describe breast cancer.
Carcinoma
This is a term used to describe a cancer that begins in
the lining layer (epithelial cells) of
organs such as the breast. Nearly all breast cancers are
carcinomas (either ductal carcinomas or lobular carcinomas).
Adenocarcinoma
Is a type of carcinoma that starts in glandular tissue
(tissue that makes and secretes a substance). The ducts and
lobules of the breast are glandular tissue (they make breast
milk), so cancers starting in these areas are sometimes
called adenocarcinomas.
Carcinoma in situ
This term is used for the early stage of cancer, when it
is confined to the layer of cells where it began. In breast
cancer, in situ means that the cancer cells remain confined
to ducts (ductal carcinoma in situ) or lobules (lobular
carcinoma in situ). They have not invaded into deeper
tissues in the breast or spread to other organs in the body,
and are sometimes referred to as non-invasive breast cancers.
Sarcoma
Sarcomas are cancers that start from connective tissues
such as muscle tissue, fat tissue, or blood vessels. Sarcomas
of the breast are rare.
Mixed tumors
Mixed tumors are those that contain a variety of cell
types, such as invasive ductal cancer combined with invasive
lobular breast cancer. In this situation, the tumor is
treated as if it were an invasive ductal cancer.
Medullary carcinoma
This special type of infiltrating breast cancer has a
rather well defined boundary between tumor tissue and normal
tissue. It also has some other special features, including
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the large size of the cancer cells and the presence of immune
system cells at the edges of the tumor. Medullary carcinoma
accounts for about 3% to 5% of breast cancers. The outlook
(prognosis) for this kind of breast cancer is generally
better than for the more common types of invasive breast
cancer. Most cancer specialists think that true medullary
cancer is very rare, and that cancers that are called
medullary cancer should be treated as the usual invasive
ductal breast cancer.
Metaplastic carcinoma
Is a very rare type of invasive ductal cancer. These
tumors include cells that are normally not found in the
breast, such as cells that look like skin cells (squamous
cells) or cells that make bone. These tumors are treated like
invasive ductal cancer.
Mucinous carcinoma
Also known as colloid carcinoma, this rare type of
invasive breast cancer is formed by mucus-producing cancer
cells. The prognosis for mucinous carcinoma is usually better
than for the more common types of invasive breast cancer.
Tubular carcinoma
Tubular carcinomas are another special type of invasive
ductal breast carcinoma. They are called tubular because of
the way the cells are arranged when seen under the
microscope. Tubular carcinomas account for about 2% of all
breast cancers and tend to have a better prognosis than most
other infiltrating ductal or lobular carcinomas.
Papillary carcinoma
The cells of these cancers tend to be arranged in small,
finger-like projections when viewed under the microscope.
These cancers are most often considered to be a subtype of
ductal carcinoma in situ (DCIS), and are treated as such. In
rare cases they are invasive, in which case they are treated
like invasive ductal carcinoma, although the outlook is
likely to be better. These cancers tend to be diagnosed in
older women, and they make up no more than 1% or 2% of all
breast cancers.
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Phyllodes tumor
This very rare breast tumor develops in the stroma
(connective tissue) of the breast, in contrast to carcinomas,
which develop in the ducts or lobules. Other names for these
tumors include phylloides tumor and cystosarcoma phyllodes.
These tumors are usually benign but on rare occasions may be
malignant. Benign phyllodes tumors are treated by removing
the mass along with a margin of normal breast tissue. A
malignant phyllodes tumor is treated by removing it along
with a wider margin of normal tissue, or by mastectomy. While
surgery is often all that is needed, these cancers may not
respond as well to the other treatments used for invasive
ductal or lobular breast cancer.
Angiosarcoma
This is a form of cancer that starts from cells that
line blood vessels or lymph vessels. It rarely occurs in the
breasts. When it does, it is usually seen as a complication
of radiation to the breast. It tends to develop about 5 to 10
years after radiation treatment. However, this is an
extremely rare complication of breast radiation therapy.
Angiosarcoma can also occur in the arm of women who develop
lymphedema as a result of lymph node surgery or radiation
therapy to treat breast cancer. These cancers tend to grow
and spread quickly. Treatment is generally the same as for
other sarcomas.
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B I B L I O G R A P H Y
Smeltzer, S.C., Bare, B.G., Hinkle, J.L., and Cheever, K.H. (2008).
Brunner and Suddarth’s Textbook of Medical-Surgical Nursing 11th
edition. Philippines: Lippincott Williams and Wilkins.
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