Cancer of Breast - easy ppt for Nursing Students Definition Risk factors Clinical manifestations Assessment & diagnostic findings Management Surgery Breast cancer rehabilitation

1. SWA T ILEK HA DA S, RN
B .SC (H)NU RSING,
M .SC (M SN)
A SST . PRO FESSO R
CANCER OF BREAST

2. Cancer of the breast
Cancer of the breast is a pathologic entity that starts
with a genetic alteration in a single cell and may take
several years to become palpable.

3. Cancer of the breast
 The most common histologic type of breast cancer is
infiltrating ductal carcinoma (80% of cases),
whereby tumors arise from the duct system and
invade the surrounding tissues.
 Infiltrating lobular carcinoma accounts for 10% to
15% of cases.

4. RISK FACTORS
 Gender (female) and increasing age.
 Previous breast cancer
 Family history
 Genetic mutations (BRCA1 or BRCA2) account for
majority of inherited breast cancers.

5. Cont.
 Hormonal factors: early menarche (before 12 years of
age), nulliparity, first birth after 30 years of age, late
menopause (after 55 years of age), and hormone
therapy (formerly referred to as hormone
replacement therapy).
 Other factors may include exposure to ionizing
radiation during adolescence and early adulthood
obesity, alcohol intake (beer, wine, or liquor), high-
fat diet (controversial, more research needed).

6. CLINICAL MANIFESTATIONS
 Generally, lesions are nontender, fixed, and hard
with irregular borders; most occur in the upper outer
quadrant.
 Some women have no symptoms and no palpable
lump but have an abnormal mammogram.
 Advanced signs may include skin dimpling, nipple
retraction, or skin ulceration.

7. ASSESSMENT AND DIAGNOSTIC
METHODS
 Biopsy (eg, percutaneous, surgical) and histologic
examination of cancer cells.
 Tumor staging and analysis of additional prognostic
factors are used to determine the prognosis and
optimal treatment regimen.
 Chest x-rays, CT, MRI, PET scan, bone scans, and
blood work (complete blood cell count,
comprehensive metabolic panel, tumor markers [ie,
carcinoembryonic antigen (CEA), CA15-3]).

8. MANAGEMENT
Various management options are available. The
patient and physician may decide on surgery,
radiation therapy, chemotherapy, or hormonal
therapy or a combination of therapies.

9. SURGERY
 Modified radical mastectomy involves removal of
the entire breast tissue, including the nipple–areola
complex and a portion of the axillary lymph nodes.
 Total mastectomy involves removal of the breast
and nipple– areola complex but does not include
axillary lymph node dissection (ALND).

12.  Breast-conserving surgery: lumpectomy, wide
excision, partial or segmental mastectomy,
quadrantectomy followed by lymph node removal for
invasive breast cancer.
 Sentinel lymph node biopsy: considered a standard
of care for the treatment of early-stage breast cancer.
 Breast reconstruction

14.  External-beam radiation therapy
 Chemotherapy : cyclophosphamide (Cytoxan),
methotrexate, fluorouracil, anthracycline-based
regimens (eg, doxorubicin [Adriamycin], epirubicin
[Ellence]), taxanes (paclitaxel [Taxol], docetaxel
[Taxotere]).

15.  Hormonal therapy based on the index of estrogen
and progesterone receptors: Tamoxifen (Soltamox) is
the primary hormonal agent used to suppress
hormonal-dependent tumors; others are inhibitors
anastrazole (Arimidex), letrozole (Femara), and
exemestane (Aromasin).
 Targeted therapy: trastuzumab (Herceptin),
bevacizumab (Avastin).

16. BREAST CANCER REHABILITATION
Breast cancer is a complicated disease treated with
multimodality therapy.
A rehabilitation program must address the physical
and psychosocial aspects of breast cancer, both at
presentation and at recurrence. For a patient with
early breast cancer, lifestyle changes may be
important

18. THANK YOU