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benign disorders
of the breast
Question | Answer |
---|---|
most dreaded disease, one in three new cancer dx, second most common cause of cancer death, 28% of all cancers affecting women, second now only to lung cancer, 1 of 8 woemen faces dx in her lifetime, up from one in 20 from the 1950's, early dx with? | loss of breast, significant threat to feminity and self image, death sentence |
lactation is from elements in the blood, what drains the breast? | axillary and mammary lymph nodes |
how do hormones affect the breast? | prolactin stimulates milk production, progesterone stimulates the development of alveoli, estrogen increases the production of tubules and ducts to transport milk |
breast self exam, clinical breas exam, and mammography are factors in what? | early detection of breast cancer |
BSE | a regular monthly systematic examination of the breast & axillary visualization and palpation |
what is key to identification during BSE | Regularity that supports knowing the normal status for her so she can identify abnormal |
what percent of lumps are found durint BSE | 90% |
true or false, majority of breast lumps are not cancer. | true |
true or false cancerous breast lesions are treatable | true |
Inspection | strip to waist, look in mirror with arms at sides, hands on hips pressed into hips, contracting chest muscles, hands over heaad with thetorso in the uprifht position, hands over head with the torso leaning forward |
palpation | may be done in the shower, soap and water assist the hands to glide over skin, the examination of large breast and acillary should be done in the supine position, examine breast in a systematic way |
what is considered systematic | clockwise circular motion applying firm pressure with thepads of fingers, check every part of the breast from the armpit to the collar bone, compress the nipple to check for discharge, palpate the areola |
report what changes to a physician/ | SIZE, shape, symmetry, orange peel appearance to skin, trtraction or dimpling of the skin or nipple, painless mass moveable or fixed, sero or sanguinous dischargeenlargement of the axillary lymph nodes |
timing of BSE in menstrating women | 3 to 8 days after the end of the menstrual perios best done one week after menstruation ( hormones are at their lowest point and the breast are less congested) |
timing of BSE in post menopausal women | first day of each month or any special day that they can remember, but always the same day. |
CBE | a trained health care provider who will observe, inspect and palpate the breasts, gynecologic exam, anual physical, before mammogram, excellent opportunity to learn how to perform BSE...Mammography a low dose of x-ray of the breasts in combo w/physical |
how many women get mammograms each year? | approximately 2 mil annually, it detects what BSE can't: a tumor must me at least 1 cm to be detectable by palp, which may take 10 years to reach that size of growth |
how large a lump can mammography detect? | 0.5 cm, early detection can prevent metastasis, improved technique has reduced radiation exposure r/t mammogram testing |
what makes mammography more effective? | having mammograms in same facility, less effective in younger women because of greater tissue density, mammograms do not reveal 10-25% of breast cancers |
what is required even if a mammogram is unremarkable? | biopsy |
screening is performed based on what parameters? | beginning at age 40, depending on pt risk factors, and assessment findings, mammograms are good screening but cannot diagnose cancer |
what are established risk factors for breast cancer in women? | age over 50, over 40 if post menopausal, family hx of breast cancer, defective gene BRCA 1 and BRCA, age is the most reliable risk factor because other signs are not present in 50 % of breast cancer pts. |
what is BRCA 1 and BRCA? | a tumor suppressor gene, |
how is it affecting women? | when mutated a womean has a 50% chance of developing cancer by age 50, 85% chance by age 80, 5-10% of women who develop breast cancer have this gene mutation, |
other risk factors? | chronic alcohol use, white women are higher risk for breast cancer, black women are m ore likely to die from it, nulliparity decreases if chilfbirth before 18 yrs of age, nulliparity increases if not sexually active or infertile |
more risk factors | having children afte the age of 35, age at menopause late (after 55 yrs of age), age at menarche: early before age 12, obesity, hx of breast cancer, other primary cancer, exposure to ionizing radiation in child hood or adolescence, |