Breast Cancer

 Know the different types of surgeries and why a person would choose one over the other
o Review pre & post op procedures, patient teaching, precautions
 Lumpectomy
 Single Mastectomy
 Partial or segmental mastectomy
 Subcutaneous mastectomy
 Modified Radical Mastectomy
 Radical mastectomy
 Mastectomy –
o Post op: report over 100ml (Jackson Pratt drain) bright red drainage w/in 24 hrs
o Signs of shock or hemorrhage
 Avoid affected arm FOREVER
o No IV, no blood draws, no BP, no vaccines
 Prevent swelling or lymphedema – compression sleeve, elevate, exercise
o Numbness & Lymph node swelling are normal
o Numbness can occur along the inside of the arm
o Post Op Considerations with Mastectomy~ No procedures or affect arm. Post signs, remind patient
to no to overuse the arm..
 Why would a client choose to have surgery when no cancer is detected.?
o Prophylactic surgery
o What Gene puts the client at higher risk
 Breast changes
o often incorrectly called fibrocystic breast disease, is a nonspecific term used to describe an array of
benign findings including palpable nodularity, lumpiness, swelling, or pain. The changes do not
necessarily indicate a cystic or disease process
o The nurse may recommend that the patient wear a supportive bra both day and night for a week,
decrease her salt and caffeine intake, and take ibuprofen (Advil) as needed for its anti-inflammatory
actions. Vitamin E supplements may also be helpful.
o Darkening of the skin with fibrotic skin changes could indicate complications
o Pleuritic pain associated with rib fractures could indicate complications
o Mass usually felt in upper outer quadrant or beneath the nipple
o Asymmetry, with affected breast higher
o Skin dimpling, retraction, or ulceration
o Skin edema or peau d ’orange- lymphatic involvement (blocked skin drainage causes skin edema and
an “ orange peel” appearance
o Lymphedema of affected arm
o Metastatic symptoms
o Mammography shows presence of lesion
o
 Causes/Risks
o Over 50 /postmenopause o Oral contraceptives
o Family HX  Estrogen and progesterone
o Personal HX ovarian or uterine cancer o Diet high fat, low fiber
o Genetic Mutation BRCA o ETOH & Smoking
o Early menstruation age o High dose radiation
o Weight gain/Obesity
 Breast self-exam
o Same day every month, Shower and after period,
o Any red or warm
o Orange peel skin
o Report breast changes NOT related to menstrual cycle
o Pitting or small indented areas
o Hard painless swelling. No pain until it spreads
o Benign – Mobile
o

BReAst Carcinoma Subtyping; BRACS contains 6 different subtypes of lesions including also images
representing atypical lesions.

One in five invasive breast cancers is HER2-positive, making this one of the more common breast cancer
subtypes in the United States.

BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2) are genes that produce proteins that help
repair damaged DNA. Everyone has two copies of each of these genes—one copy inherited from each
parent. BRCA1 and BRCA2 are sometimes called tumor suppressor genes because when they have
certain changes, called harmful (or pathogenic) variants (or mutations), cancer can develop.