Caring for Clients with Breast Disorders

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Caring for Clients with Breast Disorders

• CHAPTER 60

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Fibrocystic Breast Disease

• Fibrocystic breast disease, also called mammary
  dysplasia (abnormal development of breast tissue)
  or chornic cystic mastitis, is a benign breast
  condition that affects women primarily between
  the ages of 30 and 50 years.
• Results from hormonal changes during the
  menstrual cycle.
• Caffeine and nicotine also may aggravate.

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Fibrocystic Breast Disease

• Condition resolves with menopause.
• See Nursing Management on pg. 1047!!

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Fibroadenoma 1048

• A fibroadenoma is a solid, benign breast mass
  composed of connective and glandular tissue Fig.
  60-2 pg. 1050.
• Usually occurs in women during late adolescence
  and early adulthood, but occasionally is found in
  older women.
• Cause unknown
• Presents as a painless, non-tender lump
• Nursing Management on pg. 1050!

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Cancer of the Breast

• One woman in eight develops breast cancer, a mass
  of abnormal cells.
• Risk increases with age.
• Does occur in men, the ratio is 1150 cases in
  women.
• Women deaths, breast second to lung.
• 5 year survival rate for small lesions is at
  least 80.

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Risk Factors

• Female
• gt 50
• Family hx
• Exposure to ionizing radiation
• Hx of colon or endometrial cancer
• Chronic alcohol consumption

• Early menarche
• Late menopause
• Obesity
• Having no children or having them after 30
• White women

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Cancer of the Breast

• S/S painless mass in the breast, most often in
  the upper outer quadrant. Fig. 60-3 pg. 1051.
• May have been developing for as long as 2 years
  before becoming palpable
• Bloody discharge from the nipple
• Dimpling
• Retraction of the nipple
• Peau dorange (orange peel) appearance of the
  skin
• Difference in size of the breast

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Cancer of the Breast

• Mammography detects breast lesions earlier than
  they can be palpated.
• Treatment depends on the stage of the breast
  tumor. (surgery, chemotherapy, hormone therapy,
  radiation)

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DCIS
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Cancer of the Breast

• Lymphedemasoft tissue swelling from accumulated
  lymphatic fluid, occurs in some women after
  breast cancer surgery.
• Temporary or permanent enlargement of the arm and
  hand on the side of the amputated breast.
• Impaired lymphatic circulation predisposes to
  disfigurement, reduced range of motion, heaviness
  of the limb, skin changes, infection, and in
  severe cases, tissue necrosis that may require
  amputation of the limb.

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Cancer of the Breast

• NURSING CARE PLAN Pg. 1056-1060!!
• EXERCISES pg. 1061

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Metastatic Breast Cancer

• Metastasis means the migration of cancer cells
  from one part of the body to another.
• Spread through direct extension through the
  lymphatic system, bloodstream, and cerebrospinal
  fluid.
• Treatment aims for palliation (relieving symptoms
  without curing the disease)

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Breast Cancer Prevention

• Pg. 1060