Comprehensive Guide to Breast Cancer Diagnosis and Treatments
School
American University of the Caribbean School of Medicine**We aren't endorsed by this school
Course
BIO 1000
Subject
Nursing
Date
Dec 10, 2024
Pages
7
Uploaded by mirandaclaudia315
BreastCancerPresentationTreatment1.Asymptomaticscreen1.Exposuretoestrogen+localtherapy2.BreastLump4Earlymenarche*Radiation3.skindimpling,fixedaxillarynodes,⊥LateMenopause*surgery(t)largebreastmass,skinretractionNulliparitysentinempnudebicymphedemaUHR+;OLPs#NObreastCancerscreening2.Radiation-Lymphoma-SystemicTherapy1selfbreastexam3.Genes-BRCA112*Chemotherapy-Doxaricinolcyclophraphamide2.Mammogram-andstandardandPaclitaxel4startatsoy10+every2years*Targeted->MERZINer+Trastermar(+3.MRI+breastscreeningBoundariesforMERL/Ner(-)+BevacizumabDiagnosismasectomyGoodPrognosis:ERIPRIH+SERMPremenopause-Mammogram+Biopsy-1coreneedlebiopsy+superior:clavicleAromataseinhibiterMammogramtoscreen,carebiopsytodiagnose-Interior:InframmaryFoldPostmenopause*C30y10YWAIT+VISmassacyst+FAI Play+Medial:Sternumvid-Lateral:LatissimusdesiINVASIVECarcinomaBreast-conservingsurgeryandBoundariesforaxillarysentinellymphnodebiopsyBONUSDissectionBRACA1/2(+)+Prophylacticbilateral+superior:AxillaryVeinmasectory-Posterior:LongthoracicnerveTamoxifen+DuTBendometrialcancermedial:Lateral,underneath,ormediedtopecteralisminer-estrogenagauistat+Lateral:LatissimusdarsiMaloxiven+NOriskuterusRisk-ReducingInterventionsuForBreastCancerI#Highriskpatients+BRCAmutation(H)Estrogenreceptor*Bilateralmasectomy ioophorectoryAntagonistatbreast
BasicBreastAndtomyBloodSupplyofBreastModifiedsebaceousglandcomposedArterialvenousofglandular,vibrorsandadiposetissue#Axillaryarteryviathe*Followsarterialsupply*EachMammaryglandwas15.20lateralthoracic'sthoracoacromial*Axillary,internalmammary,lobuleseachofwhichhasalactiverorsbranchesandinterestedrainsductthatopensontheaerola*Internalmammaryarteryvia*AxillaryVeinresponsibleveritspercratingbranchesandmajorityofvenuousdrainage*Looper'sLigmanents:structuralsupportadiacentintercostonarteriesthatextendsfromthedeeppectoralFasciatothesuperficialdermalfasciaLymphaticDrainagePectoralisminer#Breasttissuesometimesextendsinto-LevelI:LateraltolateralbaderMuscle+Landmarkaxillaastheaxillarytailofspenceofpectoralismingverdistinguishingthe+LevelI:Deeptopectralisminersurgicallevelsof↑LevelI:MedialtomedicalborderofaxillarylymphnodesPectech'sminerdwingdisection+Rottersmodes:LiebluPecterial'smapersminer*a7%drainstoaxillarylymphnodes;2%.GraintointernalmammaryVenousDrainageBreastNervesLargelyresponsibleformetatasesNerveMusclessuppliedDeficitifinirredtotheSpinethroughPARAVERTEBRALLONGThoracicServatorsAnteriorWingingofscapulaPLEXUSOFBATSONNerveMoracodorsalcannotpushcneselfupfromNeuveLatissimusDasiSittingposition,weakupperextremityADDUCTIONmedialandlateralweaknessofpecteralisDecturalnervesPecteralismajormindmusclescrossesaxillatransverselyIntercostalbrachietosupplyinneraspectAreaofanesthesiaonNerveofarminnerarm
AlgorithimforDXofDifferentialDXBreastCancer*Infections)Inflammatory->Mustitis->FatNecrosis(rarmalDominantMass>Mandor'sDisease*BenignLesions:suspiciousNon-sripicious-Fibroadenama->Fibrocysticchanges-->mammaryductectasiamammogram~>PhyllodestumarMammogram->IntraductalPapilloma+GynecomastiaI*UremalignantDisease:~suspiciousNon-suspicious-DuctalCarcinomainsituDCISBiopsy(+LobularCarcinomainslLCIS~MFine-weedle*MalignantTumors:LiverabrainSuspiciousAspirationFrA-Infiltratingdrital:metstoaxilla,bone,longs,-InfiltratingLobular:metsaxilat,meningesI-Inflammatorycarcinoma-PagetdiseaseofbreastUltrasound1stif<30y10;NonsuspiciousInflammatoryMostlethalbreastCancerIfCystic+FNAV#Emthema,peard'orange,andnippleretractionObservation*BlockageofefferentlymphaticdrifeedemaDX:Skinbiopsysnowsdermallymphaticinvasion⊥Wetanoption↑X:Ihemotherapyfollowedbysurgeryandloif<30yloradiation
BreastNippleDischargeBloodyor&crosanguinousMilkyPathologicPhysiologic~~W~<30y/830-39y10>40x10Mammogram+PregnancyTestUltrasoundIMammogram+ultrasoundMammogram~Itrasound->Galactoneaevaluationv~MRIOfbreastMeasureProlactinifmammogramNormalElevatedandVISareIf-B-MYG,TSM,CrReassuranceandobservation↑TSHTB-MIL↑Cr↓↓↓PrimaryPregnancyIhrcicHypothyroidRencFailure
PalpableBreastMassVW~Age<30y10Age30-39y10Age>40y10~~~UltrasonogramcanuseMammogrameitherImammogramalgorithmIUltrasoundvWvsimplecomplexsuspiciousforCystCyst/massmaliquancy-~NeedleImage-~AspirationguidedcoreCoreBiopsyLifsymptomaticBiopsyIfmassstillthereafteraspiration->core-needlebiopsy
FibroadenomaInflammatoryBreastCarcinoma*Fibrousstromasurroundsductlikee epithelium*Dermallymphaticinvasionoftumorcells->lymphatic*Adolescentsandyoungremales+20-30y10Obstruction*Smooth,white,well-circumscribed,firm'smobile*AxillaryLymphadenopathy*Estrogensensitive;↑tendernessinpregnancy*Peord'Orange:Erythematous,warm,edematousskinplaquesDX:FNA*FendernessandburningsensationTX:*Rapidonsetunilateral,pruriticbreastrashwhemythern4<2 cm:Observeandedema4>2Cm:surgicalexcisionDX:Core-needlebiopsyandfullthicknessskinpunchbiopsy2)Patients>YoylorecommendexcisingmassFibrocysticDisease*Women20-s0y10Lobular/Ductalcarcinomainsite*Premenstrualmultifocalbreastpain,breastnodries,clear↑riskVerinvasivebreastormilkyhippledischarge*characterizedbypresenceofcysts,stromalvibrosisandCancerlikeinvasiveductalandapocrinemetaplasidinvasivelobularDuctalcarcinoma*Insitu:Microcalcificationsonmammogram*Disorganized,smallduct-likeglandularcellswlstromalinvasion+desmoplasticstroma*Rock-hardmassLobularcarcinoma*Monomorphiccellsinasingle-filepatternaretodecreasedE-cadherin*Nocalcifications#NoductformationordesmoplasticstromaPagetDiseaseofNipple+underlyingLCISorarctalcarcinoma*Tender,itenynipplewhorwhobloodydischarge*Erythemators,scalyresicularraghovernipple#NippleretractionDXBlopsyshowsPagetcellsTX:modifiedradicalmasectory