DESCRIPTION OF BREAST CANCER

Breast cancer is a cancer that starts in the tissues of the breast. Cancer occurs as a result of mutations in the genes responsible for regulating the growth of cells and keeping them healthy. When the changed cells continue dividing out of control they form a tumor. Malignant tumors are cancerous and if left untreated the cancer can spread to other parts of the body. There are two types of breast cancer:
y y

Ductal carcinoma: Ducts that move milk from breast to nipple.(Most common) Lobular carcinoma: Starts in then lobes that produce milk.

DESCRIPTION OF BREAST CANCER CONTINUE

1 in 8 woman in the U.S. have breast cancer. Breast cancer death rates are higher than any other cancer besides lung cancer. More than 1 in 4 cancers are breast cancer in woman. Less than 1% of all new breast cancer cases occur in men. About 90% of all breast cancers are not due to heredity, but genetic mutations that happen as a result of the aging process. 5-10% of breast cancers are due to an abnormality inherited from mother or father.

PATHOPHYSIOLOGY
Cancer begins in the simple cells that make up tissues,tissues make up the organs of the body Cells grow and divide to form new cells as the body needs them Cells then die and are replaced with new ones Sometimes the cellular process goes wrong,new cells form and the body doesnt need them and old cells do not die when they should The extra cells can form a mass of tissue called a growth or tumor Tumors can be benign or malignant

PATHOPHYSIOLOGY
Breast cancer invades locally and spreads through the regional lymph nodes,bloodstream or both Estrogen and progesterone receptors are nuclear hormone receptors that promote DNA replication and cell division present in some breast cancers Human epidermal growth factor receptor 2(HER2)its presence correlates with a poorer prognosis at any stage of breast cancer

PATHOPHYSIOLOGY
Most breast cancers are epithelial tumors that develop from cells lining ducts or lobules Less common are non epithelial cancers of the supporting stroma(from the greek word meaning anything spread out for sitting or lying upon) Cancers are divided into carcinoma in situ and invasive cancer

PATHOPHYSIOLOGY
Carcinoma in situ- proliferation of cancer cells within the ducts or lobules and without invasion of stromal tissue Ductal carcinoma in situ(DCIS) is detected on mammogram and is localized to one area but,may become invasive Lobular carcinoma in situ(LCIS) is nonpalpable and discovered via biopsy,non malignant but,its presence indicates increased risk of invasive carcinoma in either breast LCIS often multifocal and bilateral

CLINICAL MANIFESTATION
Breast mass or thickening Unusual lump in the underarm or above the collarbone Persistent skin rash near the nipple area Flaking or eruption near the nipple Dimpling, pulling or retraction in an area of the breast Nipple discharge Change in nipple position Burning, stinging, or pricking sensation

DIAGNOSTIC TESTING
Clinical breast examination (CBE) Mammogram Percutaneous needle biopsy Stereotactic needle biopsy Excisional biopsy Ductal lavage and nipple aspiration

HOW DO I CHECK FOR LUMPS?

Start by standing in front of a mirror. Look at your breasts with your arms at your side, with your arms raised behind your head, and with your arms on your hips and your chest muscles flexed. Next, lie down with a pillow under your left shoulder. Put your left hand behind your head and feel your left breast with the pads of the 3 middle fingers on your right hand. Start at the outer edge and work around your breast in small circles, getting closer to your nipple with each circle. After you've finished checking your breast, squeeze your nipple gently and look for discharge (fluid coming out of the nipple). Do the same thing to your right breast with a pillow under your right shoulder.

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Be sure to include the area up to your collarbone and out to your armpit. You have lymph nodes in this area. Cancer can spread to lymph node tissue.

RISK FACTORS

Genetics
BRCA-1 and BRCA-2 y Family history y Personal history
y

Hormones Estrogen Early menarche Late menopause Nulliparity Late first pregnancy

RISK FACTORS CONTINUE

Environmental
y y y y y y

Radiation Breast biopsies Moderate to high alcohol intake High fat diet Smoking Pollution

LIFESTYLE & OTHER FACTORS

Gender and Age Being Caucasian and African American Obesity Wearing antiperspirants/deodorants Wearing underwire bras Lack of exercise

RESOURCES
American Cancer Society www.cancer.org National Cancer Institute www.cancer.gov Susan G. Komen Foundation ww5.komen.org National Coalition for Breast Cancer www.stopbreastcancer.org Breast Cancer Network of Strength www.networkofstrength.org BreastCancer.org www.breastcancer.org Army of Women www.armyofwomen.org

REFERENCE

Breast Cancer. (n.d.). Retrieved from http://www.merck.com Breast Cancer [Pathophysiology]. (n.d.). Retrieved from http://www.medicinenet.com Bland, Kirby I., Beenken, Samuel W., & Copeland III, Edward M. (2005). Schwartz's Principles of Surgery - 8th Edition. Retrieved from STAT!Ref Online Electronic Medical Library. Gauthier, Susan P. (1996). Clinical Handbook for Medical-Surgical Nursing Critical Thinking in Client Care . Menlo Park , CA : Addison-Wesley Nursing, a Division of The Benjamin/Cummings Publishing Company. Lemone, P., & Burke, K. (2004). Medical Surgical Nursing: Critical Thinking in a Client Care (3rd ed.). Upper Saddle River, New Jersey: Person Education, Inc.. Mayer, M., Batur, P., & Moore, H. (n.d.). Breast Disorders and Breast Cancer Screening [Breast Disorders and Breast Cancer Screening]. Retrieved October 6, 2009