1. TOPIC :BREAST CANCER
SUBJECT:MEDICAL
SURGICAL NURSING II
COURSE: GNM
YEAR: IInd year
DATE:26/11/2020
PRESENTED BY
Victoria Angela
Fernandez
Clinical Instructor
VCON

2.  Breast cancer is a disease in which malignant (cancer)
cells form in the tissues of the breast. It occurs in both
sex, but very rare in men.
 Breast cancer is the most common cause of cancer
death among women in 140 of 184 countries
worldwide.
 Approximately 1 in 8 women (13%) will be diagnosed
with invasive breast carcinoma in their lifetime.(acc.
To American Cancer Society)

3.  The term “breast cancer”
refers to a malignant tumor
that has developed from cells
in the breast.
 Breast cancer is a group of
diseases of breast in which
cells in breast tissue changes
and divide uncontrolled,
typicaaly resulting in lump or
mass.

4.  Female: women account for 99% of breast cancer
cases.
 Age: >50 year, majority of breast cancers are
found in postmenopausal women. After age 60,
increase in incidence.
 Hormone use: use of estrogen & progesterone as
hormone therapy, especially in postmenopausal
women.

5.  Family history: Breast cancer in a first-degree
relative.
 Genetic factors: gene mutations play a role in 5 –
10% of breast cancer cases.
 Personal history of breast cancer, colon cancer,
ovarian cancer
 Early menarche ( before age 12): lead to an increase
in total lifetime number of ovulatory menstrual cycle
& a corresponding 30 – 50% increase in breast cancer
risk.
 late menopause (after age 55):. A women who
experiences natural menopause before age 45 years
has a high risk for breast cancer.

6.  First full-term pregnancy after age 30, nulliparity:
prolong exposure to unopposed estrogen increases
risk for breast cancer.
 Weight gain & obesity after menopause: fat cells
store estrogen, which increases the likelihood of
developing breast cancer.
 Exposure to ionizing radiation: Women who
received radiation for the treatment of other disease,
follow-up examination detect these lesions early.
 Alcohol consumption& smoking: women who take
moderate alcohol ( one to two drinks per day)
increases the risk of breast cancer by altering estrogen
metabolism.

9. Non-invasive breast
cancer
Invasive breast
cancer
Lobular
Carcinoma
in Situ
(LCIS)
Ductal
Carcinoma
In Situ
(DCIS)
Invasive
Ductal
Carcinoma
Invasive
Lobular
Carcinoma
Inflammatory
breast cancer

10.  Non-invasive breast cancer(In situ breast cancers do
not spread but it is localised to a place.)
Ductal Carcinoma In Situ (DCIS)
 It occurs in the lactiferous ducts of breast .
 DCIS is considered a pre-cancer because sometimes it
can become an invasive cancer.

11.  Lobular Carcinoma in Situ (LCIS):
 It may also be called lobular neoplasia.
 In this breast change, cells that look like cancer cells
are growing in the milk-producing glands of
the breast (called the lobules), but they don’t grow
through the wall of the lobules.

13.  Invasive Breast Cancer –(Invasive or infiltrating
cancers have spread (invaded) into the surrounding
breast tissue.)
Invasive Ductal Carcinoma:
 It is the most common type of breast cancer
accounting for milk ducts & then breaks through
the walls of the duct, invading the surrounding
tissue.
 It may metastasize to other parts of the body.
 Subtypes of invasive ductal carcinoma include
medullary carcinoma, tubular carcinoma, colloid
(mucinous) carcinoma, papillary carcinoma &
metaplastic carcinoma.

14.  Invasive Lobular Carcinoma:
 It begins in the lobules (milk – producing glands) of
the breast & accounts for approximately 10% to 15%
of invasive breast cancers. The cancer cells can break
out of the lobule& have potential to metastasize to
other areas of body.

16.  Inflammatory breast cancer
 In the early stages, it is often mistaken for mastitis.
 However, the inflammatory changes do not improve with
antibiotics, as the lymph channels in the skin of the
breast are blocked by cancer cells. Because of the skin of
the breast are blocked by cancer cells.
 Because of skin involvement, the breast looks red, feels
warm & has a thickened appearance that is often
described as resembling as orange peel (peau d’ orange).
 A breast mass may not be present & changes may not
show up on mammograms, thus making diagnosis will
be difficult.

18.  STAGE 0: Tumor is confined to milk duct.
 STAGE I: Tumor is less than 2 cm in diameter and
confined to breast.
 STAGE 2A: Tumor is less than 5 cm or tumor is
smaller with 1-3 axillary node involvement.
 STAGE 2B: Tumor is greater than 5 cm and upto
3 axillary lymph node involved.

19.  STAGE 3A: Tumor is greater than 5cm and is
confined to 4-10 lymph nodes.
 STAGE 3B: Tumor regardless of the size has
spread to the chest wall and skin.
 STAGE 3C: Tumor of any size with involvement
of 10or more lymph nodes but not metastases.
 STAGE 4: Tumor is distant metastised to other
organs.

21.  Lump or thickening in the breast (hard, irregular,
non-mobile and non-tender)
 Nipple discharge (usually unilateral, clear or
bloody
 Nipple retraction
 Change in the size or contours of the breast
 Peaud’orange appearance
 Dimpling of overlying skin
 Ulceration

22.  History
 Breast self examination
 Triple assessment:
 Clinical Breast Examination
 Imaging (mammography, ultrasonography, or both)
 Needle biopsy (FNAC): By inserting a needle into the
lesion and aspirating tissue into a syringe.
 Breast MRI
 Biopsy

23.  Radiation therapy.
 External radiation
 Brachytherapy
 Palliative radiation therapy
 Drug therapy
 Chemotherapy.
 Hormonal therapy
 Immunotherapy
 Targeted therapy.

24.  Surgical :
 Lumpectomy ( only the tumor is removed and also
some axillary lymph nodes).
 Partial Or Segmental Mastectomy ( the tumor and
some Breast tissue and some Lymph nodes are
removed).
 Simple Or Total Mastectomy ( all breast tissue is
removed. No lymph node dissection is performed).

26.  Subcutaneous Mastectomy ( all breast tissue is
removed but the skin and nipple are left intact).
 Modified Radical Mastectomy( the Breast, some
lymph nodes , the lining over the chest muscles
and pectoralis minor muscles are removed).
 Radical Mastectomy ( the Breast, axillary lymph
nodes, pectoralis Major and minor muscles are
removed).