1. MANIFESTATIONS
1.1. PAPILLARY
1.1.1. invasive micropapillary breast cancer
1.1.1.1. high rate of lymph node metastasis
1.1.1.2. skin retraction
1.1.1.3. presents as a palpable mass in 60% of cases
1.1.1.4. tends to affect left breast more often than right in 65% of cases
1.1.2. invasive papillary breast cancer
1.1.2.1. Cancer cells break through walls of the breast ducts and into breast tissue.
1.1.2.1.1. SYMPTOMS
1.1.2.1.2. May be asymptomatic
1.1.3. intracystic/encapsulated/encysted papillary cancer
1.1.3.1. cancer is found inside of a cyst or a dilated duct
1.1.3.1.1. SYMPTOMS
1.1.4. Papillary Ductal Carcinoma in situ
1.1.4.1. abnormal cells are contained within breast ducts
1.1.4.1.1. generally asymptomatic
1.1.4.1.2. POSSIBLE SYMPTOMS
1.1.5. Additional Links
1.2. METASTATIC
1.2.1. Bone metastasis
1.2.1.1. breast cancer cells spread to any bone
1.2.1.1.1. Commonly found in:
1.2.1.1.2. SYMPTOM
1.2.2. Lung Metastasis
1.2.2.1. breast cancer in lung(s)
1.2.2.1.1. often asymptomatic
1.2.2.1.2. POSSIBLE SYMPTOMS
1.2.3. Brain Metastasis
1.2.3.1. breast cancer in brain
1.2.3.1.1. SYMPTOMS
1.2.4. Liver Metastasis
1.2.4.1. breast cancer spreads to liver
1.2.4.1.1. often asymptomatic
1.2.4.1.2. POSSIBLE SYMPTOMS
1.3. EARLY WARNING SIGNS
1.3.1. Breast
1.3.1.1. Lumps outside of breast
1.3.1.2. lumps in breast
1.3.1.3. skin
1.3.1.3.1. redness
1.3.1.3.2. swelling
1.3.1.3.3. visible difference from normal
1.3.1.4. nipple
1.3.1.4.1. change in appearance
1.3.1.4.2. discharge other than breast milk
1.4. SYMPTOMS OF INVASIVE BREAST CANCER
1.4.1. Breast
1.4.1.1. lump
1.4.1.1.1. thickening of lump
1.4.1.2. nipple
1.4.1.2.1. retraction
1.4.1.2.2. discharge of not breast milk
1.4.1.2.3. peeling of nipple skin
1.4.1.2.4. flaking of nipple skin
1.4.1.3. irritated or itchy breasts
1.4.1.4. Breast size
1.4.1.4.1. change over short period of time
1.4.1.5. Breast shape
1.4.1.6. sensation
1.4.1.6.1. feel hard
1.4.1.6.2. feel tender
1.4.1.6.3. feel warm
1.4.1.7. skin
1.4.1.7.1. redness or pitting of breast skin
1.4.2. Lump/swelling in underarm
2. NURSING CONSIDERATIONS
2.1. PREVALENCE
2.1.1. Women
2.1.1.1. Breast cancer is more prevalent in women after menopause.
2.1.1.1.1. If
2.1.2. Genetics
2.1.2.1. You are substantially more likely to have a genetic mutation linked to breast cancer if:
2.1.2.1.1. You have blood relatives (grandmothers, mother, sisters, aunts) on either your mother's or father's side of the family who had breast cancer diagnosed before age 50.
2.1.2.1.2. There is both breast and ovarian cancer on the same side of the family or in a single individual.
2.1.2.1.3. You have relative(s) with triple negative breast cancer.
2.1.2.1.4. There are other cancers in your family in addition to breast, such as prostate, melanoma, pancreatic, stomach, uterine, thyroid, colon, and/or sarcoma.
2.1.2.1.5. Women in your family have had cancer in both breasts.
2.1.2.1.6. You are of Ashkenazi Jewish (Eastern European) heritage.
2.1.2.1.7. You are Black and have been diagnosed with breast cancer at age 35 or younger.
2.1.2.1.8. A man in your family has had breast cancer.
2.1.2.1.9. There is a known abnormal breast cancer gene in your family.
2.1.2.2. Hereditary
2.1.2.2.1. About 5-10% of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.
2.2. ANTICIPATORY GUIDANCE
3. MYTHS
3.1. "If there is no family history of breast cancer, a woman will not get breast cancer."
3.1.1. Only around 5-10% of breast cancers are thought to be hereditary which suggests that the vast majority of breast cancer cases result from different factors such as lifestyle and/or environmental factors.
3.2. "Breast cancer is guaranteed to be found early with annual mammograms."
3.2.1. Mammograms are the best early-detection tool, however, they do not always detect breast cancer in its early stages.
3.3. "Breast cancer only occurs in women that are middle-aged and older."
3.3.1. Women under the age of 40 account for 1 in 25 cases of invasive breast cancer.
3.4. "Men cannot get breast cancer."
3.4.1. Less than 1% of breast cancer occurs in males. Men have breast tissue and, therefore, are also at risk of developing breast cancer.
3.5. "Wearing a bra can lead to breast cancer."
3.5.1. Despite some media coverage and claims on the internet, there is no evidence to support that wearing a bra causes cancer.
3.6. "Deodorant use can result in breast cancer."
3.6.1. Currently, there is no definitive evidence linking antiperspirants to breast cancer, however, studies have found that females who use deodorants containing aluminum have a greater likelihood of having aluminum within their breast tissue.
3.7. "Breast cancer always presents with a lump."
3.7.1. A woman may not always feel a lump, especially in the beginning stages, therefore getting mammograms in conjunction with regular self-examinations are important.
3.8. "Carrying a cell phone in your bra can result in breast cancer."
3.8.1. Although this theory is still being researched, there is no definitive link between the two, however, cellphone manufacturers do recommend that you keep your phone away from your body if possible.
3.9. "Consuming excessive amounts of sugar can cause breast cancer."
3.9.1. There is no supporting evidence that proves a link between the two, however, excessive sugar intake may contribute to being overweight which is considered a risk factor for developing breast cancer.
4. ETIOLOGY/RISK FACTORS
4.1. GENETIC FACTORS
4.1.1. Gender
4.1.1.1. Women develop breast cancer 100 times more than men.
4.1.2. Age
4.1.2.1. The risk of developing breast cancer increases with age.
4.1.2.2. Greater than 65 years old increases risk.
4.1.3. Family History
4.1.3.1. An individual has a higher risk of developing breast cancer if they have a family history of the disease.
4.1.4. Genetic Predisposition
4.1.4.1. Certain mutations in genes can increase your risk for breast cancer.
4.1.4.1.1. The BRCA1, BRCA2, PALB2, TP53 have a significantly higher risk of developing breast cancer.
4.1.5. Early Menstration
4.1.5.1. Early menstruation (before the age of 12) and late menopause (age 55 and older) can be a risk factor of cancer.
4.2. ENVIRONMENTAL FACTORS
4.2.1. Diet
4.2.2. Physical Activity
4.2.3. Obesity
4.2.4. Radiation to the Chest
4.2.5. Alcohol Consumption
4.3. OTHER FACTORS
4.3.1. Breast Density
4.3.1.1. Dense breasts are associated with a higher risk of developing breast cancer. Due to the higher concentration of connective tissue in dense breasts, compared to fatty tissue, it can be more difficult to detect tumors on a mammogram.
4.3.2. Personal History of Breast Disease (or other cancers)
4.3.2.1. Women who have had cancerous or non-cancerous breast diseases are at a higher risk of developing breast cancer.
4.3.2.1.1. Non-cancerous breast diseases include atypical hyperplasia, lobular carcinoma and many more. Hx of ovarian or endometrial cancer
4.3.3. Use of Diethylstilbestrol (DES)
4.3.3.1. Used to prevent miscarriage, DES was given to pregnant women between 1940 and 1971. Women who used DES are at higher risk of breast cancer as well as individuals who’s mother took DES during their pregnancy.
4.3.3.1.1. High endogenous estrogen or testosterone levels
4.3.4. High endogenous estrogen or testosterone levels
4.3.5. Recent and long term use of menopausal hormone therapy
4.3.6. Recent hormonal contraceptive use
5. PATHOPHYSIOLOGICAL COMPOMENTS
5.1. Cancer Cells
5.1.1. Tumors/Lesions
5.1.1.1. Epithelial Tumors
5.1.2. Disturbed growth
5.1.2.1. tumors/lesions
5.1.2.1.1. cells lining ducts or lobules
5.1.3. Invasion
5.1.3.1. Local
5.1.3.1.1. spread through
6. EDUCATIONAL RESOURCES
6.1. PATIENT EDUCATIONAL RESOURCES
6.1.1. Susan G. Komen
6.1.1.1. Patient Education Interactive Learning Tools
6.1.1.2. Breast Cancer 101 Interactive Tool and Treatment Navigation Tool
6.1.2. American Cancer Society
6.1.2.1. Resources for follow up care after treatment
6.2. MAMMOGRAM RESOURCES
6.2.1. FreeMammograms.org
6.2.1.1. Resource for free mammogram in TN at St. Thomas West Breast Center
6.2.2. Susan G. Komen
6.2.2.1. Information on getting a mammogram
6.3. BREAST CANCER TRIAL RESOURCE
6.3.1. BreastCancerTrials.org
6.3.1.1. Resources to connect the breast cancer patient in all stages to appropriate trials
6.4. SOCIOECONOMIC SUPPORT RESOURCES
6.4.1. YMCA
6.4.1.1. After Breast Cancer (ABC) Program
6.4.1.1.1. emotional support groups
6.4.1.1.2. nutritional support
6.4.1.1.3. exercise resources
6.4.2. CancerCare
6.4.2.1. Financial resources for those going through treatment or those that need treatment
6.4.2.2. Offers counseling, support groups, and patient education