SAS 18

• The health history includes common or concerning symptoms such as a lump or mass in the breast or axilla.
• Your instructor will instruct you to record three things you learned from the lesson.
• After answering the question, your instructor will station himself/herself at the door and collect the “exit pass” as you depart from the room.
• You will record two things that you found interesting and that you like to learn more or if you still have something to be clarified about the topic.
• Questions to ask patients about a lump or mass in the breast or axilla include the onset, location, duration, characteristic symptoms, and associated manifestations.
• The physical examination techniques performed to evaluate the breasts and axillae include palpation, inspection, and auscultation.
• The health history of the breasts and axillae should be performed accurately.
• The clinical breast examination should be demonstrated by the student.
• A complete breast and axilla assessment can be documented utilizing information from the health history and the physical examination.
• The measures for prevention or early detection of breast cancer should be determined by the student.
• The breasts and axillae have specific structures and functions.
• Mammographic breast density has been identified as “the most undervalued and underused risk factor” in studies of breast cancer.
• Age of 65 years and above, two or more first-degree relatives with breast cancer diagnosed at an early age, high breast tissue density, and low breast tissue density are not risk factors for breast cancer.
• The nurse must teach a female patient to do monthly breast self-examination at around 5-7 days after the onset of menses.
• Alcohol consumption, Jewish heritage, personal history of endometrium, ovary, or colon cancer are modifiable risk factors in the development of breast cancer.
• The histology results of a patient who is suspected to have breast cancer came back as having atypical lobular hyperplasia, indicating a small increased risk.
• Retractions seen on breasts of females can be present in conditions such as fibroadenoma, cysts, adenocarcinoma, and cancer.
• Mammographic breast density is a strong independent risk factor even after adjusting for the effects of other risk factors, and it has the important attribute of “being present in the tissue from which the cancer arises.”
• In identifying women at risk for BRCA1 or 2 mutation, the doctor must establish a family history of breast cancer, two or more relatives with a diagnosis of breast cancer before age 50, or two or more relatives with a diagnosis of ovarian cancer.
• The recommended age for mammography in order to detect breast cancer in women who are asymptomatic should be at around 40 to 50 years.
• When palpating for the shape of the breast mass in patients with breast cancer, the nurse must observe for a round, disc-like, or lobular shape.
• Peau d’orange on the lower portion of the patient’s breast is indicative of edema.
• Cysts can occur in women who are ages 15-25, usually during puberty and young adulthood, but up to age 55.
• Breast cancer is the second leading cause of cancer death in women, with highest mortality rates in women 35 years or younger and older than 75 years.
• Edema of the breast can occur and can be painful.
• Nipple retraction is when the nipple is pulled inward and can be an indicator of breast cancer or adhesions below the skin surface.
• On initial assessment, the woman’s age and physical characteristics of the mass provide clues about its etiology.
• Dimpling of the breast tissue can occur and is usually constant.
• Declines in new cases of invasive breast cancer are due to decreased mammography screening, which leads to underdiagnosis or delayed diagnosis rather than a true decrease in disease incidence, and decreased use of HRT.
• Mammograms are resulting in increasing numbers of breast biopsies, and clinicians should now understand the effects of benign breast disease on risk for later breast cancer.
• Nurses assist patients to follow up for accurate diagnosis and treatment.
• Within a decade of starting annual screening, 20% of women have had a breast biopsy.
• Breast masses show marked variation in etiology, from fibroadenomas and cysts seen in younger women, to abscess or mastitis, to primary breast cancer.
• Rashes or scaling of the skin can occur and can be itchy.
• Nurses are the advocates and help navigate the complex health care system.
• Breast lesions are believed to evolve in somewhat linear fashion from usual ductal hyperplasia, or unfolded lobules, to atypical hyperplasia, to the pathologic stages of ductal carcinoma in situ (DCIS) and invasive cancer.
• These disorders are now classified by degree of cellular proliferation on biopsy and degree of risk for breast cancer.
• Breast cancer occurs in up to 4% of women with breast complaints, in approximately 5% of women reporting a nipple discharge, and in up to 11% of women specifically complaining of a breast lump or mass.
• Breast cancer is the most commonly diagnosed cancer among African American women.