T. Breasts

Question 1

Lobules::

Answer 1

milk-producing glands

Question 2

Ducts

Answer 2

milk passages that connect lobules and the nip

Question 3

Breast cancer arises from

Answer 3

Epithelial lining of ducts

Epithelium of lobules

Question 4

Paget’s Disease

Answer 4

• Persistent lesion of the nipple and areola with or without palpable mass
• Different from Paget’s disease of the bone
• Itching, burning, bloody nipple discharge

Question 5

Inflammatory Breast Cancer

Answer 5

• Caused by cancer cells blocking lymph channels
• an aggressive cancer because it grows quickly
• Skin of the breast
– Looks red
– Feels warm
– Has a thickened appearance, resembling an orange peel

Question 6

Breast Cancer

Answer 6

• Detected as lump or mammographic abnormality in breast
• Most often in upper, outer quadrant of breast
• Dense with glandular tissue

Question 7

Tumour size

Answer 7

• The larger the tumour, poorer the prognosis.
• The more well differentiated the tumour, the less aggressive it is.
• Poorly differentiated tumours appear morphologically disorganized and are more aggressive.

Question 8

Estrogen and progesterone Receptor-positive tumours

Answer 8

• Well differentiated
• Diploid DNA content and low proliferative indices
• Low chance for recurrence
• Frequently hormone dependent and responsive to hormonal therapy

Question 9

Estrogen and progesterone Receptor-negative tumours

Answer 9

• Poorly differentiated
• Increased incidence of aneuploidy and higher proliferative indices
• Frequently recur
• Unresponsive to hormonal therapy

Question 10

Ploidy status

Answer 10

• correlates with tumour aggressiveness.

* Diploid tumours have a significantly lower risk of recurrence than aneuploid tumours.

Question 11

Mastectomy

Answer 11

• Removal of breast, pectoral muscles, axillary lymph nodes, all fat and adjacent tissue
• Historically, was the standard of care

Question 12

TNM system

Answer 12

• Staging of breast cancer

• Tumour size (T)
• Nodal involvement (N)
• Presence of metastasis (M)

Question 13

Axillary Node Dissection

Answer 13

• a procedure to remove these lymph nodes.
on same side as breast cancer is often performed.
• Until recently, was standard of care for invasive breast cancer

Question 14

Lymphedema

Answer 14

• Accumulation of lymph in soft tissues
• Can occur as a result of excision or radiation of lymph nodes
• When axillary nodes cannot return lymph fluid to central circulation, fluid accumulates in arm, causing obstructive pressure on veins and venous return.

Question 15

Breast Conservative Therapy

Answer 15

• Involves removal of entire tumour with a margin of normal tissue
• Radiation therapy is delivered to entire breast, ending with a boost to tumour bed.
• Evidence of systemic disease may warrant chemotherapy before radiation.

Question 16

Modified Radical Mastectomy

Answer 16

• Removal of breast and axillary lymph nodes
• Preserves pectoralis major muscle
• Selected over breast reconstruction surgery if tumour is too large to excise
• Client has best option of breast reconstruction.

Question 17

Postmastectomy Pain Syndrome

Answer 17

• Can occur following a mastectomy or an axillary node dissection
Symptoms
• Chest and upper arm pain, tingling down arm
• Numbness, shooting or prickling pain
• Unbearable itching persisting beyond 3-month healing time

Question 18

Radiation Therapy

Answer 18

• Usually performed after local excision of breast mass

* Breast is radiated daily over ~4–6 weeks.

Question 19

High-dose brachytherapy

Answer 19

• Internal radiation delivered using a multicatheter implant

* After placement, radioactive seed delivered into each catheter to treat target area

Question 20

Chemotherapy

Answer 20

• Use of cytotoxic drugs to destroy cancer cells
• Breast cancer is one of the solid tumours that is most responsive to chemotherapy.
• Given preoperatively in some clients to decrease size of primary tumour

Question 21

Hormonal therapy

Answer 21

• Removes or blocks source of estrogen, promoting tumour regression
• Estrogen can increase growth of breast cancer cells if cells are estrogen receptor positive.

Question 22

Aromatase inhibitors

Answer 22

interfere with the enzyme that synthesizes endogenous estrogen.