Breast tumors

Annie Emerentia G.

Diagnosis
Mammography

Axillary lymph node status Axillary lymph node dissection

Lymphatic mapping & sentinel lymph node dissection

Tumor size prognostic variable

Estrogen and progesterone receptor status

Receptive-positive tumors are well differentiated, diploid DNA content
and low proliferative indices, lower chance for recurrence and frequently hormone dependent and responsive to hormonal therapy.

Receptive negative tumors are poorly differentiated histologically, high

incidence of aneuploidy (abnormally high or low DNA content) and higher proliferative indices, frequently recur and unresponsive to hormonal therapy.

Collaborative Care
Surgical therapy
ALND removal of 15 20 lymph nodes

Complications of ALND : Lymphedema (accumulation of lymph in soft tissue)

heaviness, pain, impaired motor function in the arm, numbness and paresthesia of the fingers, cellulitis and progressive fibrosis

Breast conservation Surgery lumpectomy + radiation therapy & chemotherapy Modified radical mastectomy (preservation of pectoralis major muscle) Follow-up care : monthly BSE + professional examination Q6monthly upto 2 years

Adjuvant Therapy (additional)

Dependent factors
Stage of disease
Menstrual status and age Cancer cell characteristics Presence or absence of estrogen
receptors

Pre-existing health problems

What does it include?

Radiation therapy after breast
conservation surgery

Systemic therapies like

chemotherapy and hormonal therapy

Radiation therapy
Primary radiation therapy 5 to 6 weeks, given by
external beam

High dose brachytherapy - balloon brachytherapy,

mammosite technique

Palliative Radiation therapy to reduce pain and

reduce tumor size

Nursing care
Postoperative exercises Psychologic care Home care