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MDC 3 EXAM 1 QUESTIONS AND ANSWERS/2025 SPRING What is the 2nd most common malignancy in women and 2nd leading cause of death in women? Breast cancer How does breast cancer start? From the epithelial lining of the ducts or the epithelium of the lobules 99% of breast cancers occur in what gender? women breast cancer is slightly more common in what race of women? white
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What is the 2nd most common malignancy in women and 2nd leading cause of death in women?
Breast cancer
How does breast cancer start?
From the epithelial lining of the ducts or the epithelium of the lobules
99% of breast cancers occur in what gender?
women
breast cancer is slightly more common in what race of women?
white
breast cancer in men is similar across?
all ethnic groups
Risk factors for breast cancer?
-post menopause (increasing in age after 60)
-Estrogen (HRT: hormone replacement therapy) (post menopause therapy) can be with progesterone or alone.
-Alcohol
-Childbirth after age 30
-Obesity
-Smoking
-Breast cellular changes: hyperplasia, atypical appearance (increased risk)
Breast cancer signs and symptoms
-lump in breast
-swelling
-skin irritation
-dimpling
-breast pain
-nipple pain
Breast health large breast challenges
-Impaired comfort
-Back pain
-diffculty finding clothing that fits
-expensive bras
-fungal infections under breasts
-redness, chaffing or rash, under breasts.
Breast health small breast challenges
-some choose breast augmentation (important to avoid foods, medications, herbs that increase bleeding before/after surgery)
-Can still perform self examination and have mammograms- but may not be as sensitive
-some evidence of increased risk for non Hodgkins lymphoma Not breast cancer
Breast Cancer Types
-In situ (non-ivasive) breast cancer remains in the mammary
DCIS: ductal carcinoma in situate duct or lobules
-ILC: invasive lobular carcinoma
IDC: invasive ductal carcinoma
Non-invasive or In situ breast cancer is
DCIS: ductal carcinoma is situate
Invasive breast cancer is
ILC or IDC
-the cancer grows into the surrounding tissue and can metastasize
-most likely cause of skin dimpling or peau'd orange
-Aggressive form : itching, rapidly growing lump, breast pain, erythema & edema
Most common invasive cancer
IDC: infiltrating ductal carcinoma
breast cancer treatment
-Surgery: breast conserving & masectomy
-Radiation therapy
Most common chemotherapy drugs 2 or 3 of these drugs mixed usually
-Anthracyclines (doxurubicin & epirubicin)
-Taxanes (paclitazel & docetaxel)
-Cyclophosphadmide
-Carboplatin
Typical side effects of chemotherapy
-hair loss
-nail changes
-mouth sores
-loss of appetite
-N/V
-Diarrhea
-Increase risk of infection
-Easy bruising or bleeding
-Fatigue
-Menstrual changes and infertility
-"Chemo brain"
Lower risk side effects of chemotherapy
-heart damage
-risk of leukemia
-hand foot syndrome (numb, tingling, red, swollen hands & soles)
-Nerve damage
Hormone therapy cancer treatment options
-many block estrogen receptors
-SERM: selective estrogen modulators: tamoxifen, toremifene, fulverstrant.
-AI: artomatase inhibitors: prevent production of estrogen: anastrozole, letrozole, exemestane.
Breast Cancer Prognosis
-tumor size
-nodal involvement
-tumor differentiation
-estrogen & progesterone receptor status
-HER-2 Status: human epidermal growth factor receptor 2
Survival breast cancer rates
-Localized breast cancer: 99%
-Spread to regional lymph nodes: 85%
Assessment details
-patient history
-nutrition history
-personal/familyhistory
-co-morbid issues
-history of presenting condition
-physical exam (breast, abdomen, pelvis, genitals)
-psychosocial assessment
-diagnostic (labs usually hormone levels)
Breast cancer nursing interventions
-pain management
-diet support
-comfort
-drug therapy
-support groups
-symptom management
-education
-links to resources
-depression/ anxiety screening
-surgery prep
-post surgery care
-involve client in care planning
-ARM health: functional restoration, precautions, supported with pillow, excercises, PT/OT if appropriate, not dependent for long periods of time, use other arm to carry bags, hygeine habits
Uterine Leiomyoma
-Uterine fibroids
-Benign uterine growth in the myometrium (smooth muscle) classified by locaiton
-Most common benign tumors in women
-3 types: Intramural (in uterine wall), Submucosal(protrudes into the cavity of the uterus can cause bleeding/disrupt pregnancy), Subserosal (protrudes through the other surface, can press against other organs)
Uterine Leiomyoma signs and symptoms
-bleeding, pain, symptoms associated with pelvic pressure
Uterine Leiomyoma Treatment options
-Non-ivasive: monitor, oral contraceptives (most common treatment), magnetic resonance guided focused ultrasound surgery, uterine arter embolization.
-Surgery: laparoscopic myomectomy, hysterectomy
anterior colporrhaphy
tightens pelvic muscles for better bladder support, splint abdomen, limit physical activity, weight rest 5lbs, no sex for 6 weeks.
posterior colporrhaphy
reduces rectal bulging, low residue (fiber) diet to decrease bowel movements, avoid straining, sitz baths pain management to aid in fecal elimination.
Endometrial Cancer
-Most common gynecologic malignancy
-usually slow growing
-if diagnosed early 95% survival rate
S/S of endometrial (uterine) cancer
-abnormal uterine bleeding, especially in post menopausal women
-pain during urination
-pain during intercourse
Endometrial cancer diagnostic
-endometrial biopsy: gold standard
Treatment for endometrial (uterine) cancer
-Total hysterectomy
-radiation
-chemotherapy
-hormonal therapy
Cervical Cancer is known as
"silent killer" generally asymptomatic in early stages
How to detect cervical cancer early?
pap smear
Late stage symptoms of cervical cancer
vaginal discharge that becomes dark and foul smelling, vaginal bleeding becomes heavier, pain, weight loss, anemia, cachexia: wasting syndrome (weight and muscle loss)
Cervical Cancer is usually seen in _____ and endometrial cancer is usually seen in
women in reproductive years
Girls & young women
Ovarian Cancer
leading cause of death for reproductive cancers
-epithelial tumors grow on the surface of the ovaries
Risk factors for ovarian cancer
-over 40
-personal or family history of ovarian or breast cancer
-diabetes
-Nulliparity (or first child after 30)
-Infertility
-Early menarche/ late menopause
-Endometriosis
-Obesity or high fat diet
Ovarian Cancer signs/ symptoms
-mild or vague symptoms: nausea, indigestion, gas
-abdominal pain/ swelling
-Late stage:
ascites, pleural effusions, lymphedema, intestinal obstruction, malnutrition
Diagnosis of Ovarian cancer:
-dependent on yearly pelvic examinations
-Can use screening tumor marker CA-125 but it is non specific so it could be an indicator or endometriosis, fibroid, or other benign conditions.
Toxic shock
overstimulation of immune responses by bacterial exotoxins in the blood (can be caused by tampons)
polycystic ovarian syndrome
BPH risk factors
-age
-obesity
-sedentary life
-alcohol
-erectile dysfunction
-smoking
-diabetes
-1st degree relative
Screening & diagnostics for BPH
-physical exam
-medical tests
-personal & family history
Potential complications of BPH
-retention
-uti
-calculi in the bladder
-hydronephrosis or pyelonephritis can lead to renal failure
Treatment for BPH?
-dietary changes (decreasing caffeine & alcohol)
-avoid decongestant and anticholinergic medications
-minimally invasive procedures
-Surgery TURP & TUIP
-Medications: alpha blockers, PD5 inhibitors, 5-alpha reductase inhibitors, combination.
Minimally invasive procedures that can relieve symptoms and destroy enlarged prostate tissue and widen the urethra?
-Transurethral needle ablation: uses heat
-Transurethral microwave therapy: usus microwaves
-high intensity focused ultrasound: uses ultrasound waves
-Transurethral electrovaporization: uss electric current
-water induce thermotherapy: uses heated water
-Prostatic stent insertion: small device to stent the narrowed opening
Surgery for BPH
