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Treatments for Breast Cancer

Contents
  1. Breast Cancer: Introduction
  2. Treatment list for Breast Cancer
  3. Alternative Treatments
  4. Latest treatments for Breast Cancer
  5. News about treatments
  6. Discussion of treatments for Breast Cancer
  7. Buy Products Related to Treatments for Breast Cancer
  8. Breast Cancer: Introduction

Treatments for Breast Cancer

The list of treatments mentioned in various sources for Breast Cancer includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Breast Cancer: Is the Diagnosis Correct?

The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Breast Cancer may include:

  • Normal breasts - not all breast lumps are abnormal; breast changes can also occur from aging, menstruation, pregnancy, menopause, oral contraceptives, and other reasons.
  • more diagnoses...»

Hidden causes of Breast Cancer may be incorrectly diagnosed:

  • The cancer can return at the original site. This is called a local recurrence
  • The cancer can recur nearby, such as in the chest. This is called a regional recurrence
  • The cancer can spread to a distant location in the body, such as lymph nodes, bone marrow, or lungs. This is called a distant recurrence, or a metastasis
  • more causes...»

Breast Cancer: Marketplace Products, Discounts & Offers

Products, offers and promotion categories available for Breast Cancer:

Curable Types of Breast Cancer

Possibly curable types of Breast Cancer may include:

Breast Cancer: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Drugs and Medications used to treat Breast Cancer:

Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment or change in treatment plans.

Some of the different medications used in the treatment of Breast Cancer include:

Unlabeled Drugs and Medications to treat Breast Cancer:

Unlabelled alternative drug treatments for Breast Cancer include:

  • Medroxyprogesterone - used as part of combination therapy
  • Alti-MPA - used as part of combination therapy
  • Amen - used as part of combination therapy
  • Curretab - used as part of combination therapy
  • Cycrin - used as part of combination therapy
  • Depo-Provera - used as part of combination therapy
  • Premphase - used as part of combination therapy
  • Prempro - used as part of combination therapy
  • Proclim - used as part of combination therapy
  • Provera - used as part of combination therapy
  • Riva-Medrone - used as part of combination therapy
  • Prednisone - used as part of a combination therapy
  • Apo-Prednisone - used as part of a combination therapy
  • Aspred-C - used as part of a combination therapy
  • Deltasone - used as part of a combination therapy
  • Liquid Pred - used as part of a combination therapy
  • Meticorten - used as part of a combination therapy
  • Metreton - used as part of a combination therapy
  • Novoprednisone - used as part of a combination therapy
  • Orasone - used as part of a combination therapy
  • Panasol-S - used as part of a combination therapy
  • Paracort - used as part of a combination therapy
  • Prednicen-M - used as part of a combination therapy
  • Prednisone Intensol - used as part of a combination therapy
  • SK-Prednisone - used as part of a combination therapy
  • Sterapred - used as part of a combination therapy
  • Sterapred-DS - used as part of a combination therapy
  • Winpred - used as part of a combination therapy
  • Mifepristone
  • RU-486
  • RU-38486
  • Mifeprex
  • Octreotide
  • Sandostatin
  • Sandostatin LAR
  • Sandostatina
  • Vinorelbine
  • Navelbine

Latest treatments for Breast Cancer:

The following are some of the latest treatments for Breast Cancer:

Hospital statistics for Breast Cancer:

These medical statistics relate to hospitals, hospitalization and Breast Cancer:

  • 17,321 admissions to public hospitals for procedures on breast diseases in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
  • 27,688 admissions to private hospitals for procedures on breast in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
  • 39.4% of hospitalisations for procedures on breast were single day in private hospitals in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
  • 45.5% of hospitalisations for procedures on breast diseases were single day in public hospitals in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
  • 47,375 patient days spent in public hospitals for procedures on breasts in Australia 2001-02 (AIHW National Hospital Morbidity Database, Australia’s Health 2004, AIHW)
  • more hospital information...»

Hospitals & Medical Clinics: Breast Cancer

Research quality ratings and patient incidents/safety measures for hospitals and medical facilities in specialties related to Breast Cancer:

Hospital & Clinic quality ratings » »

Choosing the Best Treatment Hospital: More general information, not necessarily in relation to Breast Cancer, on hospital and medical facility performance and surgical care quality:

Medical news summaries about treatments for Breast Cancer:

The following medical news items are relevant to treatment of Breast Cancer:

Discussion of treatments for Breast Cancer:

Breast Cancer: NWHIC (Excerpt)

There are treatments for all patients with breast cancer. Four types of treatment are used: surgery (taking out the cancer in an operation), radiation therapy (using high-dose x-rays to kill cancer cells), chemotherapy (using drugs to kill cancer cells), and hormone therapy (using hormones to stop the cells from growing). Biological therapy (using your body’s immune system to fight cancer) and bone marrow transplantation are now being tested in clinical trials. Several treatments may be combined, and specific treatment recommendations depend on the type and location of the tumor, the stage at which it has been detected, and the patient’s age and general health. (Source: excerpt from Breast Cancer: NWHIC)

Early Stage Breast Cancer: NWHIC (Excerpt)

Most women who are newly diagnosed with early-stage breast cancer have a choice: breast-conserving surgery (such as lumpectomy) or a mastectomy (also called a modified radical mastectomy). The decision is not between your breast and your life. Women with early-stage breast cancer who undergo breast-conserving surgery with radiation therapy live just as long as those who undergo mastectomy. Life expectancy is the same regardless of which choice a woman makes.

When the patient is told that the survival rate for lumpectomy with radiation is the same as for mastectomy, some women may be surprised or skeptical. (Source: excerpt from Early Stage Breast Cancer: NWHIC)

Early Stage Breast Cancer: NWHIC (Excerpt)

Studies have shown that tamoxifen improves the chances of survival and helps prevent recurrence of breast cancer, if the cancer cells are estrogen receptor-positive. Tamoxifen is not an effective treatment for breast cancer that is estrogen receptor-negative, and therefore should not be taken for those cancers. Tamoxifen may have unpleasant side effects that are similar to menopause, such as hot flashes, vaginal dryness, irregular periods, and weight gain. Tamoxifen also slightly increases the risk of uterine cancer and blood clots. Studies suggest that Tamoxifen should not be taken for more than five years (Source: excerpt from Early Stage Breast Cancer: NWHIC)

What You Need To Know About Breast Cancer: NCI (Excerpt)

Breast cancer may be treated with local or systemic therapy. Some patients have both kinds of treatment.

Local therapy is used to remove or destroy breast cancer in a specific area. Surgery and radiation therapy are local treatments. They are used to treat the disease in the breast. When breast cancer has spread to other parts of the body, local therapy may be used to control cancer in those specific areas, such as in the lung or bone.

Systemic treatments are used to destroy or control cancer throughout the body. Chemotherapy , hormonal therapy , and biological therapy are systemic treatments. Some patients have systemic therapy to shrink the tumor before local therapy. Others have systemic therapy to prevent the cancer from coming back, or to treat cancer that has spread.

Surgery is the most common treatment for breast cancer, and there are several types of surgery. The doctor can explain each type, discuss and compare their benefits and risks, and describe how each will affect the patient's appearance.

  • An operation to remove the cancer but not the breast is called breast-sparing surgery or breast-conserving surgery . Lumpectomy and segmental mastectomy (also called partial mastectomy) are types of breast-sparing surgery. After breast-sparing surgery, most women receive radiation therapy to destroy cancer cells that remain in the area.

  • An operation to remove the breast (or as much of the breast as possible) is a mastectomy . Breast reconstruction is often an option at the same time as the mastectomy, or later on.

  • In most cases, the surgeon also removes lymph nodes under the arm to help determine whether cancer cells have entered the lymphatic system. This is called an axillary lymph node dissection .

In lumpectomy, the surgeon removes the breast cancer and some normal tissue around it. (Sometimes an excisional biopsy serves as a lumpectomy.) Often, some of the lymph nodes under the arm are removed.

In segmental mastectomy, the surgeon removes the cancer and a larger area of normal breast tissue around it. Occasionally, some of the lining over the chest muscles below the tumor is removed as well. Some lymph nodes under the arm may also be removed.

In total (simple) mastectomy , the surgeon removes the whole breast. Some lymph nodes under the arm may also be removed.

In modified radical mastectomy , the surgeon removes the whole breast, most of the lymph nodes under the arm, and, often, the lining over the chest muscles. The smaller of the two chest muscles also may be taken out to help in removing the lymph nodes.

In radical mastectomy (also called Halsted radical mastectomy), the surgeon removes the breast, both chest muscles, all of the lymph nodes under the arm, and some additional fat and skin. For many years, this operation was considered the standard one for women with breast cancer, but it is almost never used today. In rare cases, radical mastectomy may be suggested if the cancer has spread to the chest muscles.

Here are some questions a woman may want to ask her doctor before having surgery:

  • What kinds of surgery can I consider? Is breast-sparing surgery an option for me? Which operation do you recommend for me? What are the risks of surgery?

  • Should I store some of my own blood in case I need a transfusion?

  • Do I need my lymph nodes removed? How many? Why? What special precautions will I need to take if lymph nodes are removed?

  • How will I feel after the operation?

  • Will I need to learn how to do special things to take care of myself or my incision when I get home?

  • Where will the scars be? What will they look like?

  • If I decide to have plastic surgery to rebuild my breast, how and when can that be done? Can you suggest a plastic surgeon for me to contact?

  • Will I have to do special exercises?

  • When can I get back to my normal activities?

  • Is there someone I can talk with who has had the same treatment I'll be having?

Breast reconstruction (surgery to rebuild the shape of a breast) is often an option after mastectomy. Women considering reconstruction should discuss this with a plastic surgeon before having a mastectomy.

Radiation therapy (also called radiotherapy) is the use of high-energy rays to kill cancer cells. The radiation may be directed at the breast by a machine (external radiation). The radiation can also come from radioactive material placed in thin plastic tubes that are placed directly in the breast (implant radiation). Some women have both kinds of radiation therapy.

For external radiation therapy, the patient goes to the hospital or clinic, generally 5 days a week for several weeks. For implant radiation, a patient stays in the hospital. The implants remain in place for several days. They are removed before the woman goes home.

Sometimes, depending on the size of the tumor and other factors, radiation therapy is used after surgery, especially after breast-sparing surgery. The radiation destroys any breast cancer cells that may remain in the area.

Before surgery, radiation therapy, alone or with chemotherapy or hormonal therapy, is sometimes used to destroy cancer cells and shrink tumors. This approach is most often used in cases in which the breast tumor is large or not easily removed by surgery.

Before having radiation therapy, a patient may want to ask her doctor these questions:

  • Why do I need this treatment?

  • What are the risks and side effects of this treatment?

  • Are there any long-term effects?

  • When will the treatments begin? When will they end?

  • How will I feel during therapy?

  • What can I do to take care of myself during therapy?

  • Can I continue my normal activities?

  • How will my breast look afterward?

  • What are the chances that the tumor will come back in my breast?

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy for breast cancer is usually a combination of drugs. The drugs may be given in a pill or by injection. Either way, the drugs enter the bloodstream and travel throughout the body.

Most patients have chemotherapy in an outpatient part of the hospital, at the doctor's office, or at home. Depending on which drugs are given and her general health, however, a woman may need to stay in the hospital during her treatment.

Hormonal therapy keeps cancer cells from getting the hormones they need to grow. This treatment may include the use of drugs that change the way hormones work, or surgery to remove the ovaries , which make female hormones. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body.

Biological therapy is a treatment designed to enhance the body's natural defenses against cancer. For example, Herceptin® (trastuzumab) is a monoclonal antibody that targets breast cancer cells that have too much of a protein known as human epidermal growth factor receptor-2 (HER-2). By blocking HER-2, Herceptin slows or stops the growth of these cells. Herceptin may be given by itself or along with chemotherapy. (Source: excerpt from What You Need To Know About Breast Cancer: NCI)

What You Need To Know About Breast Cancer: NCI (Excerpt)

A woman's treatment options depend on a number of factors. These factors include her age and menopausal status; her general health; the size and location of the tumor and the stage of the cancer; the results of lab tests; and the size of her breast. Certain features of the tumor cells (such as whether they depend on hormones to grow) are also considered. In most cases, the most important factor is the stage of the disease. The stage is based on the size of the tumor and whether the cancer has spread. The following are brief descriptions of the stages of breast cancer and the treatments most often used for each stage. (Other treatments may sometimes be appropriate.) (Source: excerpt from What You Need To Know About Breast Cancer: NCI)

What You Need To Know About Breast Cancer: NCI (Excerpt)

After a mastectomy, some women decide to wear a breast form (prosthesis ). Others prefer to have breast reconstruction, either at the same time as the mastectomy or later on. Each option has its pros and cons, and what is right for one woman may not be right for another. What is important is that nearly every woman treated for breast cancer has choices. It is best to consult with a plastic surgeon before the mastectomy, even if reconstruction will be considered later on.

Various procedures are used to reconstruct the breast. Some use implants (either saline or silicone); others use tissue moved from another part of the woman's body. The safety of silicone breast implants has been under review by the Food and Drug Administration (FDA) for several years. Women interested in having silicone implants should talk with their doctor about the FDA's findings and the availability of silicone implants. Which type of reconstruction is best depends on a woman's age, body type, and the type of surgery she had. A woman should ask the plastic surgeon to explain the risks and benefits of each type of reconstruction. (Source: excerpt from What You Need To Know About Breast Cancer: NCI)

What You Need To Know About Breast Cancer: NCI (Excerpt)

Exercising the arm and shoulder after surgery can help a woman regain motion and strength in these areas. It can also reduce pain and stiffness in her neck and back. Carefully planned exercises should be started as soon as the doctor says the woman is ready, often within a day or so after surgery. Exercising begins slowly and gently and can even be done in bed. Gradually, exercising can be more active, and regular exercise becomes part of a woman's normal routine. (Women who have a mastectomy and immediate breast reconstruction need special exercises, which the doctor or nurse will explain.)

Often, lymphedema after surgery can be prevented or reduced with certain exercises and by resting with the arm propped up on a pillow. If lymphedema occurs, the doctor may suggest exercises and other ways to deal with this problem. For example, some women with lymphedema wear an elastic sleeve or use an elastic cuff to improve lymph circulation. The doctor also may suggest other approaches, such as medication, manual lymph drainage (massage), or use of a machine that gently compresses the arm. The woman may be referred to a physical therapist or another specialist. (Source: excerpt from What You Need To Know About Breast Cancer: NCI)

What You Need To Know About Breast Cancer: NCI (Excerpt)

Regular followup exams are important after breast cancer treatment. Regular checkups ensure that changes in health are noticed. Followup exams usually include examination of the breasts, chest, neck, and underarm areas, as well as periodic mammograms. If a woman has a breast implant, special mammogram techniques can be used. Sometimes the doctor may order other imaging procedures or lab tests. (Source: excerpt from What You Need To Know About Breast Cancer: NCI)

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Book Excerpts: Treatment of Breast Cancer

Treatments of Breast Cancer: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Breast Cancer.

Breast Pain & Discharge: Treatment
(In a Page: Signs and Symptoms)

  • Fibrocystic changes
    –Caffeine avoidance is often effective in decreasing pain
    –Aspirate cysts or medical therapies (e.g., danazol, oral contraceptives, tamoxifen, bromocriptine, evening primrose oil, GnRH agonists, vitamin E) for pain relief
    –Routine follow up is sufficient unless cytologic atypia is present
  • Breast cancer: Surgery, radiation, chemotherapy, and/or hormonal therapy as indicated by stage
  • Mastitis: Warm compress, antibiotics to cover Staphylococcus aureus and streptococci (e.g., cephalexin); consider inflammatory breast cancer if no response after 5 days in a nonlactating female
  • Abscess: Incision and drainage, antibiotics
  • Cyst: Aspiration; cytology of aspirated fluid if bloody or recurrent

    • » READ BOOK EXCERPT ONLINE »

    Source: In a Page: Signs and Symptoms, 2004

    Breast cancer: Treatment
    (Professional Guide to Diseases (Eighth Edition))

    Much controversy exists over breast cancer treatments. In choosing therapy, the patient and physician should take into consideration the stage of the disease, the woman's age and menopausal status, and the disfiguring effects of the surgery. Treatment of breast cancer may include one or any combination of the following:

    ❑Surgery involves either mastectomy or lumpectomy. A lumpectomy may be done on an outpatient basis and may be the only surgery needed, especially if the tumor is small and there's no evidence of axillary node involvement. In many cases, radiation therapy is combined with this surgery.

    A two-stage procedure, in which the surgeon removes the lump and confirms that it's malignant and then discusses treatment options with the patient, is desirable because it allows the patient to participate in her plan of treatment. Sometimes, if the tumor is diagnosed as clinically malignant, such planning can be done before surgery. In lumpectomy and dissection of the axillary lymph nodes, the tumor and the axillary lymph nodes are removed, leaving the breast intact. A simple mastectomy removes the breast but not the lymph nodes or pectoral muscles. Modified radical mastectomy removes the breast and the axillary lymph nodes. Radical mastectomy, the performance of which has declined, removes the breast, pectoralis major and minor, and the axillary lymph nodes.

    The spread of breast cancer to regional lymph nodes is considered a vital prognostic indicator. Sentinel lymph-node biopsy, a reliable and minimally invasive procedure, is used to identify and sample the sentinel lymph node closest to the breast tumor. During the patient's surgery, the axillary node is injected with dye to help with identification and then sent to the pathologist to assess for cancer spread. If the node is negative, the patient can be spared an axillary node dissection, which carries its own risks and the potential for long-term complications .

    Reconstructive breast surgery can be performed at the same time as mastectomy or it can be planned for a later date. Several options are available for breast reconstruction, including the insertion of breast implants or a transverse rectus abdominis musculocutaneous flap.

    ❑Chemotherapy, involving various cytotoxic drug combinations, is used as either adjuvant or primary therapy, depending on several factors, including the TNM staging and estrogen receptor status. The most commonly used antineoplastic drugs are cyclophosphamide, fluorouracil, methotrexate, doxorubicin, vincristine, and paclitaxel. A common drug combination used in both premenopausal and postmenopausal women is cyclophosphamide, doxorubicin, and paclitaxel.

    Tamoxifen, an estrogen antagonist, is the adjuvant treatment of choice for postmenopausal patients with positive estrogen receptor status. It's also been found to reduce the risk of breast cancer in women at high risk.

    ❑ Peripheral stem cell therapy is an option, but it's rarely used for advanced breast cancer.

    ❑ Primary radiation therapy before or after tumor removal is effective for small tumors in early stages with no evidence of distant metastasis; it's also used to prevent or treat local recurrence. Presurgical radiation to the breast in inflammatory breast cancer helps make tumors more surgically manageable.

    ❑ Estrogen, progesterone, androgen, or antiandrogen aminoglutethimide therapy may also be given to breast cancer patients. The success of these drug therapies — along with growing evidence that breast cancer is a systemic, not local, disease — has led to a decline in ablative surgery.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Diseases (Eighth Edition), 2005

    Malignant spinal neoplasms: Treatment
    (Professional Guide to Diseases (Eighth Edition))

    Treatment of spinal cord tumors generally includes decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it isn't usually indicated for metastatic tumors. If the tumor is slowly progressive or if it's treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and his outlook is ominous. If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy with dexamethasone minimizes cord edema and temporarily relieves symptoms until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time. Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy. Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to opioid analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers. Chemotherapy generally hasn't proven effective against most spinal tumors, but may be recommended in some cases.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Diseases (Eighth Edition), 2005

    Mastitis and breast engorgement: Treatment
    (Professional Guide to Diseases (Eighth Edition))

    Antibiotic therapy, the primary treatment for mastitis, generally consists of oral cephalosporins, cloxacillin, or dicloxacillin to combat staphylococcus; azithromycin may be used in patients allergic to penicillin. Although symptoms usually subside 2 to 3 days after treatment begins, antibiotic therapy should continue for 10 days. Other appropriate measures include analgesics for pain and, rarely, when antibiotics fail to control the infection and mastitis progresses to breast abscess, incision and drainage of the abscess.

    The goal of treatment of breast engorgement is to relieve discomfort and control swelling, and may include analgesics to alleviate pain, and ice packs and an uplift support bra to minimize edema. Rarely, oxytocin nasal spray may be necessary to release milk from the alveoli into the ducts. To facilitate breast-feeding, the mother may manually express excess milk before a feeding so the infant can grasp the nipple properly.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Diseases (Eighth Edition), 2005

    Nipple discharge: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Counsel your patient to be aware of discharge characteristics—its consistency (thick or thinning), odor, origin in single or multiple ducts, and relation to the menstrual cycle. If the discharge becomes bloody, instruct the patient to seek medical evaluation. Instruct the patient to perform breast self-examinations and maintain appointments for breast examinations by a physician and mammograms as recommended.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Nipple retraction: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Teach your patient breast self-examination and advise her to always seek medical evaluation for breast changes.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Breast nodule [Breast lump]: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    When teaching patients how to perform breast self-examination, advise them to do the examination 5 to 7 days after the first day of their last menstrual period.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Breast cancer: Treatment
    (Handbook of Diseases)

    Much controversy exists over breast cancer treatments. In choosing therapy, the patient and physician should consider the stage of the disease, the woman’s age and menopausal status, and the disfiguring effects of the surgery. Treatment for breast cancer may include one or any combination of the following.

    Surgery

    With breast cancer, surgery involves either lumpectomy or mastectomy. A lumpectomy may be done on an outpatient basis and may be the only surgery needed, especially if the tumor is small and there’s no evidence of axillary node involvement. Radiation therapy is often combined with this surgery.

    A two-stage procedure, in which the surgeon removes the lump, confirms that it’s malignant, and discusses treatment options with the patient, is desirable because it allows the patient to participate in her treatment plan. Sometimes, if the tumor is diagnosed as malignant, such planning can be done before surgery. In lumpectomy and dissection of the axillary lymph nodes, the tumor and the axillary lymph nodes are removed, leaving the breast intact.

    A simple mastectomy removes the breast but not the lymph nodes or pectoral muscles. A modified radical mastectomy removes the breast and the axillary lymph nodes. A radical mastectomy, the performance of which has declined, removes the breast, the pectoralis major and minor, and the axillary lymph nodes.

    After a mastectomy, reconstructive surgery can create a breast mound if the patient desires it and doesn’t have evidence of advanced disease.

    Chemotherapy, tamoxifen, and peripheral
    stem cell therapy

    Various cytotoxic drug combinations are used as either adjuvant or primary therapy, depending on several factors, including staging and estrogen receptor status. The most commonly used antineoplastics are cyclophosphamide, fluorouracil, methotrexate, doxorubicin, vincristine, paclitaxel, and prednisone. A common drug combination used in both premenopausal and postmenopausal women is cyclophosphamide, methotrexate, and fluorouracil.

    Tamoxifen, an estrogen antagonist, is the adjuvant treatment of choice for postmenopausal patients with positive estrogen receptor status.

    Peripheral stem cell therapy may be used for patients with advanced breast cancer.

    Primary radiation therapy

    Used before or after tumor removal, primary radiation therapy is effective for small tumors in early stages with no evidence of distant metastasis; it’s also used to prevent or treat local recurrence. Presurgical radiation to the breast in patients with inflammatory breast cancer helps make tumors more surgically manageable.

    Other drug therapy

    Breast cancer patients may also receive estrogen, progesterone, androgen, or antiandrogen aminoglutethimide therapy. The success of these drug therapies with growing evidence that breast cancer is a systemic, not local, disease has led to a decline in ablative surgery.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Diseases, 2003

    Nipple discharge: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Counsel your patient to be aware of discharge characteristics, including its consistency (thick or thinning), odor, origin (in single or multiple ducts), and relation to the menstrual cycle. If the discharge becomes bloody, instruct the patient to seek medical evaluation. Instruct the patient to perform breast self-examinations and to maintain appointments for breast examinations by a physician and for mammograms as recommended.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Nipple retraction: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Teach your patient breast self-examination, and advise her to always seek medical evaluation for breast changes.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Peau d'orange: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Because peau d’orange usually signals advanced breast cancer, provide emotional support for the patient. Encourage her to express her fears and concerns. Clearly explain expected diagnostic tests, such as mammography and breast biopsy.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Breast nodule: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    When teaching patients how to perform breast self-examination, advise them to do the examination 5 to 7 days after the first day of their last menses.

    Advise the patient with mastitis to pump her breasts to prevent further milk stasis, to discard the milk, and to substitute formula until the infection responds to antibiotics.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Nipple discharge: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Apply a breast binder, which may reduce discharge by eliminating nipple stimulation.

    ▪ Prepare the patient for diagnostic tests such as tissue biopsy (if a breast lump is found), cytologic study of the discharge, mammography, ultrasonography, transillumination, and serum prolactin level.

    Patient teaching

    ▪ Explain when to seek medical attention.

    ▪ Discuss the importance of breast self-examination, medical appointments, and mammograms.

    ▪ Explain the nature and origin of the patient's nipple discharge and the treatment plan.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Nipple retraction: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Prepare the patient for diagnostic tests, including mammography, cytology of nipple discharge, and biopsy.

    Patient teaching

    ▪ Teach the patient to perform monthly breast self-examination.

    ▪ Advise the patient to seek medical attention for breast changes.

    ▪ Explain the cause of the nipple retraction and the treatment plan.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Peau d'orange: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Because peau d'orange usually signals advanced breast cancer, provide emotional support for the patient.

    ▪ Encourage her to express her fears and concerns.

    ▪ Prepare the patient for biopsy, surgery, chemotherapy, or radiation therapy.

    Patient teaching

    ▪ Explain the underlying cause and treatment plan.

    ▪ Explain expected diagnostic tests, such as mammography and breast biopsy.

    ▪ Teach the patient how to perform monthly breast self-examinations.

    ▪ Discuss signs and symptoms the patient should report.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Breast nodule [Breast lump]: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Provide a simple explanation of your examination, and encourage the patient to express her feelings.

    ▪ Prepare the patient for diagnostic tests, which may include transillumination, mammography, thermography, needle aspiration or open biopsy, and cytologic examination of nipple discharge.

    ▪ Postpone teaching the patient how to perform breast self-examination until she overcomes her initial anxiety at discovering a nodule.

    ▪ Although most nodules occurring in the breast-feeding patient result from mastitis, the possibility of cancer demands careful evaluation.

    Patient teaching

    ▪ Advise the patient with mastitis to pump her breasts to prevent further milk stasis, to discard the milk, and to substitute formula until the infection responds to antibiotics.

    ▪ Explain the importance of clinical breast examination and mammography following the American Cancer Society guidelines.

    ▪ Teach the patient how to perform breast self-examination.

    ▪ Explain how to treat mastitis.

    ▪ Teach the patient about the cause of the breast nodule and the treatment plan after a diagnosis is established.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007



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