1.
BREAST CANCER
Facilitator: Ma'am Shamsa And Ma'am
Musarat Ijaz

2.
GROUP MEMBERS
Naeem Ul Haq
Muhammad Amir
Safir Ullah
Ansar Ullah
Muhammad Wazir

3.
NAEEM UL HAQ

4.
OBJECTIVES
• At the end of this session the learner will be able to
Define breast cancer .
Explain anatomy & physiology of breast.
Explain pathophysiology of breast cancer.
Enlist the causes and risk factors of breast cancer.
Enlist sign/symptoms of breast cancer.
Enlist the diagnostic perimeters for breast cancer.
Explain medical and surgical management of breast
cancer.
Explain nursing diagnosis and nursing management
related to breast cancer.

5.
CASE SCENARIO
• A 65-year-old woman who recently underwent a
mammogram offered by a doctor. The radiologist
detected a breast mass on the right side. She has a
younger sister who had breast cancer as well. Her sister
died 2 years ago at the age of 62. Her menses began at
age 11 and cessation of menstruation occurred around
age 58. She is overweight and is on estrogen
replacement therapy. She does not have any children.

6.
INTRODUCTION
Cancer is a dreadful disease, 80% to 90% of all cancers are
the result of the things we do to our selves. Among
women breast cancer is the second most common cancer.
Breast cancer is the most common malignant condition of
breast.
• Breast cancer can also occur in men, but it is far less
common
• Cancer of breast most commonly affect upper outer

7.
ANATOMY & PHYSIOLOGY
• The breasts comprise
glandular, connective and
fatty tissue. Within these
tissues are milk-producing
cells. Tiny openings in the
nipple allow milk to flow.
Surrounding the nipple is the
areola, an area of darker skin
that becomes both larger and

8.
PATHOPHYSIOLOGY
• Breast cancer is a globally pervasive disease that
significantly impacts all races and affects both sexes.
Cancerous abnormalities of the breast occur in two types
of tissue – ductal epithelium and lobular epithelium.
Although most breast cancers arise from within the
ductal epithelium, malignant cells can also originate
within lobular (milk-producing) glands.

9.
MUHAMMAD AMIR

10.
ETIOLOGY
• In breast cancer, some of the cells in the breast begin
growing abnormally.
• These cells divide more rapidly than healthy cells do and may
spread (metastasize) through the breast, to lymph nodes or
to other parts of the body
• The most common type of breast cancer begins in the milk-
producing ducts, but cancer may also begin in the lobules or
in other breast tissue
• In most cases, it is not clear what causes normal breast cells

11.
• Puberty (boys/girls)
• Infection of the breast
• Hormone imbalance __ too much estrogen
• Birth control pills
• Breast feeding __ when breast engorged (milk)
• Injury of the breast
• Noncancerous tumour in the breast (fibroma)
• Breast cyst
• Condition called hyperprolactinemia

12.
RISK FACTORS
A breast cancer risk factor is any thing that makes it more
likely you will get breast cancer but having one or even
several breast cancer risk factors doesn’t necessarily mean
you will develop breast cancer. Many women who develop
breast cancer have no known risk factors other than
simply being women
The risk factors are
• Being female: Women are more much likely than men are
to develop breast cancer

13.
• Increasing age Your risk of breast cancer increases as
you age
• A personal history of breast condition
• A personal history of breast cancer
• A family history of breast cancer
• Certain gene mutation; {BRCA1 and BRCA2}
• Obesity; Being obese increases your risk of breast cancer
• Beginning your period at younger age; {before 12 years}
• Menopause at older age; If you began menopause at an
older age you are more likely to develop breast cancer

14.
• Pregnancy; Women who have never been pregnant have a
greater risk of breast cancer than women who have had
one or more pregnancies.
• Post menopausal hormone theraphy; Women who take
hormone theraphy medication that combine estrogen
and progesterone to treat the sign and symptoms of
menopause have an increased risk of breast cancer
• Alcohol ; Drinking alcohol increase the risk of breast
cancer

15.
SAFEER ULLAH

16.
SIGN & SYMPTOMS
Different people have different symptoms of breast
cancer ,some warning of breast cancer are
• New lump in the breast or underarm (armpit).
• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin .
• Redness or flaky skin in the nipple area or breast.
• Pulling in of the nipple or pain in the nipple area

17.
SIGN & SYMPTOMS
• Nipple discharge other than breast milk, including blood
• Any change in the size or shape of the breast
• Pain in any area of the breast

18.
ASSESSMENT OF BREAST CANCER

19.
DIAGNOSTIC PARAMETERS
• Breast exam; your doctor
will check both of your
breast and lymph nodes in
your armpit, feeling for
any lump or other
abnormalities.
• Mammogram;
Mammogram is a special
type of x-ray taken to look
for abnormal growth or

20.
DIAGNOSTIC PARAMETERS
• Breast ultrasound; an
ultrasound can distinguish
between solid mass, which
may be cancer, and a fluid
filled cyst, which is usually
not cancer
• Removing a sample of breast
cells for testing (biopsy); a
needle is used to draw
sample fluid and tissue from
a lump to be studied
• MRI (magnetic resonance

21.
COMPLICATION
Long-term physical changes include
• anatomic changes
• chronic pain
• phantom breast pain
• axillary web syndrome
• lymphedema.
In addition, women may have decreased strength, aerobic
capacity, mobility, fatigue, and cognitive dysfunction.

22.
MUHAMMAD WAZIR

23.
MEDICAL MANAGEMENT
Treatment:
Different types of treatment may be used including….
• Chemotheraphy (Using special Medicine to shrinken or kill cancer cells )
• (tamoxifen,raloxifen)
• Hormonal theraphy; (Block cancer cells from getting the hormones they
need to grow) (selective estrogen receptors modulators SERMs) for
breast cancer and aromatase inhibitors.
• Biological theraphy;(targeted theraphy)
Trastuzumab(Herceptin)
Lapatinib (tykerb)
Bevacezumab (avastin)
•

24.
MEDICAL MANAGEMENT
• Radiotheraphy; is given after surgery to the region of the
tumour bed and region lymph nodes to destroy
microscopic tumour cells that may have escaped surgery.
• Immunotheraphy; is also given for breast cancer.

25.
SURGICAL MANAGEMENT
• Lumpectomy; Removal of lump or mass
• Mastectomy; Removal of breast parts
• Types of mastectomy
• Partial mastectomy (removal of small parts of breast)
• Sigmental mastectomy (in this surgery remove part of
axillary node)
• Total mastectomy (total removal of breast parts)

26.
ANSAR ULLAH

27.
NURSING DIAGNOSIS &
INTERVENTION
• Nursing diagnosis; fear and ineffective coping related to
the diagnosis of BREAST CANCER, it’s treatment and
prognosis.
• Goal; reduction of emotional stress, fear and anxiety
• Intervention;
1. begin emotional preparation of the patient (and partner )
as soon as she is informed of tentative diagnosis
2. Informed the patient of the recent research and New
treatment modalities for breast cancer

28.
• Nursing Diagnosis;Disturbed body image related to the
nature of surgery and Side effects of radiation or
chemotherapy
• Goal; realistic adaptations to changes That will occur
relatives to treatment modalities
• InterVention;
1. Explain that it is normal To experience grief at the loss
of a body part
2. Encourage Visits by loved ones and understanding
Friends

29.
• Nursing diagnosis; acute pain related tO tissue trama
from incision
• Goal; absence of pain and discomfort
• Intervention;
1. Administer analgesics by IV, im or oral routes as
prescribed
• Nursing diagnosis; dressing/ grooming ,
bathing/hygiene ,self care deficit related to Partial
immobility of upper extremity On side of breast surgery.
• Goal; avoidance of impaired mobility and achievement of
self care To the fullest Possible level

30.
• Intervention; make progressive modification in the
patient’s exercise Program as directed by Comfort and
tolerance level.
• Nursing diagnosis; possible sexual dysfunction related to
Loss of body part and Fear of partner’s reaction To this
loss.
• Goal; Identification of alternative satisfying/Acceptable
sexual experience
• Intervention; Emphasize that behaviorial changes take
time And should not be interpreted as rejections

31.
TEACHING AND PREVENTION
• Avoid becoming overweight.
• Keep physically active.
• Drink little or no alcohol.
• Avoid hormone replacement therapy.
• Don’t smoke .
• Breast feed your babies for as long as possible.
Breast cancer is a globally pervasive disease that
significantly impacts all races and affects both sexes1,2.
Cancerous abnormalities of the breast occur in two types
of tissue – ductal epithelium and lobular epithelium.
Although most breast cancers arise from within the ductal
epithelium, malignant cells can also originate within
lobular (milk-producing) glands.

32.
REFERENCES
• Anxiety. (n.d.). Cancer.Net. Retrieved March 16, 2022, from
https://www.cancer.net/coping-with-cancer/managing-
emotions/anxiety
• Breast cancer – Diagnosis and treatment. (2021, October
16). Mayo Clinic. Retrieved March 19, 2022, from
https://www.mayoclinic.org/diseases-conditions/breast-
cancer/diagnosis-treatment/drc-20352475
• Breast Cancer: Lymphedema After Treatment. (n.d.). Johns
Hopkins Medicine. Retrieved March 19, 2022, from
https://www.hopkinsmedicine.org/health/conditions-and-
diseases/breast-cancer/breast-cancer-lymphedema-after-