How to diagnose Breast Cancer? (Stewart, 2018) • Mammography (reveals tumors that are small to be detected through palpation) • Ultrasound (differentiate between a solid mass and fluidfilled cyst) • Chest X-rays (detect metastases) • Alkaline phosphatase levels (ALP) and liver function tests (reveal distant metastases) • Scanning of other organs such as bone, brain, and liver (detect distant metastases) • Hormonal receptor assay (determine if the cancer is estrogen or progesterone dependent) • Fine-needle aspiration and excisional biopsy (histologic examination to confirm the diagnosis) Explore treatment options! (Stewart, 2018) • Chemotherapy – used to destroy breast cancer cells through drug therapy • Radiation - to help prevent local recurrence and make small tumors surgical manageable • Surgical Procedures Lumpectomy can be combined with radiation – dissection of axillary lymph nodes Quadrant excision Simple mastectomy – remove breast tissue without lymph nodes or muscles Modified radical mastectomy — remove the breast and axillary lymph nodes Radical mastectomy (rarely used) — removes the breast, axillary lymph nodes, and pectoralis major and minor muscles Reconstructive surgeries • Pharmacological Therapies Biotherapies (trastuzumab, bevacizumab, and lapatinib) Selective estrogen receptor modulators (tamoxifen) Aromatase inhibitor (anastrozole, and letrozole) https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcon tent_type%3A3d%5D=1&filters%5Bcontent_type%3Aimage%5D=1&k=sick+breast+cancer&order=relevance&safe_search=1&limit=100&search_page=1&search_type=autosuggest&acp=0&aco=breast+cancer&get_facets=0&asset_id=121296891 Consider the benefits of prophylactic treatments and tests for gene mutations (Ignatavicius et al., 2021). A tool offered by the National Cancer Institute (n.d.) cited by Ignatavicius et al. (2021) called Breast Cancer Risk Assessment can be used to evaluate risks for breast cancer. Financial needs – address the patient's risk for unemployment and interventions to help the patient return to work by educating about warranted policies at state and national levels (Meernik et al., 2021). Within each community, there are numerous breast cancer charities and resources. Due to the distinctive and long-term nature of metastatic breast cancer therapy, nurses should educate patients about communitybased breast cancer charities, help patient to assess their programming to ensure that assistance is given (at all stages of the disease) (Rosenzweig et al., 2019). Physical needs – Friedenreich et al. (2021) show that health care professionals can educate about obesity, sedentary behavior, and tobacco or alcohol risks. In addition, patients should be educated and encouraged on smoking cessation and maintenance of their quality of life. The incentive to perform physical activity can help save lives. Friedenreich et al. (2021) mention that The International Agency for Research on Cancer established a relationship between obesity and 13 types of cancer, and the Physical Activity Guidelines for Americans (PAGA) documented physical activity recommendations to reduce cancer risk. It is anticipated that 4 in 10 cancers are avoidable due to risk factors modifications. It is vital to help the patient find a support group program and other necessary resources to succeed in their treatment. Psychosocial needs – studies show that mHealth mobile apps develop the crucial role of lowering anxiety and improving selfesteem because they give psychoeducational interventions to help understand the disease, self-management, diagnosis, treatment, monitoring, data collection, communication, and counseling. As a result, it will help to minimize stress and provide disease-related information, support, treatment adherence, and how to manage the side effects (Ghanbari et al., 2021). What is Breast Cancer? Breast cancer can start in different breast parts and can originate from one or both breasts. Uncontrollable growth and probable spread of cells characterize it. It has a significant incidence among women, but men can also get the disease (Ignatavicius et al., 2021). It is critical to recognize early signs and symptoms and make preventions regularly. Be aware that any breast lump or abnormality in the breasts needs to be checked by a health care professional to determine if benign or malignant (American Cancer Society, 2021). Breast Cancer is the second leading cause of death by cancer among women, according to the American Cancer Society (2021). CDC (2022) reveals data from 2019, in which were registered 863,830 new cases of cancer among women and 283,722 deaths from it. What to do to avoid being part of this statistic? https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type% 3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcontent_type%3A3d%5D=1 &filters%5Bcontent_type%3Aaudio%5D=0&filters%5Bcontent_type%3Aimage%5D=1&filters%5Binclude_stock_enterprise%5D=0&filters%5Bis_edit orial%5D=0&k=sick+breast+cancer&order=relevance&safe_search=1&limit=100&search_page=3&search_type=pagination&get_facets=0&asset_i d=41281414 Recognize Signs & Symptoms (Stewart, 2018): • • • • • • • • • Mass or lump in the breast that does not cause pain Changes in the symmetry or size of the breast Breast pain Any abnormality in breast skin (thickening, scaly skin) Changes in breast appearance, format, ulceration, discharge, drainage Nipple itching, burning, erosion, or retraction Hypercalcemia or bone fractures with pathologic cause; bone pain Arm or axillary enlargement or swollen Widened blood vessels that can be visible What are the risk factors that can contribute to Breast Cancer? (Stewart, 2018): • • • • • • • • • • • • • A genetic predisposition in the BRCA 1 and BRCA 2 genes Family history of the disease or personal history of breast cancer Being a female Dense breast tissue Aging (higher risk after 60 years old) Race/ethnicity - being African-American and older than 45 years of age or Caucasian between 60 and 84 Menarche prior to the age of 12 and menopause after the age of 55 Late pregnancy and not breastfeeding Use of hormones to stimulate fertility or in post menopause therapy Breast implants Use of tobacco or alcohol Obesity and lack of physical activity Exposure to radiation or environmental exposure It is better to implement precautions than be sorry. Prevention and early detection is the key! Self-examination, breast cancer screenings, mammography, early treatments and diagnosis, and follow-up care are essential. You can perform your self-examination by inspecting the breast tissue thoroughly in front of a mirror and palpating the breasts during a shower. The palpation using a circular pattern, wedge pattern, and vertical pattern. Patient should cover the area from the clavicle to the bra line and from the sternum to the posterior axilla. After palpation, the next step is to compress the nipples to observe for discharge (Ignatavicius et al., 2021). https://stock.adobe.com/search?filters%5Bcontent_type%3Aphoto%5D=1&filters%5Bcontent_type%3Aillustration%5D=1&filters%5Bcontent_type%3Azip_vector%5D=1&filters%5Bcontent_type%3Avideo%5D=1&filters%5Bcontent_type%3Atemplate%5D=1&filters%5Bcontent_type%3A 3d%5D=1&filters%5Bcontent_type%3Ai mage%5D=1&k=breast+cancer+signs+and+symptoms&order=relevance&safe_search=1&limit=100&search_page=1&search_type=usertyped&acp=&aco=breast+cancer+signs+and+symptoms&get_facets=0&asset_id=226447343 American Cancer Society (2022) Recommendations for the Early Detection of Breast Cancer: • Annual screenings with mammograms if you are between 40 and 44 years of age. • Mammograms performed every year if you are between the ages of 45 to 54. • Mammograms every other year with the choice of yearly screening if you are older than 55. • MRI and yearly mammogram if you are in the high-risk group. Multidimensional nursing care interventions Understanding our body as a whole (body, mind, and spirit) is essential in utilizing multidimensional care interventions. Weil (2018) mentions that all individuals have an innate ability for whole-person health across all dimensions. Taking care of and understanding the importance of promoting physical well-being and changing modifiable risk factors can profoundly impact breast cancer incidence. It is crucial to facilitate therapeutic communication and active listening. Encourage the patient to express her feelings, concerns, and fears, explore coping mechanisms and reinforce them, reduce anxiety and fear, offer emotional support, explore spiritual support, provide calmness and promote the patient's ability to make informed decisions by providing treatment discussion. A respectful environment and anticipatory guidance are necessary to achieve psychological well-being (Doenges et al., 2019). Spiritual needs – Are often very complex, but they are shown in many studies to contribute positively to the best survival and quality of life rates. Nurses need to assess cultural and spiritual needs to improve treatments and educate and guide patients to use mobile apps or internet websites that will be congruent with their beliefs, efficiently improving adherence to their care (Xing et al., 2018). Cultural needs – A throughout assessment of the patient culture, ethnicity, and genetics will provide better covering and prevention of breast cancer in the beginning, which will also increase the chances for survival and quality of life. Assist the patient in overcoming any cultural barrier to their care.
