Breast Cancer
Submitted by Vanessa McCoy, CHUC, of Savannah, GA
Learning Objectives:
1: Define breast cancer.
2 List at least three signs or symptoms of breast cancer.
3: Describe two types of mammograms.
Breast cancer starts in abnormal cells in the breast. These abnormal cells are very
different from healthy cells. They begin to grow out of control and produce more cells
that grow into tumors or growths. The cancer cells can grow in the breast and spread to
other parts of the body. This single cell multiplies until it becomes a tumor. As a tumor
grows, the danger is that cancer cells can break away and travel to other parts of the body.
Breast cancer cells can spread to lymph nodes in the armpit or to blood vessels, which
can carry the cells to the lungs, liver, bones or other parts of the body.
Breast cancer in its early stage is usually, but not always, painless. In its very early stages,
it’s too small to find by feeling the breast. As it grows larger, it feels like a lump or
thickening. Breast cancer can start anywhere in the breast. Breast cancer is the most
common cancer that women have to face in their lifetime. It can happen at any age, but it
is much more likely after age 40.
The most common sign of breast cancer is a lump (mass) or thickening in one breast that
can be felt (palpitated). Often the lump is painless, but occasionally it may be associated
with pain or tenderness. A lump that is cancerous is usually firm to hard and it may have
irregular borders, although some cancerous lumps are more soft and rounded. Most
tumors develop in the upper outer portion of the breast close to the armpit. A tumor that
can be felt (palpable mass) is most often discovered by a women herself either by
accident or through a breast self examination. Sometimes a feeling of discomfort or a
bump to the breast may draw attention to a lump. A lump can be discovered by a partner
during lovemaking or by a doctor during a routine physical exam. There are other signs
and symptoms that include:
 Differences in the size and shape of one breast compared with the other
 A generalized swelling of part of the breast
 A spontaneous nipple discharge from one breast (bloody or clear in color)
 A recent inversion of one or both nipples that can’t be turned outward again
 Thickening or irritation of one or both nipples that may be accompanied by an
itching, burning, or scaly rash (Paget’s disease of the nipple)
 Dimpling, thickening or puckering of the skin on one or both breasts
 A change in the skin of the breast in which it takes on the consistency of an
orange peel
 Enlarged lymph nodes in armpit area.
In the earliest stages of breast cancer and even in some later stages, there can be no signs
or symptoms. This is when screen mammography becomes helpful. A mammogram may
reveal a lump or abnormality that can’t otherwise be visually or palpably detected. A
mammogram is an x-ray test that produces an image of the inner breast tissue on film.
Mammograms use radiation, but the amount is very low and is not harmful. A
mammogram can visualize breast cancer in its earliest stages, before an individual or
even a skilled
health professional can feel a lump.
Mammograms may be performed in a radiology facility, a hospital, clinic or a doctor’s
office. There are two types of mammograms: screening and diagnostic. A screening
mammogram is an x-ray of the breast in a woman who has no symptoms or problems.
Usually two sets of pictures are taken of each breast, a side view and a view from above.
A diagnostic mammogram is performed when a woman has noticed something different
about her breast. This mammogram involves taking more pictures than a screening
mammogram. A mammogram can visualize an abnormality, but cannot tell whether the
abnormality is cancerous. If a mammogram reveals something suspicious, a biopsy will
be ordered. A biopsy is the removal of cells or tissues from the breast to check them for
cancer under a microscope. Biopsies are done under a local anesthetic using a thin needle
or making a surgical incision to remove a piece of tissue.
When breast cancer is found there are several treatment options:
 Lumpectomy- surgery to remove the abnormal tissue or cancer from the breast
and a small amount of tissue around it.
 Mastectomy- surgery to remove the breast
 Modified Radical Mastectomy- surgery in which the breast, most or all of the
lymph nodes under the arm and the lining of the chest muscles are removed.
Sometimes the surgeon removes part of the chest wall muscles.
The healthcare specialists involved in the care of breast cancer are:
 Radiation Technologist- the health care team member who takes the
mammograms/x-rays.
 Radiologist- the physician who reads the x-ray images and looks for abnormalities.
 Oncologist- the physician who specializes in diagnosing and treatment of cancer.
 Radiation Oncologist- the physician who uses radiation to treat the cancer.
 Medical Oncologist- the physician who uses chemotherapy and other drugs as
treatment
 Surgeon- the physician who performs the operation to remove the breast, tissue or
tumors.
 Pathologist- the physician who identifies disease by looking at body tissue and
fluids under a microscope.
 Oncology Nurse Specialist- the registered nurse who has specialized training in
chemotherapy drugs and other medications used to treat cancer.
 Oncology Social Worker- the health care team members with a master’s degree in
social work. who provides counseling, support and connections to resources for
issues surrounding the patient as a whole and the emotional stress of a cancer
diagnosis.
 Case Manager- the team member who coordinates the overall care of the patient
and works with all members of the interdisciplinary team. The case manager is
able to help you understand how the medical system works and help you handle
crises that may arise
 Breast Specialists- Some surgeons or doctors are breast specialists because they
focus on breast health. They may have a lot of knowledge in this area, however at
this time medical schools do not teach or certify in breast care
Sources
Hartmann, L, M.D. & Loprinzi, C, M.D. (Eds.) 2012 The Mayo Clinic Breast Cancer Book. Intercourse, PA: Good
Books
Lloyd, F. P, M.D, Rawis, G, M.D., 2001 Managing Cancer Book Roscoe, IL: Hilton
Curtis and Elizabeth Anderson Cancer Institute at Memorial University Medical Center,
Savannah, GA
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Subject: Breast Cancer
Submitted by: Vanessa McCoy, CHUC, of Savannah, GA
Objective: To identify facts about Breast Cancer
Resources: Accompanying article submitted by Vanessa McCoy, CHUC
Instructions: After reading the article, please circle the best answer.
1. What is breast cancer?
a. Abnormal cells decreasing
b. Abnormal cells multiplying
c. Healthy cells multiplying
d. Normal cells decreasing
2. The most common sign of breast cancer is:
a. change in skin color.
b. a lump
c. pain.
d. swelling in both breasts.
3. What diagnostic test is typically used to find breast cancer?
a. Genetic testing
b. Lung scan
c. Mammogram
d. MRI of chest
4. All of the following are signs and symptoms of breast cancer except:
a. fluid from under the armpit.
b. nipple discharge.
c. swelling of part of the breast.
d. thickening or irritation of a nipple.
5. What is a mammogram?
a. A nuclear scan that produces an image of the nipples.
b. An ultrasound scan that produces an image of the bottom of the breast.
c. An x-ray that produces an image of the inner breast tissue.
d. An x-ray that produces an image of the top of the breast
6. A screening mammogram is an x-ray of the breast done in which of the following
circumstances?
a. A woman that has no breakfast.
b. A woman that has breast problems.
c. A woman that has breast pain.
d. A woman that has no symptoms or problems.
7. Which of the following is a doctor that specializes in diagnostic and treatment of
cancer?
a. Board Certified Breast specialist
b. Oncologist
c. Pathologist
d. Radiologist
8. What is a mastectomy?
a. Surgery to remove a small amount of normal tissue around the breast.
b. Surgery to remove abnormal tissue.
c. Surgery to remove cancer from the breast.
d. Surgery to remove the breast.
9. The surgery that removes abnormal tissue or cancer from the breast and a small
amount of normal tissue around it is called:
a. lumpectomy.
b. mastectomy.
c. radical mastectomy.
d. tylectomy
10. What is a biopsy?
a. Additional images of the breast to check for abnormal cells
b. Excision of lymph nodes
c. Removal of cells or tissues to check for cancer under a microscope
d. Repair of breast wall muscles