SHARE

In 2013, American Cancer Society (ACS) estimated 232,340 new cases of invasive breast cancer will be diagnosed among women in the US, as well as an estimated 64,640 additional cases of in situ breast cancer. Also on the same year, approximately 39,620 women are expected to die from breast cancer.

Breast cancer is the leading killer of women ages 35 to 54 worldwide. More than a million women develop breast cancer without knowing it and almost 500,000 die from it every year

According to Philippine Breast Cancer Network (PBCN), Philippines has the highest incidence rate of breast cancer in Asia and registered the highest increase of 589% among 187 countries over a 30 year period from 1980 to 2010. And 1 out of 13 Filipino women will develop breast cancer in her lifetime.

Risk Factors

Age: Breast cancer incidence and death rates generally increase with age. According to statistics, seventy-nine percent of new cases and 88% of breast cancer deaths occurred in women 50 years of age and older. (ACS, 2013)

Female Gender:Breast cancer is the most common cancer in women. 1 in 8 women in the United States can expect to develop breast cancer over the course of an entire lifetime.

Family History:Women with close relatives who’ve been diagnosed with breast cancer have a higher risk of developing the disease.

Race/ethnicity:According to Breast Cancer Organization, “white women are slightly more likely to develop breast cancer than African American, Hispanic, and Asian women. But African American women are more likely to develop more aggressive, more advanced-stage breast cancer that is diagnosed at a young age”.

Other significant factors:

  • Radiation exposure
  • Premenopausal woman older than age 45
  • High-fat diet
  • Obesity
  • Benign breast disease
  • Nulligravida
  • Use of hormonal contraceptives
  • Early onset of menstruation
  • Late Menopausal

Clinical Manifestations

  • Painless lump on the breast: fixed, nontender, with irregular borders
  • Skin dimpling
  • Nipple retraction
  • Scaly skin around the nipple
  • Skin ulceration
  • Clear, milky, or bloody breast discharges
  • Pain related to advancement of tumor

Surgical Management

  1. Total mastectomy or also known as simple mastectomy is the removal of the breast and nipple-areola complex but does not include axillary lymph node dissection. No muscles are removed from beneath the breast.
  2. Modified radical mastectomy is recommended for women with invasive cancer. The procedure involves the removal of the entire breast is removed with the axillary lymph node.
  3. Radical mastectomy is the removal of the entire breast including the muscles under the breast.
  4. Partial mastectomy or lumpectomy is recommended to treat noninvasive breast cancer. This procedure only involves removal of the tumor and with the normal tissues around it.

Nursing Care Plan Breast Cancer

Nursing Problem with cuesNursing Diagnosis
With Rationale
Objectives
(SMART)
Nursing InterventionsRationale for Interventions 
 Problem:

Client’s

unawareness to illness and available treatments

 

Subjective cues:

“I am not sure what will happen to me now that I have cancer. I don’t know what treatments to cure my disease.”, as verbalized by the client

 

 

Deficient knowledge regarding illness and  treatmentsRelated to unfamiliarity with information sources.

Rationale:

Deficient knowledge and misconceptions about breast cancer may interfere treatments, delay healing, and increase anxiety or fears of the client towards the illness.

Short-term goal: After 2 hours of health teaching, client will be able to verbalize  understanding and recall information  about breast cancer , cancer medications,  available surgical treatments (mastectomy) and  other therapies (chemotherapy, or radiation therapy)Assessment:a1. Review client’s understanding of breast cancer, surgical treatments such as mastectomy, and future expectations from the treatments

b1. Determine client’s perception of breast cancer and breast cancer treatments such as (mastectomy, chemotherapy, radiotherapy, and etc.)

Health Teaching: 

a2. Provide clear, accurate information in a factual but sensible manner about breast cancer and available treatment for this condition.  Answer questions specifically, but do not bombard with unnecessary information.

b2. Review specific medication regimen prescribed to the client.

c2. Provide guidance or information regarding treatment protocol, length of therapy, expected results, and possible side effects.

d2. Provide written materials or audio-visual aides about breast cancer and its medical management.

e2. Review with the client the importance of maintaining optimal nutritional status.

f2. Stress importance of continuing medical follow-up.

a1. Validates current level of understanding, identifies learning needs, and provides knowledge base from which client can make informed decisions.b1. Aids in identification of ideas, attitudes, fears, misconceptions, and gaps in knowledge about breast cancer.

a2. Helps with adjustment to the diagnosis of breast cancer by providing essential information with time to absorb it.

b2. Enhances ability to manage self-care and avoid potential complications, and drug reactions or interactions.

c2. Client has the right to know and participate in the decision of his/her treatment.

d2. Written materials and other information aides will provide reinforcement and clarification about information as client needs it.

e2. Promotes well-being and is critical for the client to tolerate treatments.

f2. Provides ongoing monitoring of progression or resolution of disease process.

References:

  • American Cancer Society. (2013).Breast Cancer Facts & Figures 2013-2014. Atlanta: 
  • American Cancer Society, Inc.
  • Breast Cancer Organization. (May 16, 2013). What Is Mastectomy?. Retrieved at http://www.breastcancer.org/treatment/surgery/mastectomy/what_is
  • Doenges, M., Moorhouse, M., Murr, A. (2006) Nursing Care Plans: Guidelines for individualizing client care across the lifespan. F. A Davis Company, Philadelphia. 7th edition.
  • http://www.pbcn.org/.
  • Mosby. 2006. Mosby’s Pocket Dictionary of Medicine, Nursing, and Health Professions. Elsevier Singapore. 5th edition.
  • Smeltzer, S., Bare, B., Hinkle, J., Cheever, K. 2010. Brunner & Suddarth’s Textbook of Medical-Surgical Nursing. Lippincott Williams & Wilkins. 12th edition
SHARE
This is a community of professional nurses gifted with literary skills who share theoretical and clinical knowledge, nursing tidbits, facts, statistics, healthcare information, news, disease data, care plans, drugs and anything under the umbrella of nursing. All information expressed here are courtesies of the respective authors. Views on topics do not generally reflect that of the entire community. Articles submitted here are original but are checked for minor typographical errors, and are formatted for site compatibility.This is a site that continuously improves and broadcasts healthcare information relevant to today's ever-changing world.