1. The client/caregiver can define breast cancer.
   1. Breast cancer is second only to lung cancer as the cause of cancer deaths in American women. One in every nine women may get breast cancer.
   2. It is staged according to the size of the primary lesion, the extent of spread to regional lymph nodes, and metastasis to other parts of the body.
   3. Paget’s disease is found in 1% to 4% of breast cancer. It involves skin changes in the nipple caused by a tumor growing through the ducts into the nipple.
2. The client/caregiver can list factors regarding the risk of breast cancer.
   1. Factors that increase risk
      • Females (males also get breast cancer)
      • Aging increases risk (80% of breast cancers occur in women older than 50 years)
      • Personal history of breast cancer
      • Positive family history (mother, sister, or daughter with either breast or ovarian cancer)
      • Genetic predisposition
      • Radiation exposure (the younger the exposure, the greater the risk)
      • Excess weight (especially weight around the waist)
      • Exposure to estrogen (late menopause, after the age of 55; early menses, before the age of 12; women who have never had children; or first pregnancy after 35)
      • Higher risk of developing breast cancer in white women (but black women are more likely to die of breast cancer)
      • Hormone therapy (especially combination of estrogen plus progestin)
      • Talk with a physician about the current reports of birth control pill use as a risk factor.
      • Smoking (even exposure to secondhand smoke)
      • Exposure to pesticides, chemical components of cigarette smoke, and so forth
      • Excessive use of alcohol
      • Breast density
3. The client/caregiver can list measures for early detection.
   1. Mammograms. The American Cancer Society (2003) and National Cancer Institute (2004) guidelines suggest an annual mammogram for women 40 years old and older.
   2. Self-breast exams. Know how your breasts normally feel, and report any changes to your doctor. Starting in your 20s, breast self-examination is an option.
   3. A health care professional exam is important every 3 years until the age of 40, and then annual exams should be performed.
4. The client/caregiver can list warning signs of breast cancer.
   1. .A lump or thickening (often painless) in the breast or in the underarm area
   2. A change in the size or shape of the breast
   3. Nipple tenderness
   4. A retraction or indentation of the nipple or of the skin over the breast
   5. Spontaneous clear or bloody discharge from the nipple
   6. Redness or pitting of the skin over the breast, areola, or nipple (like the skin of an orange)
5. The client/caregiver can list treatments for breast cancer.
   1. Surgery
      • Lumpectomy
      • Partial or segmental mastectomy
      • Simple mastectomy
      • Modified radical mastectomy
      • Sentinel lymph node biopsy
      • Reconstructive surgery
   2. Radiation
   3. Chemotherapy
   4. Hormonal therapy to reduce estrogen

Resources

National Cancer Institute
https://www.cancer.gov/cancer_information

National Cancer Society
https://www.cancer.org/docroot/home/index.asp

Y-ME National Breast Cancer Organization
https://y-me.org

Susan G. Komen for the Cure
https://www.komen.org