BREAST CANCER

• By: HASBULLAH BIN ROSLI

• SD01-201704-002560
• DIPLOMA IN MEDICAL ASSISSTANT
• SEMESTER 4
• CASE STUDY(SURGICAL)

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 INTRODUCTION
• Breast cancer is cancer that forms in the cells of the breasts.
• Breast cancer can occur in both men and women, but it's far more common in
women.
• Substantial support for breast cancer awareness and research funding has helped
improve the screening and diagnosis and advances in the treatment of breast cancer.
• Breast cancer survival rates have increased, and the number of deaths steadily has
been declining, which is largely due to a number of factors such as earlier detection,
a new personalized approach to treatment and a better understanding of the disease.

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 PATHOPHYSIOLOGY
• Begins as a single transformed cells
• Is hormone dependent
• Classified: non- invasive or invasive
• Categories: Ca of mammary ducts, Ca of mammary lobules, or sarcoma of the
breast.
• Most: adenocarcinoma
• 70% infiltrating ductal ductal carcinoma
• metastasis to the other sites.

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 SIGN AND SYMPTOMS
• A breast lump or thickening that feels different from the surrounding tissue
• Change in the size, shape or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple
(areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange

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 CAUSES
• 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 isn't clear what causes normal breast cells to become
cancerous.

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 DIAGNOSIS
• Clinical brest exam - mammogram
• Magnetic resonance imaging (MRI)
• Breast Ultrasound
• Molecular breast imaging (MBI)

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 TREATMENT
Surgery
• Removing the breast cancer (lumpectomy).
• Removing the entire breast (mastectomy).
• Removing a limited number of lymph nodes (sentinel node biopsy).
• Removing several lymph nodes (axillary lymph node dissection).
• Removing both breasts.

Radiation theraphy
• Chemotheraphy

Hormone Theraphy
• Medications that block hormones from attaching to cancer cells.
• Medications that stop the body from making estrogen after menopause.

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 HEALTH EDUCATION
• Taking aspirin
• No/limit alcohol
• Maintain a healthy weight
• Avoid a long term hormone theraphy
• Stay physically active
• Eats food high in fiber
• Emphasize olive oil
• Avoid exposure to pesticide

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 SUMMARY
Breast cancer is cancer that forms in the cells of the breasts.Breast cancer can
occur in both men and women, but it's far more common in women.Begins as
a single transformed cells. Is hormone dependent. Classified: non- invasive or
invasive. Categories: Ca of mammary ducts, Ca of mammary lobules, or
sarcoma of the breast. Most: adenocarcinoma. 70% infiltrating ductal ductal
carcinoma metastasis to the other sites. Sign and symptoms such as a breast
lump or thickening, change in the size, shape or appearance,also peeling,
scaling or flaking of the pigmented area of skin surrounding the nipple. After
we get the right diagnosed about this patient. We started treatment. such as
surgery treatmeant, radiotheraphy treatment, and hormonal therapy treatment.
Then after that, we give an health education to patient after they have done all
the treatment and surgery. continue follow up with doctor until the breast
cancer reduces.

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 PATIENT PARTICULAR
1.Medical Records V/S:-
2.Name:MRS.Wong Kiou BP: 120/70
3.Gender:Female RR: 20
4.Age:51 years old PR: 60
TEMP: 37
5.Ethnic:Chinese
6.Occupation:Officer cleaner and Funeral Services agent
7.Weight:74.2kg Height:162cm
8.Diagnosis: L Breast Ca

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 CASE BACKGROUND
• Mrs Wong Kiou
• 51y/o, Chinese, Female
• Coming at Emergency Deparment HTAR with complaint have small lump
at Left Breast for 6/12.

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 PATIENT HISTORY
History of chief complaint
- Left breast swelling for 6/12
- Pain upon touch and discomfort
- No skin changes
- No discharge
- Nipple retraction (t) since long ago
Past Medical History
- Hypertension for 7 years on T.atenolol 25mg OD
-Dyslipidemia on T.Simvastatin 40mg OD
- Follow up at KK pandamaran
Past surgical History
- L Breast surgery - lumpectomy in 1995 (claimed non-cancerous)
Past Antenatal History
- 3x giving birth- all boys/ SVD
Family History
-Mother has Breast Ca
-Sister has Breast Ca

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Drug History
- Hypertension - T.atenolol 25mg OD
- Cholestrol- T.simvastatin 40mg OD
Social History
- Married with 3 children
-Non smoking
-Non alcoholic
-Stay in Perlabuhan Klang
Menstrual History
-Last Menstrual Period(LMP): 31/8/2017
-Normal cycle; 5-7 days
-Changes 3-4 pads in 2 days
Occupational History
- Work as Officer cleaner and Funeral Services Agent

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Investigation
-Clinical brest exam - mammogram
-Magnetic resonance imaging (MRI)
-Breast Ultrasound
-Molecular breast imaging (MBI)

Diagnosis:
-Provisional diagnosis:- L Mastectomy and Axillary clearange
-Differential diagnosis:- L Breast Ca
-Diagnosis:- L Breast Ca

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Management
1.Ca + Analgesic - T.PCM 1g QID
- C.Celebrex 200mg BD x 3/7
- C.Tramal 50mg QID
2.E orally
3.Drain charting
4.Upper lymp physio

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