HA | Primer Breast and Lymphatic System

🩺 Breast Health & Cancer — High-Yield Study Guide (RN prep)1) Classifications & Key TypesDCIS: In-duct only, noninvasive.IDC: Most common (≈80–90%), past duct; firm ± fixed.ILC: ≈10%; often thickening vs discrete lump.IBC: Aggressive red-swollen breast, peau d’orange; urgent eval.Paget dz (nipple): Erythema, flaking, burning, discharge, pain (late); often linked to intraductal CA.Triple-Negative (ER-/PR-/HER2-): 10–20%; more in younger & Black pts; faster course.2) Common BenignFibrocystic changes: Cyclic tender “rubbery/granular” lumps ↑ pre-menses, ↓ after; hormonal.3) Red Flags → Refer ⚠️New mass that’s hard, fixed, poorly defined.Spontaneous, unilateral, bloody/guaiac+ discharge.Skin changes: peau d’orange, new dimpling/retraction.New nipple inversion.Inflammatory signs (redness/warmth/rapid enlargement) → think IBC.4) Bedside Approach (Nursing)HPI: COLDSPA for pain/lumps.Teach risk reduction: regular exercise, ≤1 drink/day, weight control; high-risk pts discuss enhanced screening.Med review (can cause pain/discharge): hormones/OCPs, antipsychotics (e.g., haloperidol/risperidone), antidepressants, sedatives, some antihypertensives; herbs: fennel/anise/fenugreek.5) Screening (ACS-style talking points) 🎯Mammogram: annually from 40 (50–74 may go q2y).CBE: q2–3y in 20s–30s; yearly ≥40.BSE: optional—teach correct method; goal = body awareness.6) Risk Factors (know these!) 🧬Non-modifiable: female, ↑age, BRCA1/2 (≈5–10%), prior LCIS/atypia, early menarche/late menopause, prior chest radiation, dense breasts.Reproductive: nulliparity or 1st birth >30.Lifestyle: obesity, post-meno HRT, alcohol (esp. ≥2/day), night-shift/2nd-hand smoke, high-fat diet.7) Physical Exam (how to) 🧪Position: Inspect sitting (both breasts exposed); palpate supine.Inspect: symmetry, color/texture, venous pattern, areola/nipple, retraction/dimpling.Palpate: all 4 quadrants + Tail of Spence (🔺most tumors here); note location, size, shape, mobility, consistency, tenderness.Nodes: Axillary anterior (pectoral), posterior (subscap), lateral (brachial), central.