Breast Cancer

About this course

Breast cancer is the most common cancer diagnosed in women. Breast cancer commonly spreads to the nearby lymph nodes but can further spread throughout the body to the bones, lungs, brain, and liver via lymph nodes and blood vessels. This course will review the different breast cancer types, their diagnosis, staging, and treatment, lifestyle modifications, and nursing considerations necessary to reduce symptoms and reduce the risk of breast cancer recurrence.

Learning objectives

• Describe the various types of breast cancer
• Review diagnostic tests for breast cancer
• Differentiate the stages and characteristics of breast cancer
• Understand the treatment options for various breast cancer types
• Understand the lifestyle modifications to reduce breast cancer risks

Course outline

24 sections · finish in any order across devices

1. 1

   Introduction

   Breast cancer is the most common cancer diagnosed in women, making it the second most common cause of death in women worldwide.1 Breast cancer commonly spreads to the nearby lymph nodes but can further spread throughout the body to the bones, lungs, brain, and liver via lymph nodes and blood vessels

   4 min

2. 2

   Breast Cancer Types, Diagnosis, and Staging

   There are various types of breast cancer that are diagnosed based on the areas affected. They are also classified as invasive (spread to surrounding tissues, organs, and blood vessels) or non-invasive (does not grow beyond the milk ducts or lobules).2 Generally, most breast cancers are divided into

   4 min

3. 3

   Ductal Carcinoma in Situ (DCIS)

   Ductal carcinoma is the most common type of cancer and can be invasive and non-invasive.4 Ductal Carcinoma in Situ (DCIS) is a non-invasive cancer that is restricted to the lining of the milk ducts and does not spread to the surrounding breast tissues.4 It is a precursor to invasive breast cancer an

   4 min

4. 4

   Lobular Carcinoma in Situ (LCIS)

   Lobular carcinoma is not considered breast cancer but rather a risk for developing invasive breast cancer in the future.1 It is characterized by cancer-like cells conforming to the lining of the breast's lobules (milk-producing glands), with expanded and filled acini.1,7 It does not invade through t

   4 min

5. 5

   Symptoms

   Like ductal carcinoma in situ, this non-invasive breast mass shows no apparent symptoms that can direct toward a diagnosis. Thus, it is a silent disease. Frequent screenings are recommended for individuals with a family history of breast cancer or other risk factors, as it can progress to invasive b

   4 min

6. 6

   HER2 Positive

   Around 15 to 20% of all breast cancers have a higher concentration of the HER2 protein; such cancers are termed HER2 positive. The protein helps cancer cells to grow quickly and spread faster and wider than HER2-negative breast cancers.8 Diagnosis is important to find the best treatment action plan.

   4 min

7. 7

   Clinical Evaluation

   Clinical evaluation includes an examination of a lump or nodule in the breast.2 Diagnostic procedures are also recommended when an abnormal mass is found through screening tests.2 However, it is important to note that most breast cancer types show no outward symptoms during the initial stages; thus,

   4 min

8. 8

   Imaging

   Imaging tests are often done before the patient shows any signs or symptoms and may help in early detection, decreasing morality, and identifying people with a high risk of developing breast cancer.3 Most effective imaging tests include

   4 min

9. 9

   Tissue Biopsy

   Once imaging tests indicate that cancer is present, a biopsy is conducted to make a confirmed diagnosis.2 Different types of biopsies are available based on the tissue sample, technique, and needle size used, such as:

   4 min

10. 10

    Staging

    Diagnosis is also useful in determining the breast cancer’s stage and if the lymph nodes and distant body parts are affected.2 Cancer staging also helps predict a patient’s prognosis, recovery chances, and possible treatment options.2 The most common method of staging used is the TNM system staging,

    4 min

11. 11

    Sentinel Lymph Node in Breast Cancer

    When cancer metastasizes from its original site, the first group of lymph nodes it reaches are called the sentinel lymph nodes. In cases of breast cancer, axillary lymph nodes (lymph nodes under the underarms) are sentinel lymph nodes.2

    4 min

12. 12

    Treatment Options for Different Breast Cancer Types

    In breast cancer, a multidisciplinary team consisting of oncologists, specialized surgeons, radiologists, and pathologists work together to create a personalized treatment plan for the patient, as each cancer case is different.2 When developing a treatment plan for breast cancer, multiple factors ar

    4 min

13. 13

    Surgery

    In most breast cancer cases, women prefer surgery; a wide-local excision (WLE)/lumpectomy or mastectomy.5 Surgery involves the removal of the tumor and a small margin of the surrounding healthy tissue to prevent a recurrence. There are two types of surgical options available.2 A lumpectomy involves

    4 min

14. 14

    Radiation Therapy

    In early-stage cancer that has not reached the lymph nodes, external beam radiation therapy is given after a lumpectomy for 3 to 4 weeks. If cancer is present in the lymph nodes, it can increase up to 5 to 6 weeks. The duration depends on the tumor size, and initially, the whole breast is targeted.

    4 min

15. 15

    Hormonal Therapy

    If DCIS is hormone-receptor-positive, hormonal therapy is considered.6 Endocrine therapy is also known as endocrine therapy or anti-estrogen therapy.6 It blocks hormone actions or lowers the level of hormones in the body.2 Different types of hormonal therapies are available based on the drugs given,

    4 min

16. 16

    HER2 Positive

    In patients with HER2-positive breast cancer that is 2 cm in size or larger and involves lymph nodes, neoadjuvant chemotherapy with a targeted drug is recommended.2 Aside from this, another targeted drug therapy involves administering pertuzumab with trastuzumab before surgery.2

    4 min

17. 17

    Survival Rates, Chances of Recurrence, and Metastasis

    Survival rates refer to the percentage of patients that can survive the effects of cancer. Survival statistics are based on a large group of people. Still, it is important to remember that no two patients are exactly alike, and thus we cannot say for sure how an individual will react to a treatment

    4 min

18. 18

    Symptoms of Metastasis

    Metastatic breast cancer refers to stage IV breast cancer, when the cancer has spread to distant body parts from the original tumor site.14 It is also known as advanced breast cancer and can spread to any body part. However, the most common parts of the body include the brain, bones, liver, and lung

    4 min

19. 19

    Body Weight

    Multiple studies have researched the effect of body weight on breast cancer prognosis and developed different mechanisms. For instance, increased body weight increases circulating sex hormones, proinflammatory cytokines, and insulin-like growth factors. Another theory concludes that any 3 of the fol

    4 min

20. 20

    Physical Activity

    The integration of physical activity into a daily routine has the most positive and prominent effects on mortality rates. Multiple studies have shown that women participating in recreational activities significantly reduced their mortality rates.16 This is because physical activity promotes reduced

    4 min

21. 21

    Healthy Diet

    Intake of lipids and carbohydrates also influences hormonal and metabolic processes and can increases the chances of recurring breast cancer. Although it is difficult to pinpoint macro and micronutrients, multiple studies have shown that high consumption of dairy and saturated fats increases mortali

    4 min

22. 22

    Smoking and Alcohol Consumption

    Although there is no strong evidence to suggest that avoiding smoking can decrease mortality rates, a few studies support the theory and show positive results. For instance, a study found that women with breast cancer who continued to smoke after treatment had a higher chance of dying from the disea

    4 min

23. 23

    Nursing Considerations

    For many decades, the cancer care continuum concept has been used as a framework to help nurses navigate breast cancer care at different stages and in different roles and responsibilities.17 The nurses’ role during different cancer stages include:

    4 min

24. 24

    Conclusion

    Researchers continue to work on early-stage and locally-advanced breast cancer, its diagnosis, early treatment, and ways to prevent it.2 Core research areas include evaluating the best surgery methods, testing new drugs and treatments, finding alternative approaches to reconstructive surgery, and le

    4 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Alkabban FM, Ferguson T. Breast Cancer. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK482286/#:~:text=Breast%20cancer%20is%20the%20most
• View All Pages. Cancer.net. Published 2020. https://www.cancer.net/cancer-types/breast-cancer/view-all
• American Cancer Society. What is Breast Cancer? Cancer.org. Published November 19, 2021. https://www.cancer.org/cancer/breast-cancer/about/what-is-breast-cancer.html
• CDC. What Is Breast Cancer? Centers for Disease Control and Prevention. Published June 17, 2020. https://www.cdc.gov/cancer/breast/basic_info/what-is-breast-cancer.htm#:~:text=Breast%20cancer%20is%20a%20disease
• Gorringe KL, Fox SB. Ductal Carcinoma In Situ Biology, Biomarkers, and Diagnosis. Frontiers in Oncology. 2017;7. doi:https://doi.org/10.3389/fonc.2017.00248
• Ductal Carcinoma In Situ (DCIS). www.breastcancer.org. https://www.breastcancer.org/types/ductal-carcinoma-in-situ
• Lobular Carcinoma in Situ | LCIS | American Cancer Society. www.cancer.org. https://www.cancer.org/cancer/breast-cancer/non-cancerous-breast-conditions/lobular-carcinoma-in-situ.html#:~:text=Lobular%20carcinoma%20in%20situ%20(LCIS)%20is%20a%20type%20of%20breast
• American Cancer Society. Breast Cancer HER2 Status. Cancer.org. Published 2013. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-her2-status.html
• Bergin ART, Loi S. Triple-negative breast cancer: recent treatment advances. F1000Research. 2019;8:1342. doi:https://doi.org/10.12688/f1000research.18888.1
• Wang L. Early Diagnosis of Breast Cancer. Sensors. 2017;17(7):1572. doi:https://doi.org/10.3390/s17071572
• Bouquet de Jolinière J, Major A, Khomsi F, Ben Ali N, Guillou L, Feki A. The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management. Frontiers in Surgery. 2018;5. doi:https://doi.org/10.3389/fsurg.2018.00056
• National Cancer Institute. Female Breast Cancer - Cancer Stat Facts. SEER. Published 2018. https://seer.cancer.gov/statfacts/html/breast.html
• Recurrent breast cancer. Cancer Treatment Centers of America. Published June 11, 2019. https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/recurrent-breast-cancer#:~:text=According%20to%20the%20Susan%20G
• Breast Cancer - Metastatic - Introduction. Cancer.net. Published May 19, 2017. https://www.cancer.net/cancer-types/breast-cancer-metastatic/introduction#:~:text=When%20breast%20cancer%20spreads%20to
• Metastatic Breast Cancer. www.hopkinsmedicine.org. Published April 22, 2022. https://www.hopkinsmedicine.org/health/conditions-and-diseases/breast-cancer/metastatic-breast-cancer
• Hamer J, Warner E. Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health. Canadian Medical Association Journal. 2017;189(7):E268-E274. doi:https://doi.org/10.1503/cmaj.160464
• Young AM, Charalambous A, Owen RI, et al. Essential oncology nursing care along the cancer continuum. The Lancet Oncology. 2020;21(12):e555-e563. doi:https://doi.org/10.1016/s1470-2045(20)30612-4

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