Breast cancer

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After the presence of breast neoplastic, Mastectomy (Removal of the right breast)

Andrea Proaño

Pontificia Universidad Católica del Ecuador

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Abstract

One of the most common types of cancer in women is breast cancer. We present the case of a 75-year-old woman at the Specialty Hospital Carlos Andrade Marin (HCAM IESS) who went to the Primary Care consultation for presenting a lump in the right breast, due to intense pain for about a month, she was directed to perform a biopsy, upon admission to the hospital ward, a nursing care plan is drawn up.

Keywords: biopsy, hospital, nursing.

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Introduction

Breast cancer is caused by the growth of cells in the breast ducts. When the cells of this tissue are transformed and begin to divide faster than normal, that is when a tumor forms. (1)

Regular breast exams are important because early breast cancer usually does not cause symptoms. As the cancer progresses, there may be symptoms.

• There are hard and painless breast tumors.
• There are changes in the size of the breasts.
• There is a discharge of fluid from the nipple.
• Symptoms of breast cancer in men include both breast lump and increased tenderness, as well as increased pain.

The results are the following:

Affected cells can invade nearby tissues and organs and spread through the bloodstream to areas of the body where they can form tumors.

In an advanced stage of breast cancer, there are a number of symptoms, including bone pain, breast pain or discomfort, skin ulcers, swelling in one arm, and weight loss.

The risk factors that can lead to the appearance of this type of tumor have been identified by the scientific community. (2)

That is what it is?

• The risk factors that may favor the appearance of this type of tumor have been identified by the scientific community.
• Age: the risk increases with age, and although it can appear at any stage of life, it occurs more frequently between 35 and 55-60 years of age.
• Most cases are associated with the female sex.
• If a sister, mother or daughter has been affected by breast cancer, the chances of suffering from it increase. In addition, this risk increases if the relative who has suffered from cancer has done so before menopause or if it has affected both breasts.[pic 4]
• Have been diagnosed with another cancer.
• Late menopause: > 55 years
• Not having had children or having had a first birth after the age of 30.
• Some studies show a correlation between alcohol intake and breast cancer.
• Diets low in fat, rich in fruits and vegetables, as well as regular physical exercise, help prevent breast cancer, according to many scientists.
• Stress (3)

The surgical treatment used to treat and prevent breast cancer is mastectomy, which consists of removing the breast. There are four main types of mastectomies

• Total Mastectomy: Removal of breast tissue and nipple.
• Modified Radical Mastectomy: Removal of the breast, most of the underarm lymph nodes, and often the lining of the chest muscles.
• Lumpectomy: Removal of the tumor and some of the healthy tissue around it.

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Design and Method

The case of a 75-year-old woman with pain for 1 month is presented.

The present study is of a descriptive type, because it seeks to study only a population and their characteristics; cross-sectional, because the measurement of the variables will be carried out in a single moment and without follow-up, in a single time, and seeks to establish correlations between variables to determine the degree of relationship between them.

Physical exam

• Right breast: tumor in the areolar region of approximately 4 cm, fixed, of hard consistency, with extension to the chest wall and adhered to the pectoral muscle.
• Left breast: normal.
• Both axillary regions: no adenopathies were palpable.

I am aware that breast cancer is a problem public health, being today the most common tumor among women in our country, so I wanted to investigate and investigate how these women live and face the process of his disease. (3)

Likewise, in the surgical plants where I have rotated, I have had lucky to deal with some women undergoing breast surgeries. In such practices. I have noticed that the individual psychosocial needs of these women.

On a personal level, after observing in my close environment various cases that have had have to fight against a disease like cancer, whether diagnosed or prevention, detected various deficiencies both in the advice and in the treatment received by healthcare professionals.

Two main types of information sources can be distinguished, sources of primary and secondary information. The primary source of information (direct) provides first-class data hand, that is, directly from the researcher, constitute the objective of the bibliographic search. The primary sources correspond to books, articles of publications and expert testimonials. (4)

NANDA: (00132) Acute pain r/c physical injurious agents. NOC: Pain control (1605).

Indicators:

• Recognize causal factors.
• Recognize the beginning of the pain.
• Use preventative measures.
• Use available resources.

NIC: Pain management (1400).

Activities:

• Ensure that the patient receives the corresponding analgesic care.
• To determine the impact of the pain experience on the quality of life.
• Explore with the patient the factors that alleviate or worsen pain.
• Provide information about the pain, such as what causes the pain, how long it will last, and what comfort is expected from the procedure.

 NANDA: (00146) Anxiety r/c threat to the state of health. NOC: Anxiety level (1211).

Indicators:

• Verbalized anxiety.
• Increased pulse rate.
• Sleep disorder.
• Difficulties solving problems.

NIC: Administer oral medication (2304).

Activities:

• Follow the five principles of medication administration.
• Take note of the patient's medical history and allergies.
• Inform the patient of the actions and possible adverse effects of medications.

 NANDA: (00004) Risk of infection r/c invasive procedures. NOC: Knowledge: management of acute illness (1844).

Indicators:

• Signs and symptoms of complications.
• Strategies to prevent complications.
• When to contact a healthcare professional

NIC: Wound care (3660).

Activities:

• Take off the dressings and tape.
• Monitor wound characteristics, including drainage, color, size, and odor.
• Manage incision site care, as appropriate.
• Maintain sterile dressing technique when performing wound care.

Drainage care (1870).

Activities:

• Use automatic abort commands and reminders to request a command to remove the device when the prompt has been resolved.
• Keep the drain pan at the proper level.
• Maintain correct hand hygiene before, during and after the insertion or manipulation of the drain.

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Results and Discussions

In 2017–2022, in Ecuador, they have 2,386 cases of breast cancer and 2,502 controls, aged 25–74, in 5 hospitals. (1)  They estimate the incidence of breast cancer by age and risk factors. The risk increases with family history, early age at menarche, older age at first delivery, nulliparity, exogenous use of hormones, and decreased physical activity. Nulliparity has a higher risk in 40–74 years than in 25–39 years. ACHO and hormone replacement therapy increase the risk of breast cancer. The truth is that breast cancer is a great shock for women10. The prevalence and risk factors of depression-anxiety in women with early breast cancer were studied, within 5 years of diagnosis, in 170 women under 60 years of age, with a psychiatric interview 5 months after diagnosis and every 18 months. up to 5 years old, and seeing the stress factors of their vital experience. 50% of women have depression-anxiety in the first year of diagnosis, 25% in the second year and 15% in the rest of the years. With recurrences, there is 45% depression-anxiety rate 3 months after diagnosis. In the long term, depression-anxiety is related to previous psychological disorders, lack of a confidant intimate relationship (predicts fewer episodes), being young and experiencing great life stress (not due to cancer), and with an early episode of depression-anxiety after diagnosis. Consultation services are needed for psychological intervention with breast cancer and need for social support.

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