Breast cancer: Nursing pathophysiology

Breast cancer is the uncontrolled growth of abnormal cells in the breast tissue that can spread to other parts of the body.

Ok. So breasts also called mammary glands are milk producing glands that sit on the chest wall on top of the ribs and the pectoral muscles made up of glandular adipose and connective tissue.

The glandular tissue makes the milk during lactation and is made up of 15 to 20 lobes that surround the nipple in a radial pattern.

And each lobe contains many smaller lobules inside. Each of these lobes are grapelike structures called the alveoli containing secretory epithelial cells that produce milk during lactation.

And myoepithelial cells that contract to move milk from the alveoli. The alveoli lobules and lobes are connected through a network of ducts called the lactiferous ducts that drain the milk produced during lactation surrounding the glandular tissue is the stroma which contains fibrous connective tissue and adipose tissue which makes up the majority of the breast.

Lastly located throughout the breasts are blood vessels as well as lymphatic vessels that drain into the lymph nodes. For examination purposes.

The breasts are divided into quadrants which include the upper outer quadrant, upper inner quadrant, lower outer quadrant and lower inner quadrant.

Now, breast cancer is caused by mutations to DNA within breast tissue that results in uncontrolled cellular proliferation.

There are modifiable and non modifiable risk factors that increase the risk of breast cancer. Modifiable risk factors include exposure to ionizing radiation that can come from medical diagnostics and treatments, postmenopausal hormone replacement therapy, alcohol consumption, exposure to certain environmental chemicals like polychlorinated biphenyls or PCBs, obesity and physical inactivity.

Non modifiable. Risk factors include age over 65 early menarche or late menopause being biologically female.

Though biological males can also develop breast cancer. A family history of breast cancer and inherited mutations to certain genes such as BRCA one and BRCA two.

Ok. So most breast cancers are adenocarcinomas.

Meaning the cancerous cells form from glandular tissue in ductal carcinoma. In situ or DCIS, the tumor grows from the walls of the ducts into the lumen.

As the tumor progresses, it can cross the basement membrane to become invasive ductal carcinoma. On the other hand, in lobular carcinoma in situ or L CS, the tumor cells grow within the lobules without invading the ducts.

Now, as the tumor continues to grow, it can invade the nearby tissues like the pectoral muscles. The cancerous cells can also enter the lymphatic vessels causing blockages and a buildup of lymph in the interstitial space.

Finally, tumor cells can metastasize or spread via the blood or lymph to other parts of the body like the bones, liver or lungs.

Most breast cancers form in the upper outer quadrant of the breast as an irregularly shaped, firm immobile painless lump.

However, some tumors may not be palpable especially in the early stages and are oftentimes discovered in asymptomatic individuals during routine mammography, some types of breast cancer can cause nipple retraction or discharge.

The skin might also be red, swollen and warm and an ulcer may develop if the lymphatics are obstructed and fluid accumulates in the breast tissue, there may also be pitting of the skin giving it the appearance of an orange peel, known as poor metastasis of the lymph nodes may cause them to be palpable, especially in the axilla.

If the cancer has spread to the bone, bone pain can occur and spreading to the lungs may manifest as shortness of breath, chronic cough or chest discomfort.

All right, it's a quick recap. Breast cancer is the uncontrolled growth of abnormal cells in the breast tissue that can spread to other parts of the body like the bones, liver or lungs.

Tumors usually begin in the upper outer quadrant of the breast and can be palpable as an irregularly shaped firm, immobile, painless lump.