Gender Health Exam #3

Key Concepts:

Terms in this set (82)

What are the 10 risk factors for developing breast cancer?
1. Gender
2. Age
3. Genetic factors
4. Family history
5. Personal history
6. Ethnicity
7. Previous breast biopsy
8. Previous chest irradiation
9. Early menses
10. Late menopause
What are the odds for a woman to develop breast cancer?
1 in 8
What are the odds for a man to develop breast cancer?
1 in 1,000
T/F: The survival rates between men and women with breast cancer are the same.
True
What are the 7 lifestyle-related risk factors for developing breast cancer?
1. Children
2. Oral contraception
3. Hormone replacement therapy
4. Breast feeding
5. Alcohol
6. Obesity
7. Physical activity
What % of breast cancer begins in the ducts?
86%
What % of breast cancer begins in the lobules?
12%
What % of breast cancer begins in the surrounding breast tissue?
2%
What are the 2 types of breast cancer?
1. In Situ (Non-Invasive/Remains in Place)
2. Invasive/Infiltrating (Grows outside duct/lobule)
What is the most common form of non-invasive breast cancer and occurs inside the breast ducts but does not spread?
Ductal Carcinoma In Situ
What form of breast cancer is a non-invasive cancer which begins in milk-producing glands but does not penetrate through walls of lobules?
Lobular Carcinoma In Situ
What is the most common type of breast cancer which starts in the ducts and breaks through the walls and invades fatty tissue forming a hard lump?
Invasive Ductal Carcinoma
What type of breast cancer starts in the milk-producing gland and breaks through into fatty tissue?
Invasive Lobular Carcinoma
What stage of breast cancer is described as: tumor is 0-2cm, no lymph node involvement, no metastases to other organs?
Stage 1
What stage of breast cancer is described as: tumor is 2-5cm, with or without positive lymph nodes, no metastases to other organs?
Stage 2
What stage of breast cancer is described as: tumor >5cm, with or without positive lymph nodes, and may have extended into pectoral muscles?
Stage 3
What stage of breast cancer is described as: tumor has metastasized to other organs (lungs, liver, bones, brain) and positive lymph nodes?
Stage 4
What does "TNM" stand for in breast cancer staging/interventions?
T- Tumor
N- Node
M- Metastases
What are the 2 types of local treatment for breast cancer?
1. Surgery
2. Radiation
What are the 2 types of systemic treatment for breast cancer?
1. Chemotherapy
2. Hormonal Therapy
What are the 4 types of surgery required for breast cancer?
1. Lumpectomy
2. Simple Mastectomy
3. Modified Radical Mastectomy
4. Radical Mastectomy
What type of masectomy is the removal of the entire breast?
Simple Masectomy
What type of masectomy is the removal of the entire breast and some axillary lymph nodes?
Modified Radical Masectomy
What type of masectomy is the removal of the entire breast, axillary lymph nodes, and pectoral muscle?
Radical Masectomy
What procedure is performed at Stage 1 and 2 of breast cancer, and involves removing the tumor and 1-2cm margin of surrounding tissue?
Lumpectomy
What procedure is performed at Stage 2 or 3 of breast cancer, and involves removing up to 1/4 of the breast?
Partial or Segmental Masectomy
What breast cancer procedure involves removing 10-15 lymph nodes and 5-10% of patients will develop lymphedema?
Axillary Dissection
What breast cancer procedure often follows lumpectomies 3-4 weeks after surgery, and side effects include: scar fibrosis, skin changes and irritation, burns, anemia, fatigue?
Radiation
What pharmaceutical blocks the stimulant effect of estrogen on cancer cells in patients with breast cancer?
Tamoxifen
What pharmaceutical eliminates estrogen receptors in patients with breast cancer?
Faslodex
What pharmaceutical stops estrogen production in post-menopausal women with breast cancer?
Aromatase Inhibitors
What is the 5-Year Survival Rate for Stage I Breast Cancer?
100%
What is the 5-Year Survival Rate for Stage II Breast Cancer?
93%
What is the 5-Year Survival Rate for Stage III Breast Cancer?
72%
What is the 5-Year Survival Rate for Stage IV Breast Cancer?
22%
What are 3 common physical therapy interventions following breast cancer treatment?
1. Recovery of upper extremity ROM
2. Lymphedema Education
3. Exercise
What are the 5 intervention exercises performed in the first 1-7 days following breast surgery?
1. Deep breathing
2. Pump it up
3. Shoulder shrugs & circles
4. AA arm lifts
5. Should blade squeeze
What condition occurs weeks after breast cancer surgery and the cause is unkown, but causes small damaged veins in the UE?
Axillary Cording
The second stage of breast cancer healing usually starts within ___ to ___ weeks.
4 to 6 weeks
What are the 3 goals of breast reconstruction following breast cancer?
1. Make breasts look balanced when wearing bra
2. Permanently regain breast contour
3. To not need an external prosthesis
What are 2 types of reconstructive breast surgery?
1. Prosthetic Implant
2. Muscle Flap Transfers
What are 4 possible breast implant problems that could occur?
1. Pectoralis tightness
2. Loss of shoulder ROM in all planes
3. Capsular contracture
4. Can rupture
What are 2 exercise interventions prescribed for prosthetic implant issues?
1. Increase AROM in all planes
2. Prevent pectoralis tightness
What are the 2 most common muscles used in muscle flap transfers for reconstruction?
1. Transverse Rectus Abdominis
2. Latissimus Dorsi
What are the 4 common issues with TRAM muscle flap transfers?
1. Difficulty in moving to prone
2. Abdominal tightness/weakness
3. Loss of trunk mobility
4. Postural deviations leading to back pain
What are 3 exercise interventions prescribed for TRAM muscle flap issues?
1. Stretch/Strengthen abdominals
2. Strengthen back muscles
3. Restore normal posture
What are the 3 common issues with latissimus dorsi muscle flap transfers?
1. Loss of Shoulder AROM
2. Weakness in Shoulder Ext/IR
3. Tightness causing trunk deviations
What are 3 exercise interventions prescribed for latissimus dorsi muscle flap issues?
1. Increase shoulder extension strength
2. Increase shoulder ROM in all planes
3. Stretch latissimus dorsi through lateral bends, prone lateral stretches, and trunk rotations
What system of the body is considered the subsystem of the circulatory system?
Lymphatic System
What are the 3 functions of the lymphatic system?
1. Collect/return interstitial fluid to the blood
2. Defends body against disease
3. Transports fats, vitamins and nutrients that are absorbed through GI wall to the blood
What lymphatic anatomical structure moves lymph fluid with waste?
Lymph Vessels
What lymphatic anatomical structure breaks down and eliminates waste products?
Lymph Nodes
What is the order of the lymphatic vessel plexus in the body?
Capillaries --> Pre-Collectors--> Collectors--> Lymph Node --> Trunks --> Ducts
The Thoracic Duct drains ____% of the lymphatic load.
75%
What lymphatic duct drains right and left lower quadrants, left upper quadrant, and left head and neck?
Thoracic Duct
The Right Lymphatic Duct drains ____% of the lymphatic load.
25%
What lymphatic duct drains right upper quadrant and right head and neck?
Right Lymphatic Duct
Lymph fluid contains what 7 substances?
1. Proteins
2. Water
3. Cells (RBC, WBC, lymphocytes)
4. Cellular debris
5. Bacteria
6. Cancer cells
7. Fat from intestinal lymph (chyle)
What condition consists of protein rich edema and occurs when the lymph volume exceeds the lymph transport capacity in any segment of the body?
Lymphedema
What causes Lymphedema to occur?
Obstruction or destruction of the lymphatic system
What type of Lymphedema occurs due to imperfect development in utero and is considered congenital?
Primary Lymphedema
What type of Lymphedema occurs due to injury/disease such as surgery, radiation therapy, trauma, metastatic cancer, Tamoxifen, filariasis, untreated chronic venous insufficiency?
Secondary Lymphedema
What are the 6 symptoms of Lymphedema?
1. Heavy swollen limb
2. Tight skin
3. Decreased flexibility
4. Jewelry tightness
5. Discolored skin or change in texture
6. Unilateral and asymmetric changes
What stage of Lymphedema is described as: lymphatic system compromised, but no edema?
Stage 0
What stage of Lymphedema is described as: spontaneously reversible, pitting edema visible, and decreases at night?
Stage I
What stage of Lymphedema is described as: spontaneously irreversible, non-pitting visible w/ spongy consistency, start to see fibrosis and increase in size, and no changes at night or w/ elevation?
Stage II
What stage of Lymphedema is described as: Lymphostatic Elephantiasis, swelling is irreversible and limb appears very large?
Stage III
For Lymphedema, what differential diagnosis must be ruled out?
Deep Vein Thrombosis
To diagnose Lymphedema, what volumetric objective measurement must be observed?
Difference of 200 ml between limbs
To diagnose Lymphedema, what circumferential objective measurement must be seen?
4 cm at single measurement site or set intervals
T/F: There is a cure for treating Lymphedema.
False, no cure, only can be managed
What is the main treatment called for managing Lymphedema?
Complete Decongestive Therapy (CDT)
What are the 5 components of Complete Decongestive Therapy (CDT)?
1. Manual lymph drainage
2. Short stretch bandaging
3. Exercise
4. Skin care
5. Self care instruction
What component of Complete Decongestive Therapy (CDT) consists of gentle, very light, rhythmic massage applied in a specific sequence and fluid is moved through existing anastomoses to bypass blocked area?
Manual Lymph Drainage
What is the reason for using short stretch banding for managing lymphedema?
To enhance pumping action of lymph vessels by providing increased resistance to push against during activity
Why aren't long stretch bandages used for Lymphedema?
Causes a tourniquet effect
Following short stretch bandaging, what is the next progression once edema reaches the baseline level?
Compression Garments
What type of exercises should be prescribed for patients with Lymphedema?
Exercises that promote muscle pumping action
T/F: For exercises prescribed to Lymphedema patients, exercises should start proximal to distal.
True
What are the 4 physical therapy precautions for patients with Lymphedema?
1. Avoid aggressive stretching, joint mobilization, and deep massage
2. CDT contraindicated for cardiac edema, renal dysfunction, and acute infections
3. Bandaging contraindicated with arterial insufficiency
4. Slow progression with exercise
What condition is a visible and palpable fibrous cord of subcutaneous tissue extending from axilla to medial arm?
Lymphatic Cording
What arm movements are painful and limited in ROM for patients with lymphatic cording?
1. Shoulder Abduction
2. Elbow/Wrist Extension
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