8.1 Benign Disorders of the Breast
A common fear of people experiencing a change in their breasts is that they have cancer, especially because many benign changes mimic symptoms of breast cancer. However, benign breast changes encompass several different conditions, including trauma, breast pain, infection, skin changes, nipple discharge, and tumors. These changes are often associated with fluctuations in estrogen, which may explain why they are more common in persons of childbearing age. Nurses play a role in educating the person on the difference between their diagnosis and breast cancer. The nurse can offer reassurance and support to the patient and family.
8.2 Cancer of the Breast
According to the CDC, more than 239,000 women were diagnosed with breast cancer in 2020, and nearly 43,000 women died from the disease (2023). Regular screening is an important step in the early diagnosis and treatment of breast cancer. How often and when that screening should occur is patient-specific, but evidence-based guidelines have been developed by several organizations, including the American Cancer Society and the U. S. Preventive Services Task Force, to help providers make those clinical decisions with their patients. The development of screening tests like the mammogram have been very successful in detecting breast cancers early in their development and reducing mortality.
When a patient presents to the health-care provider with a lump or other symptoms, or a suspicious lesion is found on a screening mammography, additional testing is required before a diagnosis can be reached. In many cases, biopsy of the suspicious lesion or mass is indicated. Once breast cancer is diagnosed, it is important to evaluate the tumor characteristics to identify how best to treat it. During biopsy or surgery, breast cancer cells may be checked to determine receptors for estrogen or progesterone. Staging a breast cancer helps the provider to understand the patient’s prognosis and how the cancer should be treated.
The medical management of breast cancer depends on the specific diagnosis and stage of the cancer. Options for treatment include surgery, chemotherapy, radiation, hormonal therapy, and other types of medications. The nurse has a complex role in caring for a person newly diagnosed with or undergoing testing for breast cancer. In addition to clinical nursing interventions such as preparing for surgery and prepping for and assisting during diagnostic testing, the nurse must provide patient education and emotional support.
The breast cancer survivor’s need for support doesn’t end with discharge from treatment. Considerable time must be spent on education and preparation for the transition to post-treatment life. Discharge planning should start early and be a comprehensive overview of what the patient and support person will need for this next stage in their life.