Metastatic Disease

invasive breast cancer who received 6–8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the

Situation: The client is a 50-year-old female teacher who was notified of an abnormal screening mammogram. Diagnosis of infiltrating ductal carcinoma was made following a stereotactic needle biopsy of a 1.5 x 1.5 cm lobulated mass at the 3:00 position in her left breast. The client had a modified radical mastectomy with lymph node dissection. The sentinel lymph node and 11 of 16 lymph nodes were positive for tumor. Estrogen receptors and progesterone receptors were both positive. Further staging work-up was negative for distant metastasis. Her final staging was stage IIB. Her prescribed chemotherapy regimen is 6 cycles of CAF after a single-lumen central line was placed.

Invasive ductal carcinoma is the most common type of breast cancer. Invasive ductal carcinoma starts in one of the milk ducts in the breast, spreads through the wall of the duct and into the fatty tissue of the breast. Once it has spread outside the duct it is possible to spread to other parts of the body through the lymphatic system and blood stream. Some signs and symptoms of invasive ductal carcinoma can include: a lump in the breast tissue or armpit area, redness, thickening, irritation or dimpling, breast pain and or swelling, and nipple changes and or discharge. (American Cancer Society, 2014., National Cancer

There's also other scans such as a ventilation perfusion scan, this looks for blood clots along the pathway to the lungs. Other

The radiologist report says, “the appearance is suspicious for malignancy, and further evaluation with PET CT is recommended.” The report on the PET scan states that the cardiophrenic mass had increased FDG uptake; the smaller nodules did not. The accuracy of this type of scan is limited on nodules under one centimeter, which many of them were on this patient. Due to this, it was undetermined if there was metastasis or not. It was also found on the PET scan that one of the patient’s ovaries was enlarged and had some FDG uptake there as well. A pelvic ultrasound was recommended as this was a concern for an ovarian

The baseline cohort was retrieved from the SEER9 database and consisted of females diagnosed with breast cancer as a first primary cancer identified by diagnosis codes from the International Classification of Diseases for Oncology

Harmful tumors require quick regulation and treatment, as threatening developments may grow quickly and metastasize (spread all through the body) at a disturbing rate. Metastases are auxiliary tumors which can show up at any area all through the body, which is an immediate impact of disease spreading by means of blood and lymph hubs.

How your results appear in the report will depend on what test you have. There are four test for HER2. ImmunoHistoChemistry (IHC test) finds out if there is too much HER2 protein in the cancer cells. The results of the IHC test can be 0 (negative), 1+ (also negative), 2+ (borderline), or 3+ (positive- HER2 protein overexpression). The Fluorescence in Situ Hybridization (FISH) test finds out if there are too many copies of the HER2 gene in the cancer cells. The results of the FISH test can be positive (HER2 gene amplification) or negative (no HER2 gene amplification). The Subtraction Probe Technology Chromogenic In Situ Hybridization (SPoT-Light HER2 CISH) test finds out if there are too many copies of the HER2 gene in the cancer cells. The results of the SPoT-Light test can be positive (HER2 gene amplification or negative (no HER2 gene amplification). The Inform Dual In Situ Hybridization (Inform HER2 Dual ISH) test finds out if there are too many copies of the HER2 gene in the cancer cells. The results of the inform HER2 Dual ISH test can be positive (HER2 gene amplification) or negative (no HER2 gene amplification). It is important to know which HER2 status test you had. Generally, only cancer that test IHC 3+, FISH positive, SPoT-Light HER CISH positive, or Inform HER2 Dual ISH positive respond to the medicines that target HER2-positive breast cancers. An IHC 2+ test

There is a lack of collective focus regarding the recommendation of estrogen hormone therapy (ET) for postmenopausal women. For advanced practice nurses (APRN), clarification is necessary in order to inform their clients experiencing menopause of the risks and benefits of hormone therapy use. In the United States, breast cancer is the second leading cause of female death behind cardiovascular disease and its etiology is recently becoming more fully defined (Eccles, 2013). Breast cancer is exacerbated by the number of years clients use hormone therapy as well as each client’s lifestyle (Beckmann, 2014). Hormone therapy combination, dose and length of therapy as well as the client’s medical history all impact onset of malignancy, but the

Assessing metastatic involvement of the lymph nodes in breast cancer patients is important in planning surgical and adjuvant therapies. A trend toward breast-conserving therapies with the goal of improving quality of life for breast cancer patients has driven the need to accurately assess lymph nodal staging. The concept of a sentinel lymph node (SLN) biopsy is a valuable tool in evaluating metastatic spread of primary breast tumors (Maaskant-Braat et al.,2012; Noushi et al., 2013). Tokin et al. (2012) describe how the process of tumor spread via the lymphatics occurs to the first draining lymph node, then to subsequent nodes within the same basin and beyond. Breast lymphoscintigraphy has emerged as a useful means of identifying the SLN, although many patient factors, choice of radiopharmaceutical, injection technique, and imaging protocol may affect the successful outcome. The ideal exam protocol would combine speed, accuracy, and sensitivity to identifying the SLN with the least amount of burden to the patient and resources involved (Povoski et al., 2006; Sadeghi et al., 2009; Tokin et al., 2012).

As the long term outcome of radiation therapy was generally poor among the LRR occurring following mastectomy, His RA et al. had concluded that the long term survival as well as local control for loco regional recurrence of breast cancer after mastectomy were high among patients with favorable subgroup (1- DFS ≥2years, 2- isolated chest wall recurrence, 3- tumor size <3cm). They also find that this favorable subgroup of patients will reasonably benefit from aggressive treatment. (18)

Breast cancer is a leading cause of death of women, secondary only to heart disease. Breast cancer will affect one of every eight women or approximately 12% of the population. In 2016 there are 246,660 new cases of invasive breast cancer that will be diagnosed as well as 46,000 cases of breast cancer in situ in women. Additionally, there are 2,600 cases of breast cancer that will be found in men. Breast cancer rates have been decreasing since the year 2000. This is thought to be partially due to increased screening measures as well as discontinuing the use of hormone replacement therapy. There was as positive link established between hormone therapy

Various investigators have found cellular pleomorphic, stromal elements or the combination of histologous stromal elements or the combination of histological features to be prognostically useful [1,8,10,11]. According to Hawkins et al. Four features-high mitotic count, stromal overgrowth, severe nuclear pleomorphism and infiltrating margins were useful predictors for the development of metastases [8]. They also showed that the most reliable predictor for metastasis was the presence of stromal overgrowth, and a primary tumor with stromal overgrowth had a 72% risk of metastatic spread [8]. Here patients need a close follow up with a CT scan of the bones and lungs.

Breast cancer is the most common cancer in women. In 2008, more than one million women underwent a diagnostic evaluation for suspected breast cancer. Approximately 182,500 women of the more than one million that received an evaluation also received a positive diagnosis (Montgomery, 2010). Risk factors linked to Breast Cancer include: gender, age, family history, prior breast cancer, previous biopsy, race and ethnicity, breast density, and long menstrual history because of prolonged hormonal stimulation. Modifiable related risk factors also include hormone replacement therapy, alcohol, weight, and physical

• A PET (positron emission tomography) scan may help to show cancer activity in some other parts of the body. This can be helpful for “staging” the cancer (see