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Chapter: Obstetric and Gynecological Nursing : Infection of the Female Reproductive Organs

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Disorder of the Breast

Breasts are usually affected by three conditions. They are infections, benign and malignant tumours.

Disorder of the Breast

 

Disorder of breasts

 

Breasts are usually affected by three conditions. They are infections, benign and malignant tumours.

Benign

 

A. Fibrocystic breast disease

 

It is a common benign breast disease in women of all ages. It can occur as early as puberty when oestrogen level rises to adult levels, but is found most commonly in women between the age of 20 and 45 years.

 

Sign and Symptom

 

·        Freely movable, well - delineated breast lamp on palpation

·        Visible lamp on the surface of breast

·        Often occur on upper outer quadrant of the breast

·        Consistency- firm and hard to soft and flexible

·        Painful (may) and tender

·        Round and fluid filled cyst. 

 

Diagnosis

 

·        Careful palpation

 

·        Mammography

 

·        Biopsy 

 

Management

 

·        Analgesia

·        Avoidance of substances contain caffene, theophylline and theobromine

·        Avoid smoking

·        Aspiration of cysts under local anesthesia

 

B.  Fibro adenoma

 

Fibro adenoma are tumors consisting of both fibrotic and glandular components that occur in response to estrogen stimulation. They tend to occure in young women and are rerely seen after menoupuse and are non malignant.

 

 

The tumors may increase in size during adolescence, pregnancy and lactation or when a woman takes an oestrogen source such as oral contraceptive.

 

Sign and symptom

 

·        No pain (pain less) and freely movable

 

·        Round and well delineated tumors

 

·        Feel firmer and more rubbery

 

·        Occasionally calcify and feel extremely hard

 

·        Not cause skin retraction

 

 

Management:-Surgical excision

 

Carcinoma of breast

 

The carcinoma of the reast commonly occurs from 30 to 60 years of age.

 

Sign and Symptoms

 

·        Lump and hard fixed mass

 

·        Pain in the breast

 

·        Blood stained discharge (late stage)

 

·        Retracted nipple ,of cancer has spread to the lymph

 

·        Orange like colour of the skin

 

 

Clinical and histological staging of breast cancer

 

 

Clinical stage (American Joint Committee)

 

Stage I

 

Tumor less than 2 cm in diameter

 

Nodes, if palpable, not felt to contain metastases

 

Without distant metastases

 

Stage II

 

Tumor less than 5 cm in diameter

 

Modes, if palpable, not fixed

 

Stage III

 

Tumor less than 5 cm or

Tumor of any size with invasion of skin or attached to chest wall

Nodes in supra clavicular area with out distant metastases

 

Stage IV

 

With distant metastases

 

Management - Surgery

 

·        Radiation

 

·        Hormonal therapy

 

·        Cytotoxic agent

 

The woman should be thought to do self examination of breast to detect, report and be diagnosed early

 

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