Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ 198.81 Secondary malignant neoplasm of breast233 Carcinoma in situ of breast and genitourinary system233.0 Carcinoma in situ of breast ++ C79.81 Secondary malignant neoplasm of breastD05.90 Unspecified type of carcinoma in situ of unspecified breast ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation16B: Impaired aerobic capacity/endurance associated with deconditioning26H: Impaired circulation and anthropometric dimensions associated with lymphatic system disorders3 +++ Description ++ Cancer originating in the tissue of the breast4Ductal or lobularInvasive or non-invasive (in situ) +++ Essentials of Diagnosis ++ MammographyMRIUltrasoundBiomarkersAxillary sentinel lymph node biopsyPET/CT to determine spreadBiopsy of tumorNeedle or core/open +++ General Considerations ++ Not always associated with painLumps in breast or axillaChange in breast/nipple shape or colorNipple discharge +++ Demographics ++ Accounts for one-third of all cancers diagnosed in American womenWomen are 100 times more likely to be diagnosed than menIncreased risk with age +++ Signs and Symptoms ++ Lumps, hard knots, or thickening in any part of the breastSwelling, warmth, redness, darkeningChange in size or shape of breastDimpling or puckering of the skinItchy, scaly, sore or rash on the nippleNew pain in one spot that does not go awayPulling in of nipple or other area of breastChest, breast, axillary, or shoulder pain of unknown etiologyNipple discharge +++ Functional Implications ++ Decreased ROMImpaired posturePain with mobilityEndurance deficitsSelf-care or ADL deficits +++ Possible Contributing Causes ++ Female sexHormone replacement therapyWeight gain and obesityOlder agePersonal or family history; heredityRace/ethnicityExcessive alcohol consumptionBRCA-1 geneChildbirthRadiationAge of menarche +++ Differential Diagnosis ++ Mammary dysplasia (fibrocystic breast disease)FibroadenomasLipomas +++ Laboratory Test ++ Blood test +++ Imaging ++ Digital mammographyMRIPETUltrasound +++ Diagnostic Procedures ++ BiopsyNeedleLymph nodeOpenStagingStages 0 through IV +++ Medication ++ TamoxifenChemotherapySide effects includeNauseaVomitingDiarrheaAlopeciaMouth soresConjunctivitisUlcersLeukopeniaAnemiaThrombocytopeniaHeadachesDizzinessMenstrual irregularitiesInfertilityPeripheral neuropathiesHormonal therapy +++ Medical Procedures ++ RadiationSide effectsPainLesionsFatigueSecondary neoplasmIntegumentary compromise (burns)Radiation fibrosisMastectomyBilateral or singleRadicalSkin sparingModified radicalAxillary lymph node dissectionSentinel lymph node dissectionReconstructionTissue expander (TE) placementLatissimus dorsi (Lat) flapTransverse rectus abdominus muscle (TRAM) flapDeep inferior epigastric perforator (DIEP) flap ++ ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.