纤维囊肿课件.ppt

Nursing care of client with breast disorders School of Nursing, CGU Li-Chueh Weng Benign breast disorders Mastalgia (breast pain) Breast infections Mastitis, breast abscess Fibrocystic changes Fibroadenoma Nipple discharge (galactorrhea, intraductal papilloma, ductal ectasia), may be benign or malignant. Gynecomastia in man 纖維囊腫Fibrocystic changes 過多的纖維組織形成, 乳腺管的上皮細胞增殖,乳腺管增生, 形成囊腫 (cyst) Hormonal influence. Aspiration or surgical biopsy may be indicated. Follow up examinations, BSE 會在單側或雙側乳房復發,持續直到停經.在月經週期開始前會感到疼痛且可能變大 Cysts do not “turn into ”cancer. 有新的腫塊出現而且不受月經週期影響,超過1-2週, 應該請醫師檢查 Fibroadenoma 纖維腺瘤 Benign breast lumps in young women Painless, single, unilateral mass Treatment: surgical excision, which is not urgent in women under 25 years of age(25歲以下通常不急著手術). cryoablation …are not reduced by radiation and are not affected by hormone therapy. Follow up examination and BSE. Gynecomastia in man The most common cause of gynecomastia is a disturbance of the normal ratio of active androgen to estrogen in plasma or within the breast itself(雌激素與睪丸酮). It may also accompany organic disease(睪丸癌,腦垂體瘤, 肝疾病), a side effect of drug therapy (digitalis, INH, Aldactone). Pubertal gynecomastia; senescent gynecomastia Breast cancer in Taiwan 4th cancer death in female (2008). Mortality 3. 8% (cancer death 2006) Mortality rate 4.35-12.8 (每十萬人口，1983-2006) Survival rate: 5 years 95%-15% by stage Age 25-44 years, younger than US women 51歲女性，一向健康狀況良好，偶爾小感冒，胃悶情形。 自己在右乳房上摸到約1-2公分硬塊，沒有去理會。過了5個月因為疼痛到醫院求診，診斷為乳癌第二期，期間先做化學治療、放射線治療。之後予右乳房局部切除。 之後乳癌復發，且轉移到肺部。有時會主訴右乳房上傷口疼痛及右手腫脹痛不舒服，甚至右腿會有抽痛感，但在服用止痛藥及注射止痛劑控制下，疼痛指數可維持在3~4分 45歲女性，一向健康情形良好，自己摸到右乳房有1指節大小的硬塊，並不理會，後來出現右手臂酸痛及腫脹，就醫後經過乳房超音波、乳房攝影及冷凍切片等檢查確定為乳癌，醫師建議接受改良式乳房全切除手術，但是個案無法接受，「開刀後是不是很醜？…開刀後那可以活多久」 「頭髮及胸部這兩項最能展現女人的美…，這次手術和化療，讓我同時失去這兩項，最讓我感到痛苦」 Breast cancer Related factor: heredity or genetically, hormonal regulation (sex hormones may act as tumor promoters). Physical inactivity, dietary fat intake, obesity and alcohol intake. Chemical, pes