MindMap Gallery breast disease
Surgical nursing mind map, including the four output paths of the breast lymphatic network, acute mastitis, breast hyperplasia, Breast tumors, etc.
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Avatar 3 centers on the Sully family, showcasing the internal rift caused by the sacrifice of their eldest son, and their alliance with other tribes on Pandora against the external conflict of the Ashbringers, who adhere to the philosophy of fire and are allied with humans. It explores the grand themes of family, faith, and survival.
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breast disease
Four output paths of the breast lymphatic network
Most of them pass through the lymphatic vessels at the outer edge of the pectoralis major muscle → axillary lymph nodes → subclavian lymph nodes → supraclavicular lymph nodes (the most active, so breast diseases in the upper outer quadrant are more common)
Lymph from the inside of the breast flows to the parasternal lymph nodes through the intercostal lymphatic vessels
There are communicating lymphatic networks under the skin on both sides of the breasts that flow to the opposite side.
The deep lymphatic network of the breast leads to the liver
acute mastitis
Most of the patients are postpartum lactating women, mostly primiparous women. It usually occurs 3-4 weeks after delivery and does not change with the menstrual cycle.
Causes: Milk stasis, bacterial invasion (mainly Staphylococcus aureus and a few Streptococci), damaged or cracked nipples are the main pathways for bacterial invasion and infection along lymphatic vessels
There is no abscess in the early stage. The main symptoms in the early stage are breast swelling and pain and local redness and swelling.
Treatment principles
non-surgical
local treatment
Stop breastfeeding and drain the milk, apply hot compress, Jinhuang Powder and Ichthyostatin ointment, or apply moist heat compress with 25% magnesium sulfate solution (to form local high osmotic pressure and reduce swelling)
Anti-infective
antibiotic
Penicillin of first choice
Avoid tetracyclines, aminoglycosides, sulfa drugs, and metronidazole, which may have adverse effects on the baby.
traditional Chinese medicine
Heat-clearing and detoxifying
Stop lactation
Oral bromocriptine 1.25 mg twice a day for 7-14 days or oral diethylstilbestrol 1-2 mg three times a day
Intramuscular injection of estradiol benzoate, 2 mg each time, once a day until milk secretion stops
Decoction of stir-fried malt with traditional Chinese medicine, 60g of it per day, divided into two times for a total of 2-3 days
Operation
Incision and drainage
Abscess in breast
radial incision
subareolar abscess
Make a curved incision along the edge of the areola
Deep or retromammary abscess
Make an arc-shaped incision along the lower edge of the breast and drain the space behind the breast
Place the drainage strip at the lowest part of the abscess cavity and perform mouth drainage if necessary.
Breast hyperplasia
Under B-ultrasound, there are burr proliferations and painful lumps that get bigger and smaller with the menstrual cycle.
Breast tumors
benign breast tumors
breast fibroadenoma
Most commonly occurs in women aged 20-25 years old
Easy to push, elastic and firm texture
Related to increased estrogen and high-fat and high-sugar diet
It usually occurs in the upper outer quadrant of the breast and is usually a single, painless lump that does not change with menstruation.
intraductal papilloma
It usually occurs in multiparous women aged 40-45 years old. It usually occurs in the lactiferous duct sinus (nipple ampulla). The mass is difficult to touch and generally has no symptoms.
Related to increased estrogen
The lump cannot be seen or touched with the naked eye
nipple discharge
bloody, dark brown, yellow
breast cancer
Common in women around menopause
Associated with elevated levels of estrone and estradiol
Pathological classification
Non-invasive and early invasive disease have better prognosis
Invasive cancer has poor prognosis. Invasive non-specific cancer has poor differentiation and poor prognosis. It is the most common type of breast cancer.
transfer
Local infiltration (more common)
lymphatic metastasis
First to reach the lungs
Blood supply transfer to lungs, bones, liver
clinical manifestations
breast lump
Changes in breast shape
Dimple sign (more common in late stages)
Cancer cells invade Cooper's ligament and cause skin depression
Orange peel
Cancer cells block lymphatic vessels, causing lymphatic drainage disorders and dermal edema.
Nipple inversion
Cancer cells invade the milk ducts and cause them to shrink, pulling the nipple toward the cancer side.
signs of metastasis
Patients with lung metastasis have chest pain and shortness of breath. Patients with bone metastasis have bone pain. Patients with liver metastasis have hepatomegaly and jaundice.
Swollen and adhesions of axillary lymph nodes on the affected side
Clinical manifestations of specific breast cancer
inflammatory breast cancer
Breast skin is congested, swollen and hot. No obvious mass. Rapid development. Prognosis is extremely poor.
Nipple eczematoid breast cancer
Initially itching and burning sensation in the nipple, followed by red, moist and erosion of the skin like eczema, which may be accompanied by yellowish-brown scaly scabs and palpable masses. The prognosis is better and it is classified as non-invasive cancer.
Auxiliary inspection
Mammography is a breast cancer screening method and the most effective method for early detection of breast cancer.
Pathological examination is the most accurate (tissue sections are the most objective)
Treatment principles
Surgical treatment is the most fundamental
Modified radical mastectomy for breast cancer to preserve appearance (chest muscles)
Survival rate after extended radical mastectomy for breast cancer remains low
Chemotherapy
Endocrine therapy
Tamoxifen (tamoxifen) is the most commonly used drug