FERRER, Froilan D.

SEPTEMBER 12,
2015

BREAST CANCER

HOSPITAL PROFILE
Manila Doctors Hospital (MDH)isapremiereprivatetertiaryhospital
operatingat667UnitedNationsAvenue,Ermita,Manila,Philippines.It
wasfoundedin1956byagroupofdoctors,underthecorporatename
ManilaMedicalServicesInc.(MMSI).In1979,MetrobankFoundation,
Inc.(MBFI)acquiredmajoritysharesofMMSI.
MDHoperatesonlyinthePhilippines,butitservesmanyinternational
clientsandplaysanactiveroleinpromotingmedicaltourisminthe
country.

2015 MDH Theme

Strengtheningthehospitalscapacitytoprovidequalityandsafe
patientcarethroughintegratedvalue-basedhealthcareservice

MDH Goal
ToprovideholisticqualityandsafepatientcareforallFilipino
andInternationalClients

Vision and Mission

Inkeepingwithourgoaltoserveasahealthandwellnesscenterfor
allFilipinoandinternationalclients,MDHadherestoathree-fold
mission:
* Tooperateaworld-classhospital
* Toundertaketrainingandresearchprogramstoconsistently
improvequalityservices,aswellaspavethewayformedical
breakthroughs
* Tocontinuouslypursuecorporatesocialresponsibilityprograms

MDH Corporate Objectives

* Toprovidehealthcareservicesthatmeettheneedsof:
* Clientsorcustomers
* Allpertinentstatutoryandregulatoryrequirements,and
* TheexpectationsofMDHtopmanagement
* Toconductresearchthatwillcontinuouslyimproveservices
* Toprovidecompetentstaffatalltimes
* Toimplementandcontinuouslyimprovethequalitymanagementsystem
* Toprovidecorporatesocialresponsibilityprogramsforthe
underprivilegedandunderservedinthecommunity

INTRODUCTION
Cancer is a major health problem worldwide and the
morbidity and mortality from cancer give rise to much
suffering. The risk of developing cancer in an individual's
lifetimeisabout33%,andtheriskofdyingofcanceris25%.
Cancerisnotonlyadiseaseoftheelderlyalthoughformany
cancerstheincidenceincreaseswithage.Breastcancerinthe
USandWesternEuropeisthecommonestfemalecancer,and
accounts for the most cancer deaths in women. Eighteen
percent of women who develop breast cancer will be under
50 years of age and with an average of 50% mortality this
willproduceasignificantnumberofdeathsinapopulationof
wives and mothers who are making major contributions to
thenurtureoffuturegenerationsandtheeconomy.

InAsia,theRepublicofthePhilippineshasthehighestreportedincidencerateof
breastcancer.From43.2in2003-2005,theagestandardized-incidencerate
(ASR)isnow47.7per100,000females,andthisfigureexceedstheratereported
forseveralWesterncountries,includingSpain,Italy,andmostEasternEuropean
countries.Manybreastcancersarediagnosedamong35to50-year-oldFilipino
women.Intermsofbreastcancerdetection,alocalstudyrevealedthattheuseof
breastself-examination(BSE)andaspirationbiopsy/openbiopsyarethemost
cost-effectivestrategiesinthePhilippinesetting,incurringsavingsforthe
governmentbyalmost3millionPhilippinePesosorUS$60,000(1989value)per
yearper100,000women.Mammographyisneitherreadilyavailablenor
affordableespeciallyintheruralareas.

PATHOPHYSIOLOGY
OFBREASTCANCER

PREDISPOSING FACTORS:
Age (Pt. is 61 y/o)
Gender (Pt. Is female)
Lifestyle (Stress)
Hereditary (Pt.s
grandmother
died because of
cancer)

PRECIPITATING FACTORS:
Unknown

Neoplasm formation in the

breast

Surgery
(Pt.
undergone
mastectom
y)

Primary tumor
begins in the
breast

S/Sx: pain on the

left upper
breast

Tumor becomes invasive

Travel (metastasize)
to other organ
systems in the body

Progress
beyond breast
to regional
lymph nodes

It becomes
systemic
Primary cancer
spreads

Chemotherapy
Radiotherapy
Interstitial laser thermotherapy

Progress
beyond breast
to regional
lymph nodes

Removal of the
breast

Cancer cell
destroyed/
removed

Cancer cell
spreads into
major organs

Some
cancer cell
remains

LUNG
S
S/Sx: DOB,

LIVER

NECK
S/Sx: Horseness
of
voice

S/Sx: RLQ
pain

Cough,
Pleural
Efussion
BONES

S/Sx: Back & bone

pain

BRAIN
S/Sx:
Headache

PATIENTS PROFILE
Name: PatientVTR
Age:61yearsold
Address:LosBanos,Laguna
Gender:Female
Birth Date:March29,1954
Birth Place: Gapan,NuevaEcija
Religion:RomanCatholic
Civil Status: Married

Nationality: Filipino
Occupation: EmployeeatInternationalRiceResearch
Institute
Date and Time of Admission:July22,2015at11:40am
Final Diagnosis: LeftBreastCancer
Admitting Physician:Dr.Cabaluna
Institution:ManilaDoctorsHospital(MDH)
Operations/ Treatment: S/PTotalMastectomy,LeftBreast
(July23,2015;9am)
Chief Complaint: BreastMass,Left

FAMILYHISTORY

Thepatientverbalizedthatonher
fatherside,hergrandmotherdieddue
tocancerattheageof82.Noother
seriousillnesseswerenotedbasefrom
thefamilygenealogy.

PASTHISTORY
Accordingtothepatient,shehadmeasles
andchickenpoxinhergradeschool.She
didntrecallifshehadimmunizations.She
hadcoughsandcoldsonceinawhileand
manageditwithOTC(overthecounter)
drugs.Furthermore,shedoesnothaveany
allergyonfoodsormedicines.Asidefrom
thatnootherillnesseswerenoted.

PRESENTHISTORY
Patientwasdiagnosedacaseofendometrial
cancerwaybackin2010atAsianHospital.
TAHBSOandchemo-therapyfor6cycleswere
doneashertreatment.5monthsPTCthepatient
wasscheduledforroutinecheck-upwereupon
physicalexam,abreastmasswaspalpatedatthe
leftbreast.Nosymptomswerenoted.
Mammogramandultrasoundweredonewhich
revealedamassontheleftbreastsuspiciousfor
malignancy.Shewasadvisedtoundergosurgery
hencesubsequentadmission.

GORDONS
11 FUNCTIONAL HEALTH
PATTERNS

LABS AND DIAGNOSTIC TE

STS

SURGICAL TREATMENT

MASTECTOMY
Mastectomy is an operation in which the entire
breast, usually including the nipple and the areola,
is removed. Mastectomy is usually performed as a
treatment of breast cancer.
In general, women with breast cancer can decide
whether to be treated with a lumpectomyor a
mastectomy.
A lumpectomy is the removal of the cancerous
breast tissue as well as a surrounding rim of healthy
breast tissue. A lumpectomy is a breast-conserving
surgery that is usually followed byradiation
therapy(high-doseX-raysor other high-energy rays
to kill cancer cells).

MASTECTOMY
There are four main types:
Total mastectomy - removal of breast tissue and nipple
Modified radical mastectomy - removal of the breast,
most of the lymph nodes under the arm and often the
lining over the chest muscles
Lumpectomy - surgery to remove the tumor and a small
amount of normal tissue around it
Radical mastectomy - the removal of the breast, lymph
nodes and chest muscles. This is no longer common
Which surgery you have depends on the stage of cancer,
size of the tumor, size of the breast and whether the
lymph nodes are involved. Many women havebreast
reconstructionto rebuild the breast after a mastectomy.

NURSING CARE PLAN

DRUG STUDY

REFLECTIVE JOURNAL

Thank You...