Breast cancer in the nineties

The experiences of and the nursing care for breast cancer patients undergoing immediate breast reconstruction

This study explores the experiences of and the nursing care for nine women with breast cancer undergoing immediate breast reconstruction (IBR) with a TRAM-flap. The study was prospective and descriptive and source and method triangulation was used. Source triangulation consisted of the patients' and nurses' perspectives, whilst method triangulation combined interviews, questionnaires and medical records. One result is that the meaning of IBR for the women operated is related to feelings of hope, normality and 'wholeness'. Another result is that not all the needs of the patients are assessed and met; the nursing care during admission is mainly focused on the physical care and after dismissal the patients are left in a situation characterized by vulnerability and a sense of emptiness. The study points to some implications in the means of quality development and rehabilitation.

Women's experience with breast biopsy

The purpose of this study was to obtain descriptions of the perioperative experiences of women who underwent breast biopsies with local anesthesia. Twenty-two participants were interviewed, and open-ended questions were used to allow the women to describe their experiences. Data analysis revealed three major themes--certitude, care, and justice. The women's most pervasive need was to have the biopsy results as soon as possible. They viewed the surgical phase of the biopsy as a stepping-stone to achieving certitude associated with having the pathology results. The surgical phase of the biopsy did not hold as much significance for the women as the researcher had anticipated.

Lymphatic mapping in breast cancer

The most accurate predictor of survival in breast cancer is the presence or absence of lymph node metastases. Lymphatic mapping with sentinel node biopsy is a new technique that provides more accurate nodal staging compared with routine histology for women with breast cancer, but without the morbidity of a complete lymph node dissection. Sentinel lymph node (SLN) biopsy is a more conservative approach to the axilla that requires close collaboration from the surgical team, nuclear medicine, and pathology. National trials are investigating the clinical relevance of the upstaging that occurs with a more intense examination of the SLN. As is the case with breast preservation as a viable alternative to mastectomy for the definitive treatment of the primary node, selective lymphadenectomy has the ability to decrease morbidity without compromising patient care.