Abstract | Dojka (lat.mamma) je kožna parna žlijezda koja se nalazi kod oba spola, ali više je svojstvena za ženski rod. Nalazi se između parasternalne linije medijalno i srednje pazušne linije lateralno, a po visini se pruţa između drugog i šestog rebra. Povećanjem ženine životne dobi raste i rizik za karcinom dojke. Zloćudne novotvorine čine skupinu više od 100 bolesti čije je obilježje nekontrolirana dioba tumorski promijenjenih stanica. Promjenom se može zahvatiti okolno tkivo i često dolazi do nastanka metastaza. Metastaze se najčešće šire preko limfnog sustava i putem krvi, a zatim i u druge organe. Stopa smrtnosti od raka dojke u Hrvatskoj je među najvišima u Europi, stoga predstavlja značajan problem u stanovništvu. Najčešće mjesto u kojem se razvija karcinom je vanjski gornji kvadrant. Simptomi koji upućuju na karcinom dojke su pojava kvržice, promjene oblika dojke, upala, otok tkiva, koža je poput narančine kore, nabiranje i uvlačenje kože, zadebljanje kože oko bradavice,promjene bradavice poput uvlačenja i iscjedak iz bradavice pogotovo ako je krvav. Samopregled je najjednostavnija metoda s kojom možemo otkriti ove simptome i pravovremeno reagirati. Postoje rizični čimbenici koji utječu na razvoj karcinoma dojke. Čimbenici kao što su reproduktivna aktivnost, korištenje hormonske terapije, prehrana, alkohol i sam način života možemo promijeniti, ali dob i nasljeđe ne možemo. Stadij, vrsta i proširenost karcinoma određuje se TNM klasifikacijom , o tome ovisi sam način i ishod liječenja stoga je bitno rano otkrivanje karcinoma dojke. Vrste liječenja se dijele na: kirurško liječenje, kemoterapijsko, radioterapijsko i hormonsko. Klinički pregled, ultrazvučni pregled, rentgensko snimanje, kompjuteriziran tomografija, magnetska rezonancija i citopunkcija su dijagnostičke metode koja nam pomažu pri otkivanju karcinoma. U liječenju karcinoma dojke je bitan timski rad koji se sastoji od liječnika, radiologa, onkologa, psihologa,anesteziologa i medicinske sestre. Uloga medicinske sestre je velika. Medicinska sestra će pripremiti bolesnicu za operativni zahvat, pružit će joj podršku i razgovor, poučit će je o vježbama disanja i vježbama ruke na bolesnoj strani koje se provode nakon operativnog zahvata, provest će edukaciju i pacijentice i obitelji. |
Abstract (english) | Breast are skin glands and they are found in both sexes. As the body organ are more pronounced with females. The breast is placed between parasternal line medial and lateral middle axillary line and hight is provided between the second and sixth ribs. Increasing the woman's age increases the risk for breast cancer. Malignant neoplasms are a group of more than 100 diseases characterized by the uncontrolled division of tumor changed cells. The change can affect the surrounding tissue and often lead to the formation of metastases. Metastases are usually spread through the lymphatic system and through the blood, and then to other organs. The death rate from breast cancer in Croatia is among the highest in Europe, is therefore a significant problem in the population. The most common place where the cancer develops is the outer upper quadrant. Symptoms suggestive of breast cancer are: changing the shape of the breast, inflammation and edema of tissue. The skin is look like an orange peel, picking and retracting of the skin, thickening of the skin around the nipple. There are nipple changes such as feeding and discharging from the nipple, especially if it is bloody fluid. Self-examination is the simplest method with which we can detect these symptoms and react. There are risk factors that affect the development of breast cancer. Factors such as: reproductive activity, use of hormone therapy, nutrition, alcohol etc. The way of life we can change, but age and a genetics we can not. Stage, type and extent of cancer is determined by TNM classification. Classification depends on the method and outcome of treatment and that is the reason why it is important the early detection of breast cancer. The types of treatment are divided into: surgery, chemotherapy, radiotherapy and hormone therapy. The clinical examination methods that help in detecting cancer are: ultrasound, X-rays, computerized tomography, magnetic resonance imaging and cytological punction. In the treatment of breast cancer is most important teamwork consisting of a physician, radiologists, oncologists, psychologists, anesthetists and nurses. The nurse will prepare the patient for surgery, offer her support and discussion, teach her about breathing exercises and exercises of hands on the sick side carried out after surgery, and also organize education of patient and family. |