Breast Cancer Archive

Birth of the Placenta

The placenta, which has provided the fetus with nourishment, is attached to the umbilical cord and is delivered about 20 minutes after the baby. Do not pull on the cord; delivery of the placenta occurs on its own. You can help by gently massaging the woman’s lower abdomen. The uterus will feel like a hard round mass.

Massaging the abdomen helps the uterus contract, which also helps stop bleeding. After the placenta is delivered, place it in a plastic bag to take with the woman and baby to the hospital. It is normal for more bleeding to occur after delivery of the placenta. Continue gently massaging the woman’s lower abdomen.

Butterfly Bandage

Direct Pressure to Stop Bleeding

A wound that is deep, bleeding heavily, or has blood spurting from it (caused by bleeding from an artery), may not clot and may not stop bleeding.

Immediate care
Call out for someone to get help, or call 911 yourself. Elevate the wound and apply direct pressure.

Chronic Lymphocytic Leukemia (CLL)

Questions to Discuss with Your Doctor:

• Have you had fevers, chills, fatigue, or weight loss?
• Have you had any recent infections?
• Do you have a cough?
• Do you have sinus congestion?
• Do you know when to seek medical attention for infections?
• Do your gums bleed when you brush your teeth?
• Have you had nosebleeds or easy bruising?
• Do you get short of breath with minimal exertion?
• Are you lightheaded?
• Have you been unusually tired?
• Have you had abdominal pain or swelling?
• Have you noticed swollen lymph nodes?

Your Doctor Might Examine the Following Body Structures or Functions:

• Lymph nodes (neck, axilla, groin)
• Heart
• Lungs
• Abdomen (for enlargement or tenderness of the liver or spleen)

Your Doctor Might Order the Following Lab Tests or Studies:

• Complete blood count
• Routine blood chemistries
• Immunoglobulin levels
• Blood test for flow cytometry
• Bone marrow biopsy.

Colonic Polyps

Questions to Discuss with Your Doctor:

• Do you have a family history of colonic polyps?
• Do you have bleeding from the rectum or bloody stools?
• Do you frequently have rectal pain or the sensation of needing to have a bowel movement?
• Do you have anemia (low blood count)?
• Do you have a family history of colon cancer?

Your Doctor Might Examine the Following Body Structures or Functions:

• Abdominal exam
• Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Stool testing for blood
• Complete blood count
• Sigmoidoscopy or colonoscopy, possibly with a biopsy or removal of a polyp (if one is found)

Dysfunctional Uterine Bleeding

Questions to Discuss with Your Doctor:

• Do you have regular menstrual cycles?
• When was your last period?
• Is your bleeding always heavy or prolonged?
• How old were you when you started menstruating?
• How long ago did you develop abnormal bleeding?
• Are you sexually active?
• How many times have you been pregnant?
• What was the outcome of each pregnancy (live births, miscarriages, cesarean sections)?
• Have you ever had difficulty getting pregnant?
• What medications are you taking (including over-the-counter drugs and herbal remedies such as ginseng)?
• Are you taking hormone replacement therapy or birth control pills?
• Have you ever had medications injected (Depo-Provera or Norplant) for birth control?
• Have you ever taken estrogen or tamoxifen?
• Are you taking warfarin or other blood thinners?
• Have you ever had an abnormal Pap smear?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, heart rate, weight
• Abdominal examination
• Pelvic exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Pregnancy test
• Blood tests such as complete blood count, coagulation (clotting) studies, and certain hormone tests (such as thyroid stimulating hormone, cortisol, prolactin, follicle stimulating hormone, testosterone)
• Pelvic ultrasound
• Pap smear
• Endometrial biopsy.

Hodgkin's Disease (after the disease has been treated)

Questions to Discuss with Your Doctor:

• Have you had fevers, heavy sweating at night, weight loss, itchy skin, or swollen lymph nodes?
• Do you have pain in any of your bones?
• Do you have a cough?
• Are you fatigued?
• Do you get lightheaded?
• Do you bruise easily or have nosebleeds?
• Do your gums bleed when you brush your teeth?
• Have you had any recent infections?
• Do you have a cough?
• Do you have sinus congestion?
• Do you have nasal discharge?
• Do you know when to seek medical attention for signs of infection?
• Do you know that you still need to practice birth control (both men and women)?
• Infertility is uncommon with newer chemotherapy regimens. If you are a woman and have undergone early menopause, have you considered hormone replacement therapy?
• Are you short of breath at rest or with minimal exertion?
• Do you get chest pain or pressure with exertion?
• Do you have swelling in your legs?
• Do you know that chemotherapy and radiation can increase your risk of developing certain other cancers?
• Are you up-to-date on all of your cancer screening tests?
• If you are a woman, have you discussed the need for regular mammograms and breast examinations with your doctor?
• Are you gaining weight?
• Are you constipated?
• Are you always cold?
• Do you have dry skin?

Your Doctor Might Examine the Following Body Structures or Functions:

• Neck veins
• Heart
• Lungs
• Abdomen (for enlargement or tenderness of the liver or spleen)
• Bones and spine (looking for areas of tenderness)
• Skin (looking for skin cancers)
• Lymph Nodes (neck, axilla, elbow, groin)

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests for complete blood counts, kidney and liver function tests
• CT scans of the chest and abdomen

Pregnancy: 1st Trimester

Questions to Discuss with Your Doctor:

• Your age and how it will affect your pregnancy.
• Have you been pregnant before? If so, what was the outcome of each pregnancy. Did you have a full-term pregnancy (your baby was born close to your due date)? Did you give birth via a vaginal delivery or a cesarean section ("C-section") surgery? If you had a C-section, what type of C-section was it? Did any of your pregnancies end in miscarriage, voluntary abortion, or an ectopic (tubal) pregnancy?
• Does this pregnancy come at a good time for you?
• When was the first day of your last menstrual period?
• What is the usual length of your menstrual cycle?
• Do you have any medical problems such as diabetes, high blood pressure, thyroid problems, asthma, tuberculosis, epilepsy, or heart disease?
• Have you ever had any sexually transmitted infections such as gonorrhea, herpes, syphilis, or human papilloma virus (HPV)?
• Do any medical problems tend to run in your family such as sickle cell anemia, cystic fibrosis, Down syndrome, or hemophilia?
• Are you taking any medications (including over-the-counter medications)? If so, what are they?
• Do you smoke? If so, how many packs per day?
• In an average week, how many alcoholic beverages do you consume?
• Do you use any recreational drugs?
• Did you have any problems getting pregnant?
• Do you eat a well-balanced diet? Are you taking any vitamins, including folic acid (folate)?
• Do you exercise regularly?
• What is your home situation like? Who do you live with? Is your partner supportive of this pregnancy? If not, has your partner hit or threatened you?
• Are you having any problems with morning sickness (that is, nausea and vomiting)?
• Are you having any bleeding from your vagina?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature, blood pressure, pulse, weight
• Chest exam
• Heart exam
• Abdominal exam
• Pelvic exam with Pap smear and cervical cultures
• Leg exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Confirm pregnancy with blood or urine test
• Complete blood count and blood type
• Blood tests for syphilis, rubella antibodies, hepatitis B, HIV
• Urinalysis
• Portable Doppler instrument or stethoscope to measure fetal heart sounds
• Urine culture
• "Triple screen" (also known as "AFP-3" or "Enhanced AFP"
• Genetic testing

Pregnancy: 3rd Trimester

Questions to Discuss With Your Doctor:

• Do you have adequate support at home from family or friends?
• How do you feel? Have you had any problems since your last visit?
• Have you had any vaginal bleeding or spotting?
• Have you had any pain or uterine cramping?
• Have you had any discharge or leakage of fluid from your vagina?
• Have you noticed swelling of your face or ankles?
• Have you had any problems with your vision?
• Are you getting frequent headaches?
• Have you noticed a change in the frequency or intensity of fetal movement?
• Are you planning to breast-feed or bottle-feed?
• Have you selected a pediatrician for your baby?
• Are you taking classes on labor and delivery?
• Have you added health insurance coverage for your new baby?
• Have you purchased a special car seat to hold your baby when riding in your car?
• Have you decided on whether the baby will have a circumcision, if a boy?
• Have you talked with your doctor about the length of your stay in the hospital?
• Do you know the signs of going into labor so that you can call your doctor when labor begins? (These include uterine contractions and rupture of the membranes).

Your Doctor Might Examine the Following Body Structures or Functions:

• Breasts (to see if your nipples are inverted)
• Abdominal exam, including measurement of the height of your fundus (top of the uterus)

Your Doctor Might Order the Following Lab Tests or Studies:

• Culture of the vagina and rectum for Group B streptococcus bacteria
• Fetal ultrasound

Pregnancy: 2nd Trimester

Questions to Discuss with Your Doctor:

• How do you feel? Have you had any problems since your last visit?
• Have you had any vaginal bleeding or spotting?
• Have you had persistent vomiting?
• Have you had any pain or uterine cramping?
• Have you noticed swelling of your face or fingers?
• Have you had any problems with your vision?
• Are you getting frequent headaches?
• Have you had any vaginal discharge?
• Have you noticed fetal movement?
• Are you planning to breast-feed or bottle-feed?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, weight
• Abdominal exam including measurement of the height of your fundus (top of the uterus) and using a portable Doppler instrument or stethoscope to measure fetal heart sounds

Your Doctor Might Order the Following Lab Tests or Studies:

• Consider repeat complete blood count
• Fetal ultrasound
• Glucose tolerance test

Your Doctor Might Order the Following Treatment:

• Rhogam (Rh-Immunoglobulin), if your blood type is Rh negative (see p. 920)