Grand Rounds

A Patient-Centered Approach for the Treatment of Fungating Breast Wounds

Karlyn L. Rupert, MPAS, PA-C, and Andrea J. Fehl, CRNP, AOCNP®

From Magee-Womens Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Karlyn L. Rupert, MPAS, PA-C, 300 Halket Street, Pittsburgh, PA 15213 E-mail: porterk4@upmc.edu


J Adv Pract Oncol 2020;11(5):503–510 | https://doi.org/10.6004/jadpro.2020.11.5.6 | © 2020 Harborside™


  

ABSTRACT

Nearly 2% to 5% of locally advanced breast cancers develop a fungating breast wound (FBW). Fungating breast wounds develop when malignant cells infiltrate the skin and cause breakdown, ulceration, and infection. Although systemic and locoregional control of locally advanced breast cancer is necessary, appropriate management of the wound is also crucial. With limited research and reference literature involving FBW, management of FBW is not well understood. The following article will highlight the comprehensive care approach needed to manage the patient with FBW, including medical management of the locally advanced breast cancer, addressing psychosocial complications, pain management, and wound care with appropriate dressing recommendations according to the specific wound characteristics. In addition, examples and brand names will be given, as the availability of products may be dictated by the facility, or price comparisons may need to be made for the patient who will have out-of-pocket costs.




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