Case Study #10 – Breast Cancer
A routine mammogram showed a large mass in the right breast of Mrs. Hall, age 42 years. A biopsy confirmed the presence of a malignant tumor. She was very concerned because her mother and an aunt had had breast cancer. No metastases were detected at this time. A mastectomy was performed, and several axillary and mediastinal lymph nodes were removed. Pathologic examination showed that several nodes from each area contained malignant cells. Given that this case was stage III, it was recommended that Mrs. H. have chemotherapy and radiation treatment following surgery and later have her ovaries removed to reduce her estrogen levels.
Discussion Questions
- Discuss the differences between a malignant and benign tumor and how they may be used in diagnosing the cancer.
- Discuss what other signs and symptoms Mrs. H may expect to experience if the tumor returns. Remember that signs are an objective, observable evidence of a problem, and symptoms are what the patient says they are experiencing.
- Other than the biopsy used in this case, discuss what other diagnostic tests could have been used to diagnose the cancer?
- Discuss the reasons why the axillary lymph nodes were removed, and it was recommended that the patient continue with chemotherapy and radiation.
- Discuss the TNM staging system and how it applies to this case.
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- Briefly explain the role of genetic testing and the following inherited gene mutations linked to breast cancer:
- ATM
- BRCA1 and BRCA2
- BRIP 1
- CDH1
- CHEK2
- PALB2
- PTEN
- STK11
- TP53
- List and explain the medications Mrs. Hall is likely to be prescribed by the MD during her hospitalization and precautions needed because of the medications for the patient.
- Provide at least two authentic patient teaching websites for Ms. Hall to learn more about breast cancer, treatments, and recovery.
- Describe at least two things you learned because of the research you did on this case and how you feel it will impact your future actions in healthcare.