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Our patient L.H is a 49 year old female who was diagnosed at age 39 with...

Our patient L.H is a 49 year old female who was diagnosed at age 39 with ductal cell carcinoma in situ. It was caught in the left breast. Pathology also found precancerous cells in the right breast as well. Our patient had significant family history and tested positive for the BRCA1 gene.

What are some Nursing Responsibilities for this patient?(I'm going to add this on my powerpoint slides. So I appreciate if you describe this briefly as outlines)

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Expert Solution

  1. Ductal cell carcinoma in situ (DIS) means that the cancer is limited to the ductal lining
  2. It has not invaded the other tissue of the breast
  3. Increased use of screening mammography has increased the chances of diagnosis of this condition.
  4. Mammographic appearance - suspicious calcification - linear, clustered, segmental, focal, mixed
  5. Based on the characteristics of nuclei DIS is further classified as
    1. Low (grade I) - this implies cancer is developing slowing
    2. Intermediate (grade II)
    3. High (grade III) - These patients will have rapidly going cancer. and will develop into invasive ductal carcinoma by 5 years.
  6. Nursing responsibilities
    1. Explain to the patient the condition she is suffering from.
    2. Explain the lesion to the patient - the disease in its infancy not full-blown yet.
    3. Explain the risk of invasive breast cancer - this patient is at increase risk due to family history of breast cancer and BRCA1 gene
    4. Explain the importance of treating this condition right now ( before it spreads)
    5. Treatment option:
      1. breast conservation surgery - if the DIS is located in a small of the breast than only that part can be removed.
      2. Simple mastectomy - if the DIS involves a large area of the breast
      3. Hormonal therapy - after the surgery is done, the surgical biopsy sample will subjected to Estrogen and progesterone receptor testing. If this sample test positive for these receptors specific medication need to started -example - tamoxifene
    6. Provide emotional support
    7. Management of comorbid condition like diabetes and hypertension
    8. Improving nutrition
    9. Encourage regular follow-up after surgery to look for recurrence

Nightingale answered 2 years ago
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