Question

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.

The following are the nursing responsibilities for this patient.

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)

   (I need 2-3 more sentences to include above about nurse contribution to diagnosis and  2 resources the family can use)

Answer 1

1. Explaining the patient the condition she is suffering from- As per the diagnosis ruled the condition you have been suffering from since 10 years is known as DCIS (Ductal carcinoma in situ) which means cancerous cells have started to grow within one of the milk-ducts of your left breast. However the recent pathology results show the presence of precancerous cells in the right breast as well,

You have been tested positive for the BRCA1 gene which means that due to a family history of breast or ovarian cancer there is possibility that you must have inherited the mutation. Its just in the stage 1 and that suggest you have an excellent chance of successful outcome.

2. Explaining the lesion to the patient - the disease in its infancy not full-blown yet.-If the cells were still confined to the milk duct, you would be classified as having a Stage 0 breast cancer. The disease is not full-blown yet and its in stage 1 which means that the further spread can be controlled effectively with the right treatment.

As It is precancerous/non-invasive lesion and it did not spread fully to the surrounding area of the breast there is a very good possibility of the being treated and cured.

3. Explaining the risk of invasive breast cancer - this patient is at increase risk due to family history of breast cancer and BRCA1 gene - Invasive breast cancer occurs when cancer cells from inside the milk ducts or lobules break out into nearby breast tissue. DCIS can sometimes become an invasive cancer. At that time, the cancer has spread out of the duct into nearby tissue, and from there, it could metastasize to other parts of the body.

Also due to the presence of positive BRAC1 gene, the gene mutation makes an individual vulnerable to cancer re-occurrence or they may be prone to aggressive forms of the disease.

Cancer cells can travel from the breast to other parts of the body through the blood stream or the lymphatic system. They may travel early in the process when a tumor is small or later when a tumor is large

Metastatic breast cancer(also called stage IV or advanced breast cancer) is invasive breast cancer that has spread beyond the breast and axillary lymph nodes to other organs in the body (most often the bones, lungs, liver or brain).

Metastatic breast cancer is not a specific type of breast cancer, but rather the most advanced stage of breast cancer.

4. Explaining the importance of treating this condition right now ( before it spreads)- As there are lot many risks associated with the invasive breast cancer its important to treat non-invasive condition to prevent further prognosis.

Undergoing the treatment in the early stages increases the survival rate and also helps prevent the further stages of breast cancer.

For early-stage breast cancer, a patient can usually get a lumpectomy rather than a mastectomy.(In a lumpectomy, only the tumour and a small margin of surrounding normal tissue are removed, along with a few lymph nodes for testing. A mastectomy involves the surgical removal of the entire breast and all the lymph nodes in the armpit.)

There have also been significant changes in post-operative radiation therapy.Typically the radiation is focused on a smaller area, using a higher dose for a shorter period of time.This approach helps to reduce side effects and limits the damage done to surrounding healthy tissue.

Not smoking tobacco increases the likelihood that your cancer treatment will work.

Aside from the cancer treatments, adopting certain lifestyles can affect chances of keeping cancer at bay. A low-fat diet and regular exercise can reduce the risk of recurrence and lower the chance of death early-stage cancer.

Considering the above risk factors it is always important to get treated in the early stages.