Question

Mrs Suzan i 45 years old.Her mother died of breast camcer and her two older sisters are breast cancer too.Mrs Suzan has neglected the possibility of breast cancer untill this time. She goes to the clinic due to pre-menopausal complaints and the mass is noticed by chance. On ultrasound, it has been seen that the cancer holds the left breast and malignancy progresses to the lymph nodes.Operation was decided immediatly.

1. How did Mrs Suzan make a mistake about her health? What were the precautions to be taken beforehand to prevent breast cancer?

2. What are the physical and psychological care needs of the patient after the surgery?

Answer 1

1. Mrs. Suzan made a mistake about her health by not having regular mammograms done and neglecting the possibility of having breast cancer, considering the fact that her mother and two older sisters had breast cancer.

The precautions to be taken beforehand to prevent breast cancer are:

Generally for all women

• Maintaining a healthy weight and staying physically active.
• Avoiding and limiting alcohol and smoking.
• Breast feeding reduces the risk of breast cancer.
• Hormone therapy increases the risk for breast cancer.

Forwomen at a high risk of breast cancer:

• Genetic testing must be done to check for mutations in the BRCA 1 or BRCA 2 gene.
• Close observation for early signs of breast cancer such as lumps or masses, regular screenings, mammograms, or breast MRIs.
• Medicines to lower risk such as tamoxifen and raloxifine which block the action of estrogen on breast tissue.

Prophylactic surgery for those with BRCA gene mutation may be considered.

2. Physical and psychological care needs of patient after surgery:

Physical care needs:

• The person may need more help in doing day to day tasks as compared to before the surgery.
• Nutrition must be given attention to, eating a well balanved nutritious diet will help regain strength and energy.
• Follow up visits with the cancer care team to prevent recurrence, also getting the suggested tests by them done.

Psychological care needs:

Psychologically, patients may experience hope and happiness after treatment and also worries fear.

They may feel a fear of the cancer coming back and also stress over any financial concerns which may lead to anxiety and also depression.

• Patients should be able to rely on support from family, friends, religious groups or counsellors.
• Staying positive and focusing energy on wellness helps the person to relax.
• Staying active.
• Understanding that recurrence is not in our control.