Question

Scenario

M.D. is a 50-year-old woman whose routine mammogram showed a 2.3- × 4.5-cm lobulated mass at the 3 o’clock position in her left breast. M.D. underwent a stereotactic needle biopsy and was diagnosed with invasive ductal carcinoma, estrogen and progesterone receptor positive, HER-2 negative. The staging workup was negative for distant metastasis. Her final staging was stage IIB. She had a modified radical mastectomy with axillary lymph node dissection. The sentinel lymph node and 4 of 16 lymph nodes were positive for tumor cells. An implanted port was placed during surgery.

1. What are the risk factors for breast cancer?

2. Describe the biopsy technique used to diagnose M.D.’s cancer.

3. Breast cancer is classified as noninvasive or invasive. Compare these terms.

4. Discuss the implications of a positive sentinel node.

5. What factors affect prognosis and treatment for breast cancer?

6. Is she a candidate for tamoxifen therapy? Explain your reasoning.

7. Surgical intervention is the primary treatment for breast cancer. Describe the surgical procedure that M.D. had.

8. Describe M.D.’s risk for lymphedema.

9. What actions will you teach M.D. to reduce her risk for developing lymphedema?

CASE STUDY PROGRESS

Eight weeks after surgery, M.D. is now beginning a prescribed chemotherapy regimen of 6 cycles of CAF (cyclophosphamide, doxorubicin, and fluorouracil).

10. M.D. asks you why she has to have chemotherapy with so many drugs if the surgeon removed all the cancer. How would you respond?

11. Name the common side effects experienced by patients receiving a chemotherapy regimen.

12. What information would you want to review with M.D. about the signs and symptoms of infection and when to seek treatment?

13. M.D. is ordered doxorubicin at 75 mg/m². Her height is 5 feet, 7 inches (170 cm), and her weight is 155 pounds. Calculate the dose she will receive.

Answer 1

Here it is a typical example of breat cancer. So from the above reading we get to know the various things

Ans 1 . The various risk factors of breast cancer are :-

A.) Reproductive history. :- Early menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.

B) Family history of breast or ovarian cancer.:- A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter

C) Previous treatment using radiation therapy.:- Women who had radiation therapy to the chest or breasts (like for treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.

There are many reasons but i have posted the main reasons.

Ans 2 . The technique here used for biopsy is stereotactic needle biopsy

Stereotactic breast biopsy uses mammography – a specific type of breast imaging that uses low-dose x-rays — to help locate a breast abnormality and remove a tissue sample for examination under a microscope. It's less invasive than surgical biopsy, leaves little to no scarring and can be an excellent way to evaluate calcium deposits or tiny masses that are not visible on ultrasound.

Ans 3 - now let's under the type of breast cancer

1. Non - invasive

2. Invasive

Non-invasive cancers stay within the milk ducts or lobules in the breast. They do not grow into or invade normal tissues within or beyond the breast. Non-invasive cancers are sometimes called carcinoma in situ or pre-cancers.

Invasive cancers do grow into normal, healthy tissues. Most breast cancers are invasive.

Ans 4.- Sentinel lymph node (SLN) mapping and biopsy is emerging as an alternative to axillary lymph node dissection (ALND) in determining the lymph node status of patients with early-stage breast carcinoma. The hypothesis of the technique is that the SLN is the first lymph node in the regional lymphatic basin that drains the primary tumor.

I am only allowed to ans first 4 questions according the guideline , if you want answer for other sub parts you can repost the question.