Luis F Vega Jr
NUR 1211
Breast Cancer Case Study
Mrs. Thomas, a 57 year old married lawyer, was found to have a 4 X 6 cm firm, fixed mass in the upper, outer quadrant of the right breast during a routine physical examination, and a stereotactic core biopsy indicated a malignant tumor. Although the surgeon recommended a mastectomy because of the size of the tumor, Mrs. Thomas chose to have a lumpectomy. Now three weeks postoperative, she is scheduled for chemotherapy.
Subjective Data
Never had a routine mammogram
Never practiced Breast Self-Examination (BSE)
States she deserves to have breast cancer for being so careless about her health
Chose to have a lumpectomy to remove the tumor despite its large size because she believes
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What can the nurse do to help Mrs. Thomas reduce or manage the common physical effects of the chemotherapy?
Nausea & Vomiting - anti-emetic drug, eat and drink slowly, drinking enough fluids
Mouth sores (Mucositis) – OTC anesthetics, ice chips or popsicles, gargling
Diarrhea - drink plenty of fluids, high-protein foods, cooked vegetables, fresh fruits without the skin
Hair loss - wear some kind of head covering (scarf, turban, hat, or wig)
4. What does the finding that Mrs. Thomas’s tumor is estrogen receptor-positive mean? What additional treatment modalities might this suggest? This means that estrogen, but not progesterone, may be supporting the growth and spread of the cancer cells. Your doctor usually will prescribe some form of hormonal therapy at some point in your treatment plan.
5. How could the nurse help Mrs. Thomas cope with her feelings of guilt and maintain a positive relationship with her husband? The nurse could listen to and explore Mrs. Thomas’s feeling of guilt. Inform her about support groups and counseling that are available in her area.
6. What are some possible reasons that Mrs. Thomas did not perform BSE or have mammography performed?
Not confident in the technique of BSE
Fear that something may be found
Losing her sexual identity
Situation: The client is a 50-year-old female teacher who was notified of an abnormal screening mammogram. Diagnosis of infiltrating ductal carcinoma was made following a stereotactic needle biopsy of a 1.5 x 1.5 cm lobulated mass at the 3:00 position in her left breast. The client had a modified radical mastectomy with lymph node dissection. The sentinel lymph node and 11 of 16 lymph nodes were positive for tumor. Estrogen receptors and progesterone receptors were both positive. Further staging work-up was negative for distant metastasis. Her final staging was stage IIB. Her prescribed chemotherapy regimen is 6 cycles of CAF after a single-lumen central line was placed.
Masson devotes a more emotional appeal throughout the article, rather than offering confirmation to display that mammograms are not beneficial. She expresses reflection to show the reader her perspective and even contradicts herself in one aspect stating “If I should happen to discover a lump in my breast, I’ll have it evaluated. I’m not opposed to having a diagnostic mammogram” (Masson, 2010). This statement shows weakness within her argument and recognizes that there is potential in mammogram screening. Although relying on mammography is not the only primary diagnostic tool, it can however assist in the initial diagnostic process.
There are no symptoms at the early stages of breast cancer which makes early detection even more difficult. When tumors become large there is an obvious breast mass which is mostly not painful. Symptoms of breast cancer include breast thickening, skin irritation, tenderness, swelling, breast scales, distortion, redness tenderness, nipple retraction and ulceration, There may also be abnormal discharge.
The facts of the case were reviewed. In 2015, Ms. Heigle was diagnosed with breasts carcinoma, and had surgery in October 2015. Ms. Heigle has had radiation and some seromas. She was prescribed Tamoxifen, and in May 2016, Ms. Heigle had a hysterectomy.
The first issue I will address to Mrs. Thomas is how to manage the pain, because the problem really worsens her quality of life, it made her self care difficult to carry out, caused her feeling hopeless, dependent, distressed, fatigue, and losing appetite. Taking pain medications on time will keep the pain
These benefits included finding a doctor in the area. Few weeks after discussing and researching with her family, she finally decided to see the doctor. Mrs. Sofia then had to make an appointment with the doctor in order to do her physical and health history. During her physical exam, the doctor asked her if she does an annual self-breast exam once a month. Mrs. Sofia told the doctor that she never checks her breast and she do not know how to do a self-breast exam. Upon physical assessment the doctor found a large lump in Mrs. Sofia’s breast. The doctor orders a diagnostic mammogram that shows that the area of abnormal tissue (lesion) is more skeptical and a biopsy should be done in order to determine if it is
The Author reports that the new recommended age for mammograms, by the United States Preventative Services Task Force, has changed from 50 to 40 to reduce the harm from over screening and overtreatment. It also reports that self-breast examinations are no longer recommended on a regular basis. This recommendation comes from evidence that there are no major benefits of early screenings and that only “one cancer death is prevented for every 1,904 women” screened, age 40 to 49. Conversely, there is evidence that frequent early screenings can lead to overtreatment
Fortunately, her mother’s doctors were able to successfully remove all signs of cancer from her breast tissue.
Mrs. Ann Thompson has several signs of breast cancer that she has noticed herself. She has been doing regular breast self-examination and because of that, she has found a lump in her breast. Even though she may not have pain with the lump, which is a true characteristic of a malignant tumour. If she has discolouration/redness of the breast and thickening of the skin (depending on how far the cancer has grown), these are also signs of breast cancer. Ann also might have fatigue and weight loss due to the systemic pain or sickness that she might feel. There are many other signs that could be evident, but these are just a few that are most likely for Ann.
Breast cancer is a malignant tumor in the glandular tissues of the breast. Such tumors, also called carcinomas, form when the chemical processes that control normal cell growth break down, enabling a single abnormal cell to multiply at a rapid rate (Hickman). Carcinomas,
The results came in confirming a malignant tumor in my mother’s breast, and I knew her hopes had been crushed, but she remained strong. After the surgery, another biopsy established that the cancer was found on the outside of her tumor and also in her lymph nodes, so it was very possible that it could spread. She would need to get a mastectomy.
and the current data results that you identified better or worse? I feel that the case
Breast cancer is the most common type of cancer in women, it accounts for one of every three diagnoses in the United States. Breast cancers are malignancies, life threatening tumors that develops in one or both breasts.
Breast cancer has been acknowledged for centuries, with records dating as far back as the ancient Egyptians, over 3500 years ago (1). However diagnosis, research and progress throughout history have been slow due to it being a matter of taboo and humiliation. In 1957 the idea of surgically removing the tumours was suggested by Henri Le Dran, introducing mastectomy to the 20th century; the first scientific step in acting against cancer. Radical mastectomy lengthened survival, however was often declined due to the disfigurement left behind. To overcome this, Bernard Fisher published results from ‘breast conserving’ surgery accompanied by radiation or chemotherapy, which were ‘just as effective’ as a radical mastectomy (1).
According to the American Cancer Society, Each year, more than 200,000 women are diagnosed with breast cancer; furthermore Twelve percent of all women will contract the disease, and 3.5% of them will die from breast cancer (American Cancer Society, 2005). There are risk factors that may lead to breast cancer. There are 4 stages of breast cancer and several treatments, although treatments vary from types and stages of breast cancer. Breast cancer is the leading cause of death among women who are 40 to 55 years old (Breast Cancer, 2009).Cancer occurs when cells divide uncontrollably. It changes from a normal cell to cancerous cells that require gene alterations. Therefore the altered genes and the uncontrolled growth may lead to tumors.