CAP302: Case studies-Medical Science Assignment Help

Breast Cancer

Mrs. Whitney 42-year-old female (Fitzpatrick III) who sees you for advice regarding skin care around her upcoming breast cancer removal and possible chemotherapy treatment. Mrs. Whitney has had a diagnostic mammogram and a fine-needle aspiration biopsy. It is determined that she has invasive Ductal Carcinoma stage II B, with tumour size approx. 30mm. Mrs. Whitney is now scheduled to have a lumpectomy (partial mastectomy) with sentinel lymph node dissection, in six weeks at her local hospital.

History

Mrs. Whitney noticed a lump in her left breast during her breast self-exam about a year ago.
Because she has been healthy, she assumed it was nothing and ignored it. Recently it appeared to get bigger, finally seeing a doctor about it.

Told that she may also need systemic chemotherapy post-surgery, every three weeks for approx. two months.

Mrs. Whitney’s oldest sister died of breast cancer when 60 after being diagnosed with stage two lymphoedema of left arm.

Consultation

Client appears healthy although somewhat overweight.

On questioning, Mrs Whitney is not aware of BRCA1 or BRCA2 gene testing and you suggest having such a test.

She asks you to interpret her blood laboratory tests which show:
WBC (4.5–11.0 mm 3) 0.5: Platelets (150-450 x103/?l) 22: Neutrophil % (42–72) 22

Medications

Tamoxifen started two weeks ago – can’t remember why and asks you about it

Social-psyco

Mrs. Whitney began having her menstrual period at 10 years of age.
Married for 20 years living with husband and two female children, (ages 22 and 18 years old) both of whom she breastfed for approximately six months.

Home care:

Has basic skin care of cleanser and moisturiser once daily.

Sometimes uses sunscreen when at the beach – not daily use.

Questions

1. What factors placed Mrs. Whitney at greater risk for the development of breast cancer? Discuss the risk factors associated with Mrs. Whitney.
2. Define in detail the preoperative care two weeks prior to surgery and the post care treatment proposed for this client.
3. Why did you suggest she have a test for the BRCA gene?
4. What could you say regarding her blood laboratory tests she has asked you about
5. Explain what lymphedema is, the chances of developing lymphedema, and its manifestations
6. What could you say regarding why tamoxifen is prescribed prior to surgery

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