Please respond to at least 2 of your peerâ€™s posts. To ensure that your responses are substantive, use at least two of these prompts:
- Do you agree with your peersâ€™ assessment?
- Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
- Share your thoughts on how you support their opinion and explain why.
- Present new references that support your opinions.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the studentâ€™s position.
A 32-year-old female with a lump on her right breast, found during a self-breast examination is seen in the office for evaluation of the lump which is firm, mobile, and measures 2 cm with no adenopathy present. I would ask the patient about pain and tenderness. If there is a pain when did the pain start? Where is the pain located? Is the pain generalized? I would also ask the patient how long ago she first noticed the lump, and if there have been any changes since she noticed the lump? Ectopic breast cancer is accountable for 0.3-0.6% of all breast cancers and may remain undetected, as it is often confused with other lesions such as subcutaneous lipoma. So, microscopic pathology should be completed (Thasanabanchong & Vongsaisuwon, 2020). Finally, I would ask this patient about any family history of breast cancer. The strongest risk factor for breast cancer in women is increasing age, and first-degree family members diagnosed with breast cancer (Bickley, 2021). In addition to family history, the age of menarche is also a risk factor. An earlier age of menarche has been associated with premenopausal and postmenopausal breast cancer due to greater exposure to endogenous hormones. The levels of prevention for this patient are Primary- which is centered around lifestyle changes to avoid risks of cancer. Secondary- which is the level the patient is in right now. Where diagnostic tests and early detection are the focus. The last level is Tertiary- this level focuses on reducing long-term suffering.
What are two questions you would ask this patient:
The first thing to ask this patient will be if she is pregnant because of her age and if not pregnant if she is taking a birth control pill or contraceptive pills.
Secondly will use SOCRATES which means site, onset, characteristics, does it radiate, any associated symptoms such as discharges, or pain, any fever, any weight loss or enlarged lymph nodes or lymphadenopathy, and history of age at onset of the first menstrual cycle
The third will conduct a comprehensive assessment that involves the family history of breast cancer or any form of cancer in the family including any surgeries to the breast or any lesions or mass.
What are two risk factors would you want to assess?
The most notable risk factor is a family history of breast cancer in a first-generation relation such as a parent, or sibling, especially if cancer occurs in a premenopausal woman.
The second risk factor is the use of hormonal pills or contraceptive estrogen alone or combined with progesterone is a higher risk although per research further research is needed on this risk factor.
What are the levels of prevention for this patient?
Because cancer is not a single disease but a group of related dx such as genes, lifestyle, and environment around us works together to increase or decrease the risk of getting cancer. The best levels of prevention for this patient include:
Early detection and self-breast examination monthly is the best prevention and for family history will recommend early mammogram and elective surgery for a strong family history of cancer.
Avoid the use of post-menopausal and hormonal therapy.
Staying active, and healthy, and avoiding things that have been noted to increase the chances of cancer such as drinking alcohol, smoking, caffeine, and exposure to radiation such as frequent x-rays.