This case study presents a scenario involving a 53-year oldAfrican American female patient who has unusual hyperplasia, and someof her family members had suffered from breast cancer. Even thoughthe patient rarely attends cancer screening, she is less likely to besuffering from breast cancer. However, she has a higher chance todevelop breast cancer as per her previous medical history.Furthermore, going by the family history of this woman, it is clearthat she stands a high risk of getting breast cancer. It is possibleto quantify the cancer dangers she faces using Gail model (Schuiling& Likis, 2013). The model takes into account first live birth,patient’s current age, last breast examination, family history, andage at first menarche (Perry et al., 2012). Ductal hyperplasiais critical in identifying breast cancer development with somedifficulties of being distinguished from DCIS. A condition likeLobular carcinoma-in-situ (LCIS) contains ductal hyperplasia, but itmarks a substantially increased threat to patients as can lead to thedevelopment of breast cancer. Patients who had a mammographicultrasound examination need to develop an advanced risk mitigation toavoid getting breast cancer.
Current consensus recommends patients with symptoms such asthese portrayed by this woman to be examined for breast cancerregularly with frequent visits to a specialized breast center. Thispatient should continue with annual mammography though may alsoconsider the use of screening MRI so as to make the results moreprecise. Also, Tamoxifen or raloxifene may be recommended for heruse. Furthermore, model like Tyrer-Cuzick can be used to estimate thelevel of risk exposed to this woman since she has LCIS (Perry et al.,2012). The physician may examine the possibility of BRCA 1 or BRCA 2gene mutation basing on the patient`s family history (Tharpe etal., 2013). Though the patient is not young, genetic testing isnecessary because of her family cancer history. Carriers of the BRCAgene mutation have a 50-80% chance to develop breast cancer in theirlifetime (Perry et al., 2012). Such women need to considerincreased surveillance or early mastectomy. For this patient, abiopsy may be relevant specifically fine needle aspiration (FNA) asit leaves no scar. With ultrasound, guided biopsy when used willguide the needle to the right direction and eventually determine therisk of cancer development to the patient after examination. As aresult of lump presence within the breast, the radiologist can have atissue to examine. Description of biopsy to the particular patientwill be necessary as the pathological report will be availableexplaining the content of the sample hence finer details will beavailable on whether the patient is at risk of developing breastcancer.
An annual MRI screening is deemed for BRCA mutant patients orwith hereditary breast and ovarian cancer as per recommendations fromU.S Cancer Society (Schuiling & Likis, 2013). MRI screening isalso useful even to those women with no family history of cancerpatients. The patient also needs to make decisions concerning testingor take preventive surgery to reduce chances of developing breastcancer. The patient needs a positive verbal interaction withencouragements to have an attitude focused basically on the treatmentas an excellent follow-up care. Provision of supportive staff tooffer help and training the patient on effective communication mayresult in better understanding and improved health.
Perry,N., Broeders, M., De Wolf, C., Törnberg, S., Holland, R., & VonKarsa, L. (2012). European guidelines for quality assurance inbreast cancer screening and diagnosis. — Summary document. Annalsof Oncology, 19(4),614-622.
Schuiling,K. D., & Likis, F. E. (2013). Women’s gynecologic health (2ndEd.). Burlington, MA: Jones and Bartlett Publishers.
Tharpe,N. L., Farley, C., & Jordan, R. G. (2013). Clinical practiceguidelines for midwifery & Women’s health (4th Ed.).Burlington, MA: Jones & Bartlett Publishers.