A 32-year-old female presents for an evaluation of a lump in her right breast that she found on breast self-examination. The lump is found to be 2cm in size, firm, and mobile. No Adenopathy noted.

What are two questions you would ask this patient?

One of the first questions I would ask the patient is the onset of symptoms. For example, I would ask the patient when she first noticed the lump. The second question I would ask is if the patient has noticed any change in the size, shape, or pain level of the lump over time. A good method of gathering information about the patient’s symptoms would be utilizing OLDCARTS in order to gather as much subjective data from the patient as possible to order the appropriate testing and reach the correct diagnosis. Gathering information about the patient’s social and family history in this case is also important since lumps such as this can vary in size with hormonal changes due to the patient’s menstrual cycle, or can be cancerous, therefore knowing if the patient has a family history of cancer is an indication for early testing and preventative measures (Hodgson &Turashvili, 2020). A study by Łukasiewicz et al., (2021). Shows approximately 13–19% of patients diagnosed with breast cancer report a first-degree relative affected by the same condition, and the risk might be even higher when the affected relatives are under 50 years old.

What are two risk factors would you want to assess for?

The two risk factors I would assess this patient for would include hormonal changes and breast density. Hormone levels in women tend to fluctuate during certain periods of time, including during menses, pregnancy, and menopause. Thus, bringing about physical changes in the body, including the breasts. With age, the breasts become susceptible to genetic mutations, which can lead to cancer. Additionally, experts believe that exposure to estrogen, which adds up over a lifetime, can cause cancer to develop in some women. Several studies regarding the risk of exogenous hormones and breast cancer revealed that the combination of progestins and estrogen increased the risk of breast cancer compared with the effects of estrogen alone (Łukasiewicz et al., 2021).

Additionally, there is a large correlation between breast tissue density and the development of cancer, meaning, the greater the density, the higher the risk of developing breast cancer. This is true for both women in the premenopausal and postmenopausal states. Studies also suggest that breast tissue-density screening could be a promising, non-invasive, and quick method enabling rational surveillance of females at increased risk of cancer (Łukasiewicz et al., 2021).

What are the levels of prevention for this patient?

Primary prevention for this patient will include living a healthy lifestyle by incorporating a healthy diet low in fat, exercising daily, and refraining from smoking will reduce the development of memory gland cancer and decrease morbidity and mortality rate. Secondary prevention will include diagnostic testing such as mammography, ultrasonography, MRI, and breast self-examination to aid in early detection and treatment (Łukasiewicz et al., 2021).


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