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 Adenopothy noted.
When a patient presents with a breast lump, it’s crucial to take a detailed history to understand the potential risks and characteristics associated with the lump.
What are two questions you would ask this patient?
Duration and Changes: How long have you noticed the lump, and have you observed any changes in its size, shape, or associated pain?
Associated symptoms: Have you experienced any nipple discharge, skin changes (such as dimpling or redness) over the lump, or pain in the area?
What are two risk factors would you want to assess for?
Family history: Does she have a family history of breast or ovarian cancer, especially in first-degree relatives (like mother, sister, or daughter)?
Menstrual and Reproductive History: When did you have your first menstrual period, and did you have any children? (Earlier menarche and later age at first childbirth can be risk factors.)
What are the levels of prevention for this patient?
- Primary Prevention refers to actions taken before the disease process starts in order to stop the onset of illness (AbdulRaheem, 2023). For breast cancer, this might involve lifestyle modifications like a healthy diet, regular exercise, and limiting alcohol consumption. Additionally, chemoprevention (like tamoxifen) could be considered for high-risk individuals.
- Secondary Prevention involves early detection and prompt treatment to prevent disease progression. In the context of breast cancer, this includes breast self-examinations, clinical breast examinations by a healthcare provider, and screening mammograms. For this patient, she already practiced secondary prevention by performing a breast self-examination and seeking medical attention.
- Tertiary Prevention refers to managing and treating the disease to prevent complications and improve quality of life. Consider this patient’s lump is diagnosed as malignant. In that case, she might undergo surgery, chemotherapy, radiation, targeted therapies, follow-up care, and monitoring to prevent recurrence and manage side effects.
After assessing the patient’s age and the characteristics of the lump, further evaluation, such as imaging with a diagnostic mammogram and ultrasound and possibly a biopsy, may be needed to determine the nature of the lump.