Case study | adult health

Breast Cancer

R M. is a 72-year-old female who went to her health care provider with a complaint of “feeling tightness” around a lump in her right breast. She has a history of hypertension and smoking (25 pack-year history).

Subjective Data

• Has a family history of breast cancer-one sister recently had lumpectomy and radiation therapy. Mother and aunt died from breast cancer when they were in their 60s.
• Has had history of “lumpy” breasts, but this lump feels “different”
• Says she cannot quit smoking because of all of the stress in her life. Her husband recently left her, and she has not seen her two daughters in more than 6 months.
• She spends most of her time watching TV

Objective Data

Physical Examination

• 5’9”, 205 lb
• Blood pressure 165/100, pulse 76, respirations 20, temperature 98.8°F
• Palpable mass in right breast in upper outer quadrant

Diagnostic Studies

• Bilateral mammogram and ultrasound of right breast

Case Study Progress

R.M. goes to her follow-up visit and is told that the mammogram and ultrasound show a 4-cm mass. She undergoes a core needle biopsy. The results indicate that the mass is infiltrating lobular carcinoma. She undergoes a lumpectomy and axillary lymph node dissection. Six of 15 axillary lymph nodes are positive for cancer. Two weeks after surgery, she is being seen to discuss further treatment options.