Breast Cancer Case Study
Luis F Vega Jr
NUR 1211
Breast Cancer Case Study
Mrs. Thomas, a 57 year old married lawyer, was found to have a 4 X 6 cm firm, fixed mass in the upper, outer quadrant of the right breast during a routine physical examination, and a stereotactic core biopsy indicated a malignant tumor. Although the surgeon recommended a mastectomy because of the size of the tumor, Mrs. Thomas chose to have a lumpectomy. Now three weeks postoperative, she is scheduled for chemotherapy.
Subjective Data
Never had a routine mammogram
Never practiced Breast Self-Examination (BSE)
States she deserves to have breast cancer for being so careless about her health
Chose to have a lumpectomy to remove the tumor despite its large size because she believes that her breasts are critical in her relationship with her husband
Objective Data
Physical examination:
Right breast: Healed lumpectomy breast incision and right axiliary incision
Limited ROM of right arm
Groshong broviac catheter in place on left upper chest
Diagnostic studies
Pathology: Estrogen receptor-positive infiltrating ductal carcinoma; 8 of 12 lymph nodes positive for malignant cells
Staging: Stage IIIB carcinoma of the right breast
Clinical course
Lumpectomy performed to remove tumor 3 weeks ago
Chemotherapy with CAF protocol planned – cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), and 5-fluorouracil (5-FU)
1. Why is chemotherapy indicated for Mrs. Thomas? It is indicated for Mrs. Thomas as adjuvant treatment and may help reduce the chance of breast cancer recurrence.
2. Compare the three chemotherapeutic agents planned for Mrs. Thomas with respect to classification type, cell specificity and common side effects?
1) Cyclophosphamide (Cytoxan)
Alkylating agent
DNA replication
Side effects – low blood counts, hair loss, n&v, loss of fertility, discoloration of the skin or nails
2) Doxorubicin (Adriamycin)
Anthracycline antibiotic
Intercalating DNA side effects – Pain (med site), n&v, low
NUR 1211
Breast Cancer Case Study
Mrs. Thomas, a 57 year old married lawyer, was found to have a 4 X 6 cm firm, fixed mass in the upper, outer quadrant of the right breast during a routine physical examination, and a stereotactic core biopsy indicated a malignant tumor. Although the surgeon recommended a mastectomy because of the size of the tumor, Mrs. Thomas chose to have a lumpectomy. Now three weeks postoperative, she is scheduled for chemotherapy.
Subjective Data
Never had a routine mammogram
Never practiced Breast Self-Examination (BSE)
States she deserves to have breast cancer for being so careless about her health
Chose to have a lumpectomy to remove the tumor despite its large size because she believes that her breasts are critical in her relationship with her husband
Objective Data
Physical examination:
Right breast: Healed lumpectomy breast incision and right axiliary incision
Limited ROM of right arm
Groshong broviac catheter in place on left upper chest
Diagnostic studies
Pathology: Estrogen receptor-positive infiltrating ductal carcinoma; 8 of 12 lymph nodes positive for malignant cells
Staging: Stage IIIB carcinoma of the right breast
Clinical course
Lumpectomy performed to remove tumor 3 weeks ago
Chemotherapy with CAF protocol planned – cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), and 5-fluorouracil (5-FU)
1. Why is chemotherapy indicated for Mrs. Thomas? It is indicated for Mrs. Thomas as adjuvant treatment and may help reduce the chance of breast cancer recurrence.
2. Compare the three chemotherapeutic agents planned for Mrs. Thomas with respect to classification type, cell specificity and common side effects?
1) Cyclophosphamide (Cytoxan)
Alkylating agent
DNA replication
Side effects – low blood counts, hair loss, n&v, loss of fertility, discoloration of the skin or nails
2) Doxorubicin (Adriamycin)
Anthracycline antibiotic
Intercalating DNA side effects – Pain (med site), n&v, low