Case Study 7.1 M.T is a 65-year-old Hispanic woman who underwent a mammogram off
ID: 152197 • Letter: C
Question
Case Study 7.1 M.T is a 65-year-old Hispanic woman who underwent a mammogram offered by a com nity "health on wheels" clinic. The radiolo detected a breast mass on the right side. She h younger sister who had breast cancer as wel sister died 2 years ago at the age of 62. M.T ses began at age 11 and cessation of menst occurred around age 58. She is overweight on estrogen replacement therapy. She does have any children. recently has a . Her .s men- enstruation is 1. Outline the process that has occurred in her boo y. 2. What were the risk factors that she demonstrated? 3. What would you expect for clinical manifesta- tions? 4. What additional diagnostic tests could be used? 5. What treatment measures would you anticipate? Log on to the Internet. Search for a relevant journal article or Web site (such as www.cancer.govl cancertopics/pdq/genetics/breast-and-ovarian/ healthprofessional) that details breast cancer to con- firm your predictions.Explanation / Answer
1. As her sister had breast cancer as well and about 5-10% cases of breast cancer are linked to gene mutations passed through gerneration of family.
The most well known inherited mutated genes that increases the likelyhood of breast cancer and ovarian cancer are BRCA1 (Breast cancer gene 1) and BRCA 2 (Breast cancer gene 2).
So she must have got some mutations in the BRCA1 and BRCA 2 genes which are passed from one generation to another if there is a family history of cancer.
2.The risk factors were -
3. The clinical manifestations would include -
4. In addition to mammogram, ultrasound could be used that makes a picture of breast tissue known as sonogram.It helps in distinguishing if the solid mass is a tumor or benign cyst (fluid filled lump).
MRI (magnetic resonance imaging) can also be used to take detailed pictures of areas inside breast.MRI can sometimes detect breast lump or large lymph nodes that were missed by mammogram or ultrasound.
Besides this, breast biopsy can also be done in which a small sample of breast cells or tissue or entire lump is removed to check for signs of disease. It is used to find out if the cells are cancerous.
5. Treatment for breast cancer - The treatment depends on the stage of cancer and may involve surgery, chemotherapy,radiation or hormone therapy.
-Surgery :
-Radiation :
- External beam in which the radiation comes from a machine outside the bosy
-Internal radiation (branchytherapy) in which the radioactive source is put inside the body for a short time
-Chemotherapy : Kills cells that are growing or multiplying too quickly.It uses anti-cancer drugs to be given either after surgery to remove any cancer cells that are left or before surgery to shrink the tumour so it can be removed with less extensive surgery.
Example include - Anthracyclines, taxanes , 5-fluorouracil
-Hormone therapy : It is used post surgery to reduce the risk of the cancer coming back. e.g Tamoxifen is used to block estrogen receptors on breast cancer cells and stops them from growing and dividing.
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