Posted: Nov 16, 2018
Women breasts undergo several normal and healthy changes, but many of them lack a clear understanding of them. It is the mandate of the care provider to examine the patients properly to identify when a change is a result of a normal or abnormal cause that requires treatment and management. The diagnosis of a breast condition arising from an abnormal change is traumatizing for women. The Essay provides a discussion of how to diagnose, manage, and support a patient with certain breast conditions.
The selected case study is;
Case Study 1:
You are seeing a 60-year-old Latina female, Gravida 4 Para 3104, who is concerned about a thick greenish discharge from her left breast for the past month. The discharge is spontaneous and associated with dull pain and burning. Upon questioning, she also tells you that she breastfed all her children and is currently not on any medications except for occasional Tylenol for arthritis. Her last mammogram, 14 months ago, was within normal limits. On exam, her left breast around the areola is slightly reddened and edematous. Upon palpation of the right quadrant, a greenish-black discharge exudes from the nipple. You note an ovoid, smooth, very mobile, non-tender 1 cm nodule in the RUIQ at 11:00 5 cm from the nipple. No adenopathy, dimpling, nipple discharge, or other associated findings. Her right breast is unremarkable. The patient expresses her desire to decrease her risk of developing breast cancer proactively.
The differential diagnosis for the patient is unusual nipple discharge and abnormal mammogram. Nipple discharge involves the release of a colored discharge from the nipple, but it is not a precursor to breast cancer (Tharpe, Farley & Jordan, 2013). An abnormal mammogram is the experiencing of non-routine results for the breast health checks. The most likely diagnosis for the patient is unusual nipple discharge described by the color, consistency, and mode of release of the fluid (Schuiling & Likis, 2013). The patient experiences thick greenish discharge which is spontaneous and associated with pain and burning from one nipple. As such, her discharge is abnormal.
The most preferred method of treatment is the removal of the lump by use of a biopsy procedure since the lump is benign. It helps to remove the mobile lump from the breast to avoid the reddening and discharge. The patient requires understanding that she does not have a diagnosis of breast cancer, but should take preventive measures against any occurrence of the disease. The best method for educating the patients about the disorder is the use of sensitization programs in the community on the need for early screening of any disorder. They can also acquire the information from print materials and the media that target a large population.
Schuiling, K. D., & Likis, F. E. (2013). Women’s Gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers. Chapter 16, "Breast Conditions" (pp. 377–401)
Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical Practice Guidelines for Midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers. "Care of the Woman with Nipple Discharge" (pp. 396–399)
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