Week 4 Breast Cancer Case Study 

Week 4 Breast Cancer Case Study 

Week 4 Breast Cancer Case Study 

Cancer is one of the non-communicable diseases with high prevalence and incidence globally. The burden of disease due to cancer is enormous for patients and their families. Effective treatment of cancer prolongs the lives of the patients. Therefore, this paper explores breast cancer. It explores its pathophysiology, diagnostic testing and implications of the lessons learned from the activity to the practice by a master’s prepared nurse.

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Description of the Disease

The selected cancer for this assignment is breast cancer. Breast cancer refers to a malignancy that begins in the cells of the breasts. Risk factors such as age, gender, family history, histological factors, reproductive factors, and use of exogenous hormones predispose patients to breast cancer. Often, DNA damage as well as gene mutations occur following the exposure of the patients to estrogens, inducing the development of breast cancer. The inheritance of gene mutations such as BRCA1 and BRCA2 also causes breast cancer in individuals with family history of the disease (Alkabban & Ferguson, 2021). Breast cancer occurs in tissues that include the lobular epithelium and ductal epithelium. Most of the cancers originate from the ductal epithelium, with minor arising from the lobular epithelium. Patients with breast cancer present to the hospital with a range of signs and symptoms. They include changes in the texture and look of the nipple, nipple discharge, palpable breast mass, irregularity in breast tissues, thickening of breast tissues, and unexpected weight loss (Wang, 2017). Patients may also report breast pain and changes in the shape of the breast.

Diagnostic Testing

Wide ranges of diagnostic testing interventions are utilized for breast cancer. One of them is mammography. Mammography is a radio-imaging technique that utilizes low-dose ionizing x-rays to provide detailed images of the tissue of the breast. Mammography has sensitivity ranging between 75 and 90% with specificity of 90-95%(He et al., 2020). The other imaging modality is magnetic resonance imaging (MRI). MRI uses low-energy radio waves as well as strong magnets to provide detailed images of the breast structures. The method has sensitivity of 75-100% and specificity of 83-98.4%. It has enhanced ability to detect malignancies of the breast that cannot be identified using mammography. The radio imaging technique is dynamic contract enhanced MRI, which takes multiple MRI scans. The technique is applicable for monitoring patient’s response to therapy. Diffusion weighted imaging is also used where non-radioactive imaging is required. There is also MR elastography (MRE) which is non-invasive in nature providing cross-sectional imaging of the breast structures. Ultrasound is also done to visualize the lesions in the breast tissue. Besides radio imaging, biopsy is also used in the diagnosis of breast cancer. Biopsy entails the removal of breast tissue for examination of breast cells (Wang, 2017). The last diagnostic investigation is physical examination of the breast and lymph nodes of the armpit to determine any abnormalities such as lumps and lymphadenopathy.

Evidence-Based Treatment Modalities

The existing evidence shows that several classes of drugs can be utilized in the treatment of breast cancer. One of the utilized drugs is tamoxifen. Tamoxifen is an anti-estrogen that produces its actions by partially blocking estrogen uptake by estrogen receptors. It reduces the risk of recurrence of breast cancer by half (Chan et al., 2017). Aromatase inhibitors are another group of drugs used in breast cancer. They work by blocking estrogen production in postmenopausal women and the conversion of androgens into estrogen for estrogen depletion. The examples of aromatase inhibitors include aminoglutethimide (first-generation), vorozole, and fadrozole (second-generation) (Chan et al., 2017). The other class of drugs is luteinizing hormone releasing hormone analogs such as leuprolide and goserelin, which act by suppressing the production of luteinizing hormone by the ovaries (Exman et al., 2019). The other class comprises of the selective estrogen receptor degrader such as fulvestrant used in cancer models that are resistant to tamoxifen.

Surgery is the other treatment approach for breast cancer. Surgery provides effective local control of solid tumors in breast cancer. Radiotherapy is also used in breast cancer treatment. Radiotherapy is effective in reducing the risk of breast cancer recurrence by up to 50% in 10 years and breast cancer mortalities by about 20% at 15 years (Tong et al., 2018). It is highly indicated in large tumors more than 5 cm and cases of positive lymph nodes (Tong et al., 2018). It is also used in cases of advanced breast cancer involving bones and the central nervous system.

Effect on Master’s Prepared Nurse

The information in this case informs the practice of a master’s prepared nurse in a number of ways. It strengthens the understanding of the master’s prepared nurse about the different treatment options for patients with breast cancer. The nurse has enhanced understanding of the different options they can consider to optimize the treatment outcomes in breast cancer patients (Chan et al., 2017). The information also informs the health education that the master’s prepared nurse will provide to patients and their families on the signs and symptoms as well as the management of breast cancer.

Use by Information

The master’s prepared nurse will use the information in this assignment in designing patient education session with a patient with breast cancer. The nurse will design an educational poster with the basics of breast cancer such as risk factors, signs and symptoms using the information. The nurse will also use the information in guiding the patient on self-management of breast cancer. The nurse will also use the information in educating the patient about the various treatment options that are available for breast cancer. They will also use the information to guide the patient in making an informed decision about the needed treatment and the anticipated outcomes. Through it, the understanding of the patient will improve significantly.

Most Important Information Presented In This Case

The most important information presented in this case includes that related to pathophysiology, signs and symptoms and evidence-based treatment of breast cancer. The information is the most important, as it can be used to create awareness among the public and healthcare providers on breast cancer. The information can also be used in determining the appropriate treatment plans as well as patient education.

Most Confusing Information Presented In This Case

The most challenging information presented in this case relates to the different classes of cancer medications. Nurses and other healthcare providers should have adept knowledge about the indications for use of the different drugs in breast cancer, hence, challenging when the information is presented in brief.

Patient Safety Issue

One of the patient safety issues that patients with breast cancer may experience is the side effects of medications. Despite being effective, cancer drugs may have adverse effects on the health of the patients. For example, the use of tamoxifen is associated with the risk of endometrial cancer stroke, and blood clots (Moon et al., 2017). Therefore, the risk should be addressed by weighing the benefits versus the risks of tamoxifen prior to its initiation in breast cancer treatment.

Conclusion

Overall, breast cancer is a critical health concern. Patients and populations at risk should be informed about the signs and symptoms of breast cancer. The treatment modalities for breast cancer include chemotherapy, surgery, and radiotherapy. A master’s prepared nurse should be well informed about the treatment options for breast cancer. Most importantly, safety of the selected treatments should be prioritized.

References

Alkabban, F. M., & Ferguson, T. (2021).Breast Cancer.In StatPearls.StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK482286/

Chan, C. W. H., Law, B. M. H., So, W. K. W., Chow, K. M., &Waye, M. M. Y. (2017).Novel Strategies on Personalized Medicine for Breast Cancer Treatment: An Update.International Journal of Molecular Sciences, 18(11), 2423. https://doi.org/10.3390/ijms18112423

Exman, P., Barroso-Sousa, R., &Tolaney, S. M. (2019).Evidence to date: Talazoparib in the treatment of breast cancer.OncoTargets and Therapy, 12, 5177–5187. https://doi.org/10.2147/OTT.S184971

He, Z., Chen, Z., Tan, M., Elingarami, S., Liu, Y., Li, T., Deng, Y., He, N., Li, S., Fu, J., & Li, W. (2020).A review on methods for diagnosis of breast cancer cells and tissues.Cell Proliferation, 53(7), e12822. https://doi.org/10.1111/cpr.12822

Moon, Z., Moss-Morris, R., Hunter, M. S., & Hughes, L. D. (2017). More than just side-effects: The role of clinical and psychosocial factors in non-adherence to tamoxifen. British Journal of Health Psychology, 22(4), 998–1018. https://doi.org/10.1111/bjhp.12274

Tong, C. W. S., Wu, M., Cho, W. C. S., & To, K. K. W. (2018).Recent Advances in the Treatment of Breast Cancer.Frontiers in Oncology, 8, 227. https://doi.org/10.3389/fonc.2018.00227

Wang, L. (2017). Early Diagnosis of Breast Cancer.Sensors, 17(7), 1572. https://doi.org/10.3390/s17071572

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The purpose of the case study is to have you expand upon the pathophysiological disease process by searching for evidence-based practice treatment and advanced practice nursing role implications related to the disease.

Case Study Topic:

Select a type of cancer (breast, lung, prostate, or colon cancer, melanoma, or any type of leukemia) and discuss the relationship of the disease process to the immune system.

Identify current evidence-based treatment modalities for the selected cancer and discuss how the treatment impacts the disease process.

Conduct an evidence-based literature search to identify the most recent standards of care/treatment modalities from peer-reviewed articles and professional association guidelines (www.guideline.gov (Links to an external site.)). These articles and guidelines can be referenced, but not directly copied into the clinical case presentation. Cite a minimum of three resources.

Include the following in your clinical case presentation:

A discussion the pathophysiology of the disease, including signs and symptoms
An explanation of diagnostic testing and rationales for each
A review of different evidence-based treatment modalities for the disorder obtained from guideline.gov or a professional organization such as thyroid (Thyroid society), OB-GYN (ACOG), urology (AUA), etc.
Next, address the following questions:

How does the information in this case inform the practice of a master’s prepared nurse?
How would the master’s prepared nurse use this information to design a patient education session for someone with this condition?
What was the most important information presented in this case?
What was the most confusing or challenging information presented in this case?
Discuss a patient safety issue that can be addressed for a patient with the condition presented in this case.