Case Study
CM is a 43-year-old female who presents with concerns regarding two painless right-breast lumps that she detected four months ago. She missed an appointment for evaluation by her primary-care provider at that time and presents today with reportedly no change in these findings since that time. There has been no breast discharge, bleeding, overlying skin changes, lymphadenopathy, or fevers; she denies recent or past breast trauma. She did, however, undergo a stereostatic breast biopsy three years ago that demonstrated atypical lobular hyperplasia, and there is a known family history of breast cancer (mother, diagnosis at age 48). Current review is significant for a 10-pound weight loss due to diminished appetite over the last two months. Amenorrheic x three years; no current hormonal-replacement therapy or previous oral-contraceptive use; had levonorgestrel implantation at age 28, removed at age 33 and has only used condoms since, but nothing now as she is not sexually active.
This case is meant to highlight indications for breast-cancer screening and to outline the standard evaluation of a female who presents with a breast mass.
After completing your Case Study and reviewing the guidelines for breast-cancer screening, answer the following questions using the latest evidenced based guidelines:
Discuss the questions that would be important to include when interviewing a patient with this issue, including any risk factors she may have.
1. Describe the clinical findings that may be present in a patient with this issue.
2. Are there any diagnostic studies that should be ordered on this patient? Why?
3. List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.
4. Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.
Please make sure you are using scholarly references and they should not be older than 5 years. Your posts/references must be in APA format.
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