Breast Cancer 2 Case Study
Patient Profile
J.M. is a 46-year-old patient with breast cancer, who is undergoing a left modified radical mastectomy
for infiltrating ductal carcinoma. She has two children (G2, P2). She is a nonsmoker, and drinks one to
two glasses of wine per day. Her mother had breast cancer at age 65 years, and one sister was
diagnosed with breast cancer at age 48 years.
Preoperatively, she explains to the OR nurse how the cancer was found on her most recent
mammogram. She said that she had been experiencing some fullness in her breast but could not
definitively palpate a mass. She also explains that she chose the modified approach for surgery, as she is
planning on having breast reconstruction later.
Discussion Questions
1. What are differences in benign and malignant breast tumors? (25 points)
Benign breast tumors can include fibrosis, cysts, fibroadenomas, and intraductal
papillomas, and can sometimes be reabsorbed by the body without the need for
surgery. These are not cancerous usually, and are sometimes just lumps formed by the
body. Malignant tumors can include carcinoma, adenocarcinoma, carcinoma in situ,
invasive (infiltrating) carcinoma, and sarcomas. The malignant breast cancer can
cause inflammatory breast cancer and can spread to the rest of the body (metastasize).
2. What were J.M.’s risk factors for breast cancer?
Age, being female, having children, drinking, familial history, possibly dense breast
tissue due to the inability to palpate a mass.
3. Before her surgery, what nursing assessments and teaching would be important for J.M.?
Nursing Assessments – Monitor temperature, site integrity, ensure that the patient is
prepped for surgery, ensure that the proper site is documented for the surgery, assess
readiness to learn and her ability to cope post-op.
Teaching- The care of the surgical wound and dressing, how to monitor drainage and
take care of the drains, how to recognize signs of infection, bathing and showering after
surgery, when to call the doctor or nurse, when to begin using the arm and how to do
arm exercises to prevent stiffness, when to resume wearing a bra, what medications to
expect and how to take them, and reconstruction options and when they are available
4. Postoperatively, how does the nurse assess for lymphedema? What are some measures to
prevent or reduce it after J.M.’s surgery?
Assess- Swelling of part or all of the arm or leg, including fingers or toes, feeling of
heaviness or tightness, restricted range of motion, recurring infections, hardening and
thickening of the skin (fibrosis)
Prevent/Reduce- arm exercises, compressive bandages, prevent scratches, avoid tight
clothing, moisturize skin daily, avoid saunas and excessive heat (can incite swelling),
avoid blood draws and new tattoos in the affected area