CASE STUDY 32 - Beth Calloway

Mrs. Beth Calloway, 47 years old, discovered a lump in her right breast. Mrs. Calloway is in good health with no previous hospitalizations or surgeries. She does not smoke or drink, watches the fat content of her diet, and walks about 2 miles each day. Her family history is positive for breast cancer; her mother and maternal grandmother were diagnosed with this disease before 55 years of age.
Mrs. Calloway discovered her breast lump while performing her monthly breast self-examination. She immediately brought it to the attention of her nurse practitioner who, on examination, located a 2- to 3-cm (about 1-inch) mass in the 3 o'clock position of the right breast. This mass felt firm, was well fixed to the chest wall, and was tender to the touch. No skin discoloration, nipple retraction, or drainage was identified. A pea-sized lymph node was located in the right axilla. After examination, the nurse practitioner ordered a mammogram and ultrasound of the breast. Results confirmed a solid mass, 3 cm large, located in the right breast plus a 2-cm–sized lymph node in the right axilla. Mrs. Calloway was immediately referred to a surgeon who ordered a biopsy.

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