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Mrs. B is a 52 year old female that has recently been diagnosed with breast cancer. Her mother died of breast cancer at 43 years of age. Mrs. B. has 3 daughters, all were born when Mrs. B was in her 20s. When further assessing Mrs. B., you find that she took oral contraceptive for 10 years from age 28 to 38 and that she was receiving estrogen replacement therapy after going through menopause at age 48. Alcohol intake for Mrs. B includes 2 glasses of wine 2 times each week. Mrs. B. does not exercise.
On physical exam Mrs. B has a single lump in the right upper quadrant of her right breast with 2 enlarged axillary lymph nodes on the right side. The lump is approximately 4 cm and painless. In addition, Mrs. B has an inverted nipple in the right breast.
1. Discuss Mrs. B.'s development of breast cancer and her risk factors.
2. What is the risk of breast cancer in her daughters?
3. Explain the mechanisms involved in the development of familial breast cancer due to BRCA1?
4. Explain why the signs and symptoms in Mrs. B. are more likely to be associated with breast cancer than fibrocystic disease?
5. What treatment would you expect Mrs. B to receive for her breast cancer?
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