Assignment task: M.D. is a 54-year-old woman whose routine mammogram showed a 2.3 cm x 4.5 cm lobulated mass at the 3:00 position in her left breast. She is married with no children and has a past medical history of fibroids is BRCA1 positive. M.D. underwent a stereotactic needle biopsy and was diagnosed with infiltrating ductal carcinoma that was both estrogen and progesterone receptor positive. The staging workup was negative for distant metastasis. Her final staging was stage IIB. She had a modified radical mastectomy with lymph node dissection. The sentinel lymph node and 11 of 16 lymph nodes were positive for tumor cells. An implanted port was placed during surgery. She is prescribed a chemotherapy regimen of six cycles of CAF cyclophosphamide Cytoxan, fluorouracil 5-FU, and doxorubicin Adriamycin.
1. What are M.D.'s risk factors for breast cancer List 4 and explain rationale.
2. Discuss the implications of a positive sentinel node.
3. What is the significance of her hormone receptor status
4. What is TNM staging. Using the TNM staging system, what would her classification be.
5. Surgical intervention is the primary treatment for breast cancer. Describe the surgical procedure that M.D. had.
6. M.D. asks you why she has to have chemotherapy with so many drugs if the surgeon removed all of the cancer. How would you respond.
7. M.D. is ordered doxorubicin at 75 mg/m2. Her height is 5 feet, 7 inches, and her weight is 155 pounds. Calculate the dose she will receive.