Journal Week 6
There was a recent patient that came in to establish care with my preceptor. The patient had scheduled the appointment for her annual pap and breast exam. The patient reported her mother had breast cancer in the left breast – had a mastectomy. The patient’s mother did not have her right breast removed at that time and did end up having breast cancer in the right breast 2 years later – had a right mastectomy. The patient reported she tested positive for the BRCA 1 and BRCA 2 gene and opted for a double mastectomy with reconstruction 30 years ago. The patient has mammograms twice a year with a physician in Dallas, TX. The patient reports she has two daughters, one of which tested positive for the BRCA gene and has had double mastectomies with reconstruction. The patients other daughter tested negative for the BRCA gene but continue with annual pap and breast exams. The patient reports she does do breast self-examinations daily and encourages her daughters to perform them as well. The patient was well aware of her risk for developing breast cancer since her mother had been diagnosed with breast cancer and treated.
In the U.S. the typical woman has a 12 percent, or 1 in 8, risk of developing breast cancer (Breastcancer.org, 2017). The risk of developing breast cancer increases to 80 percent with women who have an abnormal BRCA 1or BRCA 2 gene mutation (Breastcancer.org, 2017). Having abnormal BRCA 1 and BRCA 2 genes increases the risk of ovarian, colon, and pancreatic cancers too (Breastcancer.org, 2017). Women who chose to have double mastectomies may reduce their chance of developing breast cancer by 97 percent (Breastcancer.org, 2017). Removal of the ovaries and fallopian tubes also decreases the risk of developing breast cancer by 50 percent (Breastcancer.org, 2017).