Chiong - Clinical Pharmacy Breast Cancer
Chiong - Clinical Pharmacy Breast Cancer
Chiong - Clinical Pharmacy Breast Cancer
Chiong
BS Pharmacy 3
1.b. Given this clinical information, what is this patient’s clinical stage of breast cancer?
- The stage of breast cancer in this patient’s clinical is stage 3. In stage 3, the
tumor is 2 cm in diameter and has begun to spread to adjacent lymph nodes. In
this patient’s information for her left breast, “Notable for a 2.5-cm mass at the 6
o’clock position, approximately 3 cm from the nipple margin, not fixated to skin;
no nipple retraction or discharge is visualized; the massis exquisitely tender to
palpation; 1.5 cm, nontender, palpable mass in the axilla noted.”
2.b. What is the prognosis for this patient based on tumor size and nodal status?
- Breast cancer that has spread to lymph nodes is more likely to recur and has a
worse prognosis than breast cancer that has not gone to any lymph nodes. The
number of cancerous lymph nodes is also significant. The more positive lymph
nodes there are, the more likely it is that breast cancer will recur. In this patient’s
case stated “Suspicious lymph nodes are noted in the axilla. The largest node
measures 1.8 1.8 1.4 cm”. Also, Left axillary lymph node: metastatic
adenocarcinoma consistent with breast primary and Left infraclavicular lymph
node: metastatic adenocarcinoma consistent with breast primary.
2.c. In addition to the stage of disease, what other factors are important for determining
the prognosis for breast cancer?
- Risk factors can be genetic, but some lifestyle variables, such as alcohol
consumption, make it more likely.
Radiation exposure
- Radiation treatment for a cancer that is not breast cancer raises the
chance of developing breast cancer later in life.
Hormone treatments
- Hormone replacement treatment (HRT) and oral birth control pills have
been related to breast cancer owing to elevated estrogen levels.
Hormone treatments
- Researchers determined in 2012 that exposure to some carcinogens and
endocrine disruptors, such as those found in the workplace, might be
connected to breast cancer. Working night shifts was proposed to raise the
risk of breast cancer by experts in 2007, however more current study
shows that this is improbable.
- radiation therapy
- surgery
- biological therapy, or targeted drug therapy
- hormone therapy
- chemotherapy
Optimal Plan
4. Design an appropriate plan for treating this patient’s breast cancer, focusing on
pharmacologic and nonpharmacologic measures. If the plan includes chemotherapy,
identify a specific regimen, and provide your rationale for selecting it.
Pharmacologic measure:
Chemotherapy
- Chemotherapy is a medication that uses strong chemicals to
destroy rapidly developing cells in the body.Chemotherapy is most
commonly used to treat cancer because cancer cells grow and
proliferate significantly faster than the rest of the body's cells. There
are several chemotherapy medicines available. To treat a wide
range of malignancies, chemotherapy medications can be
administered alone or in combination.
Surgery
If surgery is needed, the choice will depend on the diagnosis and
the individual. Types of surgery include:
- Lumpectomy: This involves eliminating the tumor as well as
a tiny quantity of healthy tissue surrounding it. This can aid
in the prevention of cancer spread. This may be an option if
the tumor is tiny and easily separated from the surrounding
tissue.
- Mastectomy: In a simple mastectomy, the lobules, ducts,
fatty tissue, nipple, areola, and some skin are removed. Both
the lymph nodes in the armpit and the muscle from the chest
wall will be removed during a radical mastectomy.
- Sentinel node biopsy: Because breast cancer can travel
deeper via the lymphatic system and into other regions of
the body if it gets to a lymph node, removing one lymph
node can stop the disease from spreading.
- Reconstruction: A surgeon can do a reconstruction after
breast surgery to restore the breast such that it resembles
the other one. They can conduct this concurrently with a
mastectomy or at a later time. They could utilize tissue taken
from the patient's other body area or a breast implant.
Outcome Evaluation 5.a. What parameters should be monitored to evaluate the eficacy
and adverse efects of the therapy you recommended?
- The most relevant of these criteria are tumor size, histologic type, histologic
grade, axillary lymph node status, estrogen receptor status, and tumor growth
fraction. To evaluate the efficacy and adverse effects of the therapy.
Listen
Labs
Meds
Cardizem CD 180 mg PO once daily
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5.c. Based on the patient’s current medication list, create a list of potential drug therapy
problems as she begins a new therapy for cancer.