Lecture Notes: Medical Case Study on Breast Lump

Patient Background

• Age: 56-year-old woman
• Occupation: Homemaker
• Education: Educated till higher secondary
• Socioeconomic Status: Middle-class
• Medical History: No known chronic illnesses, not under any medical or surgical intervention, denies history of hypertension, does not smoke or drink
• Allergies: None reported
• Diet: Non-vegetarian
• Family History: No history of breast cancer or related malignancies like pancreatic, colorectal, or prostate cancer

Presenting Complaint

• Primary Symptom: Lump in the left breast for 4 months
• Secondary Symptoms: Ulceration and skin changes over the lump for the past month
• Lump Characteristics: Initially painless, 3x1 cm in size, grew to 6x6 cm, skin ulcer about 3x2 cm
• Other Symptoms: No nipple retraction or discharge, no complaints from the right breast

Examination Findings

• Breast Examination: Lump in the left breast, 6x6 cm, hard, non-tender, not fixed to chest wall
• Skin Changes: Ulceration on the lump, no other skin changes
• Nipple and Areola: Normal, no retraction
• Lymph Nodes: No palpable lymphadenopathy
• Systemic Examination: Cardiovascular and respiratory systems normal

Differential Diagnosis Considerations

• Consideration of malignancy given growth and ulceration
• Need to rule out metastatic disease
• Possibilities include benign conditions like fibrocystic disease, fibroadenoma, or malignant conditions like ductal carcinoma

Investigations and Diagnosis

• Radiological Tests: Recommend mammography, ultrasound
• Biopsy: Core needle biopsy to confirm diagnosis
• Possible Diagnosis: Suspected malignancy of the left breast, likely at stage 3b

Treatment Plan

• Surgical: Consider modified radical mastectomy
• Chemotherapy/Radiotherapy: Depending on receptor status and biopsy results

Discussion Points

• Importance of socioeconomic factors in health and disease
• Role of family history in cancer risk
• Consideration of hormonal replacement therapy and its implications
• Need for early detection and intervention in breast cancer

Follow-Up

• Regular monitoring and follow-up care post-treatment
• Counseling and support for the patient and family

Additional Notes

• Emphasis on maintaining privacy and patient dignity during examinations
• Importance of a multidisciplinary approach in managing complex cases