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Abstract: The patient presented with breast lumps, hard texture and nipple discharge, as well as anorexia and fatigue, and was diagnosed with breast cancer. After surgery and chemotherapy, the symptoms improved and the disease stabilized, and the treatment result was satisfactory.
Basic information】Female, 50 years old
Disease Type】Breast Cancer
Hospital】Hunan Provincial People’s Hospital
Date of consultation】July 2021
Treatment plan】Surgical treatment (double mastectomy, left axillary lymph node dissection), intravenous injection (injectable piroplasin hydrochloride, injectable cyclophosphamide) + oral medication (metoclopramide tablets, liver protection tablets)
Treatment period】17 days of hospitalization, 7 cycles of chemotherapy
Treatment effect】Surgical removal of breast lump, stable condition
I. Initial consultation
When we first saw the patient, she was fat and in a relatively poor mental state. She reported that she found a relatively hard lump palpable in her left breast one month ago, but had no other symptoms, so she did not pay attention to it. As time passed, a reddish fluid began to appear in the nipple on the side, and a lump could also be touched in the right breast, and the skin was orange peel-like. The patient’s mother had breast cancer and had passed away. The patient’s description suspected breast cancer and recommended hospitalization for further examination. The MRI findings suggested an irregular mass in the left outer quadrant with centripetal enhancement and limited diffusion, which was considered to be BI-RADS 4b-c, and uneven enhancement in the background parenchyma of the right breast; the mammogram findings suggested that the left outer upper quadrant of the breast was seen, which was considered to be BI-RADS 4b-c; the ultrasound findings suggested that The ultrasound findings suggest a lamellar hypoechoic area in the left breast, which is considered BI-RADS category 4b-c, and a hypoechoic nodule in the right breast, which is considered BI-RADS category 4a. The diagnosis of breast cancer was confirmed after examination.
II. Treatment history
The patient agreed and signed the informed consent form. Preoperative examination did not reveal any abnormality, and the patient underwent bilateral mastectomy and removal of lymph nodes in the left axilla. The patient was then given a chemotherapy regimen, including injectable piroplatin hydrochloride and injectable cyclophosphamide. During chemotherapy, the patient developed vomiting symptoms and was given metoclopramide tablets to relieve the symptoms. In addition, liver protection tablets were given to the patient to protect the liver.
III. Treatment effect
After surgical treatment and drug therapy, the patient’s breast lump was removed and the discomfort symptoms were relieved. After 17 days of hospitalization, the patient’s physical status stabilized and the examination was not contraindicated for chemotherapy to be administered, after which the patient developed vomiting syndrome. However, the vomiting symptoms were relieved after administration of metoclopramide tablets, and the patient recovered well after the operation and could be discharged. The review suggested that the patient’s appetite was restored and the symptoms of weakness were relieved, and the disease control was more stable and the treatment effect was more satisfactory.
IV. Notes
Seeing that the patient’s symptoms were relieved after the examination and her condition was relatively stable, I felt happy for her from the bottom of my heart, and at the same time reminded the patient that she should pay attention to the following matters after her discharge from the hospital.
1, in terms of life should pay attention to the adjustment, it is recommended to control the daily diet, avoid overeating in order to control the weight within the normal range, but also appropriate physical exercise, such as walking, etc..
2, patients in the diet can eat some low-fat, high-quality protein food, such as fish, lean meat, nuts, etc., can also eat some vegetables, fruits, try to avoid eating high sugar, high-fat food.
3, patients should also pay attention to regular review, it is recommended to review every 3 months within 2 years, every 6 months at 3-5 years, and every 1 year after 5 years, in order to clarify the development trend of the disease.
V. Personal insight
People like 50-year-old Auntie Li who has a family history of breast cancer should be alert to breast cancer on a daily basis and regular medical checkups are recommended. Although she achieved good results through surgery and chemotherapy, she could have a better prognosis if treated early. Therefore, women, especially those with a family history of breast cancer, are urged to actively seek medical diagnosis and surgical treatment when breast lumps appear, so as not to delay the disease and cause serious consequences or even threaten their lives.