BREAST CANCER CASE STUDY

-FRANCESCA CRUZ
BRIEF BACKGROUND
HUMANS HAVE KNOWN ABOUT BREAST CANCER FOR A LONG TIME. FOR EXAMPLE, THE EDWIN SMITH SURGICAL PAPYRUS
DESCRIBES CASES OF BREAST CANCER. THIS MEDICAL TEXT DATES BACK TO 3,000–2,500 B.C.E.
IN ANCIENT GREECE, PEOPLE MADE VOTIVE OFFERINGS IN THE SHAPE OF A BREAST TO THE GOD OF MEDICINE. AND HIPPOCRATES
DESCRIBED THE STAGES OF BREAST CANCER IN THE EARLY 400S B.C.E.
IN THE FIRST CENTURY A.D., DOCTORS EXPERIMENTED WITH SURGICAL INCISIONS TO DESTROY TUMORS. THEY ALSO THOUGHT
THAT BREAST CANCER WAS LINKED WITH THE END OF MENSTRUATION. THIS THEORY MAY HAVE PROMPTED THE ASSOCIATION OF
CANCER WITH OLDER AGE.
IN THE BEGINNING OF THE MIDDLE AGES, MEDICAL PROGRESS WAS LINKED WITH NEW RELIGIOUS PHILOSOPHIES. CHRISTIANS
THOUGHT SURGERY WAS BARBARIC AND WERE IN FAVOR OF FAITH HEALING. MEANWHILE, ISLAMIC DOCTORS REVIEWED GREEK
MEDICAL TEXTS TO LEARN MORE ABOUT BREAST CANCER.
THE RENAISSANCE SAW A REVIVAL OF SURGERY AS DOCTORS BEGAN EXPLORING THE HUMAN BODY. JOHN HUNTER IS KNOWN AS
THE SCOTTISH FATHER OF INVESTIGATIVE SURGERY. HE IDENTIFIED LYMPH AS A CAUSE OF BREAST CANCER. LYMPH IS THE FLUID
CARRYING WHITE BLOOD CELLS THROUGHOUT THE BODY. LUMPECTOMIES WERE ALSO PERFORMED BY SURGEONS, BUT THERE
WAS NO ANESTHESIA YET. SURGEONS HAD TO BE FAST AND ACCURATE TO BE SUCCESSFUL.
CLINICAL IMPRESSION

PATIENT IS A 58 YEAR OLD FEMALE WHO PRESENTS TO THE CLINIC WITH COMPLAINTS
OF RIGHT SHOULDER PAIN. SECONDARY TO PATIENTS AGE, FAMILY HISTORY, AND
SUBJECTIVE REPORT THIS PATIENT WAS ADVISED TO RETURN TO THEIR PRIMARY CARE
PROVIDER FOR FURTHER MEDICAL SCREENING. WITH THIS PATIENT BEING A 58 YEAR
OLD FEMALE SHE IS CONSIDERED TO BE AT RISK FOR BREAST CANCER. ANOTHER RISK
FACTOR THIS PT POSSESSES IS A PRIMARY RELATIVE WHO HAS RECENTLY LOST THE
BATTLE TO BREAST CANCER. A SIGNIFICANT CONCERN WITH THIS PT IS HER
COMPLAINTS OF NIGHT PAIN SO SEVERE IT WAKES HER FROM SLEEP. THIS IS A RED FLAG
THAT COULD INDICATE PRESENCE OF TUMOR DUE TO CHANGES IN HORMONE LEVELS AT
NIGHTTIME THAT ACCOMPANY NEOPLASMS. THE UNEXPLAINED WEIGHT LOSS ALSO
GIVES REASON TO SUSPECT A MORE SYSTEMIC INVOLVEMENT RATHER THAN
MUSCULOSKELETAL ORIGIN.
SUMMARY OF EXAMINATION FINDINGS

PATIENT REPORTS DEEP ACHING PAIN AWAKENING HER AT

NIGHT, DECREASED STRENGTH, AND DECREASED ROM
WHICH ARE INCONSISTENT WITH MUSCULOSKELETAL
CAUSES. PHYSICAL THERAPIST UNABLE TO REPRODUCE
PATIENT'S EXACT SYMPTOMS WITH EXAMINATION.
OUTCOMES

AFTER COMPLETING SURGERY AND RADIATION THERAPY, MOST CURRENT

MAMMOGRAM READING SHOWED NO SIGNS OF ABNORMAL CELL GROWTH IN L BREAST
TISSUE. PATIENT HAS SINCE BEEN PARTICIPATING IN YOGA, PILATES, WEIGHT TRAINING
AS WELL AS DOING A CYCLING CLASS AT HER LOCAL GYM. SHE HAS ALSO BEEN
ATTENDING BREAST CANCER SUPPORT GROUPS THROUGH THE HOSPITAL TO WHICH SHE
UNDERWENT TREATMENT. PATIENT STATES THAT THE EXERCISE SHE FEELS HAS REALLY
HELPED IN HER RECOVERY. SHE FEELS MORE IN CONTROL OF HER LIFE AND CONDITION.
THE EXERCISES CLASSES MAKE HER FEEL VERY EMPOWERED AND FEELS VERY
ENERGIZED AFTERWARDS. ATTENDING THE SUPPORT GROUP MAKES HER FEEL A SENSE
OF COMMUNITY AND KNOWS THAT SHE IS NOT ALONE IN THIS BATTLE.