Case Histories in Human Physiology - Reproductive Case Histories

Reproductive Case Histories - Case 33

A 55-year-old postmenopausal, retired school teacher, with a family history of breast cancer in her mother and sister, noticed a painless hard lump in the upper-outer quadrant of the right breast. A history and physical exam were followed by a mammogram that identified a 1cm lump in the right breast. She chose a breast conserving treatment consisting of localized surgery called a lumpectomy to remove what turned out to be an adenocarcinoma of the breast, followed by removal of some of the axillary lymph nodes. She was started on Tamoxifen, a drug that acts as an anti-estrogen toward breast cancers, but has estrogenic affects on certain other tissues such as the endometrium. This individual has two daughters, ages 35 and 37 who were strongly encouraged to have yearly physicals and mammograms by their mother's doctor, and to perform monthly self breast exams.

1. What is the function of lymph nodes?

2. What problem could develop in the arm as a result of removing the axillary lymph nodes?

3. What histologic changes would you expect in the lining of the uterus if Tamoxifen has estrogenic effects on the endometrium?

4. What role do progesterones have on the uterus in the normal menstrual cycle?

5. What uterine symptoms might this postmenopausal woman develop while taking unopposed continuous estrogens (no progesterone)?

6. What is BRCA 1 and 2?

7. Why might genetic counseling be of value for this family?

8. Discuss potential insurance problems with genetic testing.

Please enter your e-mail address:

If you would like your answers submitted to your instructor, please provide his/her e-mail address (or you must re-enter your e-mail address here for this form to work):

Please enter your full name:

A copy of your answers will also be submitted to your e-mail address so you may print the information.

Table of Contents