Chief Complaint Case Studies

A chief complaint from a patient I have received in the past, while working in women’s health, was “During my monthly self breast examination I discovered a lump and it’s painful”. The patient was a 22-year-old Hispanic woman with a history of two miscarriages and presented post-op dilation and curettage. The patient had an aunt who passed away from breast cancer about a year before this visit and she was concerned that her lump could signify that she had breast cancer. Bickley and Szilagyi (2012) state location, quality, quantity, timing, setting, factors alleviating or aggravating the symptoms and associated manifestations as the seven attributes that should be paid attention to when considering the patient’s chief complaint. Seven questions …show more content…
According to the American Cancer Society (2016) having a round and moveable lump that is tender to touch may suggest that the lump is a cyst. Cyst can be found in women of any age and they are due to monthly hormonal changes that occur in women and they are most noticeable before a women’s menstrual cycle and disappear after. This is why also the attribute “timing” is important to ask. The larger the cyst become the more painful they are (cancerous lumps are less likely to be painful). Being round and moveable doesn’t completely eliminate the possibility of it the lump being cancerous but it does suggest it may be just a cyst. Another significant attribute important to examine is associated manifestations. The National Cancer Institute (2015) suggest individuals to contact their health care provider if they notice any of the following breast changes in addition to lumps: changes in the skin around the breast (itchiness, redness, dimpling etc.) and changes in the breast nipples including bloody discharge. Diagnostic mammograms, breast ultrasounds and a biopsy are procedures that can further confirm and diagnose whether a patient’s lump is a cyst, benign or cancerous (American Breast Cancer Foundation,