NU 629 Week 14 Discussion 1 Preventative Guidelines – One Guideline and Two Scenarios

Sample Answer

In this scenario, one woman is 72 years old while the other is 48 years old. The 72 year old woman is African American and she is complaining of breast tenderness. It is also stated that she has never gotten a mammography before and her last breast exam was thirty years ago.

The second woman is 48 years old and she is concerned that she has a STI. She also states that two years ago she had gotten a mammography and was referred to get an ultrasound, but never went. These women will be treated in a different manner as they are two different ages. When discussing mammography, it is important to understand that the risk of developing breast cancer increases with age (Reeves, 2021).

Breast cancer is most commonly diagnosed in women 55 to 64 years old (Reeves, 2021). According to the American Cancer Society, women should start getting mammograms starting at age 45 however, they can start as early as 40 years old (“American Cancer Society Guidelines”, 2021).

For Sally, the 48 year old, she had a mammogram at 46 years old that her doctor wanted to re-evaluate. For her plan of care, I would treat her for her STI and refer her to get re-evaluated to determine what her mammogram had shown two years ago. 17% of breast cancer is diagnosed in women who are younger than 50 years old (Seely & Alhassan, 2018).

The sooner Sally gets re-evaluated the sooner she can start treatment and be cured if she does have breast cancer. For Eleanor, the 72 year old, I would discuss the benefits and risks of her getting her first mammogram at this age. Mammography can be done up to the age of 74 years old asz most places won’t perform them on those who are older due to not enough evidence (Schrager et al., 2020).

Those who are 70 years or older are at increased risk as the incidence of breast cancer among this group is 28% (Seely & Alhassan, 2018). Since Eleanor has never gotten a mammogram and she also hasn’t had a breast exam in 30 years until now, she is more likely to have a higher stage of breast cancer if anything were to be detected on the mammogram.

Therefore, it may not be beneficial to her if she is at that point since her survival rate will already be significantly reduced (Schrager et al., 2020). Getting a mammogram at her age could be beneficial if she is still in good overall health and has a life expectancy of 10 years or longer (Schrager et al., 2020). To determine her state of health, more information would need to be gathered.

References

• American Cancer Society Guidelines for the Early Detection of Cancer. American Cancer Society. (2021, August 27). Retrieved November 30, 2021, from https //www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html.
  
• Reeves, R. (2021, July 31). Mammography. StatPearls. Retrieved November 30, 2021, from https //www.statpearls.com/ArticleLibrary/viewarticle/38665.
  
• Schrager, S., Ovsepyan, V., & Burnside, E. (2020). Breast cancer screening in older women The importance of shared decision making. NCBI. Retrieved November 30, 2021, from https //www.ncbi.nlm.nih.gov/pmc/articles/PMC7822071/.
  
• Seely, J. M., & Alhassan, T. (2018, June 13). Screening for breast cancer in 2018-what should we be doing today? NCBI. Retrieved November 30, 2021, from https //www.ncbi.nlm.nih.gov/pmc/articles/PMC6001765/.
  564 words