Painless Lump in Right Breast

A 34-year-old female presents with a painless lump in her right breast that she noticed 6 weeks ago. She denies any changes in the size of the lump, skin changes, or nipple discharge. Her last menstrual period was 2 weeks ago, and she notes no significant changes in the lump related to her menstrual cycle. She has no family history of breast or ovarian cancer but reports limited awareness of her paternal side’s medical history. Her medical history includes hypothyroidism, managed with levothyroxine.

Questions

1. Differential Diagnoses
   What are the potential differential diagnoses based on this presentation? Prioritize these diagnoses based on the patient’s risk factors and clinical symptoms.
2. Diagnostic Workup
   What diagnostic tests would you order to differentiate between these diagnoses? Explain the rationale for each test.
3. Treatment Plan
   Develop a comprehensive treatment plan for the most likely diagnosis considering the patient’s age, comorbidities, and potential side effects.
4. Patient Education
   What important information should you provide to the patient and their family regarding the diagnosis, treatment, and prevention of further episodes?

For peer response answer this:

• What is the plan for ongoing monitoring of the breast lump or related findings, especially if imaging is inconclusive or biopsy results are benign?

How will you engage the patient in shared decision-making about treatment options and preventive strategies, such as lifestyle changes or genetic counseling?

Submission Instructions:

• Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

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