DR PARKER: Mrs K is a 43-year-old woman with
metastatic breast cancer. Formerly an elementary school teacher, she now stays
home with her husband and 5-year-old son. She has private insurance and has
experienced no restrictions in her complex care.
Her mother died of breast cancer at age 58 years. Therefore, Mrs K started
breast self-examinations at age 20 years and mammograms every 6 months at
age 25 years. Due to the birth of her child and breast-feeding, she had an
interval of 2 years without a mammogram. During that period in 1995, she detected
a breast lump, which was malignant. She underwent a modified radical mastectomy
followed by cyclophosphamide, methotrexate, and fluorouracil chemotherapy
for 6 months. At the time of surgery, lymph nodes were negative.
Spiegel D. A 43-Year-Old Woman Coping With Cancer. JAMA. 1999;282(4):371–378. doi:10.1001/jama.282.4.371
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