A patient contacts the office and tells the nurse that she is worried about her 10-year-old daughter having breast cancer. She describes a unilateral enlargement of the right breast with associated tenderness.
She is worried because the left breast is not enlarged. What would be the nurse's best response? Tell the mother that:
a.
Breast development is usually fairly symmetric and that the daughter should be examined right away.
b.
She should bring in her daughter right away because breast cancer is fairly common in preadolescent girls.
c.
Although an examination of her daughter would rule out a problem, her breast development is most likely normal.
d.
It is unusual for breasts that are first developing to feel tender because they haven't developed much fibrous tissue.
Question 2
A 9-year-old girl is in the clinic for a sport physical examination. After some initial shyness she finally asks, Am I normal? I don't seem to need a bra yet, but I have some friends who do. What if I never get breasts?
The nurse's best response would be:
a.
Don't worry, you still have plenty of time to develop.
b.
I know just how you feel, I was a late bloomer myself. Just be patient, and they will grow.
c.
You will probably get your periods before you notice any significant growth in your breasts.
d.
I understand that it is hard to feel different from your friends. Breasts usually develop between 8 and 10 years of age.
The phosphorus cycle. Numbers are 1012 g P or fluxes as 1012 g P per year (data from Schlesinger 199
The carbon cycle. Numbers are storage as 1015 g or fluxes as 1015 g per year (data from Schlesinger
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