In reviewing genetic testing for a female client, you note the ...

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In reviewing genetic testing for a female client, you note the presence of BRCA1, BRCA2, and CHEK2. How should these findings be interpreted?
 
  a. There is no increased likelihood that the client will develop breast or ovarian cancer.
  b. There is an increased likelihood only for the development of breast cancer in a woman.
  c. More information is needed to interpret these findings based on the client's family history and the client's current and past medical history.
  d. A radical bilateral mastectomy is required immediately because the cancer may have already undergone sub-metastasis.

Question 2

Which option could be used for the treatment and management of a client who reports mild pain associated with a clinical diagnosis of fibrocystic breast disease?
 
  a. Chamomile tea as a relaxant therapy
  b. Danazol (Danocrine)
  c. Tamoxifen (Nolvadex)
  d. Over-the-counter nonsteroidal antiinflammatory drug (NSAID) therapy

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Answer to Question 1

ANS: C
The presence of genetic markers (BRCA1, BRCA2, and CHEK2) provides strong indicators of the increased risk for the development of breast cancer in males and females and ovarian cancer. It is important to obtain additional information so that a treatment plan can be developed and implemented to improve client outcomes. There is an increased likelihood that the client will develop breast or ovarian cancer, but stating that there is an increased likelihood only for the development of breast cancer in a woman fails to include that men are also at risk of developing breast cancer. At this point, surgical intervention is speculative because the presence of biomarkers does not indicate that sub-metastasis has occurred or that the cancer has even developed.

Answer to Question 2

ANS: D
Because the client is reporting mild pain, NSAIDs may provide adequate pain relief and comfort. It is recommended that tea, coffee, and/or other stimulants be limited or restricted for clients with fibrocystic breast disease. Danazol is typically used for moderate to severe pain for clients with fibrocystic breast disease because its use is associated with more serious side effects. The client reports mild pain so this would not be warranted. Tamoxifen is a selective estrogen receptor modulator (SERM) used for the treatment of breast cancers and also for moderate to severe pain in fibrocystic breast disease. The client reports mild pain, so this would not be warranted.

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