Symptomatic

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76 yo female. History: Breast cancer survivor 3 yrs. Lumpectomy. Overall good health. C/O swollen arm and hand, shortness of breath. 5' 3" 180 lbs. C/O being tired off and on. Pt has been told that the swelling is due to carrying bags and reaching. Any thoughts as to prognosis

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Specializes in med/surg, telemetry, IV therapy, mgmt.

I'm not being mean here, but nurses don't diagnose or prognose. What is the purpose of this assignment supposed to be? Are you supposed to be doing the pathophysiology of what is going on with this lady? My first thought was that she probably has metastasis to the axillary lymph nodes which is now affecting the circulation in her arms. But, I'm not a doctor!

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the pt states the breast cancer is gone 3 years. what else causes the swelling now. she had the surgery 3 years ago.

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Specializes in med/surg, telemetry, IV therapy, mgmt.
the pt states the breast cancer is gone 3 years. what else causes the swelling now. she had the surgery 3 years ago.

metastasis to the axillary lymph nodes and the lungs. with a lumpectomy they don't remove any lymph nodes, so how do they know that there was no lymph node involvement then or now? hmmmm? have they done a lymph node biopsy recently? it's the first thing i'd be pushing for if i was the patient. when breast cancer metatasizes to the axillary lymph nodes it causes all kinds of problems with the circulation in the affected arm including massive edema. breast cancer also metastizes to the lung. one of the presenting symptoms of cancer of the lung is shortness of breath. we just went through this with my mother last year. bilateral mastectomies. a clear ct scan of the lung a year and a half ago. then, one year later she started having sob. a new ct scan showed suspicious nodules. it was metastatic breast ca. she was dead six weeks later. you are not considered a survivor of cancer until it has been way longer than 3 years post op.

http://www.cancer.gov/cancertopics/wyntk/breast - "what you need to know about breast cancer" from the national cancer institute. please read this page on follow-up care in this booklet: http://www.cancer.gov/cancertopics/wyntk/breast/page14. it states "talk to your doctor about headaches, dizziness, shortness of breath, coughing or hoorificeness, backaches, or digestive problems that seem unusual or that don't go away. such problems may arise months or years after treatment. they may suggest that the cancer has returned, but they can also be symptoms of other health problems".

other problems to rule out would be anemia, heart arrhythmias, pulmonary edema. the lady is also overweight. we are not doctors and it would be inappropriate of us to diagnosis this. is this a real patient? a scenario? a school assignment? someone you know looking for advice?

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She is my stepmother. She had a a lymph biopsy of the left arm 3 years ago. In the last 2 mos she noticed SOB and edema to the left arm. She had an abdominal CT yesterday and blood work. I am just trying to get some idea of where she is health wise.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

LVN2006. . .I feel as if you've tricked me into giving you some kind of opinion about what MIGHT be going on with your relative. I thought you were talking about a patient for a school assignment. That wasn't right of you to do that. Don't you know that giving medical advice is against the TOS on allnurses?

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Hello, LVN2006,

The giving of medical advice is beyond the scope of the members of allnurses.com. You did receive an excellent response from Daytonite.

Please talk with your step-mother and maybe the two of you, together, can discuss this with her PCP.

We wish your step-mother well.

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