Linda Jonides, BS, RN, CPNP Private Practice with Dr. Allen Dumont Ann Arbor, Michigan
Carol Rudy, MPH, ARNP, CPNA Rockwood Clinic Pediatrics Spokane, Washington Sally Walsh, BS, RN, CPNP Pediatric Associates of Norwood Boston, Massachusetts
. Breast Masses in Adolescent
w
endy, who is 12 years 10 months old, comes in the office with her mother with the chief complaint of a lump that she had noticed 4 days ago in her left breast. The lump is not tender. She feels well and has had no fever or fatigue. Her last menstrual period began 1 day before the visit. Family history indicates that three paternal aunts were diagnosed with fibrocystic breast disease in their twenties. On physical examination a discrete, movable, nontender, 2-centimeter, mass is palpable at the midline of the breast, just above the areola. No palpable axillary or supraclavicular nodes are noted; no other lymphadenopathy or hepatosplenomegaly is found. Jasmine, who is 14% years old, arrives in your office with the complaint of a lump on her left breast. She is accompanied by her mother. Jasmine noticed the lump 2 weeks ago. It is not tender and has not changed. Her
274
Girls
w
last menstrual period was 24 to 26 days ago; she normally has a period every 30 days. She is taking tetracycline twice daily for acne. Family history is negative for breast disease. On physical examination a firm, discrete, nontender 1.25 by l-centimeter nodule is palpable in the lower outer quadrant of her left breast. No palpable lymphadenopathy or hepatosplenomegaly is found. 1. What are the most common causesof breast mussesin ad&scent fdes? 2. What are the steps in diapwsis of a breast muss in an adolescent? 3. What interventkmltreamzent is indicated? 4. Is an adolescent with a breast muss at increased rirk for subsequent breast cancer? (Questions
JOURNAL
and
OF
Answers
on pages
PEDIATRIC
287-288.)
HEALTH
CARE
Carol Rudy, MPH, ARNP, CPNA Rockwood Clinic Pediatrics Spokane, Washington Sally Walsh, BS, RN, CPNP Pediatric Associates of Norwood Boston, Massachusetts
. Breast Masses in Adolescent
w
endy, who is 12 years 10 months old, comes in the office with her mother with the chief complaint of a lump that she had noticed 4 days ago in her left breast. The lump is not tender. She feels well and has had no fever or fatigue. Her last menstrual period began 1 day before the visit. Family history indicates that three paternal aunts were diagnosed with fibrocystic breast disease in their twenties. On physical examination a discrete, movable, nontender, 2-centimeter, mass is palpable at the midline of the breast, just above the areola. No palpable axillary or supraclavicular nodes are noted; no other lymphadenopathy or hepatosplenomegaly is found. Jasmine, who is 14% years old, arrives in your office with the complaint of a lump on her left breast. She is accompanied by her mother. Jasmine noticed the lump 2 weeks ago. It is not tender and has not changed. Her
274
Girls
w
last menstrual period was 24 to 26 days ago; she normally has a period every 30 days. She is taking tetracycline twice daily for acne. Family history is negative for breast disease. On physical examination a firm, discrete, nontender 1.25 by l-centimeter nodule is palpable in the lower outer quadrant of her left breast. No palpable lymphadenopathy or hepatosplenomegaly is found. 1. What are the most common causesof breast mussesin ad&scent fdes? 2. What are the steps in diapwsis of a breast muss in an adolescent? 3. What interventkmltreamzent is indicated? 4. Is an adolescent with a breast muss at increased rirk for subsequent breast cancer? (Questions
JOURNAL
and
OF
Answers
on pages
PEDIATRIC
287-288.)
HEALTH
CARE
