Mrs. Rebecca Anderson, a 48-year-old female, recently discovered she has invasive ductal carcinoma of the left breast during a routine mammogram. The mass is at stage 3 but genetic testing has revealed she carries the BRCA1 mutation, further increasing her risk of breast cancer. As a proactive measure, Mrs. Anderson has been recommended to undergo a double mastectomy. She has filled in a consent form for this procedure but when you admit her, she expresses to you that she is unsure if she really wants to “lose both breasts” during the surgery. Mrs. Anderson has a history of hypertension and mild anxiety. She is adopted, so lacks knowledge of any family medical history. She currently works as a teacher and resides with her husband and two teenage children. Mrs. Anderson identifies as Christian, and her spiritual beliefs are integral to her well-being.
Please answer the following:
- How may Mrs. Anderson’s age, occupation, family situation, and Christian beliefs contribute to her surgical experience and influence her decision regarding the double mastectomy?
- Mrs. Anderson has expressed that she is unsure about her upcoming operation. Provide a description of the legal and ethical considerations involved, emphasising principles such as informed consent, confidentiality, and privacy. How would this affect your care?
- Describe the pathophysiology of common surgical complications following a double mastectomy. How do these complications influence Mrs. Anderson’s postoperative care?
- Mrs. Anderson expresses concerns about pain management during and after the surgery. How would you educate her on both pharmacological and non-pharmacological options for pain relief?
