Case Study 1 Women experience physiological and physical changes in the breast throughout their reproductive period. These changes may be normal and healthy. However, abnormal changes may indicate underlying conditions which are detrimental to the overall health of a woman (Schuiling & Likis, 2017). Most women may not necessarily notice and understand these changes early enough. Indeed, early identification of such changes, timely diagnosis and treatment have helped reduce the occurrence of pathological breast conditions in women. 

 Case Study 1,

a 60-year-old Latina female is concerned about a thick greenish discharge she has been experiencing for about a month. The greenish discharge occurs spontaneously with a burning and dull pain. The patient stated that she had been taking an occasional dose of Tylenol to manage arthritis. Additionally, she reported that her last mammogram, done about 14 months ago was within normal parameters. A physical examination indicated that her left breast is slightly reddened and edematous. Upon palpating, a greenish discharge is observed characterized by smooth ovoid and non-tender 1 cm nodule in the right upper quadrant about 11:00 5cm from her nipple. She is particularly worried about the risk of developing cancer of the breast.

Diagnosis

In the case study, the differential diagnosis of the patient includes mammary duct ectasia, intraductal papilloma, ductal carcinoma in situ, breast cancer, and periductal mastitis. These conditions are the most likely causes of certain symptoms of the patient such as nipple discharge, nodules on palpation and pain in the breast. However, intraductal papilloma is quickly eliminated as it involves a bloody nipple discharge and is felt like a typical slump inside the breast ducts. Moreover, breast cancer and periductal mastitis involve a breast lump that is tender when palpated. Breast cancer is further eliminated because of an absence of nipple retractions and breast swelling.

However, the most likely diagnosis is mammary duct ectasia. Unique to the case study are symptoms that are consistent with this breast condition. The main symptoms are indicative of mammary duct ectasia that the female patient presents with include a thick greenish discharge, dull and burning pain around the ducts. Additionally, edema, redness, and non-tender nodules are symptoms specific to this breast condition. Mammary duct ectasia is a condition characterized by BREAST CONDITIONS IN WOMEN 3 widening breast duct making the duct walls thick hence build-up of fluid around the breast. This results in edema and redness with burning pain. This condition centers around the breast duct and nearby tissues become red and form nodules which sometimes clump and may be confused for breast cancer. It is mostly diagnosed in women over 50 years of age.

Treatment and Management

The treatment of mammary duct ectasia involves the use of antibiotics, pain medication and surgery in severe cases. Antibiotics treat breast infections and are given for about 10 to 14 days while pain medications include acetaminophen (Tylenol) and Motrin IB (Advil) that relieve pain and breast discomfort. Tylenol is given in two particular strengths mainly as 325 mg every four hours as well as 500mg every six hours that does not exceed 4000 mg daily (Wang & Hu, 2016). In mild cases, patients should apply warm compresses to soothe the surrounding tissue. Surgery done by incision on the tissue to release fluid is recommended in extreme cases especially when the antibiotics and self-care measures are not effective. A diagnosis of mammary duct ectasia may sometimes be confused for breast cancer which can bring emotional devastation. Therefore, patients are always sufficiently educated on home and lifestyle remedies to either relieve discomfort or prevent future occurrences. Patients are trained on how to use pads meant for nipple discharge, use of supporting bras as well as education on how to quit unhealthy health practices such as smoking. Patients can also be provided with study information and trained on how to detect the early signs of the condition to assist in the timely diagnosis of the disease. It is also important to create awareness among women about specific signs and symptoms of the disease and holding free diagnosis camps for women.