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A 38 year old female complains of bilateral breast lumps that are tender to the touch. She states that the lumps are in the same place every menstrual cycle. The pain is worse leading up to menses and then subsides a few days after menses. The nurse practitioner evaluates the patient and observes bilateral breasts have symmetrical nodes that are mobile and rubbery. There is no dominant mass, no skin changes, and no nipple discharge. What is an appropriate treatment option of this patient?

a. Vitamin E and evening primrose capsules daily
b. Do not wear a bra as often as possible to allow for free movement
c. Vitamin B12 and omega 3 capsules
d. Ice therapy

1 Answer

2 votes

Final answer:

For a 38-year-old female with cyclical mastalgia associated with her menstrual cycle, treatment options may include hormonal birth control to regulate hormones, or non-hormonal treatments like ice therapy for symptomatic relief.

Step-by-step explanation:

A 38-year-old female with bilateral breast lumps that are painful premenstrually and then subside post-menses likely has cyclical mastalgia, a common condition associated with hormonal changes during the menstrual cycle. Since there is no dominant mass, no skin changes, and no nipple discharge, and the lumps are symmetrical and mobile, this suggests benign changes rather than cancer. In such cases, an appropriate treatment option may include hormonal birth control to regulate hormone levels and reduce symptoms.

Considering the patient's description of the lumps being tender and pain subsiding after menses, optimizing her menstrual cycle with hormonal birth control could help alleviate the discomfort. Given the cyclic nature of her symptoms, non-cancerous causes like fibrocystic changes are more likely, particularly if the lumps are mobile and rubbery. If hormonal options are not suitable, other non-hormonal treatments like ice therapy can be considered for symptomatic relief. Ice therapy can help to reduce swelling and pain, but should be used cautiously and not as a sole therapy for persistent or severe cases.

User Gabriel Kaffka
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