A clinical interview is one of the most viable diagnostic tools for physicians. Interviews create an environment where the doctor can gather relevant information concerning the health condition of the patient. It is, however, important to note that clinical interviewing is one of the challenging skills for physicians to master. Interviewing skills demand for both emotional and intellectual competence (Henry, et al. 2011). A balance between the analytical skills of diagnostic reasoning and interpersonal skills must be established to ensure communication with the patient is effective. Interviewing is a critical component of the art of medicine. The physician must ask questions that will aid in determining the most likely cause of the patient’s problem. Information gathered during the interview also assists in ruling out possible health conditions in addition to facilitating the development of an effective management plan.

Interview questions for breast cancer patient.

The physical health of a patient is an important aspect to consider during the diagnosis of any healthy condition. When dealing with a patient suspected of breast cancer the physician should inquire about the physical health of the patient (Henry, et al. 2011). The patient should be asked whether she has experienced any skin irritation, breast and nipple pain, abnormal discharge from the nipples, swelling of the breast as well as scaling and redness (Dirbas & Scott-Conner, 2011). These questions would help determine whether the patient is presenting with symptoms of breast cancer. The patient should also be asked whether she has painful and swollen lymph nodes around the collarbones and under the arm. It is also important to ask the patient whether she can feel masses or lumps in her breasts. The patient should also be asked whether the family has a history of breast cancer since genetic factors largely predispose this condition. An inquiry of the patient’s lifestyle should also be done during the interview. The patient should be asked whether she drinks alcohol, the birth control method she uses, whether she takes part in physical activities as well as her breastfeeding history (Dirbas & Scott-Conner, 2011).

Clinical findings

Patients suffering from breast cancer present with different symptoms ranging from minor to intense. These symptoms include swelling of the breasts, intense skin irritation, and pain on the nipples and the breast. The patient may also experience thickening of the nipples in addition to redness and scaling. Nipple retraction and nipple discharge are also common symptoms in breast cancer patients. A change in the size and appearance of the breasts may also be noted in breast cancer patients.

Diagnostic studies

Diagnosis of possible cases of breast cancer involves several diagnostic studies. The first study which is carried out by the physician is physical breast examination. The physician should examine the breasts and the lymph nodes in the collarbone and armpits to feel for abnormalities. A mammogram should also be conducted to detect abnormalities in the breast. A breast ultrasound may also be orders to generate images of structures deep in the breast (Henry, et al. 2011).

Primary diagnosis:

Invasive Breast Cancer: The typical clinical presentations that led to the diagnosis of breast cancer include the change in breast size and appearance, thickening, swelling and redness of the nipples and breast, as well as swollen and painful lymph nodes (Henry, et al. 2011).

Differential diagnoses

Breast abscesses: The main symptoms of this condition include pain in the breast, swelling, and pus from the nipples. Nipple inversion whereby the nipple is drawn into the breast instead of pointing out may occur. Patients with breast abscesses also present with fever (Henry, et al. 2011).

Ductal carcinoma in situ: a lump in the breast and abnormal discharge from the nipple are the main symptoms of this condition. The breast may also change in appearance and shape, and the skin around the breast may become thickened (Dirbas & Scott-Conner, 2011).

Cyst: The symptoms of breast cysts include breast tenderness, painful sensation, breast lump, and change in breast appearance. Nipple discharge is also a common symptom in breast cysts.

Management plan

A comprehensive assessment of the breast condition should be carried out to determine the type of breast cancer the patient is presenting with. The treatment options depend on the size of the tumor, the age, and the general health of the patient, as well as the associated risk factors, and results of pathological tests. The patient should be provided with the available options for breast cancer treatment including chemotherapy and mastectomy. She should then be advised on the most appropriate option. The patient should be given adjuvant systemic therapy to prevent the continued growth of cancer cells (Henry, et al. 2011). Staging should be done to determine the current stage of cancer and initiate appropriate treatment. The patient should also be advised to avoid activities that increase the risk of cancer progress such as consumption of junk foods that lead to obesity and overweight, inactivity, and the use of over the counter medications that may complicate cancer treatment (Dirbas & Scott-Conner, 2011). Follow-up care is necessary for breast cancer patients undergoing treatment. A monthly follow-up plan is suitable for the patient.

References:

Dirbas, F., & Scott-Conner, C. E. H. (2011). Breast surgical techniques and interdisciplinary management. New York: Springer.

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Harmer, V. (2011). Breast cancer nursing: Care and management. Chichester, West Sussex, U.K: Wiley-Blackwell. Bottom of Form

Henry, J. B., et al. (2011). Henry’s clinical diagnosis and management by laboratory methods. Philadelphia, PA: Elsevier/Saunders,

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