Ms. Barker’s Case Study: The Cysts of Fibrocystic Breast Disease

What term is used to describe the benign condition that may have caused Ms. Barker’s breast mass?

The mass in Ms. Barker’s breast might be fibrocystic breast disease. It is a common condition among women, and the fact of never having children might have had hormonal consequences leading to it. Such a type of fibrocystic breast changes as a carcinoma is also possible; carcinomas are usually firm or hard, non-tender, single, and might be nonmobile (White, Duncan, & Baumle, 2013, p. 1164). It is also possible that the patient is suffering from traumatic fat necrosis (Gray & Kocjan, 2010, p. 186-187). It is a condition when fat forms round, firm, and hard lumps, usually not painful. It commonly appears after trauma, but Ms. Barker might not remember injuring her breast. It is also possible that she is suffering from cancer.

What is inside the cysts of fibrocystic breast disease?

The cysts of fibrocystic breast disease are often nodular and granular. They are usually filled with liquid (White, Duncan, & Baumle, 2013, p. 1164).

Mammography and ultrasonography reveal a solid lesion (not cystic). What is the most common type of breast cancer?

The most common types of breast cancer are ductal carcinomas, the high-grade (comedo) ductal carcinoma in situ (responsible for approximately 85% of all cases of breast cancer in situ), and invasive ductal carcinoma (accounts for nearly 75% of invasive breast cancers) in particular (Harmer, 2011, p. 20, 22). The ductal carcinoma in situ appears when the abnormal cells grow inside the breast ducts in an uncontrolled way; however, these cells remain within the ducts. On the other hand, an invasive ductal carcinoma grows through the walls of the ducts and into the tissue around them. It is also capable of spreading over the other parts of the body, causing metastases.

Biopsy determines that Ms. Barker has invasive carcinoma of the breast. What is the difference between ductal carcinoma in situ and invasive carcinoma of the breast?

Carcinoma in situ is a situation when carcinoma cells are located inside the terminal duct lobular unit, as well as within the adjacent ducts, but these cells do not penetrate the basement membrane (Harmer, 2011, p. 19). If the carcinoma in situ is ductal, it means that it originates from the ducts (not from lobules, as lobular carcinoma in situ does). It causes ducts, as well as ductules, to expand due to the presence of swollen diseased cells with large irregular nuclei (Harmer, 2011, p. 19).

On the other hand, the invasive carcinoma of the breast (which can be ductal, lobular, mucinous, medullary, tubular, papillary, and of some other origins) is not contained inside the place where it appeared, but grows into the surrounding tissue and can spread around the body, leading to metastatic cancer (Harmer, 2011, p. 22). The invasive cancers are more dangerous than cancers in situ.

Ms. Barker’s breast cancer has metastasized to her lungs. What is the difference between metastatic lung cancer and primary lung cancer?

Metastases appear when the abnormal cells affected by cancer develop the ability to penetrate the walls of their primary location. Often, they penetrate the walls of the vessels; it becomes possible for them to invade lymphatic and blood vessels. After that, these cells leave the place where they developed (the primary location) and start circulating inside the bloodstream (or lymph stream). At some point, they stop somewhere in the vessel (e.g., by causing mucin embolism), penetrate it once again, and multiply. This results in the formation of another cancer tumor, which is called metastasis.

Therefore, primary lung cancer is cancer that originally started developing inside the lungs. On the other hand, metastatic lung cancer is cancer that first appeared in any other organ and then spreads to the lungs. Apart from blood or lymph vessels, cancer may spread to the lungs as a result of direct extension from the primary tumor located in the breast or the chest wall (Debois, 2002, p. 3).


Debois, J. M. (2002). TxNxM1: The anatomy and clinics of metastatic cancer. New York, NY: Kluwer Academic Publishers.

Gray, W., & Kocjan, G. (Eds.). (2010). Diagnostic cytopathology. Philadelphia, PA: Elsevier Health Sciences.

Harmer, V. (Ed.). (2011). Breast Cancer Nursing Care and Management (2nd ed.). Ames, IA: John Wiley & Sons.

White, L., Duncan, G., & Baumle, W. (2013). Medical surgical nursing: An integrated approach. Clifton Park, NY: Delmar Cengage Learning.

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