Breast Cancer Screening
A 39-year-old female presents to your office for her annual well-woman exam. She reports that she has a maternal aunt and a cousin who has had breast cancer, so she does her self-breast exams every month. She would like to start getting mammograms, but her friends all say she doesn’t need to worry about a mammogram until she’s at least close to 50.
What are the mammogram recommendations from American College of Obstetrics and Gynecology (ACOG), American Cancer Society (ACS), and United States Preventive Services Task Force (USPSTF)?
What is meant by shared decision-making regarding screening for breast cancer?
What are the screening recommendations regarding self-breast exams and clinical breast exams?
Based on the scenario provided, what recommendations would you give this patient? What factored into your decision making?
Cervical Cancer Prevention/Screening
An 18-year-old is accompanied by her mother for her first visit to the gynecologist. She has never been sexually active. She has no concerns with her menses. Her mom reports that she brought her in “because she is 18 and when I turned 18, I had to get my first Pap smear.” Her mother requests the patient have a Pap smear and be tested for HPV “just in case.” The patient is up to date on all vaccines “mandatory for school” but has never had the HPV vaccine.
What are the recommendations on the HPV vaccine?
How would you counsel this patient about the HPV vaccine?
What are the current ASCCP guidelines for Pap smears and HPV testing?
How will you explain the rationale to the patient and the mother?
STI Prevention and Screening
A 52-year-old female presents to your clinic concerned that she may have contracted a sexually transmitted infection (STI). She states she is recently divorced and admits she never had to practice “safe sex” before and that she has been with several people over the last few months. She has been drinking “way too much” and feels she should just be tested for everything as she has been experimenting.
What type of questions would you want to ask to begin to focus your plan? How will her risk factors affect your screening?
There are several preventive guidelines related to STI risk and screening. What do the current guidelines indicate she should be screened for?
What recommendations should you make regarding “safe sex” practices?
Are there any other preventive guidelines you should address with this patient?
