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QQ-3190 Mrs Fenna Lisa - Nursing – Rinu Shajan – Adenocarcinoma


22 January 2010

Dr Stevenson

Royal Darwin Hospital

Rockland Drive Tiwi

Po Box 41326

Casuarinas Nt 0811

Dear Dr Stevenson,

Re: Mrs Fenna Lisa

DOB: 6 January 1964

I write to refer Mrs Fenna lisa,who require further care and management from your service. She was diagnosed with Breast Cancer.

On 13 april 2009,Mrs lisa presented to the hospital with a lump in the upper part of right breast. On examination i is showed that an ill defined 1.5cm upper lump in the upper quadrant of right breast with absence of other abnormal change.On 20 april 2009, Mrs lisa had extreme concern about the possibility of cancer as she experienced difficulty to sleep at night as well as lack of concentration, unable to cope with house hold chores and even sometimes irritation.After several investigation,her ultrasound reports reveals solid lump and cytology examination shows malignant cells.Therefore,she underwent core biopsy under local anesthesia.

On followup, Mrs lisa had local excision and auxillary clearance with radiotherapy to residual right breast for local control .Subsequently,her general condition were recuperating well with no evidence of metastasis and shows hormone receptors as negative.

Today,Mrs lisa presented with sudden onset of severe back pain thereafter mild back pain four night exacerbation by movement along with that weight loss.She experiencing pain distribution over bilateral lower extremities and absence of knee jerk.Through assessment it is cleared that the tumor has being spread to lumbar spine

It would be greatly appreciated ,if you could provide further assessment and palliative care for Mrs lisa. Please note that,her bone scan,ct scan of chest and abdomen and radiotherapy to control pain are pending to do and other reports will be attached to this letter.

If you have any queries, please do not hesitate to contact me.

Yours sincerely,

Registered nurse


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