case 48 y.o. healthy woman right breast mass present for 4 weeks no other known health problems...
TRANSCRIPT
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Case
• 48 y.o. healthy woman
• Right breast mass present for 4 weeks
• No other known health problems
• Clinical breast examination:– Fullness visible in R breast w/o skin changes– 3.5cm palpable mass R upper outer quadrant– Palpable R axillary lymph node
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RIGHT 9 O’CLOCK PALPABLE
RIGHT LEVEL 1 AXILLA ABNORMAL LN
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Imaging Results
• Right breast 9 o’clock– Irregular mass– Maximum dimension 52 mm
• Right axilla– Multiple abnormal lymph nodes
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RIGHT 9 O’CLOCK US BIOPSY
RIGHT 9 O’CLOCK US BIOPSY MARKER CLIP
RIGHT AXILLARY LN US BIOPSY
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Histopathology Results
• Right breast 9 o’clock– IDC – Nottingham II/III– ER+/PR+, Her2 neg by FISH– Ki67 50%
• Right axilla– LN with metastatic IDC
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BASELINE MRI
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RIGHT 9 O’CLOCK KNOWN IDC RIGHT LEVEL 1 AXILLA KNOWN METASTATIC LAN
LEFT 3 O’CLOCK NMLE 23 MM MRI BX = DCIS
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Staging Studies
• CT C/A/P: no distant metastases
• Bone scan: no distant metastases
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Treatment Options
• Surgery?
• Radiation Oncology?
• Medical Oncology?
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2/09 Clinical MRI 3/09 MRI after 1 week sunitinib
6/09 MRI after 12 weeks sunitinib/paclitaxel
10/09 MRI after 15 weeks doxorubicin/cyclophosphamide
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