Unnamed: 0
int64 1
868
| section
stringclasses 51
values | subsection
stringclasses 4
values | label
stringclasses 9
values | text
stringlengths 1
98.9k
|
|---|---|---|---|---|
1 | Case 1 | Courses of Treatment | Benign and Proliferative | Courses of Treatment. → 2022-02-11 Excision, Lt. (8H and 5H).. C. W. Lee · B. H. Choi (*). Department of Radiology, National Cancer Center,. Goyang, Republic of Korea. e-mail: cwlee@ncc.re.kr; iawy82@ncc.re.kr. Y. Kwon. Department of Radiology, Center for Breast Cancer, National. Cancer Center, Goyang, Gyeonggi, Republic of Korea. e-mail: ymk@ncc.re.kr. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. . 20. . . . 1.3.1. . Pathology Report. • Breast, left 8 o’clock, excision:. –. – Intraductal papilloma with usual ductal. hyperplasia.. • Breast, left 5 o’clock, excision:. –. – Sclerosing adenosis.. 2. |
9 | Case 1 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 1. 2. 1.3. |
15 | Case 1 | Patient History | Benign and Proliferative | Patient History and Progress. Female/37 years old, pre-menopause.. Screen detected mass lesion on left breast. 8 o’clock and 5 o’clock direction.. Outside result of biopsy: Papillary neoplasm.. No family history.. No comorbidities.. 1.2. |
2 | Case 1 | Courses of Treatment | Carcinoma In Situ | Carcinoma In Situ. Eun Sook Lee, Chan Wha Lee, Youngmi Kwon,. Yunju Kim, and Bo Hwa Choi. 1. . 1.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. 1.3.1. . Operation. 5. 6. 1.3.2. . Pathology Report. Ductal carcinoma in situ, pathological TN cat. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 5.2 cm (pTis).. . 2. Nuclear grade: high.. E. S. Lee et al.. 53. . . Carcinoma In Situ. 54. . 3. Necrosis: present.. . 4. Architectural pattern: papillary/cribriform/. solid/comedo.. . 5. Surgical margins:. . (a) deep margin: 6 mm,. . (b) superficial margin: subareolar margin:. (see Note 1).. . 6. Lymph nodes: no metastasis in one axillary. lymph node (pN0(sn)) (sentinel LN: 0/1).. . 7. Microcalcification: present, tumoral.. Note: 1. The subareolar margin of the mastec. tomy specimen (slide 11) is close to ductal carci. noma in situ (<1 mm), but this margin submitted. for frozen diagnosis (Fro 2) is free of tumor.. Result. Intensity Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in. 16% of tumor. cells. 2. |
10 | Case 1 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 1 2 3. 4. E. S. Lee. Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. C. W. Lee (*) · B. H. Choi. Division of Diagnostic Radiology, Center for Breast. Cancer, National Cancer Center,. Goyang, Republic of Korea. e-mail: cwlee@ncc.re.kr; iawy82@ncc.re.kr. Y. Kwon. Department of Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Gyeonggi,. Republic of Korea. e-mail: ymk@ncc.re.kr. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. |
16 | Case 1 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected a mass lesion on left breast in. 10 o’clock direction.. No family history of breast cancer or other. cancers.. S/P Uterine myomectomy.. 1.2. |
3 | Case 1 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | . 1.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab) + Operation + Post-. operative radiation therapy + Tamoxifen. 20 mg/day.. 7. 1.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of invasive component: 0.2 cm (pT1a).. 3. Size of intraductal component: 1.0 cm.. 4. Histologic grade:1/3 (tubule formation: 2/3,. nuclear pleomorphism: 2/3, mitotic count:. 1/3, 4/10 HPF).. 5. Intraductal component: present, extratumoral. (99%) (nuclear grade: high, necrosis: pres. ent, architectural pattern: cribriform/solid/. comedo, extensive intraductal component:. present).. 6. Surgical margins:. S. Park. Department of Surgery, Wonkwang University. Sanbon Hospital, Gunpo, Republic of Korea. R. Song · E.-G. Lee (*). Division of Surgery, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: thdfks37@ncc.re.kr; bnf333@ncc.re.kr. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. B. H. Choi · C. W. Lee. Division of Diagnostic Radiology, Center for Breast. Cancer, National Cancer Center,. Goyang, Republic of Korea. e-mail: iawy82@ncc.re.kr; cwlee@ncc.re.kr. E. S. Lee. Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. 300. . . . (a) superior margin: 18 mm,. . (b) inferior margin: 17 mm,. . (c) medial margin: 10 mm,. . (d) lateral margin: 10 mm,. . (e) deep margin: 4 mm,. . (f) superficial margin: 14 mm.. 7. Lymph nodes:. . (a) metastasis in one out of five axillary. lymph nodes (ypN1mi(sn)) (sentinel. LN: 1/5),. . (b) perinodal extension: absent,. . (c) size of metastatic carcinoma: 1 mm.. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: present, non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1aN1mi(sn).. Result. Intensity Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (7/8). 3. 1/3-2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 1%. of tumor cells. S. Park et al.. 301. . . HR(+) HER2(+) Breast Cancer. 302. F. ig. 5. a. b. . 2. |
11 | Case 1 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 1 2 3 4 5. 6. 1.3. |
17 | Case 1 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected mass lesion on left breast 5. o’clock direction.. No family history.. No comorbidities.. 1.2. |
4 | Case 1 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | HR(+) HER2(−) Breast Cancer. Yunju Kim, Bo Hwa Choi, Eun-Gyeong Lee,. Ji Young You, and Youngmi Kwon. 1. . 1.1. . Courses of Treatment. Operation + Letrozole 2.5 mg/day. 1.3.1. . Operation. Left total mastectomy, sentinel lymph node. 2. Histologic grade: 2/3 (tubule formation: 2/3,. nuclear pleomorphism: 2/3, mitotic count:. 2/3, 11/10 HPF).. 3. Intraductal component: present, intratu. moral/extratumoral (30%) (nuclear grade:. low, necrosis: absent, architectural pattern:. cribriform/solid, extensive intraductal com. ponent: present).. 4. Skin and nipple: dermal involvement of tumor.. 5. Surgical margins: deep margin: 7 mm.. 6. Lymph nodes:. . (a) metastasis in one out of seven axillary. lymph nodes (pN1mi) (sentinel LN: 1/7),. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. B. H. Choi. Division of Diagnostic Radiology, Center for Breast. Cancer, National Cancer Center,. Goyang, Republic of Korea. e-mail: iawy82@ncc.re.kr. E.-G. Lee. Division of Surgery, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: bnf333@ncc.re.kr. J. Y. You. Division of Breast and Endocrine, Department of. General Surgery, Korea University Medical Center,. Seoul, Republic of Korea. e-mail: joliejean@korea.ac.kr. Y. Kwon (*). Department of Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Gyeonggi,. Republic of Korea. e-mail: ymk@ncc.re.kr. 174. . (b) perinodal extension: present,. . (c) size of metastatic carcinoma: 0.2 mm.. 7. Arteriovenous. invasion:. present,. peritumoral.. 8. Lymphovascular. invasion:. present,. peritumoral.. 9. Tumor border: infiltrative.. . 10. Microcalcification:. present,. tumoral/. non-tumoral.. . 11. Pathological TN category (AJCC 2017):. pT2N1mi.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in 4% of |
12 | Case 1 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 1, 2 and 3.. 1.3. |
18 | Case 1 | Patient History | HR(+) HER2(-) Breast Cancer | Patient History and Progress. Female/87 years old, post-menopause.. Screen detected mass lesion on left breast sub. areolar area.. No family history.. Hypertension, diabetes mellitus, arrhythmia,. total knee replacement, cerebrovascular accident.. 1.2. |
5 | Case 1 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | HR(−) HER2(+) Breast Cancer. Youngmi Kwon, Yunju Kim, Bo Hwa Choi,. Ji Young You, Ran Song, Jeayeon Woo,. and Soojin Park. 1. . 1.1. . pertuzumab) + Operation + Post-operative radia. tion therapy + Trastuzumab.. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 42%. of tumor cells. 1.4.1. . Operation. 8. 1.4.2. . Pathology Report. No residual tumor with stromal fibrosis.. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metastasis in six axillary. lymph nodes (ypN0) (sentinel LN: 0/1, non-. sentinel LN: 0/5).. . HR(−) HER2(+) Breast Cancer. 432. 2. |
13 | Case 1 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic Findings. 1 2 3. 4. Y. Kwon. Department of Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Gyeonggi,. Republic of Korea. e-mail: ymk@ncc.re.kr. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. B. H. Choi. Division of Diagnostic Radiology,. Center for Breast Cancer, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: iawy82@ncc.re.kr. J. Y. You. Division of Breast and Endocrine,. Department of General Surgery,. Korea University Medical Center, Seoul,. Republic of Korea. e-mail: joliejean@korea.ac.kr. R. Song · J. Woo. Division of Surgery, Center for Breast Cancer,. National Cancer Center, Goyang, Gyeonggi, Republic. of Korea. e-mail: thdfks37@ncc.re.kr; jaeyeon1205@ncc.re.kr. S. Park (*). Department of Surgery, Wonkwang University. Sanbon Hospital, Gunpo, Gyeonggi,. Republic of Korea. e-mail: amiamo.com@gmail.com. 428. . . . . Y. Kwon et al.. 429. F. ig. 4. . After Neoadjuvant. Chemotherapy. 5 6. 7 |
19 | Case 1 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/59 years old, post-menopause.. Self-detected mass lesion on right breast 12. o’clock direction.. No family history.. S/P Tuberculosis.. 1.2. |
6 | Case 1 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | HR(−) HER2(−) Breast Cancer. Eun Sook Lee, Chan Wha Lee, Youngmi Kwon,. Jeayeon Woo, and Yunju Kim. 1. . 1.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin. and. cyclophosphamide. +. #4 cycles of docetaxel) + Operation + Post-. operative radiation therapy.. 1.3.1. . Operation. 7. 1.3.2. . Pathology Report. Breast, left, lumpectomy:. . 1. No residual tumor with stromal degeneration.. . (a) Post-chemotherapy status.. . (b) Lymph nodes: no metastasis in four axil. lary lymph nodes (ypN0(sn)) (sentinel. LN: 0/1, non-sentinel LN: 0/3).. . 2. Fibroadenomatous change.. Result. Intensity. Positive. %. Estrogen. receptor. Negative (2/8). 1. <1%. Progesterone. receptor. Negative (2/8). 1. <1%. C-erbB2. Negative (0). Ki-67. Positive in 65%. of tumor cells. . . . . HR(−) HER2(−) Breast Cancer. 578. . 2. |
14 | Case 1 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic Findings. 1 2. 3. E. S. Lee. Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. C. W. Lee. Division of Diagnostic Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: drlee4958@gmail.com. Y. Kwon. Department of Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: ymk@ncc.re.kr. J. Woo. Division of Surgery, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: jaeyeon1205@gmail.com. Y. Kim (*). Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. . © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023. E. S. Lee (ed.), A Practical Guide to Breast Cancer Treatment,. https://doi.org/10.1007/978-981-19-9044-1_8. 576. . . E. S. Lee et al.. 577. 1.2.1. . After Neoadjuvant. Chemotherapy. 4 5. 6. 1.3. |
20 | Case 1 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/40 years old, pre-menopause.. Screen detected a mass lesion at 1 o’clock. direction of the left breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected,. CHEK2 VUS (variant of uncertain).. 1.2. |
7 | Case 1 | Courses of Treatment | Local Recurrence | Local Recurrence. Yunju Kim, Eun-Gyeong Lee, Ran Song,. and Eun Sook Lee. 1. . 1.1. . Courses of Treatment. Right breast IDC → Neoadjuvant chemotherapy. → Operation → Adjuvant therapy → Right. breast recurrence (IDC).. 1.2.1. . Primary Treatment. 1 2 3. 4. Neoadjuvant Chemotherapy. Neoadjuvant chemotherapy #4 cycles of doxoru. bicin and cyclophosphamide followed by #4. cycles of docetaxel and trastuzumab.. Operation. . 5. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.4 cm (ypT1a).. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. E.-G. Lee · R. Song. Division of Surgery, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: bnf333@ncc.re.kr; thdfks37@ncc.re.kr. E. S. Lee (*). Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023. E. S. Lee (ed.), A Practical Guide to Breast Cancer Treatment,. https://doi.org/10.1007/978-981-19-9044-1_9. . 718. . . . . . . 3. Histologic grade: 2/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 1/3, 1/10HPF).. 4. Intraductal component: present, intratumoral/. extratumoral (10%) (nuclear grade: high,. Y. Kim et al.. 719. necrosis: absent, architectural pattern: cribri. form, extensive intraductal component: absent).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: 40 mm.. . (b) Inferior margin: 30 mm.. . (c) Medial margin: 5 mm.. . (d) Lateral margin: 15 mm.. . (e) Deep margin: 1 mm from invasive ductal. carcinoma.. 7. Lymph nodes: no metastasis in two axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/2).. 8. Vascular invasion: absent.. 9. Lymphatic invasion: present, intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathologic stage (AJCC 2010): ypT1aN0(sn).. Result. Intensity. Positive %. Estrogen. receptor. Weak (2/7). 1. <10%. Progesterone. receptor. Negative (0/7). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 7%. of tumor cells. Adjuvant Therapy. Postoperative radiation therapy.. Trastuzumab for 1 year + Tamoxifen 20 mg/. day for 8.9 years.. 1.2.2. . Treatments After Recurrence. 6 7. 8. Neoadjuvant Therapy. Neoadjuvant. chemotherapy. #6. cycles. of. docetaxel and trastuzumab and pertuzumab.. Operation. 9. Pathology Report. No residual tumor with stromal degeneration.. . . . . Local Recurrence. 720. . . . . . 1. Post-chemotherapy status.. . 2. Post-lumpectomy status.. Result. Intensity. Positive %. Estrogen. receptor. Negative (2/8). 1. <1%. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 18%. of tumor cells. Adjuvant Therapy. Postoperative radiation therapy.. Trastuzumab and pertuzumab.. 2. |
21 | Case 1 | Patient History | Local Recurrence | Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected mass lesion on lower medial. and lower outer portion of right breast.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 1.2. |
8 | Case 1 | Courses of Treatment | Metastatic Breast Cancer | Metastatic Breast Cancer. Youngmi Kwon, Yunju Kim, Bo Hwa Choi,. Eun-Gyeong Lee, Ji Young You, and Eun Sook Lee. 1. . 1.1. . Courses of Treatment. Left breast cancer → Operation + Adjuvant. therapy → Chest wall recurrence → Palliative. therapy. →. Pleural. fissure. recur. rence → Palliative therapy.. 1.2.1. . Primary Treatment. Operation. Mar. 2007 Left modified radical mastectomy.. Pathology: Invasive ductal carcinoma, stage. pT1N0, Size of tumor: 1.5 * 1.0 cm, Lymph. node: 0/21.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 11%. of tumor cells. Adjuvant Therapy. Adjuvant Chemotherapy #5 cycles (Fluorouracil. & Epirubicin & Cyclophosphamide).. Concurrent Trastuzumab therapy #9 cycles.. Zoladex for 2 years + Tamoxifen 20 mg/day. for 5 years.. Y. Kwon. Department of Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Gyeonggi,. Republic of Korea. e-mail: ymk@ncc.re.kr. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. B. H. Choi. Division of Diagnostic Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: iawy82@ncc.re.kr. E.-G. Lee. Division of Surgery, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: bnf333@ncc.re.kr. J. Y. You. Division of Breast and Endocrine, Department of. General Surgery, Korea University Medical Center,. Seoul, Republic of Korea. e-mail: joliejean@korea.ac.kr. E. S. Lee (*). Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. 862. 1.2.2. . Treatments After Recurrence. Chest Wall Recurrence. >2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. Result. Intensity. Positive %. C-erbB2. Equivocal (2+). Ki-67. Positive in. 21% of tumor. cells. SISH. Negative. Operation. Apr. 2014 Left chest wall wide excision and. bilateral salpingo-oophorectomy.. Pathology: Invasive ductal carcinoma, clini. cally recurrent, size of tumor: 1.0 cm, residual.. Adjuvant Therapy. Post-operative radiation therapy to chest wall+. Letrozole 2.5 mg/day for 5 years.. Pleural Fissure Recurrence. Mar. 2022 PET-CT: R/O pleural/fissural seedings. in left hemithorax.. See Figs. 2 and 3.. Palliative Therapy |
22 | Case 1 | Patient History | Metastatic Breast Cancer | Patient History and Progress. Female/49 years old, post-menopause.. No family history.. 1.2. |
23 | Case 10 | Courses of Treatment | Benign and Proliferative | Courses of Treatment. →2021-11-09 excision (Lt. 3H SA, Lt. nipple. mass).. Pathology Report. • Breast, “left subareolar 3 o’clock”, excision:. –. – Atypical ductal hyperplasia.. • Breast, “left nipple mass,” excision:. –. – Nipple adenoma (florid papillomatosis).. . . C. W. Lee et al.. 29. . . 11. |
31 | Case 10 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 16. 17. 10.3. |
37 | Case 10 | Patient History | Benign and Proliferative | Bloody discharge from left nipple.. No family history.. No comorbidities.. 10.2. |
24 | Case 10 | Courses of Treatment | Carcinoma In Situ | 10.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 47. 48. Pathology Report. Ductal carcinoma in situ, pathological TN cat. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 2.0 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Skin: no involvement of tumor.. . 6. Surgical margins:. . (a) deep margin: 2 mm,. . (b) superficial margin: 2 mm.. E. S. Lee et al.. 73. . . tumoral.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Intermediate. (6/8). 3. 10%-1/3. C-erbB2. Negative (1+). Ki-67. Positive in 1%. of tumor cells. Carcinoma In Situ. 74. . . . E. S. Lee et al.. 75. 11. |
32 | Case 10 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 43 44 45. 46. 10.3. |
38 | Case 10 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected microcalcification on mid. inner portion left breast.. Outside result of biopsy:. Left 9:30 o’clock, ductal carcinoma in situ.. Right 11 o’clock, flat epithelial atypia with. microcalcification.. No family history.. BRCA 1 and 2 mutation: Not detected.. 10.2. |
25 | Case 10 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 10.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab) + Operation + Post-. operative radiation therapy + Trastuzumab. emtansine + Letrozole 2.5 mg/day with. goserelin.. S. Park et al.. 329. . . . HR(+) HER2(+) Breast Cancer. 330. . 58. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Post-chemotherapy status.. . (b) Size of tumor: 3.0 cm (ypT2).. . (c) Histologic grade: 2/3 (tubule formation:. 3/3, nuclear pleomorphism: 3/3, mitotic. count: 1/3, 3/10 HPF).. . (d) Intraductal component: present, intratu. moral/extratumoral (5%) (nuclear grade:. high, necrosis: present, architectural pat. tern: cribriform/solid/comedo, extensive. intraductal component: absent).. . (e) Skin: dermal involvement of tumor.. . (f) Nipple: no involvement of tumor.. . (g) Surgical margins:. • deep margin: (see Note 1),. • superficial margin: (see Note 2).. S. Park et al.. 331. F. i. g. . 55. (white arrow) in the left. breast. Hypermetabolic. lymph nodes at the left. axilla, internal. mammary chain, and. supraclavicular area. (black arrows). . (h) Lymph nodes:. • metastasis in seven out of nine axil. lary lymph nodes (ypN2a) (sentinel. LN: 1/3, axillary LN: 6/6),. • perinodal extension: present,. • size of metastatic carcinoma: 10 mm.. . (i) Arteriovenous invasion: absent.. . (j) Lymphovascular invasion: present, intra. tumoral/peritumoral.. . (k) Tumor border: infiltrative.. . (l) Microcalcification:. present,. tumoral/. non-tumoral.. . (m) Pathological TN category (AJCC 2017):. ypT2N2a.. HR(+) HER2(+) Breast Cancer. 332. . . . 2. Fibroadenoma. Note: 1. The deep margin of the lumpectomy. specimen (slides 1 and 2) is close to invasive duc. tal carcinoma (<1 mm) but this margin submitted. for frozen diagnosis (Fro 5) is free of tumor.. 2. The superficial margin of the lumpectomy. specimen (slide 1) is close to invasive ductal car. cinoma (<1 mm) but this margin submitted for. frozen diagnosis (Fro 6) is free of tumor.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Weak (3/8). 2. <1%. C-erbB2. Positive (3+). Ki-67. Positive in 4% of. tumor cells. S. Park et al.. 333. . 11. |
33 | Case 10 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 52 53 54 55 56. 57. 10.3. |
39 | Case 10 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/32 years old, pre-menopause.. Self-detected skin changes and mass lesion on. left breast.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, NBN. and PALB2 VUS (variant of uncertain).. 10.2. |
26 | Case 10 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of docetaxel & cyclophospha. mide). +. Post-operative. radiation. ther. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, axillary lymph. 5. Surgical margins:. . (a) superior margin: 10 mm,. . (b) inferior margin: 30 mm,. . (c) medial margin: (see note),. . (d) lateral margin: 19 mm,. . (e) deep margin: 11 mm,. . (f) superficial margin: 2 mm.. 6. Lymph nodes:. . (a) metastasis in one out of seventeen axil. lary lymph nodes (pN1a) (sentinel LN:. 1/3, axillary LN: 0/14),. . (b) perinodal extension: absent,. . (c) size of metastatic carcinoma: 5 mm.. 7. Arteriovenous invasion: absent.. 8. Lymphovascular. invasion:. present,. peritumoral.. 9. Tumor border: pushing.. . 10. Microcalcification: absent.. . 11. Pathological TN category (AJCC 2017):. pT2N1a.. Note: 1. The medial margin of the lumpec. tomy specimen (slide 7) is close to ductal. carcinoma in situ (2 mm) but this margin. submitted for frozen diagnosis (Fro 6) is free. of tumor.. Result. Intensity. Positive %. Estrogen receptor. Intermediate (6/8). 2. 1/3–2/3. Progesterone receptor. Intermediate (6/8). 2. 1/3–2/3. C-erbB2. Negative (1+). Ki-67. Positive in 19% of tumor cells. Y. Kim et al. |
34 | Case 10 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 48, 49, 50 and 51.. 10.3. |
40 | Case 10 | Patient History | HR(+) HER2(-) Breast Cancer | No comorbidities.. 10.2. |
27 | Case 10 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 10.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Trastuzumab and. pertuzumab.. Operation. 77. a. b. . . Y. Kwon et al.. 469. Pathology Report. No residual tumor with stromal degeneration.. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metastasis in six axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/1,. non-sentinel LN: 0/5).. Result. Intensity. Positive %. Estrogen. receptor. Negative (2/8). 1. <1%. Progesterone. receptor. Negative (2/8). 1. <1%. C-erbB2. Positive (3+). Ki-67. Positive in. 33% of tumor. cells. 11. |
35 | Case 10 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic. Findings. 69 70 71. 72. . . . HR(−) HER2(+) Breast Cancer. 466. . Y. Kwon et al.. 467. 10.3. . After Neoadjuvant. Chemotherapy. 73 74 75. 76. . . . . . HR(−) HER2(+) Breast Cancer. 468. 10.4. |
41 | Case 10 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/36 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 9 o’clock direction.. Family history of breast cancer, aunt. (paternal).. S/P Tuberculosis, s/p salpingectomy.. BRCA 1 and 2 mutation: Not detected, ATM. VUS (variant of uncertain).. 10.2. |
28 | Case 10 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 10.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin and cyclophosphamide + #4. cycles of paclitaxel and cisplatin) + Operation. + Post-operative radiation therapy + ada. gloxad simolenin plus capecitabine.. Operation. 73. E. S. Lee et al.. 609. . . . HR(−) HER2(−) Breast Cancer. 610. . . . . E. S. Lee et al.. 611. . . . . HR(−) HER2(−) Breast Cancer. 612. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.9 cm (ypT1c).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 21/10HPF).. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: 8 mm.. . (b) Inferior margin: 25 mm.. . (c) Medial margin: 10 mm.. . (d) Lateral margin: 20 mm.. . (e) Deep margin: <1 mm from invasive duc. tal carcinoma (slide 2).. . (f) Superficial margin: 3 mm.. 7. Lymph nodes: no metastasis in three axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/1,. axillary LN: 0/2).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular. invasion:. present,. intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: present, non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1cN0(sn).. Result. Intensity. Positive. %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 86%. of tumor cells. 11. |
36 | Case 10 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic. Findings. 66 67. 68. After Neoadjuvant. Chemotherapy. 69 70 71. 72. 10.3. |
42 | Case 10 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/56 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. Asthma.. 10.2. |
29 | Case 10 | Courses of Treatment | Local Recurrence | 10.1. . Courses of Treatment. Right breast IDC→ Operation → Adjuvant ther. apy → Right breast recurrence (IDC).. Primary Treatment. 76 77. 78. Operation. . . 79. 80. Pathology Report. . 1. Invasive ductal carcinoma.. . (a) Size of tumor: 1.8 cm (pT1c).. . (b) Histologic grade: 2/3 (tubule formation:. 3/3, nuclear pleomorphism: 2/3, mitotic. count: 1/3, 5/10HPF).. . (c) Intraductal component: present, intratu. moral/extratumoral (10%) (nuclear grade:. low,. necrosis:. present,. architectural. . pattern: cribriform/solid, extensive intra. ductal component: absent).. . (d) Skin: no involvement of tumor.. . (e) Surgical margins:. . . . . Local Recurrence. 746. a. b. . a. b. . • Deep margin: <1 mm from invasive. ductal carcinoma (slide 3).. • Superficial margin: (see note 1).. . (f) Lymph nodes:. • Metastasis in one out of five axillary. lymph nodes (pN1mi(sn)) (see note 2). (sentinel LN: 1/4, non-sentinel LN: 0/1).. • Perinodal extension: absent.. • Size of metastatic carcinoma: 1.2 mm.. . (g) Arteriovenous invasion: absent.. . (h) Lymphovascular invasion: present, intra. tumoral/peritumoral.. . (i) Tumor border: infiltrative.. . (j) Microcalcification: present, non-tumoral.. . (k) Pathological TN category (AJCC 2017):. pT1cN1mi(sn).. . 2. Intraductal papilloma.. Note: 1. The superficial margin of the lumpec. tomy specimen (slide 3) is close to ductal carci. noma in situ (<1 mm), but this margin submitted. for frozen diagnosis (Fro 2) is free of tumor.. 2. Micrometastasis is present only in the per. manent section of Fro 3.. Result. Intensity. Positive %. Estrogen. receptor. Strong (7/8). 2. >2/3. Progesterone. receptor. Strong (7/8). 2. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in 5%. of tumor cells. Adjuvant Therapy. Tamoxifen 20 mg/day for 3.5 years.. Treatments After Recurrence. 81. 82. Operation. 83. 84. Y. Kim et al.. 747. . . . . Adjuvant Therapy. Adjuvant chemotherapy #4 cycles of doxorubicin. and cyclophosphamide followed by #4 cycles of. docetaxel.. Plan for postoperative radiation therapy.. Plan for letrozole with goserelin.. Local Recurrence. 748. . 11. |
43 | Case 10 | Patient History | Local Recurrence | Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 5. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. No family history.. s/p myomectomy.. 10.2. |
30 | Case 10 | Courses of Treatment | Metastatic Breast Cancer | 10.1. . Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral breast and lung recur. rence → Palliative therapy → Progression on. lung, left breast.. Primary Treatment. See Figs. 31, 32, and 33.. Operation. Dec. 2020 Left breast conserving surgery, senti. nel lymph node biopsy.. Pathology: Invasive ductal carcinoma, stage. pT2N0(sn).. Size of tumor: 2.1 cm, lymph node: 0/1.. Y. Kwon et al.. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Negative. (1+). Ki-67. Positive. in 68%. of tumor. cells. Adjuvant Therapy. Adjuvant chemotherapy #4 cycles (Docetaxel &. cyclophosphamide).. Treatments After Recurrence. Mar. 2021 PET-CT. . 1. R/O malignancy vs post-op change in left. breast upper outer periphery (2h′). rec) follow-up or further evaluation.. . 2. A few solid nodules in BLL; lung metastasis. cannot be excluded.. Negative. (0/8). 0. 0. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in. 77% of tumor. cells. → Chemotherapy #6 cycles (albumin-bound. paclitaxel & atezolizumab): Progressive disease. on lung, breast.. Metastatic Breast Cancer. 878. <1%. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Equivocal. (2+). Ki-67. Positive in. 52% of. tumor cells. SISH. Negative. Palliative Chemotherapy and Radiation. Chemotherapy #5 cycles (Doxorubicin &. Cisplatin).. Radiation therapy to lung~ |
44 | Case 10 | Patient History | Metastatic Breast Cancer | Patient History and Progress. Female/53 years old, post-menopause.. No family history.. S/p cholecystectomy, s/p knee giant cell tumor. excision, s/p interstitial mammoplasty.. S/p otitis media operation.. 10.2. |
45 | Case 11 | Courses of Treatment | Benign and Proliferative | 11.1. . Courses of Treatment. →2021-10-29 excision, Rt.. Benign and Proliferative Case Series. 30. . . . . Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. 12. |
53 | Case 11 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 18. 11.3. |
59 | Case 11 | Patient History | Benign and Proliferative | Patient History and Progress. Female/39 years old, pre-menopause.. Serous discharge from right nipple.. No family history.. Asthma, hyperthyroidism.. 11.2. |
46 | Case 11 | Courses of Treatment | Carcinoma In Situ | 11.1. . Courses of Treatment:. Operation. Operation. . 50. 51. Pathology Report. <First operation>. . 1. Ductal Carcinoma In Situ, Pathological TN. Category (AJCC 2017): pTis. . (a) Size of tumor: 0.3 cm (pTis).. . (b) Nuclear grade: low.. . (c) Necrosis: absent.. . (d) Architectural pattern: micropapillary/. cribriform.. . (e) Skin: no involvement of tumor.. . (f) Surgical margins:. • superior margin: 10 mm,. • inferior margin: 2 mm from ductal car. cinoma in situ (slide 3),. • medial margin: 10 mm,. • lateral margin: <1 mm from lobular. carcinoma in situ (slide 5),. • deep margin: 2 mm,. • superficial margin: 2 mm.. . (g) Microcalcification: present, tumoral/non-. tumoral.. . 2. Lobular Carcinoma In Situ. . (a) Size of tumor: 0.2 cm.. . (b) Nuclear grade: low.. . (c) Necrosis: absent.. . (d) Architectural pattern: solid.. Result. Intensity Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 3%. of tumor cells. <Second operation>. No residual tumor with foreign body. reaction.. . 1. Post-excision status.. . Carcinoma In Situ. 76. . . 12. |
54 | Case 11 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 49. 11.3. |
60 | Case 11 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. Outside result of biopsy:. Right breast, 8 o’clock, (1) adenosis, (2) fibro. cystic change, (3) flat epithelial atypia.. Family history, Father: Prostate cancer.. S/P Percutaneous closure of congenital ven. tricular septal detected.. 11.2. |
47 | Case 11 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 11.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha. mide). +. Post-operative. radiation. ther. apy + Trastuzumab + Letrozole 2.5 mg/day.. 63. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of tumor: 1.1 cm (pT1c).. . (b) Histologic grade: 2/3 (tubule formation:. 3/3, nuclear pleomorphism: 2/3, mitotic. count: 1/3, 2/10HPF).. . (c) Intraductal component: present, intratu. moral (20%) (nuclear grade: low, necro. sis:. absent,. architectural. pattern:. cribriform, extensive intraductal compo. nent: absent).. S. Park et al.. 335. . . . (d) Surgical margins:. • superior margin: 30 mm,. • inferior margin: 2 mm from invasive. ductal carcinoma (slide 5),. • medial margin: 15 mm,. • lateral margin: 10 mm,. • deep margin: 2 mm,. • superficial margin: 10 mm.. . (e) Arteriovenous invasion: absent.. . (f) Lymphovascular invasion: absent.. . (g) Tumor border: infiltrative.. . (h) Microcalcification: present, non-tumoral.. . (i) Pathological TN category (AJCC 2017):. pT1cNx.. . 2. Intraductal papilloma. HR(+) HER2(+) Breast Cancer. 336. a. b. . Lymph node, right sentinel, excision: No. metastasis in five axillary lymph nodes (pN0(sn)). (right sentinel LN: 0/5).. . 1. Post-excision status.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Weak (4/8). 2. 1–10%. C-erbB2. Positive (3+). Ki-67. Positive in 17%. of tumor cells. 12. |
55 | Case 11 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 59 60 61. 62. HR(+) HER2(+) Breast Cancer. 334. . . 11.3. |
61 | Case 11 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/60 years old, post-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. No family history.. Hypertension.. 11.2. |
48 | Case 11 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of docetaxel & cyclophospha. mide). +. Post-operative. radiation. ther. apy + Letrozole 2.5 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. 5. Surgical margins:. . (a) superior margin: 5 mm,. . (b) inferior margin: 15 mm,. . (c) medial margin: 15 mm,. . (d) lateral margin: 25 mm,. . (e) deep margin: 10 mm,. . (f) superficial margin: positive for invasive. ductal carcinoma (slide 3).. 6. Lymph nodes:. . (a) metastasis in one out of four axillary. lymph nodes (pN1a(sn)) (sentinel LN:. 0/3, intramammary LN: 1/1),. . (b) perinodal extension: absent,. . (c) size of metastatic carcinoma: 3.5 mm.. 7. Arteriovenous invasion: absent.. 8. Lymphovascular invasion: absent.. 9. Tumor border: infiltrative.. . 10. Microcalcification: present, non-tumoral.. . 11. Pathological TN category (AJCC 2017):. pT2N1a(sn).. Result. Intensity. Positive %. Estrogen receptor. Strong (7/8). 2. >2/3. Progesterone receptor. Intermediate (5/8). 2. 10%–1/3. C-erbB2. Negative (0). Ki-67. Positive in 8% of tumor cells. HR(+) HER2(−) Breast Cancer |
56 | Case 11 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 53, 54, 55 and 56.. 11.3. |
62 | Case 11 | Patient History | HR(+) HER2(-) Breast Cancer | Dyslipidemia.. 11.2. |
49 | Case 11 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 11.1. . operative radiation therapy + Trastuzumab.. Operation. 86. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.5 cm (ypT1c).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 5/HPF).. 4. Intraductal component: present, intratumoral/. extratumoral (40%) (nuclear grade: high, necro. sis: present, architectural pattern: solid/comedo,. extensive intraductal component: present).. 5. Skin and nipple: no involvement of tumor.. 6. Surgical margins:. . (a) deep margin: 2 mm,. . (b) superficial margin: 2 mm.. 7. Lymph nodes: no metastasis in six axillary. lymph nodes (ypN0) (sentinel LN: 0/3, non-. sentinel LN: 0/3).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: present, intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1cN0.. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in. 77% of tumor. cells. HR(−) HER2(+) Breast Cancer. 474. . Y. Kwon et al.. 475. 12. |
57 | Case 11 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic. Findings. 78 79 80. 81. . . HR(−) HER2(+) Breast Cancer. 470. . After Neoadjuvant. Chemotherapy. 82 83 84. 85. . . Y. Kwon et al. |
63 | Case 11 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/56 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. Diabetes mellitus, hepatitis C virus carrier.. 11.2. |
50 | Case 11 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 11.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of doxo. rubicin and cyclophosphamide + #4 cycles of. docetaxel) + Operation + Post-operative radia. tion therapy + Adjuvant capecitabine.. Operation. 82. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.2 cm (ypT1a).. 3. Histologic grade: 2/3 (tubule formation: 3/3,. nuclear pleomorphism: 2/3, mitotic count:. 1/3, 6/10HPF).. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: 20 mm.. . (b) Inferior margin: 5 mm.. . (c) Medial margin: 10 mm.. . (d) Lateral margin: 20 mm.. . (e) Deep margin: 2 mm.. . (f) Superficial margin: 2 mm.. 7. Lymph nodes: no metastasis in three axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/3).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. . tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1aN0(sn).. Result. Intensity. Positive. %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (2/8). 1. <1%. C-erbB2. Negative (0). Ki-67. Positive in 2% of. tumor cells. E. S. Lee et al.. 615. . . . . HR(−) HER2(−) Breast Cancer. 616. . . . E. S. Lee et al.. 617. 12. |
58 | Case 11 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic. Findings. 74 75 76. 77. E. S. Lee et al.. 613. . . . HR(−) HER2(−) Breast Cancer. 614. . After Neoadjuvant. Chemotherapy. 78 79 80. 81. 11.3. |
64 | Case 11 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on upper outer. portion of right breast.. Family history of breast cancer, mother and. aunt (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 11.2. |
51 | Case 11 | Courses of Treatment | Local Recurrence | 11.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy → Right breast recurrence (IDC).. Primary Treatment. Operation. Nov. 2008 Right breast conserving surgery, senti. nel lymph node biopsy (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 1.3 cm (pT1c).. . 2. Lymph nodes: no metastasis in four axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/4).. . 3. Pathologic stage (AJCC 2010): pT1cN0(sn).. Result. Intensity Positive %. Estrogen. receptor. Positive. Progesterone. receptor. Positive. C-erbB2. Negative. Ki-67. Positive in 5–10%. of tumor cells. Adjuvant Therapy. Adjuvant chemotherapy #4 cycles of doxorubicin. and cyclophosphamide.. Postoperative radiation therapy.. Tamoxifen 20 mg/day for 1.8 years.. Treatments After Recurrence. 85 86. 87. Y. Kim et al.. 749. . . . Operation. . 88. Pathology Report. Invasive Ductal Carcinomas (×2). 1. Post-chemotherapy status.. 2. Post-lumpectomy status.. 3. Size of tumor: 0.8 cm and 0.3 cm (ypT1b).. 4. Histologic grade: 2/3 (tubule formation: 2/3,. nuclear pleomorphism: 2/3, mitotic count:. 2/3, 12/10HPF).. 5. Intraductal component: present, intratu. moral/intratumoral (10%) (nuclear grade:. low, necrosis: absent, architectural pattern:. cribriform, extensive intraductal component:. absent).. 6. Skin: no involvement of tumor.. 7. Surgical margins:. . (a) Deep margin: 6 mm.. . (b) Superficial margin: 10 mm.. Local Recurrence. 750. a. b. . 8. Lymph nodes: no metastasis in one axillary. lymph node (ypN0)(sn) (sentinel LN: 0/1).. 9. Vascular invasion: absent.. . 10. Lymphatic invasion: absent.. . 11. Tumor border: infiltrative.. . 12. Microcalcification: absent.. . 13. Pathologic stage (AJCC 2010): ypT1bN0(sn).. Result. Intensity Positive %. Estrogen. receptor. Strong (7/8). 2. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). (SISH negative). Ki-67. Positive in 21% of. tumor cells. Adjuvant Therapy. Tamoxifen 20 mg/day for 5 years with goserelin.. 12. |
65 | Case 11 | Patient History | Local Recurrence | Patient History and Progress. Female/45 years old, post-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. No family history.. S/P bilateral salpingo-oophorectomy (right. ovary borderline tumor).. BRCA 1 and 2 mutation: Not detected.. 11.2. |
52 | Case 11 | Courses of Treatment | Metastatic Breast Cancer | Courses of Treatment. Both breasts cancer → Operation → Adjuvant. therapy → Right axillary lymph node. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Weak (3/8). 2. <1%. C-erbB2. Equivocal. (2+). Result. Intensity. Positive %. Ki-67. Positive in. 22% of. tumor cells. SISH. Equivocal. HER2/CEP17 gene ratio: 1.93.. Left> Invasive ductal carcinoma, stage. pT2N0(sn).. Size of tumor: 2.1 cm, lymph node: 0/2.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Weak (4/8). 2. 1–10%. C-erbB2. Equivocal (2+). Ki-67. Positive in 34%. of tumor cells. SISH. Tumor. heterogeneity. HER2/CEP17 gene ratio: 2.03.. Adjuvant Therapy. Adjuvant chemotherapy #2 cycles (Docetaxel &. cyclophosphamide) → Trastuzumab for 1 year +. Letrozole 2.5 mg/day for 2.1 years.. Treatments After Recurrence. Right Axillary Lymph Nodes Recurrence. receptor. Negative (0/8). 0. 0. C-erbB2. Equivocal (2+). Ki-67. Positive in. 25% of tumor. cells. SISH. Positive. Neoadjuvant Chemotherapy. Chemotherapy. #5. cycles. (Docetaxel. &. Carboplatin & Trastuzumab & Pertuzumab).. Operation. Mar. 2022 Right axillary lymph node dissection.. Pathology: No metastasis in four axillary. lymph nodes.. Adjuvant Therapy. Trastuzumab & Pertuzumab + Post-operative. radiation therapy (axillary and subclavian area).. 12. |
66 | Case 12 | Courses of Treatment | Benign and Proliferative | 12.1. . Courses of Treatment. →2021-10-29 excision, Lt.. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Intraductal papilloma (#1. 2 o’clock, #2.. 5 o’clock & #3. 9 o’clock) with (1) usual. ductal hyperplasia, (2) apocrine metaplasia.. C. W. Lee et al.. 31. 13. |
74 | Case 12 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 19. 20. 12.3. |
80 | Case 12 | Patient History | Benign and Proliferative | Patient History and Progress. Female/70 years old, post-menopause.. Screen detected mass lesion on left breast. 2 o’clock and 5 o’clock and 9 o’clock direction.. No family history.. s/p Right breast conserving surgery (right. breast cancer), hypertension, diabetes mellitus.. 12.2. |
67 | Case 12 | Courses of Treatment | Carcinoma In Situ | 12.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. . . 55. 56. Pathology Report. Ductal carcinoma in situ, pathological TN cat. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 1.0 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural. pattern:. cribriform/solid/. comedo.. . 5. Surgical margins:. . (a) deep margin: 10 mm,. . (b) superficial margin: 12 mm.. . 6. Lymph nodes: no metastasis in two axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/1, left. intramammary LN: 0/1).. . 7. Microcalcification: present, non-tumoral.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative. (1+). Ki-67. Positive in. 16% of. tumor cells |
75 | Case 12 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 52 53. 54. 12.3. |
81 | Case 12 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/49 years old, pre-menopause.. Screen detected mass lesion on right breast. 4:30 and 9 o’clock direction.. Outside result of biopsy:. Left breast 4: 30 o’clock, ductal carcinoma in. situ.. Left breast 9 o’clock, intraductal papilloma.. Family history of breast cancer, sister at her. 48 years old.. E. S. Lee et al.. 77. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 12.2. |
68 | Case 12 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 12.1. . Courses of Treatment. Neoadjuvant chemotherapy (#1 cycle of. docetaxel and carboplatin and trastuzumab. and pertuzumab followed by #5 cycles of. docetaxel and carboplatin) + Operation +. Adjuvant chemotherapy (doxorubicin and. cyclophosphamide) + Post-. operative radiation. therapy + Letrozole 2.5 mg/day.. 69. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.3 cm (ypT1a).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 2/3, 11/10HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (50%) (nuclear grade:. high, necrosis: absent, architectural pattern:. micropapillary, extensive intraductal compo. nent: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 10 mm,. . (b) inferior margin: (see Note 1),. . (c) medial margin: (see Note 2),. . (d) lateral margin: 20 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 2 mm.. 7. Lymph nodes: no metastasis in one axillary. lymph node (ypN0(sn)) (sentinel LN: 0/1).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1aN0(sn).. HR(+) HER2(+) Breast Cancer. 338. . Note: 1. The inferior margin of the lumpec. tomy specimen (slide A3) is close to ductal carci. noma in situ (2 mm) but this margin submitted. for frozen diagnosis (Fro 2) is free of tumor.. 2. The medial margin of the lumpectomy. specimen (slide 1) is close to ductal carcinoma in. situ (<1 mm) but this margin submitted for frozen. diagnosis (Fro 3) is free of tumor.. Result. Intensity. Positive %. Estrogen receptor. Strong (8/8). 3. >2/3. Progesterone receptor. Weak (3/8). 1. 1–10%. C-erbB2. Negative (1+). Equivocal (2+) in core needle biopsy. Ki-67. Positive in 4% of tumor cells. SISH. Positive. S. Park et al.. 339. . . HR(+) HER2(+) Breast Cancer. 340. a. b. . 13. |
76 | Case 12 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 64 65 66 67. 68. S. Park et al.. 337. . . 12.3. |
82 | Case 12 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/63 years old, post-menopause.. Screen detected mass lesion on left breast 10. o’clock direction.. No family history.. s/p Idiopathic thrombocytopenic purpura. (2020).. 12.2. |
69 | Case 12 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of docetaxel & cyclophospha. mide). +. Post-operative. radiation. ther. apy + Tamoxifen 20 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. extratumoral (30%) (nuclear grade: low,. necrosis: present, architectural pattern: solid,. extensive intraductal component: present).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 3 mm,. . (b) inferior margin: 17 mm,. . (c) medial margin: 10 mm,. . (d) lateral margin: <1 mm from ductal carci. noma in situ (slides 10 and 11),. . (e) deep margin: 5 mm,. . (f) superficial margin: positive for ductal. carcinoma in situ (slide 8).. 6. Lymph nodes: no metastasis in five axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/2,. non-sentinel LN: 0/3).. 7. Arteriovenous invasion: absent.. 8. Lymphovascular. invasion:. present,. peritumoral.. 9. Tumor border: pushing.. . 10. Microcalcification: absent.. . 11. Pathological TN category (AJCC 2017):. pT2N0(sn).. Result. Intensity. Positive %. Estrogen receptor. Weak (4/8). 1. 10%–1/3. Progesterone receptor. Intermediate (5/8). 2. 10%–1/3. C-erbB2. Negative (0). Ki-67. Positive in 4% of tumor cells. Y. Kim et al. |
77 | Case 12 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 58, 59, 60 and 61.. 12.3. |
83 | Case 12 | Patient History | HR(+) HER2(-) Breast Cancer | S/P hysterectomy, dyslipidemia, diabetes mel. litus, s/p cervical spine disc operation.. 12.2. |
70 | Case 12 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 12.1. . Invasive Ductal Carcinoma with medullary. pattern. 1. Size of tumor: 2.9 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 5/HPF).. 3. Intraductal component: present, intratu. moral/extratumoral (30%) (nuclear grade:. high, necrosis: present, architectural pattern:. Y. Kwon et al.. 477. . solid/comedo, extensive intraductal compo. nent: present).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 10 mm,. . (b) inferior margin: 5 mm,. . (c) medial margin: 20 mm,. . (d) lateral margin: 15 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 2 mm.. 6. Lymph nodes: no metastasis in four axillary. lymph nodes (pN0(sn)) (sentinel LN (fro. zen): 0/4, sentinel LN (A): 0/0, non-sentinel. LN: 0/0).. 7. Arteriovenous invasion: absent.. 8. Lymphovascular. invasion:. present,. intratumoral.. 9. Tumor border: infiltrative.. . 10. Microcalcification:. present,. tumoral/. non-tumoral.. . 11. Pathological TN category (AJCC 2017):. pT2N0(sn).. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in. 52% of tumor. cells. HR(−) HER2(+) Breast Cancer. 478. 13. |
78 | Case 12 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic. Findings. 87 88 89 |
84 | Case 12 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/66 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. Hypertension, thyroidectomy (hyperthyroid. ism), s/p salpingectomy.. 12.2. |
71 | Case 12 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 12.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of doxo. rubicin and cyclophosphamide + #4 cycles of. docetaxel) + Operation + Adjuvant capecitabine.. Operation. . . . 89. 90. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.5 cm (ypT1a).. 3. Histologic grade: 2/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 1/3, 1/10HPF).. 4. Intraductal component: absent.. 5. Surgical margins:. . (a) Deep margin: 2 mm.. . (b) Superficial margin: 8 mm.. 6. Lymph nodes: no metastasis in three axil. lary lymph nodes (ypN0(sn)) (sentinel LN:. 0/3).. 7. Arteriovenous invasion: absent.. 8. Lymphovascular. invasion:. present,. intratumoral.. 9. Tumor border: infiltrative.. . 10. Microcalcification: present, non-tumoral.. . 11. Pathological TN category (AJCC 2017):. ypT1aN0(sn).. Result. Intensity. Positive. %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in 6% of. tumor cells. E. S. Lee et al.. 619. . . HR(−) HER2(−) Breast Cancer. 620. 13. |
79 | Case 12 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic. Findings. 83 84. 85. . . . HR(−) HER2(−) Breast Cancer. 618. . . . . After Neoadjuvant. Chemotherapy. 86 87. 88. 12.3. |
85 | Case 12 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/47 years old, post-menopause.. Screen detected a mass lesion on right breast. 10 o’clock direction.. Family history of breast cancer, aunt (mater. nal) and cousin.. Family history of ovarian cancer, aunt.. Lupus (follow-up), s/p bilateral salpingo-. oophorectomy, s/p unilateral thyroidectomy.. BRCA 1 mutation carrier.. 12.2. |
72 | Case 12 | Courses of Treatment | Local Recurrence | 12.1. . Courses of Treatment. Right breast DCIS → Operation → Right breast. recurrence (microinvasive ductal carcinoma).. Primary Treatment. 89 90. 91. Operation. . 92. Pathology Report. Ductal carcinoma in situ. . 1. Size of tumor: 2.3 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: cribriform, solid and. papillary.. . 5. Skin: no involvement of tumor.. . 6. Surgical margins:. . (a) Superior margin: 20 mm.. . (b) Inferior margin: 20 mm.. . (c) Medial margin: 30 mm.. . (d) Lateral margin: 50 mm.. . (e) Deep margin: 2 mm.. . 7. Lymph nodes: no metastasis in 5 axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/4,. right intramammary LN (Fro 6): 0/1).. Y. Kim et al.. 751. . . . . . . . . 8. Microcalcification:. present,. tumoral/. non-tumoral.. . 9. Pathologic staging: pTisN0(sn).. Result. Intensity. Positive %. Estrogen. receptor. Strong (7/7). 3. >2/3. Progesterone. receptor. Strong (6/7). 3. 1/3–2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 10%. of tumor cells. Treatments After Recurrence. 93. Operation. 94. 95. Local Recurrence. 752. a. b. . a. b. . Pathology Report. . 1. Microinvasive Ductal Carcinoma involving. lactiferous duct.. . (a) Post-lumpectomy status.. . (b) Size of invasive component: <0.1 cm. (pT1mi(Paget)).. . (c) Size of intraductal component: 1.3 cm.. . (d) Histologic grade: 2/3 (tubule formation:. 3/3, nuclear pleomorphism: 2/3, mitotic. count: 1/3, 6/10HPF).. . (e) Intraductal component: present, intratu. moral/extratumoral. (99%). (nuclear. grade: low, necrosis: present, architec. tural pattern: micropapillary/cribriform,. extensive. intraductal. component:. present).. . (f) Nipple: involvement of lactiferous duct. (slide 10).. . (g) Skin: no involvement of tumor.. . (h) Surgical margins:. Y. Kim et al.. 753. • Deep margin: 3 mm.. • Superficial margin: 4 mm.. . (i) Arteriovenous invasion: absent.. . (j) Lymphovascular invasion: absent.. . (k) Tumor border: infiltrative.. . (l) Microcalcification: present, tumoral.. . (m) Pathologic. stage. (AJCC. 2010):. pT1mi(Paget).. . 2. Lobular carcinoma in situ, 0.3 cm.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Intermediate. (6/8). 2. 1/3–2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 13%. of tumor cells. Adjuvant Therapy. Tamoxifen 20 mg/day for 5 years.. 13. |
86 | Case 12 | Patient History | Local Recurrence | Patient History and Progress. Female/55 years old, peri-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. Family history of prostate cancer, father.. s/p hysterectomy, HPV infection.. 12.2. |
73 | Case 12 | Courses of Treatment | Metastatic Breast Cancer | 12.1. . Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence → Contralateral breast cancer.. Primary Treatment. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Intermediate. (6/8). 2. 1/3–2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 26%. of tumor cells. SISH. Negative. Adjuvant Therapy. Anastrozole 1 mg/day for 4.3 years.. Treatments After Recurrence. Ipsilateral Axillary Lymph Node. Recurrence. Progesterone. receptor. Weak (4/8). 3. <1%. C-erbB2. Negative (0). Ki-67. Positive in. 31% of. tumor cells. Neoadjuvant Chemotherapy. Chemotherapy. #8. cycles. (Adriamycin. +. Cyclophosphamide #4 → weekly paclitaxel #4).. Y. Kwon et al.. Contralateral Breast Cancer. See Figs. 41 and 42.. Aug. 2021 Right breast biopsy.. Pathology: Ductal carcinoma.. Operation. Oct. 2021 Right total mastectomy, sentinel lymph. node biopsy.. Pathology: Ductal carcinoma in situ, stage. pTisN0(sn).. Size of tumor: 1.6 cm, lymph node: 0/4.. Result. Intensity. Positive %. Estrogen. receptor. Strong (0/8). 0. 0. Progesterone. receptor. Weak (0/8). 0. 0. C-erbB2. Equivocal. (2+). Ki-67. Positive in. 12% of. tumor cells. → Exemestane 25 mg/day~. Adjuvant Therapy. Exemestane 25 mg/day~. Metastatic Breast Cancer. 882. 13. |
87 | Case 12 | Patient History | Metastatic Breast Cancer | Patient History and Progress. Female/78 years old, post-menopause.. No family history.. Hypertension, diabetes mellitus.. 12.2. |
88 | Case 13 | Courses of Treatment | Benign and Proliferative | 13.1. . Courses of Treatment. →2021-10-26 excision, Rt.. . Benign and Proliferative Case Series. 32. . Pathology Report. • Breast, right 12 o’clock, excision:. –. – Flat. epithelial. atypia. with. microcalcification. • Breast, right 2 o’clock, excision:. –. – Atypical. ductal. hyperplasia. with. microcalcification.. 14. |
96 | Case 13 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 21. 22. 13.3. |
102 | Case 13 | Patient History | Benign and Proliferative | Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected microcalcification on upper. center of right breast.. No family history.. No comorbidities.. 13.2. |
89 | Case 13 | Courses of Treatment | Carcinoma In Situ | . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 58. 59. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary/cribriform.. . 5. Surgical margins: positive for ductal carci. noma in situ.. . 6. Microcalcification:. present,. tumoral/non-. tumoral.. Carcinoma In Situ. 80. . . . Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (7/8). 2. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 1% of tumor. cells. <Second operation>. No residual tumor with foreign body reaction.. . 1. Post-excision status.. E. S. Lee et al.. 81. 14. |
97 | Case 13 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 57. 13.3. |
103 | Case 13 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on left breast. 10 o’clock direction.. Outside result of biopsy: Left breast. 10 o’clock, papillary neoplasm.. Family history of breast cancer, sister.. No comorbidities.. BRCA 1 and 2: Not check.. 13.2. |
90 | Case 13 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 13.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4. cycles. of. docetaxel. and. cyclophospha. mide). +. Post-operative. radiation. ther. apy + Trastuzumab + Letrozole 2.5 mg/day.. 73. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.1 cm (pT2).. 2. Histologic grade: 2/3 (tubule formation: 3/3,. nuclear pleomorphism: 2/3, mitotic count:. 1/3, 15/10 HPF).. S. Park et al.. 341. . . . 3. Intraductal component: present, intratu. moral/extratumoral (10%) (nuclear grade:. low, necrosis: present, architectural pattern:. solid/comedo, extensive intraductal compo. nent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 10 mm,. . (b) inferior margin: 10 mm,. . (c) medial margin: 5 mm,. . (d) lateral margin: 5 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 2 mm.. 6. Lymph nodes: no metastasis in one axillary. lymph node (pN0(sn)) (sentinel LN: 0/1).. 7. Arteriovenous invasion: absent.. 8. Lymphovascular. invasion:. present,. intratumoral.. 9. Tumor border: infiltrative.. . 10. Microcalcification:. present,. tumoral/. non-tumoral.. . 11. Pathological TN category (AJCC 2017):. pT2N0(sn).. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2. Positive (3+). Ki-67. Positive in 42%. of tumor cells. HR(+) HER2(+) Breast Cancer. 342. a. b. . 14. |
98 | Case 13 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 70 71. 72. 13.3. |
104 | Case 13 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/53 years old, post-menopause.. Screen detected mass lesion on left breast 1:30. o’clock direction.. No family history.. Hypertension, arrhythmia, s/p myomectomy.. 13.2. |
91 | Case 13 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of doxorubicin & cyclophosphamide. followed by #4 cycles of docetaxel) + Post-. operative radiation therapy + Letrozole. 2.5 mg/day.. Operation. sive intraductal component: absent).. 4. Skin and nipple: dermal involvement of. tumor.. 5. Surgical margins: (see note).. . (a) deep margin: <1 mm from invasive duc. tal carcinoma (slide 3).. . (b) superficial margin: 2 mm.. 6. Lymph nodes:. HR(+) HER2(−) Breast Cancer. 8. Lymphovascular. invasion:. present,. intratumoral.. 9. Tumor border: infiltrative.. . 10. Microcalcification: present, tumoral.. . 11. Pathological TN category (AJCC 2017):. pT3N2a.. Note: 1. The medial border of the mastectomy. specimen (slide 10) is close to invasive ductal. carcinoma (<1 mm).. HR(+) HER2(−) Breast Cancer. Intermediate (6/8). 2. 1/3–2/3. C-erbB2. Negative (1+). Ki-67. Positive in 26% of tumor cells. 14. |
99 | Case 13 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 63, 64, 65 and 66.. 13.3. |
105 | Case 13 | Patient History | HR(+) HER2(-) Breast Cancer | S/P Tuberculosis, S/P appendectomy.. 13.2. |
92 | Case 13 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 13.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia. 2. Size of tumor: 0.3 cm (ypT1a).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 4/HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (30%) (nuclear grade:. high, necrosis: present, architectural pattern:. cribriform/solid, extensive intraductal com. ponent: present).. . Y. Kwon et al.. 483. 5. Skin and nipple: no involvement of tumor.. 6. Surgical margins:. . (a) deep margin: 2 mm,. . (b) superficial margin: 2 mm.. 7. Lymph nodes: no metastasis in six axillary. lymph nodes (ypN0) (sentinel LN: 0/3, non-. sentinel LN: 0/3).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular. invasion:. present,. intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1aN0.. Result. Intensity. Positive %. Estrogen. receptor. Negative. (0/8). 0. 0. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Positive. (3+). Result. Intensity. Positive %. Ki-67. Positive in. 4% of. tumor cells. 14. |
End of preview. Expand
in Dataset Viewer.
No dataset card yet
New: Create and edit this dataset card directly on the website!
Contribute a Dataset Card- Downloads last month
- 2