A 58-year-old female presented with a lump in her right breast for 2 months, along with pain over the lump for 1 month. Examination found two lumps in the right breast measuring 3x2 cm and 4x3 cm. Ultrasound showed lesions in the right breast and multiple subcentimetric lymph nodes in the right axilla. Core needle biopsy revealed invasive ductal carcinoma (IDC), grade 3, estrogen receptor negative, HER2 neu negative, with a Ki67 of 40%. The working diagnosis was carcinoma of the right breast cT2N0M0, clinical stage IIA. The plan was for modified radical mastectomy followed by chemotherapy with or without radiotherapy and/or hormonal

1. A CASE OF CARCINOMA
RIGHT BREAST
PROF DR. S.P. GAYATHRE MA’AM’S UNIT S1

2. CASE SUMMARY
• A 58 year old female, P2L2, postmenopausal, known diabetic
presented with
complaint of lump in the right breast for 2 months.
Associated with pain over the lump x 1 month.
•Not a k/c/o /SHTN/Epilepsy/TB/CAD
•No prior history of similar illnesses/ blood transfusions.
•ST done 30 years back.
•No family history of cancer.

3. EXAMINATION
• ECOG 1
• No pallor
• L/E :
Right breast :
3 x 2 cm lump in the lower inner to lower outer quadrant, approximately 6’o’ clock position,
irregular margins, firm , moving with breast tissue. Core needle biopsy scar +
4x3 cm lump present in the upper inner to upper outer quadrant, approximately 12’o’ clock
position, irregular margins, firm, mobile ,moving with breast tissue.
Axillary node examination :
No palpable axillary lymph nodes.
Other system examination- normal

4. USG BILATERAL BREAST WITH AXILLA
• Ill defined irregular hypoechoic lesion measuring 2.3 x 1.7 cm in zone
2, 3 at around 5’o’ clock position with internal vascularity and tiny
echogenic linear septation.
• Another hypoechoic lesion measuring 1.03 x 0.5 x 0.5 cm noted in
zone 2 around 8’o’ clock position.
• Multiple subcentimetric lymph nodes noted in the right axillary region
largest measuring 1.2 x 0.7 cm.
• BIRADS 4 - suggested FNAC.

5. USG ABDOMEN AND PELVIS
• No significant abnormality

6. CHEST X RAY
• No evidence of metastases.

7. HPE CORE NEEDLE BIOPSY 28/04/2023
2245/23
• IDC NST GRADE 3
• ER Negative
• Her 2 Neu Negative
• IHC to be repeated for PR
• Ki67 40%

8. WORKING DIAGNOSIS
• CARCINOMA RIGHT BREAST cT2N0M0.
• Clinical Stage IIA

10. PLAN
• Modified radical mastectomy followed by chemotherapy
with/without radiotherapy with/without hormonal therapy

11. TUMOUR BOARD CONSENSUS

12. THANK YOU