Case 1: Breast Cancer - Ductal Carcinoma in Situ

Ketty Badrinath, M.D.

53 yr old F presented to Breast Care Center at Loyola for a second opinion.

HPI:   She was healthy all her life and has been getting screening mammograms since 1995 and her last mammogram was found to be abnormal.   Her mammogram showed subtle architectural distortion, without a mass or calcifications.   Read as Birads 4, and biopsy was recommended.

Course:   She underwent an ultrasound guided biopsy showing DCIS.   Slide review showed DCIS extending into lobules, cribriform and solid type, nuclear grade 1 measuring 2.2 cm in diameter.   DCIS was focally seen at inked margins.

PMHx:          None

PSHx:           None

Meds:           None

Allergies:       None

Social:   Japanese translator.   Married. Menarche at 13 yrs and menopause at 51 yrs of age.   No Hx of smoking or alcohol.   No Hx of BCP or ERT.

Family Hx:   Mother died of tongue carcinoma and multiple myeloma.   Father died of Addison's disease secondary to tuberculosis.   Two sisters are alive and well.

Review of Systems:        None

PEx:   Was normal except for S/P biopsy of right breast.   Left breast examination was normal.

Assessment:   DCIS    S/P ultrasound guided biopsy of right breast.

Plan and Recommendation:   She was advised reexcision in view of margin involvement followed by radiation and adjuvant tamoxifen.   She is currently on adjuvant tamoxifen without sequelae.