Case 2: Invasive Breast Cancer

Ketty Badrinath, M.D.

62 yr old Female was found to have a right breast abnormality on a screening mammogram.   This mammogram was repeated which revealed an abnormality measuring 1.5 cm suspicious of malignancy in the upper outer quadrant of the right breast.   She underwent a needle localization biopsy of this abnormality revealing infiltrating ductal carcinoma and DCIS.

PMHx:              History of benign disease in left breast.

PSHx:               Excision of breast lumps in left breast.   Benign.

Meds:                Vit E and calcium

Allergies:           Amoxocillin

Social:   She is a widow.   Menarche at 14 yrs of age and menopause at age 55.   She is grii pii.   (No hx of tobacco or alcohol consumption.)   (BCP x 2 yrs. No hx of ERT. )

Family Hx:   No family history of any type of cancer.

Review of Systems:    Negative.

PEx:     Was within normal limits except for mild echymosis and vague palpable abnormality at the   biopsy site.


  1. Infiltrating ductal carcinoma of right breast along with DCIS
  2. History of fibrocystic disease of left breast.

Recommendation:   She was advised lumpectomy and sentinel node biopsy pending further recommendations after sentinel node biopsy and ER, PgR data.

Pathology:   Infiltrating ductal carcinoma long with DCIS.   T 1 C, N 1 , M x .   Margins of resection clear.  

ER:           90% positive

PgR:         Negative

Her-2Neu:   Positive

Final Recommendation:   Adjuvant chemotherapy followed by Adjuvant Radiotherapy and Tamoxifen.

Follow-up:   Eight years later, the patient presents with metastases to liver, bones and brain.   Patient and family decided to go into hospice.