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Courses of Treatment
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Important Radiologic
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Patient History
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Case 7
HR(+) HER2(+) Breast Cancer
7.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. emtansine + Tamoxifen 20 mg/day.. 42. 7.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy statu...
Important Radiologic. Findings. 36 37 38 39 40. 41. 7.3. 
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction.. No family history.. Paroxysmal supraventricular tachycardia, s/p. atrial septal defect closure.. S/P thyroid lobectomy (thyroid cancer).. 7.2. 
Case 7
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. 7.3.1. . Operation. Left breast conserving surgery, sentinel lymph. (a) superior margin: 10 mm,. . (b) inferior margin: (see note),. . (c) medial margin: 10 mm,. . (d) lateral margin: 5 mm,. . (e) deep margin: <1 mm fr...
Important Radiologic. Findings. See Figs. 31, 32, 32, 33, 34 and 35.. 7.3. 
Depression.. 7.2. 
Case 7
HR(−) HER2(+) Breast Cancer
7.1. . Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy.. 7.4.1. . Operation. 53. 7.4.2. . Pathology Report. No residual tumor with stromal degeneration.. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metasta...
Important Radiologic. Findings. 48. 49. . . HR(−) HER2(+) Breast Cancer. 454. 7.3. . After Neoadjuvant. Chemotherapy. 50 51. 52.
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected mass lesion on upper outer. portion of left breast.. No family history.. S/P Nodules of vocal cord, operation.. 7.2. 
Case 7
HR(−) HER2(−) Breast Cancer
7.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. 7.3.1. . Operation. 51. 7.3.2. . Pathology Report. Metaplastic Carcinoma with sarcomatous. differentiat...
Important Radiologic. Findings. 44 45. 46. HR(−) HER2(−) Breast Cancer. 598. . . ­. 7.2.1. . After Neoadjuvant. Chemotherapy. 47 48 49. 50. 7.3. 
Patient History and Progress. Female/56 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 7.2. 
Case 7
Local Recurrence
7.1. . Courses of Treatment. Left breast microinvasive ductal carci­. noma + DCIS → Operation → Adjuvant therapy. → Right breast recurrence (DCIS).. 7.2.1. . Primary Treatment. 51 52. 53. Operation. ­. 54. Local Recurrence. 736. . ­. . . . ­. Pathology Report. Microinvasive Ductal Carcinoma. 1. Size of invasive comp...
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Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. . 4 o’clock direction.. Family history of breast cancer, mother.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 7.2. 
Case 7
Metastatic Breast Cancer
Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral breast and chest wall. recurrence → Chemotherapy → Progression on. the skin and contralateral axillary lymph. nodes.. 7.2.1. . Primary Treatment. Intensity. Positive %. Estrogen. receptor. Negative. (2/8). 1. <1%. Progesterone. receptor. Negative. (2/8)....
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Case 8
Benign and Proliferative
8.1. . Courses of Treatment. →2021-11-12 excision, Lt.. Benign and Proliferative Case Series. 26. . ­. ­. C. W. Lee et al.. 27. 8.3.1. . Pathology Report. Diagnosis. • Breast, left, excision:. –. – Atypical. ductal. hyperplasia. with. micro­. calcification.. 9. 
Important Radiologic. Findings. 12. 8.3. 
Patient History and Progress. Female/54 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of left breast.. No family history.. No comorbidities.. 8.2. 
Case 8
Carcinoma In Situ
8.1. . Courses of Treatment. Operation + Postoperative radiation therapy. (right side)  +  Tamoxifen 20  mg/day for. 5 years.. 8.3.1. . Operation. 36. 37. 8.3.2. . Pathology Report. Right.. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.3 cm (pTis)....
Important Radiologic. Findings. 34. 35. 8.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Detected bloody discharge in left nipple.. No family history.. No comorbidities.. ATM VUS (variant of uncertain).. 8.2. 
Case 8
HR(+) HER2(+) Breast Cancer
8.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 47. 8.3.1. . Pathology Report. . 1. No residual tumor with foreign body. reaction.. . (a) Post-excision status.. . (b)...
Important Radiologic. Findings. 43 44 45. 46. . HR(+) HER2(+) Breast Cancer. 324. . . . S. Park et al.. 325. 8.3. 
Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. No family history.. Hypertension,. s/p. cholecystectomy,. arrhythmia.. 8.2. 
Case 8
HR(+) HER2(-) Breast Cancer
Right nipple–areolar complex sparing mastec­. tomy, sentinel lymph node biopsy, Left nipple–. areolar complex sparing mastectomy, sentinel. lymph node biopsy (Figs. 41 and 42).. 8.3.2. . Pathology Report. [Right]. Invasive Ductal Carcinoma. micropapillary/cribriform/solid/comedo,. extensive intraductal component: pres...
Important Radiologic. Findings. See Figs. 37, 38, 39 and 40.
o’clock and left breast 2 o’clock direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: not detected.. 8.2. 
Case 8
HR(−) HER2(+) Breast Cancer
8.1. . 8.3.1. . Operation. ­. 58. 59. 8.3.2. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of invasive component: 1.1 cm (pT1c).. 2. Size of intraductal component: 3.0 cm.. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 5/HPF).. 4. Intraductal component...
Important Radiologic. Findings. 54 55 56. 57. . . Y. Kwon et al.
Patient History and Progress. Female/53 years old, peri-menopause.. Screen detected microcalcification on right. breast 1 and 10 o’clock direction.. No family history.. No comorbidities.. 8.2. 
Case 8
HR(−) HER2(−) Breast Cancer
8.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of paclitaxel)  +  Operation  +  Post-. operative radiation therapy.. 8.3.1. . Operation. 58. 59. 8.3.2. . Pathology Report. <Right>. Microinvasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2....
Important Radiologic. Findings. 52 53. 54. 8.2.1. . After Neoadjuvant. Chemotherapy. 55 56. 57. 8.3. 
Patient History and Progress. Female/56 years old, peri-menopause.. Screen detected a mass lesion on right breast 7. o’clock direction and left breast 4 o’clock. direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 8.2. 
Case 8
Local Recurrence
8.1. . Courses of Treatment. Right breast IDC/Left breast intraductal papil­. loma, sclerosing → Operation → Adjuvant ther­. apy → Left breast recurrence (DCIS).. 8.2.1. . Primary Treatment. 59. 60. Operation. 61. 62. Pathology Report. <Right>. Y. Kim et al.. 739. . 1. Invasive Ductal Carcinoma involving scleros­. i...
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Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass lesion on right breast. . 12 o’clock direction and left 6 o’clock direction.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 8.2. 
Case 8
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph nodes. recurrence.. 8.2.1. . Primary Treatment. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2. Negative (0). Ki-67. Positive in. 61% of tumor. cells. Oncotype Dx RS Score: ...
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Case 9
Benign and Proliferative
9.1. . Courses of Treatment. → 2021-11-12 Excision, Rt.. 9.3.1. . Pathology Report. Diagnosis. • Breast, right, excision:. –
Important Radiologic. Findings. 13 14. 15. 9.3. 
Patient History and Progress. Female/32 years old, pre-menopause.. Screen detected mass lesion on right breast. 8 o’clock direction.. Family history of breast cancer, mother and. maternal aunt.. No comorbidities.. 9.2. 
Case 9
Carcinoma In Situ
9.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. 9.3.1. . Operation. 41. 42. E. S. Lee et al.. 71. . 9.3.2. . Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 1.2 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: pre...
Important Radiologic. Findings. 38 39. 40. 9.3. 
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected microcalcification on inner. portion of left.. Outside result of biopsy: Ductal carcinoma in. situ, left.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not examination.. 9.2. 
Case 9
HR(+) HER2(+) Breast Cancer
9.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. therapy + Trastuzumab.. 51. 9.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.3 cm (pT1c).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nu...
Important Radiologic. Findings. 48 49. 50. 9.3. 
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected mass lesion on left breast 7. o’clock direction.. Family history of breast cancer, two sisters.. Family history of pancreatic cancer, mother.. No other history of disease, operation, or. medication.. BRCA 1 and 2 mutation: Not detected,....
Case 9
HR(+) HER2(-) Breast Cancer
9.1. . Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4  cycles of docetaxel & cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Tamoxifen 20 mg/day.. 9.3.1. . Operation. Left breast conserving surgery, sentinel lymph. moral/extratumoral (25%) (nuclear grade:. high, necrosis: present, ar...
Important Radiologic. Findings. See Figs. 43, 44, 45 and 46.. 9.3. 
Patient History and Progress. Female/55 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. Family history of Prostate cancer, paternal. uncle.. No comorbidities.. 9.2. 
Case 9
HR(−) HER2(+) Breast Cancer
9.1. . docetaxel and carboplatin and trastuzumab and. pertuzumab after followed #4 cycles of docetaxel. and. trastuzumab. and. ­. pertuzumab). +. Operation  +  Post-operative radiation ther­. apy + Trastuzumab and pertuzumab.. 9.4.1. . Operation. 68. 9.4.2. . Pathology Report. . 1. No residual tumor with stromal fi...
Important Radiologic. Findings. 60 61 62. . ­. 9.3. . After Neoadjuvant. Chemotherapy. 64 65 66. 67. Y. Kwon et al.
Patient History and Progress. Female/51 years old, pre-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. No family history.. Hypothyroidism.. 9.2. 
Case 9
HR(−) HER2(−) Breast Cancer
9.1. . Courses of Treatment. Operation  +  adjuvant chemotherapy (#4. cycles of docetaxel and cyclophosphamide) +. Operation + Post-operative radiation therapy.. 9.3.1. . Operation. 65. 9.3.2. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.3 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation...
Important Radiologic Findings. 60 61 62 63. 64. 9.3. 
Patient History and Progress. Female/65 years old, post-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. No family history.. S/P right salpingectomy (due to ectopic. pregnancy).. 9.2. 
Case 9
Local Recurrence
9.1. . Courses of Treatment. Right breast mucinous carcinoma → Operation. → Adjuvant therapy → Left breast recurrence. (IDC + DCIS)/Right breast ADH.. 9.2.1. . Primary Treatment. 66 67. 68. Operation. ­. 69. Local Recurrence. 742. . . . . ­. Pathology Report. Mucinous Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. ...
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Patient History and Progress. Female/51 years old, pre-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. Outside result of biopsy: Mucinous carcinoma.. Family history of colon cancer, father.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 9.2. 
Case 9
Metastatic Breast Cancer
. Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph nodes. recurrence.. 9.2.1. . Primary Treatment. Estrogen. receptor. Strong (7/8). 2. >2/3. Progesterone. receptor. Negative (2/8). 1. <1%. C-erbB2. Negative (0). Ki-67. Positive in. 23% of tumor. cells. Adjuvant T...
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Patient History and Progress. Female/57 years old, post-menopause.. No family history.. S/p. Myomectomy. &. bilateral. salpingo-oophorectomy.. 9.2. 
Important Radiologic Findings
Benign and Proliferative
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Important Radiologic Findings
Carcinoma In Situ
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Important Radiologic Findings
HR(+) HER2(+) Breast Cancer
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Important Radiologic Findings
HR(+) HER2(-) Breast Cancer
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Important Radiologic Findings
HR(−) HER2(+) Breast Cancer
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Important Radiologic Findings
HR(−) HER2(−) Breast Cancer
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Important Radiologic Findings
Local Recurrence
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Important Radiologic Findings
Metastatic Breast Cancer
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