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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, Republ...
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 (AJC...
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: cwl...
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 invasi...
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, mitot...
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...
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. ...
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....
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. ...
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...
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. . P...
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.. ....
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 mutatio...
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. . 5...
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,. ...
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.....
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...
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, nuclea...
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.. Path...
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/. cr...
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 closu...
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...
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,. ...
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: prese...
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...
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. Lym...
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. Equ...
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:....
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. ...
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.....
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: sol...
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, archi...
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. His...
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 th...
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. Architectu...
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...
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.....
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: pa...
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 f...
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. Surg...
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. Intra...
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