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100
Case 13
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 92 93. 94. . Y. Kwon et al.. 479. 95 96 97. 98. 13.4. 
106
Case 13
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/44 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. No family history.. No comorbidities.. 13.2. 
93
Case 13
Courses of Treatment
HR(−) HER2(−) Breast Cancer
13.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 98. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of t...
101
Case 13
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 91 92. 93. After Neoadjuvant. Chemotherapy. 94 95 96. 97. 13.3. 
107
Case 13
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/67 years old, post-menopause.. Self-detected mass lesion on left breast.. No family history.. Hepatitis C virus carrier, arrhythmia.. 13.2. 
94
Case 13
Courses of Treatment
Local Recurrence
13.1. . Courses of Treatment. Right breast microinvasive ductal carcinoma →. Operation → Right breast recurrence (DCIS).. Primary Treatment. 96 97. 98. . . . Local Recurrence. 754. a. b. . a. b. . Operation. ­. 99. 100. Pathology Report. Microinvasive Ductal Carcinoma. 1. Size of invasive component: <0.1  cm. (pT1mi)...
108
Case 13
Patient History
Local Recurrence
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 3. o’clock direction and bloody discharge from. right nipple.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: not detected.. 13.2. 
95
Case 13
Courses of Treatment
Metastatic Breast Cancer
13.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Estrogen. receptor. Intermediate. (6/8). 1. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 18% of tumor. cells. Adjuvant ...
109
Case 13
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/39 years old, post-menopause.. Family history of ovarian cancer, paternal. aunt.. BRCA. 1. mutation: VUS. (variant. of. uncertain).. S/p bilateral salpingo-oophorectomy.. 13.2. 
110
Case 14
Courses of Treatment
Benign and Proliferative
14.1. . Courses of Treatment. →2021-10-15 excision, Rt.. Pathology Report. • Breast, right, excision:. –. – Atypical ductal hyperplasia involving. intraductal papilloma with marked cautery. artifact.. C. W. Lee et al.. 33. . . 15. 
118
Case 14
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 23. 24. 14.3. 
124
Case 14
Patient History
Benign and Proliferative
Patient History and Progress. Female/60 years old, post-menopause.. Screen detected mass lesion on right breast. 9 o’clock direction.. Family history of breast cancer, mother.. s/p Total hysterectomy (leiomyoma) and Left. salpingo-oophorectomy.. 14.2. 
111
Case 14
Courses of Treatment
Carcinoma In Situ
14.1. . Courses of Treatment:. Operation. Operation. 61. 62. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.3 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary.. . 5. Surgical mar...
119
Case 14
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 60. 14.3. 
125
Case 14
Patient History
Carcinoma In Situ
Patient History and Progress. Female/54 years old, pre-menopause.. Screen detected microcalcification on upper. inner portion of left.. No family history.. Taking medication for bladder dysfunction.. 14.2. 
112
Case 14
Courses of Treatment
HR(+) HER2(+) Breast Cancer
14.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel and trastu­. zumab)  +  Post-operative radiation ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 77. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5...
120
Case 14
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 74 75. 76. 14.3. 
126
Case 14
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/51 years old, peri-menopause.. Screen detected mass lesion on portion of. lower of right breast.. Family history of breast cancer, sister.. Hypothyroidism (taking on synthroid).. BRCA 1 and 2 mutation: Not detected.. 14.2. 
113
Case 14
Courses of Treatment
HR(+) HER2(-) Breast Cancer
14.1. . Courses of Treatment. Neoadjuvant therapy (Palbociclib 125 mg/day. &. tamoxifen. 20. mg/day. with. gosere­. lin)  +  Operation  +  Post-operative radiation. therapy. +. Letrozole. 2.5. mg/day. with. goserelin.. Operation. Left breast conserving surgery, sentinel lymph. . (a) superior margin: 5 mm.. . (b) inf...
121
Case 14
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 68, 69, 70, 71 and 72.. 14.3. 
127
Case 14
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/43 years old, pre-menopause.. Screen detected mass lesion on left breast 1. and 3 o’clock direction.. No family history.. No comorbidities.. 14.2. 
114
Case 14
Courses of Treatment
HR(−) HER2(+) Breast Cancer
14.1. . Courses of Treatment. Neoadjuvant chemotherapy (#3 cycles of. docetaxel and trastuzumab and pertuzumab after. followed #3 cycles of trastuzumab and pertu­. zumab #4) + Operation + Post-operative radia­. tion therapy + Trastuzumab emtansine.. Operation. Microinvasive Ductal Carcinoma. 1. Size of invasive compo...
122
Case 14
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 100 101 102. 103. . HR(−) HER2(+) Breast Cancer. After Neoadjuvant. Chemotherapy. 104 105 106. 107. HR(−) HER2(+) Breast Cancer. 486. 14.4. 
128
Case 14
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/74 years old, post-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. No family history.. S/P retroperitoneum, excision (paragang­. lioma).. 14.2. 
115
Case 14
Courses of Treatment
HR(−) HER2(−) Breast Cancer
14.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. + #12 cycles of paclitaxel)  +  Post-­. operative. radiation therapy.. Operation. 103. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 3.0 cm (pT2).. 2. Histologic grade: 3/3 (tubule form...
123
Case 14
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 99 100 101. 102. 14.3. 
129
Case 14
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/43 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast.. Family history of breast cancer, grandmother.. s/p Right breast, mammotome excision, s/p. right ear, benign excision.. BRCA 1 and 2 mutation: Not detected.. 14.2. 
116
Case 14
Courses of Treatment
Local Recurrence
14.1. . Courses of Treatment. Right breast infiltrating ductal carcinoma →. Operation → Left breast recurrence (IDC).. Primary Treatment. 103. 104. Operation. Aug. 2003 Right breast conserving surgery, axil­. lary lymph node dissection, left breast mass. excision.. Pathology Report. <Right>. Infiltrating Ductal Carcin...
130
Case 14
Patient History
Local Recurrence
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast 1. o’clock direction and left 9 o’clock direction.. No family history.. Diabetes mellitus.. BRCA 1 and 2 mutation: Not detected, ATM. and POLE VUS (variant of uncertain).. . . ­. Local Recurrence. 756. 14.2. ...
117
Case 14
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Estrogen. receptor. Intermediate. (6/8). 2. 1/3–2/3. Progesterone. receptor. Strong (7/8). 2. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 35% of tumor. cells. Adjuvant Therap...
131
Case 14
Patient History
Metastatic Breast Cancer
Hepatitis B carrier.. 14.2. 
132
Case 15
Courses of Treatment
Benign and Proliferative
15.1. . Courses of Treatment. →2021-10-12 excision, Lt.. Benign and Proliferative Case Series. 34. . . Pathology Report. • Breast, left, excision:. –. – Atypical ductal hyperplasia, focal. –. – Fibroadenomatous change.. 16. 
140
Case 15
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 25. 26. 15.3. 
146
Case 15
Patient History
Benign and Proliferative
Patient History and Progress. Female/33 years old, pre-menopause.. Screen detected mass lesion on left breast. 3 o’clock direction.. Family history of pancreatic cancer, maternal. grandmother.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 15.2. 
133
Case 15
Courses of Treatment
Carcinoma In Situ
15.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. Operation. 67. 68. E. S. Lee et al.. 83. 2. Nuclear grade: high.. 3. Necrosis: present.. 4. Architectural pattern: micropapillary/cribri­. form/solid/comedo.. 5. Skin: no involvement of tumor.. 6. Surgic...
141
Case 15
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 63 64 65. 66. 15.3. 
147
Case 15
Patient History
Carcinoma In Situ
Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on right breast. 1 o’clock direction.. No family history.. No comorbidities.. 15.2. 
134
Case 15
Courses of Treatment
HR(+) HER2(+) Breast Cancer
15.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 82. . ­. ­. . HR(+) HER2(+) Breast Cancer. 346. . . Pathology Report. . 1. Invasive Ductal Carcinoma with apocrine. diff...
142
Case 15
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 78 79 80. 81. 15.3. 
148
Case 15
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/42 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast 6 o’clock direction.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 15.2. 
135
Case 15
Courses of Treatment
HR(+) HER2(-) Breast Cancer
15.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Anastrozole 1 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. (a) superior margin: 35 mm.. . (b) inferior margin: 10 mm.. . (c) medial margin: 15 mm.. . (d) lateral margin: 5 mm.. . (e) deep margin: 12 mm.. . (f)...
143
Case 15
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 74, 75, 76 and 77.. 15.3. 
149
Case 15
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected mass lesion on left breast 12. o’clock direction.. No family history.. Hypertension, dyslipidemia, s/p transobtura­. tor tape for stress urinary incontinence.. 15.2. 
136
Case 15
Courses of Treatment
HR(−) HER2(+) Breast Cancer
15.1. . 116. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.9 cm (ypT1c).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 2/3, 12/10HPF).. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor.. 6. Surgica...
144
Case 15
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 109 110 111. . After Neoadjuvant. Chemotherapy. 113 114. 115. . HR(−) HER2(+) Breast Cancer. 492
150
Case 15
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/61 years old, post-menopause.. Self-detected palpable mass lesion on right. breast 12 o’clock direction.. No family history.. Hypertension.. HR(−) HER2(+) Breast Cancer. 488. . Y. Kwon et al.. 489. 15.2. 
137
Case 15
Courses of Treatment
HR(−) HER2(−) Breast Cancer
15.1. . Courses of Treatment. Operation + operation.. Operation. ­. 107. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of invasive component: 0.4  cm. (pT1a).. . (b) Size of intraductal component: 4.0 cm.. . (c) Histologic grade: 3/3 (tubule formation:. 3/3, nuclear pleomorphism: 3/3, mitotic. coun...
145
Case 15
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 104 105. 106. 15.3. 
151
Case 15
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/74 years old, post-menopause.. Self-detected bloody discharge on the nipple. of the left breast.. No family history.. S/P hysterectomy (due to myoma), hyperten­. sion, s/p shoulder calcific tendinitis operation.. 15.2. 
138
Case 15
Courses of Treatment
Local Recurrence
15.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy →Left breast and axillary lymph node. recurrence (IDC) → Left axillary lymph node. recurrence.. Primary Treatment. 109. 110. Operation. 111. Pathology Report. Invasive Ductal Carcinomas (×2).. 1. Size of tumor: 2.1 cm, 0.7 cm (pT2(m)).. 2....
152
Case 15
Patient History
Local Recurrence
Patient History and Progress. Female/63 years old, post-menopause.. Self-detected mass lesion on right breast 9. o’clock direction.. Family history of breast cancer, mother.. Hypertension, s/p Left leg fracture operation.. BRCA 1 and 2 mutation: Not detected.. 15.2. 
139
Case 15
Courses of Treatment
Metastatic Breast Cancer
15.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in. 31% of tumor. cells. Adjuvant Therapy. Tamoxif...
153
Case 15
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/74 years old, post-menopause.. No family history.. Hypertension.. 15.2. 
154
Case 16
Courses of Treatment
Benign and Proliferative
16.1. . Courses of Treatment. →2021-09-13 needle biopsy.. Pathology Report. Diagnosis. • Breast, right, needle biopsy:. –. – Ductal carcinoma in situ.. Nuclear grade: low.. Necrosis: present.. C. W. Lee et al.. 35. . ­. . Benign and Proliferative Case Series. 36. . Architectural pattern: micropapillary/. cribriform/c...
162
Case 16
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 27 28. 29. 16.3. 
168
Case 16
Patient History
Benign and Proliferative
Patient History and Progress. Female/59 years old, post-menopause.. Screen detected mass lesion on right breast. 7 o’clock direction.. No family history.. s/p Total hysterectomy, s/p left nephrectomy. (donor), s/o cholecystectomy.. 16.2. 
155
Case 16
Courses of Treatment
Carcinoma In Situ
16.1. . Courses of Treatment:. Operation. Operation. 73. 74. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis(Paget)N0 (sn). . 1. Size of tumor: 1.5 cm (pTis(Paget)).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. Carcinoma In Situ. 4. Architectural. pattern:. cribrif...
163
Case 16
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 69 70 71. 72. E. S. Lee et al.. 85. . . . ­. 16.3. 
169
Case 16
Patient History
Carcinoma In Situ
Patient History and Progress. Female/75 years old, post-menopause.. Screen detected microcalcification on left. breast 12 o’clock direction.. Outside result of biopsy: Left breast 12 o’clock,. fibrosis.. Family history of breast cancer, mother.. Hypertension.. BRCA 1 and 2: Not examination.. 16.2. 
156
Case 16
Courses of Treatment
HR(+) HER2(+) Breast Cancer
16.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles. of. docetaxel. and. cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 87. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of tumor: 1.1 cm (pT1c).. . (b) Histologic grade:...
164
Case 16
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 83 84 85. 86. 16.3. 
170
Case 16
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/54 years old, peri-menopause.. Self-detected palpable mass lesion on right. breast 6 o’clock direction.. No family history.. Diabetes. mellitus,. S/P. hysterectomy,. agoraphobia.. 16.2. 
157
Case 16
Courses of Treatment
HR(+) HER2(-) Breast Cancer
16.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. cribriform/solid, extensive intraductal com­. ponent: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 20 mm.. ...
165
Case 16
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 79, 80, 81 and 82.. 16.3. 
171
Case 16
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/51 years old, peri-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. No family history.. No comorbidities.. 16.2. 
158
Case 16
Courses of Treatment
HR(−) HER2(+) Breast Cancer
16.1. . Courses of Treatment. Operation + adjuvant chemotherapy (#4 cycles of. docetaxel and cyclophosphamide)  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 121. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nucle...
166
Case 16
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 117 118 119. 
172
Case 16
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. Hypothyroidism (taking on synthroid).. 16.2. 
159
Case 16
Courses of Treatment
HR(−) HER2(−) Breast Cancer
16.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy.. Operation. 117. Pathology Report. No residual tumor with foamy histiocytic. collection. . 1. Post-chemotherapy status.. . 2. Lymp...
167
Case 16
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 109 110 111. 112. HR(−) HER2(−) Breast Cancer. 630. . . . ­. E. S. Lee et al.. 631. . After Neoadjuvant. Chemotherapy. 113 114 115. 116. 16.3. 
173
Case 16
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/42 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. s/p Cholecystectomy, s/p appendectomy, s/p. vocal cord operation.. 16.2. 
160
Case 16
Courses of Treatment
Local Recurrence
16.1. . Courses of Treatment. Left breast DCIS → Operation → Adjuvant. therapy → Left breast recurrence (DCIS).. Primary Treatment. 116. 117. Operation. 118. Pathology Report. Ductal Carcinoma In Situ. . 1. Size of tumor: 3.0 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: present.. . 4. Architectural pattern...
174
Case 16
Patient History
Local Recurrence
Patient History and Progress. Female/43 years old, pre-menopause.. Screen detected mass lesion on left breast 7. o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. 16.2. 
161
Case 16
Courses of Treatment
Metastatic Breast Cancer
16.1. . Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. pT2N1a(sn).. Size of tumor: 2.5  cm and 1.0  cm, lymph. node: 1/2, size of metastatic carcinoma: 2.1 mm.. Result. Intensity Positive %. Estrogen. receptor. Strong (8/8). 3...
175
Case 16
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/46 years old, post-menopause.. No family history.. S/p myomectomy & bilateral salpingo-. oophorectomy.. 16.2. 
176
Case 17
Courses of Treatment
Benign and Proliferative
17.1. . Courses of Treatment. →2021-09-17 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Atypical ductal hyperplasia involving. mammary cyst.. –. – Usual ductal hyperplasia, focal with. microcalcification.. 18. 
184
Case 17
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 30. 31. . Benign and Proliferative Case Series. 38. . 17.3. 
190
Case 17
Patient History
Benign and Proliferative
Patient History and Progress. Female/39 years old, pre-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. No family history.. s/p appendectomy (cecal cancer), s/p hyster­. ectomy, and bilateral salpingo-oophorectomy.. s/p partial hepatectomy.. 17.2. 
177
Case 17
Courses of Treatment
Carcinoma In Situ
17.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 79. 80. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis(Paget)N0(sn). . 1. Size of tumor: 1.5 cm (pTis(Paget)).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural. p...
185
Case 17
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 75 76 77. 78. 17.3. 
191
Case 17
Patient History
Carcinoma In Situ
Patient History and Progress. Female/40 years old, pre-menopause.. Screen detected nodule and microcalcification. on upper outer portion of right breast.. No family history.. No comorbidities.. 17.2. 
178
Case 17
Courses of Treatment
HR(+) HER2(+) Breast Cancer
17.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide) + Trastuzumab + Tamoxifen 20 mg/day.. ­. ­. ­. 92 93. 94. Pathology Report. [Right].. . 1. Ductal carcinoma in situ.. . (a) Size of tumor: 0.7 cm (pTis).. . (b) Nuclear grade: low.. . (c) Necrosis:...
186
Case 17
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 88 89 90. 91. 17.3. 
192
Case 17
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/38 years old, post-menopause.. Self-detected palpable mass lesion on left. breast 1 o’clock direction.. Family history of prostate cancer, maternal. father.. S/P salpingo-oophorectomy (2022).. BRCA 2 mutation carrier.. 17.2. 
179
Case 17
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. sive intraductal component: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 5 mm.. . (b) inferior margin: (see note 1)...
187
Case 17
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 84, 85, 86 and 87.. 17.3. 
193
Case 17
Patient History
HR(+) HER2(-) Breast Cancer
o’clock direction.. No family history.. S/P Lumbar spine disc herniation operation,. s/p pain block in lumbar spine.. S/p hormone replacement due to amenorrhea.. 17.2. 
180
Case 17
Courses of Treatment
HR(−) HER2(+) Breast Cancer
17.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel and trastuzumab)  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 126. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.8 and 1.5 cm (pT1c(2)).....
188
Case 17
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 122 123 124. 125. . HR(−) HER2(+) Breast Cancer. 498. . . . 17.3. 
194
Case 17
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast.. Family history of breast cancer, aunt. (maternal).. S/P Lumbar spine disc operation.. BRCA 1 and 2 mutation: Not detected,. MUTYH VUS (variant of uncertain).. 17.2. 
181
Case 17
Courses of Treatment
HR(−) HER2(−) Breast Cancer
17.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#2. cycles of doxorubicin and cyclophosphamide,. refuse) + Post-operative radiation therapy.. Operation. 122. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.3 cm (pT1c).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear ple...
189
Case 17
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 118 119 120. 121. 17.3. 
195
Case 17
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/70 years old, post-menopause.. Screen detected mass at the upper outer quad­. rant of the left breast.. Family history of breast cancer, niece.. h/o Tuberculosis, s/p appendectomy, s/p. myomectomy.. BRCA 1 and 2 mutation: Not tested.. 17.2. 
182
Case 17
Courses of Treatment
Local Recurrence
17.1. . Courses of Treatment. Right breast DCIS → Operation → Adjuvant. therapy → Right breast recurrence (mucinous. carcinoma).. Primary Treatment. 122. Operation. 123. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-excisional biopsy status.. . 2. Size of tumor: 1.5 cm, residual.. . 3. Nuclear grade: high.....
196
Case 17
Patient History
Local Recurrence
Patient History and Progress. Female/43 years old, pre-menopause.. Screen detected mass lesion on right breast 7. o’clock direction.. Outside result of mammotome biopsy: ductal. carcinoma in situ.. No family history.. s/p Total thyroidectomy (thyroid cancer).. BRCA 2 VUS (variant of uncertain).. 17.2. 
183
Case 17
Courses of Treatment
Metastatic Breast Cancer
17.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Estrogen. receptor. Strong. (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong. (7/8). 2. >2/3. C-erbB2. Negative. (0). Ki-67. Positive in. 15% of. tumor. cells. Adjuvant ...
197
Case 17
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/69 years old, post-menopause.. Family history of breast cancer, daughter.. BRCA. 1. mutation: VUS. (variant. of. uncertain).. 17.2. 
198
Case 18
Courses of Treatment
Benign and Proliferative
18.1. . Courses of Treatment. →2021-08-27 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Atypical ductal hyperplasia with micro-. calcification.. Post-excision status.. –. – Intraductal papilloma.. C. W. Lee et al.. 39. . . 19. 
206
Case 18
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 32. 33. 18.3. 
212
Case 18
Patient History
Benign and Proliferative
Patient History and Progress. Female/57 years old, pre-menopause.. Screen detected mass lesion on right breast. 9 ~ 10 o’clock direction.. No family history.. No comorbidities.. s/p Right breast excision.. 18.2.