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199
Case 18
Courses of Treatment
Carcinoma In Situ
18.1. . Courses of Treatment. Operation + Postoperative radiation therapy.. Operation. 83. 84. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 1.1 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: present.. . 4. Architectural pattern: micropapillary...
207
Case 18
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 81. 82. 18.3. 
213
Case 18
Patient History
Carcinoma In Situ
Patient History and Progress. Female/64 years old, post-menopause.. Screen detected mass lesion on right breast. 8 o’clock direction.. Outside result of biopsy:. Right breast 8  o’clock, atypical intraductal. papillary neoplasm, favor ductal carcinoma in. situ.. No family history.. Hypertension, diabetes mellitus.. 18....
200
Case 18
Courses of Treatment
HR(+) HER2(+) Breast Cancer
18.1. . 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  +  Letrozole 2.5  mg/day. with goserelin.. 99. Pathology Report. Invasive Ductal Carcinoma. ...
208
Case 18
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 95 96 97. 98. 18.3. 
214
Case 18
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/38 years old, pre-menopause.. Self-detected palpable mass lesion on portion. of outer half of left breast.. No family history.. Lumbar spine disc.. BRCA 1 and 2 mutation: Not examination.. 18.2. 
201
Case 18
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation (1st & 2nd, Aug. 2010)  +  Post-­. operative radiation therapy  +  Tamoxifen. 20 mg/day.. Operation (3rd, Jan. 2021) + Adjuvant che­. motherapy (docetaxel & cyclophosphamide) +. Letrozole 2.5 mg/day.. Operation (1st, Aug. 2010). comedo.. . 5. Surgical margins:. . (a) superior margin: 3...
209
Case 18
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 89, 90, 91, 92, 93, 94, 95 and 96.. 18.3. 
215
Case 18
Patient History
HR(+) HER2(-) Breast Cancer
S/P unilateral salpingo-oophorectomy, s/p. hysterectomy, Hypertension.. 18.2. 
202
Case 18
Courses of Treatment
HR(−) HER2(+) Breast Cancer
18.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab.. . Y. Kwon et al.. 503. 3/3, 3/1HPF).. 4. Intraductal component: absent.. 5. Surgical margins:. . (a) superior margin: 40 ...
210
Case 18
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 127 128 129. 130. . Y. Kwon et al.. 501. . . . HR(−) HER2(+) Breast Cancer. 502. 18.3. . After Neoadjuvant. Chemotherapy. 131 132 133. 134. 18.4. 
216
Case 18
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/61 years old, post-menopause.. Self-detected bloody discharge on nipple of. left breast.. No family history.. S/p hysterectomy.. 18.2. 
203
Case 18
Courses of Treatment
HR(−) HER2(−) Breast Cancer
18.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of paclitaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 130. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Post-chemotherapy status.. ....
211
Case 18
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic Findings. 123 124. 125. After Neoadjuvant. Chemotherapy. 126 127 128. 129. 18.3. 
217
Case 18
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion and skin. change on left breast.. Family history of breast cancer, aunt. (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 18.2. 
204
Case 18
Courses of Treatment
Local Recurrence
18.1. . Courses of Treatment. Left breast IDC→ Operation → Adjuvant. . therapy → Right breast recurrence (IDC).. Primary Treatment. Operation. May 2001 Left modified radical mastectomy. (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 3.0 cm (pT2).. . 2. Lymph nodes: two metastases in 24 ...
218
Case 18
Patient History
Local Recurrence
Patient History and Progress. Female/71 years old, post-menopause.. Screen detected mass lesion on right breast.. No family history.. Diabetes mellitus, Grave’s disease.. BRCA 2 mutation carrier.. 18.2. 
205
Case 18
Courses of Treatment
Metastatic Breast Cancer
18.1. . Courses of Treatment. Left breast cancer → Operation → Ipsilateral. chest wall recurrence → Neoadjuvant chemo­. therapy → operation → targeted therapy →. Ipsilateral lymph node recurrence.. Primary Treatment. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Pos...
219
Case 18
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/64 years old, post-menopause.. No family history.. Hypertension, diabetes mellitus.. 18.2. 
220
Case 19
Courses of Treatment
Benign and Proliferative
19.1. . Courses of Treatment. →2021-08-03 excision, Lt.. Pathology Report. Diagnosis. • Breast, left 1 o’clock, excision:. –. – Fibroadenoma.. –. – Intraductal papilloma with usual ductal. hyperplasia.. • Breast, left 8 o’clock, excision:. –. – Intraductal papilloma with (1) usual ductal. hyperplasia, (2) microcalci...
228
Case 19
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 34 35. 36. Benign and Proliferative Case Series. 40. . . . C. W. Lee et al.. 41. 19.3. 
234
Case 19
Patient History
Benign and Proliferative
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. 8 o’clock direction.. Outside result of biopsy: papillary neoplasm.. No family history.. No comorbidities.. 19.2. 
221
Case 19
Courses of Treatment
Carcinoma In Situ
19.1. . Courses of Treatment:. Operation. Operation. ­. 89. 90. Carcinoma In Situ. 92. Pathology Report. Right.. Ductal carcinoma in situ. . 1. Post-mammotome status.. . 2. Size of tumor: 0.3 cm, residual.. . 3. Nuclear grade: high.. . 4. Necrosis: absent.. . 5. Architectural pattern: cribriform/solid.. . 6. Ski...
229
Case 19
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 85 86 87. 88. 19.3. 
235
Case 19
Patient History
Carcinoma In Situ
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected diffuse non-mass lesions on. upper, central, and lower portion of left breast.. Screen detected microcalcification on inner. subareolar of right breast.. Outside result of excisional biopsy: bilateral. ductal carcinoma in situ.. No famil...
222
Case 19
Courses of Treatment
HR(+) HER2(+) Breast Cancer
19.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy + Trastuzumab +. Letrozole 2.5 mg/day.. 105. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tum...
230
Case 19
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 100 101 102 103. 104. 19.3. 
236
Case 19
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/71 years old, post-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. No family history.. Hypertension,. dyslipidemia,. s/p. appendectomy.. 19.2. 
223
Case 19
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation + Tamoxifen 20 mg/day with leup­. rolide acetate.. Operation. Left nipple–areolar complex sparing mastectomy. with immediate implant reconstruction, sentinel. lymph node biopsy (Figs. 106 and 107).. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.7 cm and 0.5 cm (pT1c(2...
231
Case 19
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 101, 102, 103, 104 and 105.. 19.3. 
237
Case 19
Patient History
HR(+) HER2(-) Breast Cancer
No comorbidities.. 19.2. 
224
Case 19
Courses of Treatment
HR(−) HER2(+) Breast Cancer
19.1. . Operation. 140. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.1 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 12/3, 2/10HPF).. 3. Intraductal component: present, extratumoral. (5%) (nuclear grade: high, necrosis: present,. architec...
232
Case 19
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 136 137 138. 139
238
Case 19
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/52 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 1 and 2 o’clock direction.. No family history.. Hepatitis B virus carrier, liver cirrhosis.. Y. Kwon et al.. 505. 19.2. 
225
Case 19
Courses of Treatment
HR(−) HER2(−) Breast Cancer
19.1. . Courses of Treatment. Operation  +  adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide + #3 cycles of paclitaxel-stop d/t drug-­. induced. pneumonitis). +. Post-operative. radiation therapy.. Operation. 134. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.2 cm (pT2).. 2....
233
Case 19
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic Findings. 131 132. 133. 19.3. 
239
Case 19
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/63 years old, post-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. No family history.. Hepatitis B virus carrier, h/o Tuberculosis.. 19.2. 
226
Case 19
Courses of Treatment
Local Recurrence
19.1. . Courses of Treatment. Left breast IDC → Adjuvant therapy.. Primary Treatment. 133 134 135 136. 137. Neoadjuvant Chemotherapy. Neoadjuvant chemotherapy #4 cycles of doxoru­. bicin and cyclophosphamide followed by. #4 cycles of docetaxel and trastuzumab.. Operation. ­. ­. 138. 139. Pathology Report. <Right>. Com...
240
Case 19
Patient History
Local Recurrence
Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on right breast. subareolar area and left breast subareolar area.. No family history.. Hypertension.. 19.2. 
227
Case 19
Courses of Treatment
Metastatic Breast Cancer
19.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence → Operation → Endocrine therapy. → Progressive disease.. Primary Treatment. Positive %. Estrogen. receptor. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2...
241
Case 19
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/45 years old, post-menopause.. No family history.. S/p bilateral salpingo-oophorectomy.. 19.2. 
242
Case 2
Courses of Treatment
Benign and Proliferative
2.1. . Courses of Treatment. → 2022-02-14 Excision, Lt.. 2.3.1. . Pathology Report. • Breast, left, excision:. –. – Atypical ductal hyperplasia with micro­. -. calcification.. –. – Intraductal papilloma with usual ductal. hyperplasia.. 3. 
250
Case 2
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 3. 2.3. 
256
Case 2
Patient History
Benign and Proliferative
Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of biopsy: Intraductal papilloma.. No family history.. No comorbidities.. 2.2. 
243
Case 2
Courses of Treatment
Carcinoma In Situ
2.1. 
251
Case 2
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 7. 8. 2.3. . Course of Treatment:. Operation. 2.3.1. . Operation. 9. 10. 2.3.2. . Pathology Report. Lobular carcinoma in situ. . 1. Size of tumor: 0.2 cm2.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Surgical margin: 2 mm from neare...
257
Case 2
Patient History
Carcinoma In Situ
Patient History and Progress. Female/47 years old, pre-menopause.. Nipple discharge on left breast.. Family history of breast cancer, mother and. sister, aunt, cousin sister.. Thrombocytopenia (Follow-up at outside. hospital).. BRCA 2 VUS (variant of uncertain).. 2.2. 
244
Case 2
Courses of Treatment
HR(+) HER2(+) Breast Cancer
2.1. . 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.. 12. 2.3.1. . Pathology Report. . 1. Microinvasive ductal carcinoma.. . (a) Post-che...
252
Case 2
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 8 9 10. 11. 2.3. 
258
Case 2
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. 1:30 and 2 o’clock direction.. No family history.. S/P Cervical spine disc operation.. 2.2. 
245
Case 2
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Anastrozole 1 mg/day.. 2.3.1. . Operation. Left breast conserving surgery, sentinel lymph. low, necrosis: absent, architectural pattern:. cribriform, extensive intraductal component:. absent).. 4. Skin: no involvement of tumor.. 5. Surgical ma...
253
Case 2
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 5, 6, 7 and 8.. HR(+) HER2(−) Breast Cancer. 3. >2/3. C-erbB2. Negative (0). Ki-67. Positive in 5% of tumor cells. 2.3. 
259
Case 2
Patient History
HR(+) HER2(-) Breast Cancer
Hepatitis B virus carrier, dyslipidemia.. 2.2. 
246
Case 2
Courses of Treatment
HR(−) HER2(+) Breast Cancer
2.1. . Courses of Treatment. Neoadjuvant chemotherapy (#2 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab + #4 cycles of docetaxel and trastu­. zumab and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. emtansine.. 2.4.1. . Operation. 17. 2.4.2. . Pathology Repo...
254
Case 2
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic Findings. 9 10 11. 434. 2.3. . After Neoadjuvant. Chemotherapy. 13 14 15. 16. . Y. Kwon et al.. 435. . ­. . . HR(−) HER2(+) Breast Cancer. 436. 2.4. 
260
Case 2
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/68 years old, post-menopause.. A self-detected skin change and nipple retrac­. tion on left breast.. No family history.. Hypothyroidism.. 2.2. 
247
Case 2
Courses of Treatment
HR(−) HER2(−) Breast Cancer
2.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide + #4. cycles of docetaxel) + Operation + Post-. operative radiation therapy.. 2.3.1. . Operation. 15. 2.3.2. . Pathology Report. No residual tumor with stromal fibrosis. . 1. Post-chemotherapy status.. . 2. Lymph...
255
Case 2
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 8 9 10. 11. E. S. Lee et al.. 579. . . . HR(−) HER2(−) Breast Cancer. 580. . 2.2.1. . After Neoadjuvant. Chemotherapy. 12 13. 14. 2.3. 
261
Case 2
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. No comorbidities.. 2.2. 
248
Case 2
Courses of Treatment
Local Recurrence
2.1. . Courses of Treatment. Left breast IDC → Operation → Adjuvant. . therapy → Left breast recurrence (IDC).. 2.2.1. . Primary Treatment. 10. Operation. Nov. 2008 Left breast conserving surgery, senti­. nel lymph node biopsy (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 0.4 cm (pT1a)...
262
Case 2
Patient History
Local Recurrence
Patient History and Progress. Female/54 years old, peri-menopause.. Screen detected mass lesion on left breast. . 2 o’clock direction.. No family history.. No comorbidities.. 2.2. 
249
Case 2
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer  →  Operation  +  Adjuvant. therapy → Lung metastasis → Palliative therapy. → Progression on rib and lung  →  Palliative. therapy → Progression on liver  →  Palliative. therapy.. 2.2.1. . Primary Treatment. Radiologic Finding. Estrogen. receptor. Strong (6/7). 2. >2/3. Progest...
263
Case 20
Courses of Treatment
Benign and Proliferative
20.1. . Courses of Treatment. →2021-05-10 excision, Lt.. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia.. –. – Fibrocystic change with microcalcification.. 21. 
271
Case 20
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 37. 38. . Benign and Proliferative Case Series. 42. . 20.3. 
277
Case 20
Patient History
Benign and Proliferative
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of left breast.. Family history of breast cancer, sister.. No comorbidities.. 20.2. 
264
Case 20
Courses of Treatment
Carcinoma In Situ
20.1. . Courses of Treatment. First Operation + Tamoxifen 20  mg/day for. 4 months.. Second Operation.. Carcinoma In Situ. 96. . ­. . Operation. First operation: Breast conserving surgery, senti­. nel lymph node biopsy (left).. Second operation: Skin sparing mastectomy. with latissimus dorsi flap reconstruction (left)...
272
Case 20
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 91. 92. 20.3. 
278
Case 20
Patient History
Carcinoma In Situ
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction at first visit.. Pain on right breast at second visit.. No family history.. No comorbidities.. NGS: negative.. 20.2. 
265
Case 20
Courses of Treatment
HR(+) HER2(+) Breast Cancer
20.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #11 cycles of weekly pacli­. taxel). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 110. Pathology Report. Invasive Ductal Carcinoma. 1. Post-mammotome excisi...
273
Case 20
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 106 107 108. 109. 20.3. 
279
Case 20
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/75 years old, post-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. No family history.. Asthma (follow-up).. 20.2. 
266
Case 20
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. extensive intraductal component: present).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 15 mm.. . (b) inferior margin: 20 mm....
274
Case 20
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 108, 109, 110, 111 and 112.. 20.3. 
280
Case 20
Patient History
HR(+) HER2(-) Breast Cancer
o’clock direction.. No family history.. S/P Tuberculosis, S/P duodenal adenoma. excision.. 20.2. 
267
Case 20
Courses of Treatment
HR(−) HER2(+) Breast Cancer
20.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab.. Operation. 147. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.1 cm (ypT1c...
275
Case 20
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 141 142. 143. HR(−) HER2(+) Breast Cancer. 508. . . . Y. Kwon et al.. 509. 20.3. . After Neoadjuvant. Chemotherapy. 144 145. 146. . . . HR(−) HER2(+) Breast Cancer. 510. 20.4. 
281
Case 20
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/54 years old, post-menopause.. Screen detected mass lesion on left breast 11. o’clock direction.. Family history of breast cancer, aunt. (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 20.2. 
268
Case 20
Courses of Treatment
HR(−) HER2(−) Breast Cancer
20.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy.. Operation. 143. Pathology Report. No residual tumor with stromal fibrosis. E. S. Lee et al.. 645. . . . HR(−) HER2(−) Breast Cancer...
276
Case 20
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 135 136 137. 138. E. S. Lee et al.. 643. . . . ­. HR(−) HER2(−) Breast Cancer. 644. . After Neoadjuvant. Chemotherapy. 139 140 141. 142. 20.3. 
282
Case 20
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/59 years old, post-menopause.. Screen detected mass lesion on left breast 9:30. o’clock direction.. Family history of breast cancer, aunt. (maternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 20.2. 
269
Case 20
Courses of Treatment
Local Recurrence
20.1. . Courses of Treatment. Right breast DCIS → Operation → Adjuvant. therapy → Right breast recurrence (microinva­. sive ductal carcinoma).. Primary Treatment. 140. Operation. Jul. 2017 Right breast conserving surgery, senti­. nel lymph node biopsy (outside).. Pathology Report. Ductal Carcinoma In Situ. 1. Size of...
283
Case 20
Patient History
Local Recurrence
Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. s/p Right breast conserving surgery (Breast. cancer), s/p parotidectomy, Panic disorder.. BRCA 1 VUS (variant o...
270
Case 20
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Operation. Sep. 1998 Left breast conserving surgery, axil­. lary lymph node dissection.. Pathology: Invasive ductal carcinoma, stage. pT1aN0.. Size of tumor: N.A, lymph node: 0/16....
284
Case 20
Patient History
Metastatic Breast Cancer
Family history of breast cancer, maternal. cousin.. BRCA 1 & 2 mutation: Not detected.. 20.2. 
285
Case 21
Courses of Treatment
Benign and Proliferative
21.1. . Courses of Treatment. →2021-07-07 excision, both.. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Intraductal papilloma.. –. – Sclerosing. adenosis. with. microcal-. cification.. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. –. – Sclerosing adenosis with microcalcification...
293
Case 21
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 39 40. 41. 21.3. 
299
Case 21
Patient History
Benign and Proliferative
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 7. o’clock direction and left 1 o’clock direction.. Outside result of biopsy: both papillary. neoplasm.. No family history.. s/p Right breast mammotome biopsy (result:. fibroadenoma).. 21.2. 
286
Case 21
Courses of Treatment
Carcinoma In Situ
21.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. . . E. S. Lee et al.. 99. Operation. 98. 99. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0 (sn). . 1. Size of tumor: 3.0 cm (pTis).. . 2. Nuclear grade: low.. ....
294
Case 21
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 95 96. 97. 21.3. 
300
Case 21
Patient History
Carcinoma In Situ
Patient History and Progress. Female/37 years old, pre-menopause.. Screen detected mass lesion on right breast. 9 o’clock direction.. Outside result of biopsy: Right 9 o’clock, duc­. tal carcinoma in situ.. No family history.. Thyroid papillary carcinoma: follow-up at. outside hospital.. BRCA 1 and 2: not detected, POL...
287
Case 21
Courses of Treatment
HR(+) HER2(+) Breast Cancer
21.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Letrozole. 2.5 mg/day.. 117. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.1 cm (...
295
Case 21
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 111 112 113 114 115. 116. 21.3. 
301
Case 21
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/69 years old, post-menopause.. Screen detected mass lesion on right breast 6. o’clock direction.. Family history of breast cancer, paternal aunt,. cousin (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 21.2. 
288
Case 21
Courses of Treatment
HR(+) HER2(-) Breast Cancer
21.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation (1st, Dec. 2020). nent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 5 mm.. . (b) inferior margin: 20 mm.. . (c) medial margin: 10 mm.. . (d) lateral mar...
296
Case 21
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 114, 115, 116 and 117.. 21.3. 
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Case 21
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/78 years old, post-menopause.. Screen detected mass lesion on left breast 12. o’clock direction.. No family history.. Hypertension, s/p hysterectomy.. 21.2. 
289
Case 21
Courses of Treatment
HR(−) HER2(+) Breast Cancer
21.1. . Operation. 156. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.0 cm (ypT1b).. 3. Histologic grade: 3/3 (tubule formation: 2/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 49/10HPF).. 4. Intraductal component: absent.. Y. Kwon et al.. 515. a. b. . 5. Sur...
297
Case 21
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 148 149 150. 151. . HR(−) HER2(+) Breast Cancer. 512. . . . ­. Y. Kwon et al.. 513. 21.3. . After Neoadjuvant. Chemotherapy. 152 153 154. 155. . HR(−) HER2(+) Breast Cancer
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Case 21
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/55 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. S/P Tuberculosis.. 21.2. 
290
Case 21
Courses of Treatment
HR(−) HER2(−) Breast Cancer
21.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Letrozole. 2.5 mg + Adjuvant capecitabine.. Operation. 152. Pathology Report. Microinvasive Ductal Carcinoma. 1. Post-chemothera...