Unnamed: 0 int64 1 868 | section stringclasses 51 values | subsection stringclasses 4 values | label stringclasses 9 values | text stringlengths 1 98.9k |
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298 | Case 21 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic Findings. 144 145 146. 147. . HR(−) HER2(−) Breast Cancer. 648. . . . . . E. S. Lee et al.. 649. . After Neoadjuvant. Chemotherapy. 148 149 150. 151. 21.3. |
304 | Case 21 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, STK11. VUS (variant of uncertain).. 21.2. |
291 | Case 21 | Courses of Treatment | Local Recurrence | 21.1. . Courses of Treatment. Right breast DCIS→ → Operation → Right. breast recurrence (DCIS).. Y. Kim et al.. 775. Primary Treatment. 146. Operation. . 147. 148. Pathology Report. Ductal Carcinoma In Situ. . 1. Size of tumor: 5.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: present.. . 4. Architectural pattern: micropapillary/solid/. comedo.. . 5. Skin: no involvement of tumor.. . 6. Surgical margins:. . (a) Deep margin: (see note).. . (b) Superficial margin: <1 mm from ductal. carcinoma in situ (slide MG5).. . 7. Lymph nodes: no metastasis in two axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/2).. . . . Local Recurrence. 776. . 8. Microcalcification:. present,. tumoral/. non-tumoral.. . 9. Pathologic stage (AJCC 2010): pTisN0(sn).. Note: 1. The deep margin of the mastectomy. specimen (slide 7) is close to ductal carcinoma in. situ (<1 mm), but this margin submitted for fro. zen diagnosis (Fro 4) is free of tumor.. Result. Intensity Positive %. Estrogen. receptor. Intermediate (5/8) 2. 10%-1/3. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 22%. of tumor cells. Treatments After Recurrence. 149. 150. Operation. 151. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-nipple-sparing mastectomy status.. . 2. Size of tumor: 1.1 cm (rpTis).. . 3. Nuclear grade: low.. . 4. Necrosis: absent.. . 5. Architectural pattern: solid.. . 6. Skin and nipple: no involvement of tumor.. . 7. Surgical margins:. . (a) Superior margin: 5 mm.. . (b) Inferior margin: 11 mm.. . (c) Medial margin: 5 mm.. . (d) Lateral margin: 10 mm.. . (e) Deep margin: (see note).. . (f) Superficial margin: 2 mm.. . 8. Microcalcification: present, tumoral.. . 9. Pathological TN category (AJCC 2017):. rpTis.. Note: 1. The deep margin of the lumpectomy. specimen (slide 1) is close to ductal carcinoma in. situ (<1 mm), but this margin submitted for fro. zen diagnosis (Fro 5) is free of tumor.. Result. Intensity. Positive %. Estrogen. receptor. Weak (4/8). 1. 10%-1/3. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 8%. of tumor cells. Adjuvant Therapy. Postoperative radiation therapy.. . . . Y. Kim et al.. 777. a. b. . . 22. |
305 | Case 21 | Patient History | Local Recurrence | Patient History and Progress. Female/55 years old, peri-menopause.. Screen detected calcification on upper portion. of right breast.. Outside result of biopsy: suggestive ductal. carcinoma in situ.. No family history.. S/p hysterectomy.. 21.2. |
292 | Case 21 | Courses of Treatment | Metastatic Breast Cancer | Left breast cancer → Operation → Adjuvant. therapy → Neck node recurrence → Lymph. nodes, bone metastasis → Skull, brain. metastasis.. Primary Treatment. Operation. Apr. 2002 Left breast conserving surgery, senti. nel lymph node biopsy.. Y. Kwon et al.. 895. Pathology: Microinvasive infiltrating duct car. cinoma, stage T1miN0(sn).. Size of tumor: N.A, lymph node: 0/2.. Result. Intensity. Positive %. Estrogen. receptor. Positive. Intermediate. 60%. Progesterone. receptor. Positive. Weak. 20%. C-erbB2. Negative. (1+). Ki-67. N.A. Adjuvant Therapy. Post-operative radiation therapy +Tamoxifen. 20 mg/day for 5 years.. Treatments After Recurrence |
306 | Case 22 | Courses of Treatment | Benign and Proliferative | 22.1. . Courses of Treatment. →2021-07-07 excision, Rt.. Diagnosis. • Breast, right, excision:. –. – Atypical. ductal. hyperplasia. with. microcalcification.. . C. W. Lee et al.. 45. . . . 23. |
314 | Case 22 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 42. 22.3. |
320 | Case 22 | Patient History | Benign and Proliferative | Patient History and Progress. Female/50 years old, peri-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. No family history.. Hypertension (taking medication), carotid. atherosclerosis.. 22.2. |
307 | Case 22 | Courses of Treatment | Carcinoma In Situ | 22.1. . Courses of Treatment:. Operation. Operation. 103. 104. Pathology Report. Ductal carcinoma in situ, pathological TN cat. egory (AJCC 2017): pTis(Paget)N0(sn). . 1. Size of tumor: 0.5 cm (pTis(Paget)).. . 2. Nuclear grade: high.. . 3. Necrosis: absent.. . 4. Architectural pattern: micropapillary.. . 5. Nipple: Paget disease with involvement of. lactiferous duct.. . 6. Surgical margins: deep margin: 20 mm.. . 7. Lymph nodes: no metastasis in two axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/2).. . 8. Microcalcification: present, non-tumoral.. Result. Intensity Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in. 14% of tumor. cells. E. S. Lee et al.. 101. E. S. Lee et al.. 103. 23. |
315 | Case 22 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 100 101. 102. 22.3. |
321 | Case 22 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/57 years old, post-menopause.. Visible detected redness on Left nipple.. Outside result of biopsy: Paget’s disease.. Family history of breast cancer, sister at her. 45 years old.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 22.2. |
308 | Case 22 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 22.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab) + Operation + Trastuzumab. + Letrozole 2.5 mg/day.. 125. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.5 cm (ypT1a).. S. Park et al.. 369. . . . 3. Histologic grade: 2/3 (tubule formation: 3/3,. nuclear pleomorphism: 2/3, mitotic count:. 1/3, <1/10HPF).. 4. Intraductal component: absent.. 5. Surgical margins:. . (a) superior margin: 10 mm,. . (b) inferior margin: (see Note 1),. . (c) medial margin: 5 mm,. . (d) lateral margin: 5 mm,. . (e) deep margin: <1 mm from invasive duc. tal carcinoma (slide 1),. . (f) superficial margin: 1 mm from invasive. ductal carcinoma (slide 3).. 6. Lymph nodes:. . (a) metastasis in two out of three axillary. lymph nodes (ypN1mi(sn)) (see note). (sentinel LN: 1/1, axillary LN: 1/2),. . (b) perinodal extension: absent,. . (c) size of metastatic carcinoma: 0.3 mm.. 7. Arteriovenous invasion: absent.. 8. Lymphovascular invasion: absent.. 9. Tumor border: infiltrative.. . 10. Microcalcification: present, non-tumoral.. . 11. Pathological TN category (AJCC 2017):. ypT1aN1mi(sn).. HR(+) HER2(+) Breast Cancer. 370. . . S. Park et al.. 371. . . Note: 1. The inferior margin of the lumpec. tomy specimen (slide 3) is close to invasive duc. tal carcinoma (<1 mm) but this margin submitted. for frozen diagnosis (Fro 5) is free of tumor.. 2. Micrometastasis is present only in the per. manent section of Fro 1.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Equivocal (2+). Ki-67. Positive in <1%. of tumor cells. SISH. Positive. HR(+) HER2(+) Breast Cancer. 372. . . S. Park et al.. 373. a. b. . 23. |
316 | Case 22 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 118 119 120 121 122 123. 124. 22.3. |
322 | Case 22 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/54 years old, post-menopause.. Self-detected nipple retraction on left breast.. No family history.. Hepatitis B carrier.. 22.2. |
309 | Case 22 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin & cyclophosphamide followed by. #4 cycles of docetaxel) + Operation + Post-. operative radiation therapy + Letrozole. 2.5 mg/day.. Operation. tumor.. 6. Surgical margins:. . (a) deep margin: positive for invasive carci. noma (slide 1).. . (b) superficial margin: positive for invasive. carcinoma (slide 4).. 7. Lymph nodes:. . (a) metastasis in nine out of nine axillary. lymph nodes (ypN2a).. . (b) perinodal extension: present.. . (c) size of metastatic carcinoma: 6 mm.. 8. Arteriovenous. invasion:. present,. peritumoral.. 9. Lymphovascular. invasion:. present,. peritumoral.. . 10. Tumor border: infiltrative.. HR(+) HER2(−) Breast Cancer. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Negative (2/8). 1. <1%. C-erbB2. Equivocal (2+). (SISH negative). Ki-67. Positive in 14% |
317 | Case 22 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 119, 120, 121, 122, 123 and 124.. 22.3. |
323 | Case 22 | Patient History | HR(+) HER2(-) Breast Cancer | Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on entire left. breast.. No family history.. Diabetes mellitus, Spinal stenosis.. 22.2. |
310 | Case 22 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 22.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of doxorubicin and cyclophosphamide) + Post-. operative radiation therapy + Trastuzumab.. Operation. 161. . a. b. . HR(−) HER2(+) Breast Cancer. 518. Pathology Report. Invasive Ductal Carcinoma with apocrine dif. ferentiation and medullary pattern. 1. Size of invasive component: 1.3 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:. 2/3, 15/10HPF).. 4. Intraductal component: present, extratumoral. (70%) (nuclear grade: high, necrosis: pres. ent, architectural pattern: solid/comedo,. extensive intraductal component: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 6 mm,. . (b) inferior margin: 6 mm,. . (c) medial margin: positive for ductal carci. noma in situ (Fro 4) (see note),. . (d) lateral margin: 6 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 5 mm.. 7. Lymph nodes: no metastasis in two axillary. lymph nodes (pN0(sn)) (sentinel LN: 0/2).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. pT1cN0(sn).. Note: 1. Ductal carcinoma in situ is present. only in the permanent section of Fro 4.. Result. Intensity. Positive %. Estrogen. receptor. Negative (2/8). 1. <1%. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 49%. of tumor cells. 23. |
318 | Case 22 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic Findings. 157 158 159. 160. . . . Y. Kwon et al.. 517. 22.3. |
324 | Case 22 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/53 years old, peri-menopause.. Self-detected palpable mass lesion on right. breast 4 o’clock direction.. No family history.. S/P hemorrhoids operation.. 22.2. |
311 | Case 22 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 22.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin and cyclophosphamide + #4. cycles of docetaxel) + Operation + Post-. operative radiation therapy + Adjuvant. capecitabine.. Operation. 161. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.9 cm (ypT1b).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 11/10HPF).. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: 25 mm.. . (b) Inferior margin: 20 mm.. . (c) Medial margin: 5 mm.. . (d) Lateral margin: 10 mm.. . (e) Deep margin: 5 mm.. . (f) Superficial margin: 10 mm.. 7. Lymph nodes:. . (a) Metastasis in two out of three axillary. lymph nodes (ypN1a(sn)) (sentinel LN:. 2/3).. . (b) Perinodal extension: absent.. . (c) Size of metastatic carcinoma: 5 mm.. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: absent.. . 12. Pathological TN category (AJCC 2017):. ypT1bN1a(sn).. Result. Intensity. Positive. %. Estrogen. receptor. Negative (2/8). 1. <1%. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 12%. of tumor cells. HR(−) HER2(−) Breast Cancer. 654. . . . . E. S. Lee et al.. 655. . . . HR(−) HER2(−) Breast Cancer. 656. . 23. |
319 | Case 22 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic. Findings. 153 154 155. 156. HR(−) HER2(−) Breast Cancer. 652. . . . . . E. S. Lee et al.. 653. . After Neoadjuvant. Chemotherapy. 157 158 159. 160. 22.3. |
325 | Case 22 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. Family history of breast cancer, uncle. (paternal).. s/p retinal detachments operation.. BRCA 1 and 2 mutation: Not detected, PALB2. PV, STK11 VUS (variant of uncertain).. 22.2. |
312 | Case 22 | Courses of Treatment | Local Recurrence | 22.1. . Courses of Treatment. Left breast mucinous carcinoma→ Adjuvant. therapy → Right breast recurrence (mucinous. carcinoma).. Primary Treatment. 152. Operation. Apr. 2007 Left breast mass excision (outside).. Pathology Report. Mucinous Carcinoma. . 1. Size of tumor: 2.0 cm.. . 2. Margin involved.. Result. Intensity Positive %. Estrogen receptor. Strong. (7/8). 3. >2/3. Progesterone. receptor. Weak. (3/8). 1. 10%-1/3. C-erbB2. Negative. (0). Operation (2nd). . 153. Pathology Report. No residual carcinoma with foreign body. reaction.. . 1. Post-excisional biopsy status.. Local Recurrence. 778. a. b. . . Adjuvant Therapy. Adjuvant chemotherapy #4 cycles of doxorubicin. and cyclophosphamide.. Postoperative radiation therapy.. Letrozole 2.5 mg/day 1.7 years, tamoxifen. 20 mg/day for 2.2 years.. Treatments After Recurrence. 154. Letrozole 2.5 mg/day (rejection of surgical. treatment).. 23. |
326 | Case 22 | Patient History | Local Recurrence | Patient History and Progress. Female/80 years old, post-menopause.. Screen detected mass lesion on upper outer. portion of Left breast.. Outside. result. of. biopsy:. Mucinous. carcinoma.. No family history.. Dementia.. BRCA 1 and 2 mutation: No examination.. 22.2. |
313 | Case 22 | Courses of Treatment | Metastatic Breast Cancer | Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Right axillary lymph node recur. rence → Right breast recurrence → Chest wall. → Bone → Pleural effusion metastasis.. Primary Treatment. mide #3 → Doxorubicin + Docetaxel #3).. Operation. Mar. 2008 Left total mastectomy, axillary lymph. node dissection.. Pathology: Invasive apocrine carcinoma, stage. ypT1bN2a.. Size of tumor: 1.0 cm, lymph node: 6/6, size. of metastatic carcinoma: 10 mm.. Result. Intensity Positive %. Estrogen. receptor. Negative (0/7). 0. 0. Progesterone. receptor. Negative (0/7). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 5%. of tumor cells. Adjuvant Therapy. Post-operative radiation therapy.. Treatments After Recurrence. Right Axillary Lymph Node Recurrence. 0. Progesterone. receptor. Negative. (0/7). 0. 0. C-erbB2. Negative. (1+). Ki-67. N.A. Neoadjuvant Chemotherapy. Chemotherapy #15 cycles (Capecitabine).. Operation. Apr. 2014 Right axillary lymph node dissection.. Pathology: Metastatic ductal carcinoma in. eight out of eight axillary lymph nodes, size of. metastatic carcinoma: 18 mm.. Metastatic Breast Cancer. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 6%. of tumor cells. Adjuvant Therapy. Post-operative radiation therapy (axilla).. Right Breast Recurrence. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in. 42% of tumor. cells. Neoadjuvant Chemotherapy. Chemotherapy #8 cycles (paclitaxel + Cisplatin).. Radiation therapy (breast).. Chemotherapy #12 cycles (Cyclophosphamide. + Methotrexate).. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 1%. of tumor cells. Chest Wall → Bone → Pleural Effusion. Metastasis. Jan. 2018 Right chest wall skin biopsy.. Pathology: Metastatic ductal carcinoma.. Result. Intensity Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 3%. of tumor cells. Palliative Therapy. Chemotherapy #10 cycles (Harven): Progressive. disease.. Chemotherapy #31 cycles (Capecitabine):. Progressive disease on bone.. Chemotherapy #11 cycles (Gemcitabine):. Progressive disease on bone.. Chemotherapy. (Vinorelbine. tartrate. +Cisplatin)~. See Figs. 77 and 78.. Y. Kwon et al. |
327 | Case 22 | Patient History | Metastatic Breast Cancer | |
328 | Case 23 | Courses of Treatment | Benign and Proliferative | 23.1. . Courses of Treatment. →2021-07-13 Excision, Lt.. Benign and Proliferative Case Series. 46. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia involving intra. ductal papilloma with microcalcification.. 24. |
336 | Case 23 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 43 44. 45. 23.3. |
342 | Case 23 | Patient History | Benign and Proliferative | Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. Outside result of biopsy: atypical papilloma.. No family history.. No comorbidities.. 23.2. |
329 | Case 23 | Courses of Treatment | Carcinoma In Situ | 23.1. . Courses of Treatment:. Operation. Operation. 107. 108. Pathology Report. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. Size of tumor: 0.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Skin: no involvement of tumor.. . 6. Surgical margins:. . (a) superior margin: <1 mm (slide 3),. . (b) inferior margin: 20 mm,. . (c) medial margin: 5 mm,. . (d) lateral margin: 5 mm,. . (e) deep margin: 10 mm,. . (f) superficial margin: 1 mm (slide 1).. . 7. Microcalcification: present, tumoral.. Result. Intensity. Positive %. Estrogen. receptor. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in 7%. of tumor cells. . . . Carcinoma In Situ. 104. . . 24. |
337 | Case 23 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 105. 106. 23.3. |
343 | Case 23 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. No family history.. No comorbidities.. 23.2. |
330 | Case 23 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 23.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab) + Operation + Post-. HR(+) HER2(+) Breast Cancer. 374. . . . operative radiation therapy + Trastuzumab +. Tamoxifen 20 mg/day.. . . 132. 133. Pathology Report. . 1. No residual tumor with stromal degeneration.. . (a) Post-chemotherapy status.. . (b) Lymph nodes: no metastasis in six axillary. lymph nodes (ypN0) (axillary LN: 0/6).. . 2. Atypical ductal hyperplasia, focal.. . 3. Intraductal papilloma.. . 4. Fibroadenoma.. Result. Intensity. Positive. %. Estrogen. receptor. Weak (4/8). 2. 1–10%. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Positive (3+). Ki-67. Positive in 30%. of tumor cells. S. Park et al.. 375. . . HR(+) HER2(+) Breast Cancer. 376. F. i. g. 130. . S. Park et al.. 377. a. b. . a. b. . HR(+) HER2(+) Breast Cancer. 378. 24. |
338 | Case 23 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 126 127 128 129 130. 131. 23.3. |
344 | Case 23 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/46 years old, pre-menopause.. Self-detected palpable mass lesion on both. breast.. Family history of breast cancer, sister.. Hypertension, S/P varicose veins operation.. BRCA 1 and 2 mutation: Not detected. (BRCAPRO mutation probability 0.118).. 23.2. |
331 | Case 23 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | 2.5 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. . (d) Histologic grade: 3/3 (tubule formation:. 3/3, nuclear pleomorphism: 3/3, mitotic. count: 2/3, 10/10 HPF). . (e) Intraductal component: present, intratu. moral/extratumoral. (99%). (nuclear. grade: high, necrosis: present, architec. tural pattern: solid/comedo, extensive. intraductal component: present).. . (f) Skin: no involvement of tumor.. . (g) Surgical margins:. • superior margin: 10 mm.. • inferior margin: (see note).. • medial margin: 5 mm.. • lateral margin: 10 mm.. HR(+) HER2(−) Breast Cancer. . (j) Lymphovascular invasion: absent.. . (k) Tumor border: infiltrative.. . (l) Microcalcification:. present,. tumoral/. non-tumoral.. . (m) Pathological TN category (AJCC 2017):. ypT1miN0(sn).. . 2. Intraductal papilloma with usual ductal. hyperplasia.. . 3. Fibroadenoma.. . 4. Complex sclerosing lesion.. Note: 1. The inferior margin of the lumpec. tomy specimen (slide 7) is close to ductal car. cinoma in situ (2 mm) but this margin. submitted for frozen diagnosis (Fro 4) is free. of tumor.. Result. Intensity. Positive %. Estrogen receptor. Strong (7/8). 3. 1/3–2/3. Progesterone receptor. Weak (3/8). 1. 1–10%. C-erbB2. Negative (1+). Ki-67. Positive in 15% of tumor cells. HR(+) HER2(−) Breast Cancer. 248. 24. |
339 | Case 23 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 126, 127, 128, 129 and 130.. Y. Kim et al. |
345 | Case 23 | Patient History | HR(+) HER2(-) Breast Cancer | sister.. Diabetes mellitus, s/p right thyroidectomy. (thyroid cancer), s/p cholecystectomy, s/p. hysterectomy.. BRCA 1 and 2 mutation: Not detected.. 23.2. |
332 | Case 23 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 23.1. . Courses of Treatment. Operation + Operation + Adjuvant paclitaxel and. trastuzumab.. Operation. . 166. Pathology Report. Breast, right, nipple-sparing mastectomy:. Microinvasive Ductal Carcinoma. 1. Size of invasive component: <0.1 cm. (pT1mi).. 2. Size of intraductal component: 6.0 cm.. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 3/10HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (99%) (nuclear grade:. high, necrosis: present, architectural pattern:. micropapillary/cribriform/solid/comedo,. extensive intraductal component: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) deep margin: 2 mm,. . (b) superficial margin: 2 mm.. 7. Lymph nodes: no metastasis in one axillary. lymph node (pN0(sn)) (sentinel LN: 0/1).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. HR(−) HER2(+) Breast Cancer. 520. . . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. pT1miN0(sn).. Result. Intensity. Positive %. Estrogen. receptor. Negative. (0/8). 0. 0. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in. 32% of tumor. cells. Operation. . 167. Pathology Report. Invasive Ductal Carcinoma. 1. Post nipple-sparing mastectomy status.. 2. Size of tumor: 0.7 cm (rpT1b).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 21/10HPF).. Y. Kwon et al.. 521. . 4. Intraductal component: absent.. 5. Skin and nipple: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 3 mm,. . (b) inferior margin: 21 mm,. . (c) medial margin: 25 mm,. . (d) lateral margin: 10 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 18 mm.. 7. Lymph nodes: not submitted (rpNx).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: absent.. . 12. Pathological TN category (AJCC 2017):. rpT1bNx.. 24. |
340 | Case 23 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic. Findings. 162 163 164. 165. . Y. Kwon et al.. 519. . . . . 23.3. |
346 | Case 23 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected bloody discharge on nipple of. right breast.. No family history.. No comorbidities.. 23.2. |
333 | Case 23 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 23.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin and cyclophosphamide + #4. cycles of docetaxel) + Operation + Post-. operative radiation therapy.. Operation. 169. E. S. Lee et al.. 657. . . . . HR(−) HER2(−) Breast Cancer. 658. . . . Pathology Report. No residual tumor with foamy histiocytic. collection. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metastasis in one axillary. lymph node (ypN0(sn)) (sentinel LN: 0/1).. Note: Histologic mapping has been done.. Result. Intensity Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 74%. of tumor cells. E. S. Lee et al.. 659. . 24. |
341 | Case 23 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic Findings. 162 163. 164. After Neoadjuvant. Chemotherapy. 165 166 167. 168. 23.3. |
347 | Case 23 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/56 years old, post-menopause.. Self-detected mass lesion on right breast.. Family history of breast cancer, aunt. (maternal).. s/p Right knee fracture operation.. BRCA 1 and 2 mutation: Not detected,. POLD1 VUS (variant of uncertain).. 23.2. |
334 | Case 23 | Courses of Treatment | Local Recurrence | 23.1. . Courses of Treatment. Left breast medullary carcinoma → Operation. → Adjuvant therapy → Left breast recurrence. (IDC)/Right breast intraductal papilloma.. Primary Treatment. Operation. 2003 Left breast conserving surgery, axillary. lymph node dissection (outside).. Pathology Report. Medullary Carcinoma.. Y. Kim et al.. 779. Adjuvant Therapy. Adjuvant chemotherapy #6 cycles of doxorubicin. and cyclophosphamide.. Postoperative radiation therapy.. Treatments After Recurrence. 155 156. 157. Operation. 158. 159. Pathology Report. <Right>. . 1. Intraductal papilloma with:. . (a) sclerosing adenosis.. . (b) microcalcification.. . 2. Sclerosing adenosis.. . 3. Columnar cell hyperplasia.. . 4. Fibroadenomatous change.. <Left>. . 1. Invasive Ductal Carcinoma with focal papil. lary pattern.. . . . Local Recurrence. 780. . . . (a) Size of tumor: 1.9 cm (pT1c(2)).. . (b) Histologic grade: 3/3 (tubule formation:. 3/3, nuclear pleomorphism: 3/3, mitotic. count: 3/3, 11/HPF).. . (c) Intraductal component: present, extratu. moral (5%) (nuclear grade: high, necrosis:. absent, architectural pattern: papillary/solid,. extensive intraductal component: absent).. . (d) Skin: no involvement of tumor.. . (e) Surgical margins:. • Deep margin: (see note).. • Superficial margin: 15 mm.. . (f) Lymph nodes: no lymph node identified.. . (g) Arteriovenous invasion: absent.. . (h) Lymphovascular invasion: absent.. . (i) Tumor border: infiltrative.. . (j) Microcalcification: absent.. . (k) Pathological TN category (AJCC 2017):. pT1c.. . 2. Invasive Ductal Carcinoma.. . (a) Size of tumor: 0.6 cm.. . (b) Histologic grade: 2/3 (tubule formation:. 3/3, nuclear pleomorphism: 2/3, mitotic. count: 1/3, 1/10HPF).. . (c) Intraductal component: present, intratu. moral/extratumoral (30%) (nuclear grade:. low, necrosis: absent, architectural pat. tern: cribriform, extensive intraductal. component: present).. . (d) Arteriovenous invasion: absent.. . (e) Lymphovascular invasion: absent.. . (f) Tumor border: infiltrative.. Note: 1. The deep margin of the lumpectomy. specimen (slide 2) is close to invasive ductal car. cinoma (<1 mm), but this margin separately sub. mitted for permanent diagnosis (slide B) is free. of tumor.. Y. Kim et al.. 781. . . Result. Intensity. Positive %. Estrogen. receptor. Negative (2/8). 1. <1%. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 48%. of tumor cells. Adjuvant Therapy. Adjuvant chemotherapy #4 cycles of cyclophos. phamide and docetaxel.. 24. |
348 | Case 23 | Patient History | Local Recurrence | Patient History and Progress. Female/49 years old, pre-menopause.. Palpable mass lesion on left breast 2 o’clock. direction.. Family history of breast cancer, maternal. grandmother.. s/p Left breast conserving surgery (breast can. cer), s/p Bilateral salpingo-oophorectomy.. BRCA 1 mutation carrier.. 23.2. |
335 | Case 23 | Courses of Treatment | Metastatic Breast Cancer | Courses of Treatment. Left breast cancer → Neoadjuvant chemother. apy → Operation → Adjuvant therapy →. Pericardial effusion, Metastatic lymph nodes. → Bone, brain metastasis.. Primary Treatment. Docetaxel #4).. Result. Intensity. Positive. %. Estrogen. receptor. Negative (0/7). 0. 0. Progesterone. receptor. Negative (0/7). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in. 40% of tumor. cells. Metastatic Breast Cancer. 900. Clinical stage: cT3N1M0.. Estrogen. receptor. Weak (3/8). 1. 1–10%. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in. 21% of. tumor cells. Adjuvant Therapy. Post-operative radiation therapy + Tamoxifen. 20 mg/day for 5 years.. Treatments After Recurrence. Chemotherapy #12 cycles (Gemcitabine &. Cisplatin): Progressive disease on leptomenin. geal, brain.. Intrathecal chemotherapy (Methotrexate).. Chemotherapy. (Vinorelbine. tartrate. &. Cisplatin)~ |
349 | Case 23 | Patient History | Metastatic Breast Cancer | |
350 | Case 24 | Courses of Treatment | Benign and Proliferative | 24.1. . Courses of Treatment. →2021-07-14 excision, both.. . . C. W. Lee et al.. 47. . . Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. Post-excision status.. Usual ductal hyperplasia.. Apocrine metaplasia.. –. – Sclerosing adenosis with microcalcification.. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia, focal.. –. – Intraductal papilloma.. 25. |
358 | Case 24 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 46 47. 48. 24.3. |
364 | Case 24 | Patient History | Benign and Proliferative | Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected mass lesion in both breasts.. No family history.. s/p total thyroidectomy (thyroid cancer), s/p. right breast excision (intraductal papilloma).. 24.2. |
351 | Case 24 | Courses of Treatment | Carcinoma In Situ | 24.1. . Courses of Treatment:. Operation. Operation. 112. 113. E. S. Lee et al.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Surgical margins:. . (a) superior margin: 11 mm,. . (b) inferior margin: 3 mm,. . (c) medial margin: 15 mm,. . (d) lateral margin: 15 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 4 mm.. . 6. Microcalcification: absent.. Carcinoma In Situ. 106. a. b. . . a. b. . E. S. Lee et al.. 107. . . Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal. (2+). Ki-67. Positive in 6%. of tumor cells. 25. |
359 | Case 24 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 109 110 111. 24.3. |
365 | Case 24 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of biopsy: Left breast 2 o’clock,. fibroadenoma, favor lobular carcinoma in situ.. No family history.. S/P Retinal detachment operation 15 years. ago.. 24.2. |
352 | Case 24 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab) + Operation + Post-. operative. radiation. ther. apy + Trastuzumab + Tamoxifen 20 mg/day.. 140. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-chemotherapy status.. . 2. Size of tumor: 0.2 cm (ypTis).. . 3. Nuclear grade: low.. . 4. Necrosis: absent.. . 5. Architectural pattern: solid.. . 6. Surgical margins:. . (a) superior margin: 5 mm,. . (b) inferior margin: 5 mm,. . (c) medial margin: 15 mm,. . (d) lateral margin: 10 mm,. . (e) deep margin: 5 mm,. . (f) superficial margin: 5 mm.. . 7. Lymph nodes: no metastasis in two axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/2).. . 8. Microcalcification:. present,. tumoral/. non-tumoral.. . 9. Pathological TN category (AJCC 2017):. ypTisN0(sn).. . . S. Park et al.. 379. . Result. Intensity. Positive %. Estrogen receptor. Negative (0/8). 0. 0. Strong (8/8) in core needle biopsy. 3. >2/3. Progesterone receptor. Negative (0/8). 0. 0. Intermediate (6/8) in core needle. biopsy. 3. 10%-1/3. C-erbB2. Positive (3+). Ki-67. Not informative due to low cellularity. HR(+) HER2(+) Breast Cancer. 380. F. ig. 137. 381. . a. b. . HR(+) HER2(+) Breast Cancer. 382. 25. |
360 | Case 24 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 134 135 136 137 138. 139. 24.3. |
366 | Case 24 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected palpable mass lesion and nipple. discharge on right breast.. No family history.. S/P appendectomy, s/p hepatitis A.. 24.2. |
353 | Case 24 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | 24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin & cyclophosphamide followed by. #4 cycles of docetaxel) & letrozole 2.5 mg/day. with leuprolide acetate + Operation + Post-. operative radiation therapy.. Operation (1st, Jan. 2021). Right breast conserving surgery, axillary lymph. sive intraductal component: absent).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: positive for ductal car. cinoma in situ (Fro 1) (see note).. . (b) inferior margin: 10 mm.. . (a) metastasis in five out of twelve axillary. lymph nodes (ypN2a) (sentinel LN: 3/3,. axillary LN: 2/9). . (b) perinodal extension: present.. . (c) size of metastatic carcinoma: 6 mm.. 8. Arteriovenous invasion: absent.. 9. Lymphovascular. invasion:. present,. intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1cN2a.. Note: 1. Ductal carcinoma in situ is pres. ent only in the permanent section of Fro 1.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Weak (3/8). 1. 1–10%. C-erbB2. Equivocal (2+). (SISH equivocal). Ki-67. Positive in 1% of. tumor cells. Operation (2nd, Feb. 2021) |
361 | Case 24 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 132, 133, 134, 135 and 136.. 24.3. |
367 | Case 24 | Patient History | HR(+) HER2(-) Breast Cancer | Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected mass lesion on right breast 9. o’clock direction and right axillary LN.. No family history.. No comorbidities.. 24.2. |
354 | Case 24 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#3 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia. tion therapy + Trastuzumab and pertuzumab.. Operation. 176. . . HR(−) HER2(+) Breast Cancer. 526. Pathology Report. . 1. No residual tumor with stromal fibrosis.. . (a) Post-chemotherapy status.. . (b) Lymph nodes: no metastasis in two axil. lary lymph nodes (ypN0(sn)) (sentinel. LN: 0/2).. . 2. Sclerosing adenosis with microcalcification.. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in. 36% of tumor. cells. 25. |
362 | Case 24 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic. Findings. 168 169 170. 171. HR(−) HER2(+) Breast Cancer. 522. . . . Y. Kwon et al.. . After Neoadjuvant. Chemotherapy. 172 173 174 |
368 | Case 24 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/55 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 10–12 o’clock direction.. No family history.. Hypertension.. 24.2. |
355 | Case 24 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of. doxorubicin and cyclophosphamide + #4. cycles of paclitaxel) + Operation + Post-. operative radiation therapy + Adjuvant. capecitabine.. Operation. 177. HR(−) HER2(−) Breast Cancer. 660. . . . . . E. S. Lee et al.. 661. . . . . . HR(−) HER2(−) Breast Cancer. 662. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 2.7 cm (ypT2).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 54/10HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (5%) (nuclear grade:. high, necrosis: absent, architectural pattern:. micropapillary, extensive intraductal compo. nent: absent).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: (see note).. . (b) Inferior margin: 15 mm.. . (c) Medial margin: 10 mm.. . (d) Lateral margin: 20 mm.. . (e) Deep margin: 10 mm.. . (f) Superficial margin: 2.5 mm.. 7. Lymph nodes: no metastasis in three axil. lary lymph nodes (ypN0(sn)) (sentinel. LN: 0/3).. . . E. S. Lee et al.. 663. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: present, non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT2N0(sn).. Note: 1. The superior margin of the lumpec. tomy specimen (slide 3) is positive for invasive. ductal carcinoma, but this margin submitted for. frozen diagnosis (Fro 1) is free of tumor.. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in. 54% of tumor. cells. 25. |
363 | Case 24 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic. Findings. 170 171. 172. After Neoadjuvant. Chemotherapy. 173 174 175. 176. 24.3. |
369 | Case 24 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/44 years old, pre-menopause.. Self-detected mass lesion on right breast.. Family history of breast cancer, aunt. (paternal).. Family history of ovarian cancer, sister.. No comorbidities.. BRCA 1 and 2 mutation: Not detected,. EPCAM and MLH1 VUS (variant of uncertain).. 24.2. |
356 | Case 24 | Courses of Treatment | Local Recurrence | 24.1. . Courses of Treatment. Left breast IDC → Neoadjuvant chemotherapy. → Operation → Adjuvant therapy → Left chest. wall recurrence (IDC).. Primary Treatment. 160 161 162. 163. Neoadjuvant Chemotherapy. #4 cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel.. Operation. 164. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 5.0 cm (ypT2).. 3. Histologic grade: 3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 2/3, 16/10HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (20%) (nuclear grade:. Local Recurrence. 782. . . . high, necrosis: present, architectural pattern:. solid/comedo, extensive intraductal compo. nent: absent).. 5. Skin and nipple: no involvement of tumor.. 6. Surgical margins:. . (a) Deep margin: <1 mm from invasive duc. tal carcinoma (slides 2 and 8).. . (b) Superficial margin: 20 mm.. 7. Lymph nodes: no metastasis in 17 axillary. lymph nodes (ypN0) (sentinel LN: 0/6, non-. sentinel LN: 0/11).. 8. Arteriovenous invasion: present, intratumoral.. 9. Lymphovascular. invasion:. present,. intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT2N0.. Y. Kim et al.. 783. . . . . Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Equivocal (2+). (SISH negative). Ki-67. Positive in 46%. of tumor cells. Adjuvant Therapy. Postoperative radiation therapy.. Adjuvant. chemotherapy. #8. cycles. of. capecitabine.. Treatments After Recurrence. 165. 166. Operation. 167. Pathology Report. Invasive Ductal Carcinoma. 1. Post-modified radical mastectomy status.. 2. Size of tumor: 1.0 cm (rpT1b).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 10/HPF).. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: 8 mm.. . (b) Inferior margin: 10 mm.. . (c) Medial margin: 20 mm.. . (d) Lateral margin: 5 mm.. . (e) Deep margin: 9 mm.. . (f) Superficial margin: 3 mm.. Local Recurrence. 784. 7. Arteriovenous invasion: absent.. 8. Lymphovascular invasion: absent.. 9. Tumor border: infiltrative.. . 10. Microcalcification: absent.. . 11. Pathological TN category (AJCC 2017):. rpT1b.. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 72%. of tumor cells. Adjuvant Therapy. Adjuvant chemotherapy #8 cycles of paclitaxel.. 25. |
370 | Case 24 | Patient History | Local Recurrence | Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected mass lesion on upper outer. portion of left breast.. Outside result of biopsy: Invasive ductal. carcinoma.. Family history of breast cancer, maternal aunt,. another aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 24.2. |
357 | Case 24 | Courses of Treatment | Metastatic Breast Cancer | Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Lung metastasis.. Primary Treatment. Estrogen. receptor. Strong (7/7). 3. >2/3. Result. Intensity. Positive %. Progesterone. receptor. Strong (7/7). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in. 30% of tumor. cells. Adjuvant Therapy. Adjuvant chemotherapy #8 cycles (Adriamycin +. Cyclophosphamide #4 → Docetaxel #4).. Post-operative radiation therapy + Tamoxifen. 20 mg/day → Letrozole 2.5 mg/day.. Treatments After Recurrence. >2/3. Progesterone. receptor. Intermediate. (6/8). 2. 1/3–2/3. C-erbB2. Negative (1+). Ki-67. Positive in 7%. of tumor cells. Palliative Therapy |
371 | Case 24 | Patient History | Metastatic Breast Cancer | 24.2. |
372 | Case 25 | Courses of Treatment | Benign and Proliferative | 25.1. . Courses of Treatment. →2021-07-27 excision, Lt.. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia involving. intraductal papilloma.. –. – Tubular adenoma.. 26. |
380 | Case 25 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 49. 50. Benign and Proliferative Case Series. 48. . . 25.3. |
386 | Case 25 | Patient History | Benign and Proliferative | Patient History and Progress. Female/46 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction.. Outside result of biopsy: Intraductal papilloma.. No family history.. No comorbidities.. 25.2. |
373 | Case 25 | Courses of Treatment | Carcinoma In Situ | 25.1. . Courses of Treatment. Operation + Postoperative radiation therapy. (Left) + Tamoxifen 20 mg/day for 5 years.. Operation. 116. 117. Pathology Report. Right.. Lobular carcinoma in situ. . 1. Size of tumor: 0.3 cm.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Skin: no involvement of tumor.. . 6. Surgical margins:. . (a) superior margin: 2 mm,. . (b) inferior margin: 5 mm,. . (c) medial margin: 2 mm,. . (d) lateral margin: 2 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: 2 mm.. . 7. Microcalcification:. present,. tumoral/non-. tumoral.. Left.. Invasive ductal carcinoma, pathological TN. category (AJCC 2017): pT1cN0(sn). 1. Size of invasive component: 1.5 cm (pT1c).. 2. Size of intraductal component: 5.0 cm.. Carcinoma In Situ. 108. . a. b. c. d. . . E. S. Lee et al.. 109. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 4/HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (70%) (nuclear grade:. high, necrosis: present, architectural pattern:. cribriform/solid/comedo, extensive intra. ductal component: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 5 mm,. . (b) inferior margin: 10 mm,. . (c) medial margin: 10 mm,. . (d) lateral margin: 10 mm,. . (e) deep margin: 2 mm,. . (f) superficial margin: <1 mm from ductal. carcinoma in situ (slide 2).. 7. Lymph nodes: no metastasis in one axillary. lymph node (pN0(sn)) (sentinel LN: 0/1).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular. invasion:. present,. intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: present, tumoral/non-. tumoral.. Result. Intensity. Positive %. Estrogen. receptor. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in. 25% of tumor. cells. 26. |
381 | Case 25 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 114. 115. 25.3. |
387 | Case 25 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on left breast. 1 o’clock direction.. Outside result of biopsy: Left breast 1 o’clock,. ductal carcinoma in situ, r/o invasion.. No family history.. S/P Robotic cholecystectomy (GB stone).. BRCA 1 and 2: Not examination.. 25.2. |
374 | Case 25 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 25.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel and. . trastuzumab) + Post-operative radiation ther. apy + Trastuzumab + Letrozole 2.5 mg/day.. . 145. 146. Pathology Report. [Right].. . 1. Invasive Ductal Carcinoma. . (a) Size of tumor: 1.2 cm (pT1c).. . (b) Histologic grade: 2/3 (tubule formation:. 2/3, nuclear pleomorphism: 2/3, mitotic. count: 3/3, 15/10 HPF).. . (c) Intraductal component: present, extratu. moral (30%) (nuclear grade: low, necro. sis:. present,. architectural. pattern:. cribriform/solid/comedo, extensive intra. ductal component: absent).. . (d) Skin: no involvement of tumor.. . (e) Surgical margins:. • superior margin: 8 mm,. • inferior margin: 15 mm,. • medial margin: 15 mm,. • lateral margin: 15 mm,. • deep margin: 2 mm,. • superficial margin: 10 mm.. . (f) Lymph nodes: no metastasis in one axil. lary lymph node (pN0(sn)) (sentinel LN:. 0/1).. . (g) Arteriovenous invasion: absent.. . (h) Lymphovascular. invasion:. present,. peritumoral.. . . . S. Park et al.. hyperplasia, (2) microcalcification.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Positive (3+). Ki-67. Positive in 26%. of tumor cells. [Left].. Invasive ductal carcinoma with micropapil. lary pattern.. 1. Size of tumor: 1.1 cm (pT1c).. 2. Histologic grade: 2/3 (tubule formation: 2/3,. nuclear pleomorphism: 2/3, mitotic count:. 2/3, 6/10 HPF).. 3. Intraductal component: present, extratumoral. (26%) (nuclear grade: low, necrosis: absent,. HR(+) HER2(+) Breast Cancer. 384. . . architectural pattern: micropapillary/cribri. form, extensive intraductal component:. absent).. 4. Surgical margins:. . (a) superior margin: 16 mm,. . (b) inferior margin: (see note),. . (c) medial margin: 20 mm,. . (d) lateral margin: (see note),. . (e) deep margin: 2 mm,. . (f) superficial margin: <1 mm from invasive. ductal carcinoma (slides 2 and 3).. 5. Lymph nodes:. . (a) metastasis in one out of seven axillary. lymph nodes (pN1a) (sentinel LN: 1/3,. non-sentinel LN: 0/4),. S. Park et al.. 385. a. b. . a. b. . . (b) perinodal extension: absent,. . (c) size of metastatic carcinoma: 6 mm.. 6. Arteriovenous invasion: absent.. 7. Lymphovascular invasion: absent.. 8. Tumor border: infiltrative.. 9. Microcalcification: present, tumoral.. . 10. Pathological TN category (AJCC 2017):. pT1cN1a.. HR(+) HER2(+) Breast Cancer. 386. Note: 1. The inferior margin of the lumpec. tomy specimen (slides 2 and 3) is close to inva. sive ductal carcinoma (<1 mm) but this margin. submitted for frozen diagnosis (Fro 3) is free of. tumor.. 2. The lateral margin of the lumpectomy spec. imen (slide 8) is close to ductal carcinoma in situ. (<1 mm) but this margin submitted for frozen. diagnosis (Fro 5) is free of tumor.. Result. Intensity. Positive. %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 19%. of tumor cells. SISH. Negative. 26. |
382 | Case 25 | Important Radiologic | HR(+) HER2(+) Breast Cancer | Important Radiologic. Findings. 141 142 143. 144. 25.3. |
388 | Case 25 | Patient History | HR(+) HER2(+) Breast Cancer | Patient History and Progress. Female/62 years old, post-menopause.. Screen detected mass lesion on right breast 5. o’clock direction and left breast subareolar area.. No family history.. Hypertension, dyslipidemia.. 25.2. |
375 | Case 25 | Courses of Treatment | HR(+) HER2(-) Breast Cancer | Courses of Treatment. Neoadjuvant therapy (giredestrant 30 mg/day. with palbociclib 100 mg/day) + Operation +. Adjuvant chemotherapy (#4 cycles of doxorubi. cin & cyclophosphamide followed by #4 cycles of. docetaxel) + Post-. operative radiation ther. apy + Letrozole 2.5 mg/day.. Operation. Left breast conserving surgery, axillary lymph. solid/comedo, extensive intraductal compo. nent: absent).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (f) superficial margin: 2 mm.. 7. Lymph nodes:. . (a) metastasis in eight out of twelve axillary. lymph nodes (ypN2a) (sentinel LN: 2/2,. axillary LN: 6/10). . (b) perinodal extension: present.. . (c) size of metastatic carcinoma: 5 mm.. 8. Arteriovenous invasion: absent.. 9. Lymphovascular. invasion:. present,. intratumoral.. . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. ypT1cN2a.. Y. Kim et al.. 1/3–2/3. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in 43%. of tumor cells. 26. |
383 | Case 25 | Important Radiologic | HR(+) HER2(-) Breast Cancer | Important Radiologic. Findings. See Figs. 139, 140, 141, 142 and 143.. 25.3. |
389 | Case 25 | Patient History | HR(+) HER2(-) Breast Cancer | o’clock direction and left axillary LN.. No family history.. No comorbidities.. 25.2. |
376 | Case 25 | Courses of Treatment | HR(−) HER2(+) Breast Cancer | 25.1. . Courses of Treatment. Operation + Post-operative radiation therapy. (adjuvant chemotherapy refuse).. Operation. 180. Pathology Report. Invasive Ductal Carcinoma. 1. Size of invasive component: 2.5 cm (pT2).. 2. Size of intraductal component: 4.0 cm.. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 2/3, 11/10HPF).. 4. Intraductal component: present, intratu. moral/extratumoral (50%) (nuclear grade:. high, necrosis: present, architectural pattern:. cribriform/solid/comedo, extensive intra. ductal component: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 15 mm,. . (b) inferior margin: positive for ductal carci. noma in situ (Fro 2) (see note),. . (c) medial margin: 10 mm,. . (d) lateral margin: 20 mm,. . (e) deep margin: <2 mm from ductal carci. noma in situ (slide 11),. . (f) superficial margin: 13 mm.. 7. Lymph nodes:. . (a) metastasis in two out of four axillary. lymph nodes (pN1a(sn)) (sentinel LN:. 2/4),. . (b) perinodal extension: present,. . (c) size of metastatic carcinoma: 8 mm.. 8. Arteriovenous invasion: absent.. 9. Lymphovascular. invasion:. present,. peritumoral.. HR(−) HER2(+) Breast Cancer. 528. a. b. . . 10. Tumor border: infiltrative.. . 11. Microcalcification:. present,. . tumoral/. non-tumoral.. . 12. Pathological TN category (AJCC 2017):. pT2N1a(sn).. Note: 1. Ductal carcinoma in situ is focally. present only in the permanent section of Fro 2.. Result. Intensity. Positive %. Estrogen. receptor. Negative. (0/8). 0. 0. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Positive. (3+). Ki-67. Positive in. 52% of. tumor cells. 26. |
384 | Case 25 | Important Radiologic | HR(−) HER2(+) Breast Cancer | Important Radiologic Findings. 177 178. 179. . Y. Kwon et al.. 527. . . . 25.3. |
390 | Case 25 | Patient History | HR(−) HER2(+) Breast Cancer | Patient History and Progress. Female/82 years old, post-menopause.. Screen detected mass lesion on left breast 2:30. o’clock direction.. No family history.. S/P Left hemiplegia (due to brain hemor. rhage), hypertension, S/P spinal stenosis opera. tion, s/p Tuberculosis.. 25.2. |
377 | Case 25 | Courses of Treatment | HR(−) HER2(−) Breast Cancer | 25.1. . 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. 185. Pathology Report. Invasive Ductal Carcinoma with (a) focal squa. mous differentiation, (b) focal papillary pattern.. 1. Post-chemotherapy status.. 2. Size of tumor: 1.2 cm (ypT1c).. 3. Histologic grade: 2/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 1/3, <1/10HPF).. 4. Intraductal component: present, intratumoral/. extratumoral (15%) (nuclear grade: high,. necrosis: absent, architectural pattern: papil. lary, extensive intraductal component: absent).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) Superior margin: 10 mm.. . (b) Inferior margin: 15 mm.. . (c) Medial margin: 10 mm.. . (d) Lateral margin: 35 mm.. . (e) Deep margin: 6 mm.. . (f) Superficial margin: 15 mm.. 7. Lymph nodes: no metastasis in two axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/1,. non-sentinel LN: 0/1).. 8. Arteriovenous invasion: absent.. 9. Lymphovascular invasion: absent.. . 10. Tumor border: infiltrative.. . 11. Microcalcification: absent.. . 12. Pathological TN category (AJCC 2017):. ypT1cN0(SN).. Result. Intensity Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in 28%. of tumor cells. HR(−) HER2(−) Breast Cancer. 664. . . . . E. S. Lee et al.. 665. . . . . HR(−) HER2(−) Breast Cancer. 666. . . E. S. Lee et al.. 667. 26. |
385 | Case 25 | Important Radiologic | HR(−) HER2(−) Breast Cancer | Important Radiologic. Findings. 178 179. 180. 25.3. . After Neoadjuvant. Chemotherapy. 181 182 183. 184. 25.4. |
391 | Case 25 | Patient History | HR(−) HER2(−) Breast Cancer | Patient History and Progress. Female/70 years old, post-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. Family history of breast cancer, cousin. (paternal).. Macular degeneration.. BRCA 1 and 2 mutation: Not tested.. 25.2. |
378 | Case 25 | Courses of Treatment | Local Recurrence | 25.1. . Courses of Treatment. Left breast IDC → Operation → Adjuvant ther. apy → Left breast recurrence (DCIS).. Primary Treatment. Operation. Nov. 2007 Left breast conserving surgery, axil. lary lymph node dissection (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 1.1 cm (pT1c).. . 2. Histologic grade: 3/3.. . 3. Lymph nodes: three metastases in fourteen. axillary lymph nodes (pN1).. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/7). 0. 0. Progesterone. receptor. Strong (6/7). 3. 1/3–2/3. C-erbB2. Equivocal (2+). (SISH negative). Adjuvant Therapy. Adjuvant chemotherapy #4 cycles of doxorubicin. and cyclophosphamide followed by #4 cycles of. docetaxel.. Postoperative radiation therapy.. Letrozole 2.5 mg/day for 5 years.. Treatments After Recurrence. 168. Operation. 169. Pathology Report. Ductal Carcinoma In Situ with apocrine dif. ferentiation involving fibroadenoma. . 1. Post-lumpectomy status.. . 2. Size of tumor: 0.6 cm (rpTis).. . 3. Nuclear grade: low.. . 4. Necrosis: present.. . 5. Architectural. pattern:. cribriform/solid/. comedo.. . Y. Kim et al.. 785. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Equivocal (2+). Ki-67. Positive in 9%. of tumor cells. 26. |
392 | Case 25 | Patient History | Local Recurrence | Patient History and Progress. Female/69 years old, post-menopause.. For chemotherapy after left breast cancer. surgery.. No family history.. s/p Left breast conserving surgery, s/p total. Thyroidectomy (thyroid cancer).. s/p. Hysterectomy. and. bilateral. salpingo-oophorectomy.. 25.2. |
379 | Case 25 | Courses of Treatment | Metastatic Breast Cancer | Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral breast skin metastasis.. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 7% of tumor. cells. Adjuvant Therapy. Tamoxifen 20 mg/day for 0.75 year.. Treatments After Recurrence. See Figs. 89 and 90.. Jun. 2021 Left breast skin biopsy.. Pathology: Invasive ductal carcinoma, clini. cally recurrent.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Intermediate. (5/8). 2. 10%–1/3. C-erbB2. Negative (1+). Ki-67. Positive in. 40% of tumor. cells. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in. 42% of tumor. cells. SISH. Negative. Oncotype Dx RS scores: 39.. Adjuvant Therapy. → Adjuvant chemotherapy #4 (Docetaxel &. Cyclophosphamide). → Letrozole 2.5 mg/day ~. 26. |
393 | Case 25 | Patient History | Metastatic Breast Cancer | Hyperthyroidism,. s/p. bilateral. salpingo-oophorectomy.. 25.2. |
394 | Case 26 | Courses of Treatment | Benign and Proliferative | 26.1. . Courses of Treatment. →2021-06-16 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma with usual ductal. hyperplasia.. . . Benign and Proliferative Case Series. 50. 27. |
402 | Case 26 | Important Radiologic | Benign and Proliferative | Important Radiologic. Findings. 51. 52. 26.3. |
408 | Case 26 | Patient History | Benign and Proliferative | Patient History and Progress. Female/72 years old, post-menopause.. Screen detected nodular asymmetry on outer. central portion of right breast.. No family history.. s/p Total thyroidectomy (thyroid cancer).. C. W. Lee et al.. 49. 26.2. |
395 | Case 26 | Courses of Treatment | Carcinoma In Situ | 26.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 121. 122. Pathology Report. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. Size of tumor: up to 0.6 cm (pTis).. . 2. Nuclear grade: low.. . . . Carcinoma In Situ. 110. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Surgical margins:. . (a) superior margin: 5 mm,. . (b) inferior margin: 5 mm,. . (c) medial margin: 10 mm,. . (d) lateral margin: 20 mm,. . (e) deep margin: 5 mm,. . (f) superficial margin: <1 mm from lobular. carcinoma in situ (slide 2).. . 6. Microcalcification: absent.. Result. Intensity. Positive %. Estrogen. receptor. Intermediate. (6/8). 2. 1/3–2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 4%. of tumor cells. . a. b. . E. S. Lee et al.. 111. a. b. . . . 27. |
403 | Case 26 | Important Radiologic | Carcinoma In Situ | Important Radiologic. Findings. 118 119. 120. 26.3. |
409 | Case 26 | Patient History | Carcinoma In Situ | Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass and microcalcification. on upper portion of right breast.. No family history.. No comorbidities.. 26.2. |
396 | Case 26 | Courses of Treatment | HR(+) HER2(+) Breast Cancer | 26.1. . 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.. 153. 154. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 2.3 cm (ypT2).. . . HR(+) HER2(+) Breast Cancer. moral/extratumoral (50%) (nuclear grade:. high, necrosis: present, architectural pattern:. solid/comedo, extensive intraductal compo. nent: present).. 5. Surgical margins:. . (a) deep margin: <1 mm from ductal carci. noma in situ (slides 1 and 2),. . (b) superficial margin: <1 mm from ductal. carcinoma in situ (slide 3).. S. Park et al.. 389. a. b. . . 6. Lymph nodes: no metastasis in three axillary. lymph nodes (ypN0(sn)) (sentinel LN: 0/3).. 7. Arteriovenous invasion: absent.. 8. Lymphovascular invasion: absent.. 9. Tumor border: infiltrative.. . 10. Microcalcification: present, tumoral.. . 11. Pathological TN category (AJCC 2017):. ypT2N0(sn).. Result. Intensity. Positive. %. Estrogen. receptor. Weak (4/8). 2. 1–10%. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 46%. of tumor cells. HR(+) HER2(+) Breast Cancer. 390. 27. |
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