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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 ...
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, sta...
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. Nip...
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. ...
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...
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...
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 ...
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. Intens...
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 di...
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.. . ...
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 tumo...
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. tura...
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 gra...
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 fo...
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. Ki...
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 ...
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...
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,. ...
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 ...
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....
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 ...
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(−) ...
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 Rep...
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. Adj...
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. Sk...
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....
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 Carcinom...
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 ...
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,. nucle...
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) foc...
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. ...
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.. T...
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. ...
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 o...