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499
Case 30
Courses of Treatment
HR(+) HER2(+) Breast Cancer
30.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy.. 179. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-chemotherapy status.. . 2. Size of tumor: 2.0 cm (ypTis).. . 3. Nuclear ...
506
Case 30
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 172 173 174 175 176 177. 178
511
Case 30
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/31 years old, pre-menopause.. Self-detected palpable mass lesion on outer. inner portion of right breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 30.2. 
500
Case 30
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. ponent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 15 mm.. . (b) inferior margin: 15 mm.. . (c) medial margin: 1...
507
Case 30
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 165, 166, 167 and 168.. 30.3. 
512
Case 30
Patient History
HR(+) HER2(-) Breast Cancer
s/p Left optic nerve palsy, hypertension, s/p. right rotator cuff tear operation.. 30.2. 
501
Case 30
Courses of Treatment
HR(−) HER2(+) Breast Cancer
30.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab and pertuzumab.. 3. Histologic grade: not applicable.. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor....
508
Case 30
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 202 203. 204. HR(−) HER2(+) Breast Cancer. 540. . ­. Y. Kwon et al.. 541. 30.3. . After Neoadjuvant. Chemotherapy. 205 206. 207. 30.4. 
513
Case 30
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected palpable mass and nipple dis­. charge on left breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 30.2. 
502
Case 30
Courses of Treatment
HR(−) HER2(−) Breast Cancer
30.1. . Courses of Treatment. Neoadjuvant chemotherapy (#2  cycles of. doxorubicin and cyclophosphamide  +  #3. cycles of paclitaxel) + Operation + Adjuvant. capecitabine.. Operation. 224. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 3.5 cm (ypT2).. 3. Histologic grad...
509
Case 30
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 216 217. 218. . E. S. Lee et al.. 683. After Neoadjuvant. Chemotherapy. 219 220 221 222. 223. 30.3. 
514
Case 30
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/69 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. h/o Tuberculosis, s/p thoracic vertebra com­. pression fracture.. 30.2. 
503
Case 30
Courses of Treatment
Local Recurrence
30.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy → Left breast recurrence (IDC).. Primary Treatment. 203 204 205. 206. . . . . Local Recurrence. 800. a. b. c. d. . Operation. 207. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.2 cm (pT2).. 2. Histologic grade: 2/3 (tub...
515
Case 30
Patient History
Local Recurrence
Patient History and Progress. Female/89 years old, post-menopause.. Screen detected mass lesion on right breast 1. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. No family history.. Hypertension, Hypothyroidism, s/p Cardiac. stent insertion (angina).. s/p Shoulder ligament rupture operation....
504
Case 30
Courses of Treatment
Metastatic Breast Cancer
30.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Bone metastasis.. Positive %. Estrogen. receptor. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2. Negative (0). Ki-67. Positive in. 5% of tumor. cells. Adjuvant Therapy. Tamoxifen 20 mg/day.. Treatm...
516
Case 30
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/50 years old, pre-menopause.. No family history.. Hepatitis B virus carrier, s/p myomectomy.. 30.2. 
517
Case 31
Courses of Treatment
Carcinoma In Situ
31.1. . Courses of Treatment:. Operation. Operation. 146. 147. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 2.0 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary/micropapil­. lary/cribriform.. E. S. ...
524
Case 31
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 144. 145. 31.3. 
529
Case 31
Patient History
Carcinoma In Situ
Patient History and Progress. Female/31 years old, pre-menopause.. Screen detected calcification on left breast. 11 o’clock direction.. Outside result of mammotome biopsy: Ductal. carcinoma in situ.. No family history.. No comorbidities.. BRCA 1 and 2: Not detected.. 31.2. 
518
Case 31
Courses of Treatment
HR(+) HER2(+) Breast Cancer
31.1. . 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.. 184. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1...
525
Case 31
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 180 181 182. 183. 31.3. 
530
Case 31
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/69 years old, post-menopause.. Self-detected nipple retraction on left breast.. No family history.. Hypertension.. 31.2. 
519
Case 31
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of docetaxel & ­. cyclophosphamide) +. Post-operative radiation therapy + Letrozole. 2.5 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. . (c) medial margin: 10 mm.. . (d) lateral margin: 10 mm.. . (e) deep margin: <1 mm from...
526
Case 31
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 170, 171, 172 and 173.. 31.3. 
531
Case 31
Patient History
HR(+) HER2(-) Breast Cancer
niece.. S/P. Hysterectomy. and. salpingo-oophorectomy.. BRCA 1 exon 9-13 deletion, exon 2-6. deletion.. 31.2. 
520
Case 31
Courses of Treatment
HR(−) HER2(+) Breast Cancer
31.1. . Operation. 213. 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:. 3/3, 5/HPF).. 3. Intraductal component: present, intratu­. moral/extratumoral (50%) (nuclear grade:. high, necrosis: pres...
527
Case 31
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 209 210 211. 212. . HR(−) HER2(+) Breast Cancer
532
Case 31
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/74 years old, post-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. No family history.. Hypertension.. 31.2. 
521
Case 31
Courses of Treatment
HR(−) HER2(−) Breast Cancer
31.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 233. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of ...
528
Case 31
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 225 226 227. 228. E. S. Lee et al.. 687. . . ­. . HR(−) HER2(−) Breast Cancer. 688. . After Neoadjuvant. Chemotherapy. 229 230 231. 232. 31.3. 
533
Case 31
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected mass lesion on right breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, STK11. VUS (variant of uncertain).. 31.2. 
522
Case 31
Courses of Treatment
Local Recurrence
31.1. . Courses of Treatment. Right breast Papillary carcinoma in situ→. Operation → Right breast recurrence (DCIS).. Primary Treatment. 212 213 214. 215. Operation. ­. ­. 216 217. 218. Pathology Report. <Right>. Y. Kim et al.. 803. . . . ­. . Papillary carcinoma in situ. . 1. Size of tumor: 5.0 cm (pTis).. . 2. Nuc...
534
Case 31
Patient History
Local Recurrence
Patient History and Progress. Female/49 years old, pre-menopause.. Screen detected mass lesion on right breast 1. o’clock direction.. No family history.. No comorbidities.. 31.2. 
523
Case 31
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Lung metastasis.. Primary Treatment. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in. 85% of tumor. cells. Adjuvant Therapy. Adjuvant chemotherapy #6 cycles (Fluorouracil. & Doxorubicin & Cyclophosphamide).. Post-opera...
535
Case 31
Patient History
Metastatic Breast Cancer
BRCA 1: positive for deleterious mutation.. S/p bilateral salpingo-oophorectomy.. 31.2. 
536
Case 32
Courses of Treatment
Carcinoma In Situ
32.1. . Courses of Treatment. Operation + Postoperative radiation therapy.. Operation. 151. 152. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 4.0 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural pattern: ­. micropap...
543
Case 32
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 148 149. 150. 32.3. 
548
Case 32
Patient History
Carcinoma In Situ
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast. 8 o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. 32.2. 
537
Case 32
Courses of Treatment
HR(+) HER2(+) Breast Cancer
32.1. . Courses of Treatment. Neoadjuvant chemotherapy (#3 cycles of. docetaxel. and. trastuzumab. and. pertu­. zumab)  +  Operation  +  Post-operative radia­. tion therapy  +  Trastuzumab emtansine +. Letrozole 2.5 mg/day.. Operation:. Left. axillary. lymph. node. ­. dissection.. Pathology Report. Metastatic Ductal C...
544
Case 32
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 185 186 187 188. 189. 32.3. 
549
Case 32
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/74 years old, post-menopause.. Self-detected mass lesion on left axillary.. No family history.. S/P Tuberculosis, asthma.. 32.2. 
538
Case 32
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. ponent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 20 mm.. . (b) inferior margin: 40 mm.. . (c) medial margin: ...
545
Case 32
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 175, 176, 177 and 178.. 32.3. 
550
Case 32
Patient History
HR(+) HER2(-) Breast Cancer
o’clock direction.. No family history.. Hypertension, s/p bronchiectasis, s/p left hip. arthroplasty.. 32.2. 
539
Case 32
Courses of Treatment
HR(−) HER2(+) Breast Cancer
32.1. . Courses of Treatment. Neoadjuvant chemotherapy (#5 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab after followed #1 cycle of trastu­. zumab and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 220. Pathology Report. No residual tumor with stroma...
546
Case 32
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 214 215. 216. 32.3. . After Neoadjuvant. Chemotherapy. 217 218. 219. Y. Kwon et al.. 547. . . ­. . HR(−) HER2(+) Breast Cancer. 548. . . 32.4. 
551
Case 32
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/55 years old, post-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. No family history.. Hypertension, thyroid nodules.. 32.2. 
540
Case 32
Courses of Treatment
HR(−) HER2(−) Breast Cancer
32.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and ­. cyclophosphamide + #4 cycles. of docetaxel)  +  Operation  +  Post-operative. radiation therapy + Adjuvant capecitabine.. . ­. . HR(−) HER2(−) Breast Cancer. 694. . . Operation. 242. Pathology Report. Invasive Ductal Carcinoma. 1...
547
Case 32
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 234 235 236. 237. . HR(−) HER2(−) Breast Cancer. 692. . ­. . ­. . E. S. Lee et al.. 693. . After Neoadjuvant. Chemotherapy. 238 239 240. 241. 32.3. 
552
Case 32
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected mass lesion on left breast.. Family history of breast cancer, aunt and. cousin (paternal).. Family history of prostate cancer, father.. Hyperthyroidism.. BRCA 1 and 2 mutation: Not detected.. 32.2. 
541
Case 32
Courses of Treatment
Local Recurrence
32.1. . Courses of Treatment. Right breast DCIS → Operation → Adjuvant. therapy → Right breast recurrence (tubular. carcinoma + DCIS).. Primary Treatment. Operation. Aug. 2014 Right breast wide excision (outside).. Pathology Report. Ductal carcinoma in situ involving intraductal. papilloma. . 1. Nuclear grade: low.. ...
553
Case 32
Patient History
Local Recurrence
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast. . 12 o’clock direction.. Outside result of lumpectomy: Ductal carci­. noma in situ.. No family history.. No comorbidities.. BRCA 2 VUS (variant of uncertain).. 32.2. 
542
Case 32
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Lung metastasis.. Primary Treatment. receptor. Intermediate. (4/7). 2. 10%–1/3. Progesterone. receptor. Strong (6/7). 3. 1/3–2/3–. C-erbB2. Positive (3+). Ki-67. Positive in. 20% of tumor. cells. Y. Kwon et al.. & Doxorubicin & Cyclophosphamide)...
554
Case 32
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/49 years old, peri-menopause.. No family history.. 32.2. 
555
Case 33
Courses of Treatment
Carcinoma In Situ
33.1. . Courses of Treatment:. Operation. Operation. 155. 156. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary/cribriform.. . 5. ...
562
Case 33
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 153. 154. 33.3. 
567
Case 33
Patient History
Carcinoma In Situ
Patient History and Progress. Female/68 years old, post-menopause.. Bloody nipple discharge from right breast.. No family history.. S/P Hysterectomy.. 33.2. 
556
Case 33
Courses of Treatment
HR(+) HER2(+) Breast Cancer
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.. 194. Pathology Report. Invasive ductal carcinoma, histologic grade 2.. No residual tumor with stromal ...
563
Case 33
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 190 191 192. 193. 33.3. 
568
Case 33
Patient History
HR(+) HER2(+) Breast Cancer
Self-detected palpable mass lesion on left. breast.. No family history.. No comorbidities.. 33.2. 
557
Case 33
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. Y. Kim et al.. micropapillary/cribriform, extensive intra­. ductal component: present).. 5. Skin: no involvement of tumor.. HR(+) HER2(−) Breast Cancer. . (e) deep margin: 3 mm.. . (f) superficial margin: 5 mm.. Y. Kim et...
564
Case 33
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 180, 181, 182, 183 and 184.. 33.3. 
569
Case 33
Patient History
HR(+) HER2(-) Breast Cancer
Restless legs.. 33.2. 
558
Case 33
Courses of Treatment
HR(−) HER2(+) Breast Cancer
33.1. . tion therapy + Trastuzumab.. Operation. 228. Pathology Report. . 1. No residual tumor with foamy histiocytic. collection.. . (a) Post-chemotherapy status.. . (b) Lymph nodes: no metastasis in four axil­. lary lymph nodes (ypN0(sn)) (sentinel. LN: 0/4).. . (c) Microcalcification:. present,. tumoral/. non-tu...
565
Case 33
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 221 222 223. 224. HR(−) HER2(+) Breast Cancer. . HR(−) HER2(+) Breast Cancer. 552. . 33.3. . After Neoadjuvant. Chemotherapy. 225 226. 227. Y. Kwon et al.
570
Case 33
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/63 years old, post-menopause.. Self-detected palpable mass lesion on left. breast 2 o’clock direction.. No family history.. Hypertension, chronic kidney disease, ven­. tricular premature contraction.. 33.2. 
559
Case 33
Courses of Treatment
HR(−) HER2(−) Breast Cancer
33.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy.. Operation. 251. Pathology Report. Atypical ductal hyperplasia, focal. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metast...
566
Case 33
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 243 244 245. 246. . ­. HR(−) HER2(−) Breast Cancer. 696. . . ­. . After Neoadjuvant. Chemotherapy. 247 248 249. 250. 33.3. 
571
Case 33
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/52 years old, post-menopause.. Screen detected mass lesion on left breast 11. o’clock direction.. No family history.. s/p cervical cancer (stage 0).. BRCA 1 and 2 mutation: Not detected.. 33.2. 
560
Case 33
Courses of Treatment
Local Recurrence
33.1. . Courses of Treatmaent. Left breast IDC → Neoadjuvant chemotherapy. → Operation → Adjuvant therapy → Left breast. recurrence (IDC).. Primary Treatment. 225 226 227. 228. Neoadjuvant Chemotherapy. Neoadjuvant chemotherapy #6 cycles of trastu­. zumab and pertuzumab and docetaxel and. carboplatin.. Operation. ­. 2...
572
Case 33
Patient History
Local Recurrence
Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected mass lesion on upper inner. portion of left breast.. Outside result of biopsy: Invasive ductal. carcinoma.. Family history of breast cancer, mother at her. 50 years old.. S/P. Hysterectomy,. s/p. bilateral. breast. augmentation.. 33.2. 
561
Case 33
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Bone metastasis.. Primary Treatment. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Intermediate. (5/8). 2. 10%–. 1/3. Result. Intensity. Positive %. C-erbB2. Equivocal (2+). Ki-67. Positive in 7%. of tumor cells. SISH. Posi...
573
Case 33
Patient History
Metastatic Breast Cancer

574
Case 34
Courses of Treatment
Carcinoma In Situ
34.1. . Courses of Treatment:. Operation. Operation. 161. 162. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary/cribriform.. . 5. ...
581
Case 34
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 157 158 159. 160. 34.3. 
586
Case 34
Patient History
Carcinoma In Situ
Patient History and Progress. Female/53 years old, pre-menopause.. Screen detected mass lesion on upper outer of. right breast.. No family history.. S/P Total gastrectomy (gastric cancer), micro­. papillary thyroid carcinoma (follow-up).. BRCA 1 and 2: Not examination.. 34.2. 
575
Case 34
Courses of Treatment
HR(+) HER2(+) Breast Cancer
34.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. and Pertuzumab + Letrozole 2.5 mg/day.. 201. Pathology Report. Invasive ductal carcinoma, histologic grade 2.. No resid...
582
Case 34
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 195 196 197 198 199. 200. 34.3. 
587
Case 34
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/55 years old, post-menopause.. Self-detected palpable mass lesion on right. breast 9 o’clock direction.. No family history.. No comorbidities.. 34.2. 
576
Case 34
Courses of Treatment
HR(+) HER2(-) Breast Cancer
34.1. . Courses of Treatment. Operation. Right nipple–areolar complex sparing mastec­. tomy with immediate implant reconstruction,. sentinel lymph node biopsy, left nipple–areo­. lar complex sparing mastectomy with immedi­. ate implant reconstruction (Figs. 190, 191 and. 192).. Pathology Report. [Right]. Invasive Duct...
583
Case 34
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 186, 187, 188 and 189.. 34.3. 
588
Case 34
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/43 years old, pre-menopause.. Screen for high risk for breast cancer.. Family history of breast cancer, mother.. Pancreatic cancer, maternal uncle.. No comorbidities.. BRCA 1 mutation carrier.. 34.2. 
577
Case 34
Courses of Treatment
HR(−) HER2(+) Breast Cancer
34.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of. doxorubicin. +. cyclophosphamide). +. Operation + Trastuzumab.. Operation. 233. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5 cm (pT1c(Paget)).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism:...
584
Case 34
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 229 230 231. 232. . HR(−) HER2(+) Breast Cancer. 556. . ­. . . 34.3. 
589
Case 34
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/54 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. S/P. unilateral. salpingo-oophorectomy,. dyslipidemia.. HR(−) HER2(+) Breast Cancer. 554. a. b. . Y. Kwon et al.. 555. 34.2. 
578
Case 34
Courses of Treatment
HR(−) HER2(−) Breast Cancer
34.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#1. cycles of docetaxel and cyclophosphamide,. stop d/t mucositis).. Operation. 255. Pathology Report. Invasive Ductal Carcinoma associated with. paraffinoma. 1. Size of tumor: 3.0 cm (pT2).. . . E. S. Lee et al.. 701. 2. Histologic grade: 3/3 (tubul...
585
Case 34
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 252 253. 254. . . HR(−) HER2(−) Breast Cancer. 700. 34.3. 
590
Case 34
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/79 years old, post-menopause.. Screen detected mass lesion on left breast 12. o’clock direction.. No family history.. S/P paraffin injection, s/p appendectomy, s/p. hysterectomy, s/p hemicolectomy (colon cancer).. S/P radical total gastrostomy (advanced gas­. tric cancer).. BRCA 1 a...
579
Case 34
Courses of Treatment
Local Recurrence
34.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy → Right breast recurrence (IDC).. Primary Treatment. 233 234. 235. Operation. 236. Pathology Report. Invasive Ductal Carcinoma. 1. Size of invasive component: 0.7 cm (pT1b).. 2. Size of intraductal component: 1.0 cm.. 3. Histologic grade...
591
Case 34
Patient History
Local Recurrence
Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. Family history of ovarian cancer mother.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 34.2. 
580
Case 34
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Right pleural, liver, right adrenal. gland, bone metastasis → Brain metastasis.. Primary Treatment. (0/8). 0. 0. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Equivocal. (2+). Ki-67. Positive. in 46% of. tumor. cells. SISH. Positive. A...
592
Case 34
Patient History
Metastatic Breast Cancer
No family history.. 34.2. 
593
Case 35
Courses of Treatment
Carcinoma In Situ
35.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 165. 166. 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. ...
600
Case 35
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 163. 164. 35.3. 
605
Case 35
Patient History
Carcinoma In Situ
Patient History and Progress. Female/59 years old, post-menopause.. Screen detected ductal dilatation on left breast. 12 o’clock direction.. No family history.. S/P Hysterectomy and bilateral salpingo-­. oophorectomy, S/P total thyroidectomy (thyroid. cancer), hypertension.. 35.2. 
594
Case 35
Courses of Treatment
HR(+) HER2(+) Breast Cancer
35.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. S. Park et al.. 209. 210. Pathology Report. Invasive ductal carcinoma, histologic grade 3.. No residual tumor with stromal degeneration.. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metastasis in...
601
Case 35
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 202 203 204 205 206 207. 208. 35.3. 
606
Case 35
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/39 years old, pre-menopause.. Self-detected skin change and palpable mass. lesion on right breast 9:30 o’clock direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 35.2. 
595
Case 35
Courses of Treatment
HR(+) HER2(-) Breast Cancer
35.1. . 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: 15 mm.. . (c) medial margin: 10 mm.. . (d) lateral margin: 10 mm.. . (e) deep margin: 2 mm.. . (f) superficial margin: 2...
602
Case 35
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 193, 194, 195, 196 and 197.. Y. Kim et al.