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701
Case 40
Patient History
Metastatic Breast Cancer

702
Case 41
Courses of Treatment
Carcinoma In Situ
41.1. . Courses of Treatment. 194. 195. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 194. 195. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 1.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Archite...
705
Case 41
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 191 192. 193. 41.3. 
706
Case 41
Patient History
Carcinoma In Situ
Patient History and Progress. Female/46 years old, pre-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of biopsy: R/O Atypical ductal. hyperplasia or ductal carcinoma in situ.. No family history.. No comorbidities.. 41.2. 
703
Case 41
Courses of Treatment
Local Recurrence
41.1. . Courses of Treatment. Left breast IDC → Operation → Adjuvant ther­. apy → Right breast recurrence (DCIS).. Primary Treatment. 272 273. 274. Operation. 275. Pathology Report. Invasive Ductal Carcinoma. 1. Size of invasive tumor: 1.2 cm (pT1c).. 2. Size of ductal carcinoma in situ: 3.5 cm.. 3. Histologic grad...
707
Case 41
Patient History
Local Recurrence
Patient History and Progress. Female/62 years old, post-menopause.. Screen detected mass lesion on left breast sub­. areolar and retraction of left nipple.. No family history.. No comorbidities.. 41.2. 
704
Case 41
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Lung, liver, and bone metastasis.. Primary Treatment. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. weak (4/8). 2. 1–10%. C-erbB2. Positive. (+3). Ki-67. Positive in. 19% of. tumor cells. Adjuvant Therapy. Adjuvant chemotherapy # 8 cycles (D...
708
Case 41
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/52 years old, peri-menopause.. No family history.. S/p Tuberculosis.. 41.2. 
709
Case 42
Courses of Treatment
Carcinoma In Situ
42.1. . Courses of Treatment. Operation + Postoperative radiation therapy.. Operation. 200. 201. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisNx. . 1. Size of tumor: 1.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary/c...
712
Case 42
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 196 197 198. 199. 42.3. 
713
Case 42
Patient History
Carcinoma In Situ
Patient History and Progress. Female/57 years old, post-menopause.. Screen detected microcalcification on left. breast 6 o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. Diabetes mellitus.. 42.2. 
710
Case 42
Courses of Treatment
Local Recurrence
42.1. . Courses of Treatment. Left breast ILC → Operation → Adjuvant ther­. apy → Right breast recurrence (IDC).. Primary Treatment. 280. Operation. Aug. 2017 Left nipple-areolar complex sparing. mastectomy with transverse rectus abdominis. muscles flap reconstruction (outside).. Pathology Report. Invasive Lobular Car...
714
Case 42
Patient History
Local Recurrence
Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. Family history of breast cancer, younger sister. at her 44 years old.. s/p Left breast Nipple sparing mastectomy. (invasive lobula...
711
Case 42
Courses of Treatment
Metastatic Breast Cancer
. Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Lung metastasis.. Primary Treatment. Progesterone. receptor. Strong (7/7). 3. >2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 5%. of tumor cells. FISH. Negative. Adjuvant Therapy. Adjuvant chemotherapy # 6 cycles (Fluorouracil-5. & Doxorubi...
715
Case 42
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/57 years old, post-menopause.. No family history.. Arrhythmia (taking on medicine).. 42.2. 
716
Case 43
Courses of Treatment
Brief Overview of Breast Cancer Treatment
Brief Overview of Breast Cancer Treatment. 150. . (b) Multicentric or multifocal lesions or with. an extensive intraductal component of. 25% or greater and tumor size that is sig­. nificantly reduced after neoadjuvant. therapy.. . (c) A lesion significantly reduced in size. after neoadjuvant therapy that is a T1 or. ...
717
Case 43
Courses of Treatment
Carcinoma In Situ
43.1. . Courses of Treatment. Operation + Postoperative radiation therapy (left).. E. S. Lee et al.. 145. . ­. ­. . Operation. 206. 207. 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...
720
Case 43
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 202 203 204. 205. 43.3. 
721
Case 43
Patient History
Carcinoma In Situ
Patient History and Progress. Female/67 years old, post-menopause.. Screen detected mass lesion on left breast 4. o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. Diabetes mellitus, hypertension.. 43.2. 
718
Case 43
Courses of Treatment
Local Recurrence
43.1. . Courses of Treatment. Right breast ILC→ Operation → Adjuvant ther­. apy → Left breast recurrence (microinvasive. ductal carcinoma).. Primary Treatment. 285. 286. Operation. ­. 287. Pathology Report. Invasive Lobular Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histologic grade: 2/3 (tubule formation: 3/3,...
722
Case 43
Patient History
Local Recurrence
Patient History and Progress. Female/64 years old, post-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. Family history of breast cancer, older sister.. Diabetes mellitus, fatty liver, dyslipidemia.. BRCA 1 and 2 mutation: Not detecte...
719
Case 43
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Brain metastasis.. Primary Treatment. receptor. Strong (7/7). 3. >2/3. Progesterone. receptor. Strong (7/7). 3. >2/3. C-erbB2. Negative. (1+). Ki-67. Positive in. 8% of tumor. cells. Adjuvant Therapy. Post-operation radiation to right breast +....
723
Case 43
Patient History
Metastatic Breast Cancer
BRCA 1 & 2 mutation: Not detected.. S/p bilateral salpingo-oophorectomy.. 43.2. 
724
Case 44
Courses of Treatment
Local Recurrence
44.1. . Courses of Treatment. Left breast microinvasive ductal carcinoma →. Operation → Adjuvant therapy → Right breast. recurrence (IDC).. Primary Treatment. 293 294 295. 296. . . . . ­. . Local Recurrence. 840. Operation. ­. 297. Pathology Report. Microinvasive Ductal Carcinoma. 1. Size of invasive component: <0.1 ...
726
Case 44
Patient History
Local Recurrence
Patient History and Progress. Female/54 years old, post-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. Outside result of biopsy: Ductal carcinoma.. No family history.. No comorbidities.. 44.2. 
725
Case 44
Courses of Treatment
Metastatic Breast Cancer
44.1. . Courses of Treatment. Right breast cancer with bone metastasis →. Palliative therapy.. Progesterone. receptor. Negative. (0/8). 0. 0. C-erbB2. Negative. (1+). Ki-67. Positive in. 57% of. dissection.. Pathology: Invasive ductal carcinoma, stage. ypT1cN1a.. Size of tumor: 2.0  cm, lymph node: 3/7. (2 mm).. Resul...
727
Case 44
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/49 years old, post-menopause.. No family history.. S/p bilateral salpingo-oophorectomy.. 44.2. 
728
Case 45
Courses of Treatment
Local Recurrence
45.1. . Courses of Treatment. Right breast LCIS→ Operation → Right breast. recurrence (DCIS).. Primary Treatment. 303. Operation. 304. 305. Pathology Report. <Right>. Y. Kim et al.. 843. . 1. Lobular Carcinoma In Situ. . (a) Size of tumor: up to 0.4 cm, multifocal. (pTis).. . (b) Surgical margins:. • Superior marg...
730
Case 45
Patient History
Local Recurrence
Patient History and Progress. Female/57 years old, post-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. Outside result of biopsy: Lobular carcinoma. in situ.. Family history of breast cancer, older sister.. Panic disorder.. BRCA 1 and 2 mutation: Not detected.. 45.2. 
729
Case 45
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer with lung and bone metas­. tasis → Palliative therapy.. See Figs. 137, 138, and 139.. Left invasive ductal carcinoma, stage IV. (metastasis in lung, bone).. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Negative. (2/8). 1. <1%....
731
Case 45
Patient History
Metastatic Breast Cancer

732
Case 46
Courses of Treatment
Local Recurrence
46.1. . Courses of Treatment. Right breast papillary carcinoma in situ →. Operation → Adjuvant therapy → Right breast. recurrence (IDC).. Primary Treatment. Operation. 308. Pathology Report. Papillary Carcinoma In Situ in background of. multiple papilloma (see note). . 1. Size of intraductal carcinoma: 0.5  cm. (pTis...
734
Case 46
Patient History
Local Recurrence
Patient History and Progress. Female/69 years old, post-menopause.. Screen detected mass lesion on upper outer. portion of right breast.. No family history.. No comorbidities.. 46.2. 
733
Case 46
Courses of Treatment
Metastatic Breast Cancer
46.1. . Courses of Treatment. Right breast cancer with bone metastasis →. Palliative therapy.. See Figs. 140 and 141.. Metastatic Breast Cancer. 934. Right invasive ductal carcinoma, Stage IV. (R/O metastasis in bone, T-spine 10).. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone....
735
Case 46
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/61 years old, post-menopause.. No family history.. s/p appendectomy, hypertension.. 46.2. 
736
Case 47
Courses of Treatment
Local Recurrence
47.1. . Courses of Treatment. Right breast Infiltrating ductal carcinoma→. Operation → Adjuvant therapy → Left breast. recurrence (IDC).. Primary Treatment. 314. 315. Operation. Aug. 2003 Right breast conserving surgery, axil­. lary lymph node dissection.. Pathology Report. Infiltrating ductal carcinoma.. 1. Size of ...
738
Case 47
Patient History
Local Recurrence
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast 1. o’clock direction.. No family history.. Diabetes mellitus.. BRCA 1 and 2 mutation: Not detected, ATM. VUS (variant of uncertain).. POLE VUS (variant of uncertain).. 47.2. 
737
Case 47
Courses of Treatment
Metastatic Breast Cancer
47.1. . Courses of Treatment. Right breast cancer → Neoadjuvant chemother­. apy → Operation → Adjuvant therapy → Ipsilateral. breast recurrence → Lung metastasis.. Primary Treatment. receptor. Negative 0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Positive in 5%. Operation. Aug. 2013 Left breast conserving surgery, senti...
739
Case 47
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/46 years old, pre-menopause.. No family history.. 47.2. 
740
Case 48
Courses of Treatment
Local Recurrence
48.1. . Courses of Treatment. Left breast Mucinous carcinoma → Operation. → Adjuvant therapy → Left breast recurrence. (mucinous carcinoma).. Primary Treatment. 320. 321. Operation. 322. Pathology Report. Mucinous Carcinoma. 1. Size of invasive carcinoma: 0.6 cm (pT1b).. 2. Size of intraductal carcinoma: 1.5 cm.. 3....
742
Case 48
Patient History
Local Recurrence
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast 9. o’clock direction.. Outside. result. of. biopsy:. Mucinous. carcinoma.. No family history.. No comorbdities.. 48.2. 
741
Case 48
Courses of Treatment
Metastatic Breast Cancer
48.1. . Courses of Treatment. Right breast cancer with mediastinum and. bone metastasis → Palliative therapy.. Progesterone. receptor. Intermediate. (5/8). 2. 10%–1/3. C-erbB2. Negative (0). Ki-67. Positive in. 54% of tumor. cells. Neoadjuvant. chemotherapy. #8. cycles. (Doxorubicin + Cyclophosphamide #4 →. Docetaxel ...
743
Case 48
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/45 years old, post-menopause.. No family history.. BRCA 1 & 2 mutation: Not detected.. S/p bilateral salpingo-oophorectomy.. 48.2. 
744
Case 49
Courses of Treatment
Local Recurrence
49.1. . Courses of Treatment. Right breast IDC→ Operation → Adjuvant ther­. apy → Left breast recurrence (IDC).. Primary Treatment. 328. 329. Operation. Apr. 2004 Right breast conserving surgery, senti­. nel lymph node biopsy.. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histolo...
746
Case 49
Patient History
Local Recurrence
Patient History and Progress. Female/63 years old, post-menopause.. Self-detected mass lesion on right breast. . 2 o’clock direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: No examination.. Local Recurrence. 854. 49.2. 
745
Case 49
Courses of Treatment
Metastatic Breast Cancer
49.1. . Courses of Treatment. Right breast cancer with bone metastasis →. Palliative therapy.. See Figs. 148 and 149.. Right invasive ductal carcinoma, stage IV. (metastasis in bone).. Metastatic Breast Cancer. Strong(8/8). 3. >2/3. C-erbB2. Negative. (1+). Ki-67. Positive in. 75% of. tumor cells. Clinical trial: Tamo...
747
Case 49
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/55 years old, post-menopause.. No family history.. S/p bilateral salpingo-oophorectomy, s/p Left. pelvis cementoplasty.. 49.2. 
748
Case 5
Courses of Treatment
Benign and Proliferative
5.1. . Courses of Treatment. →2021-12-17 Excision, Lt. (11H, 1H).. 5.3.1. . Pathology Report. • Breast, left, excision:. –. – Atypical ductal hyperplasia (#1. 1 o’clock. & #2. 11  o’clock) involving intraductal. papilloma with microcalcification.. C. W. Lee et al.. 23. . . 6. 
756
Case 5
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 7. 8. 5.3. 
762
Case 5
Patient History
Benign and Proliferative
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of left breast.. Family history of breast cancer, mother and. sister.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 5.2. 
749
Case 5
Courses of Treatment
Carcinoma In Situ
Courses of Treatment. Operation + Postoperative radiation therapy.. 5.3.1. . Operation. 25. 26. 5.3.2. . Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.3 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: crib...
757
Case 5
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 21 22 23. 24. 5.3. 
763
Case 5
Patient History
Carcinoma In Situ
Screen detected mass lesion on left breast 11,. 3 and 2 o’clock direction.. Outside result of biopsy:. Left breast 11 o’ clock: Intraductal prolifera­. tive lesion.. Left breast 3 o’ clock: Adenosis and fibrocys­. tic change.. Left breast 2 o’clock: Fibrocystic change.. No family history.. No comorbidities.. 5.2. 
750
Case 5
Courses of Treatment
HR(+) HER2(+) Breast Cancer
5.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles. of. docetaxel. and. cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 28. 5.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histologic grade: 3/3 ...
758
Case 5
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 24 25 26. 27. 5.3. 
764
Case 5
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/53 years old, peri-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. No family history.. Hypothyroidism, dyslipidemia, s/p cold knife. conization of cervix.. 5.2. 
751
Case 5
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4  cycles of docetaxel & cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Letrozole 2.5 mg/day.. 5.3.1. . Operation (1st, Dec. 2020). Right breast conserving surgery, sentinel lymph. low, necrosis: present, architectural pattern:. micropapil...
759
Case 5
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 20, 21, 22 and 23.. 5.3. 
765
Case 5
Patient History
HR(+) HER2(-) Breast Cancer
o’clock direction.. No family history.. No comorbidities.. 5.2. 
752
Case 5
Courses of Treatment
HR(−) HER2(+) Breast Cancer
5.1. . Courses of Treatment. Operation + Post-operative radiation therapy.. 5.3.1. . Operation. 40. 5.3.2. . Pathology Report. . 1. Invasive ductal carcinoma.. . (a) Size of invasive component: 0.2  cm. (pT1a).. . (b) Size of intraductal component: 2.0 cm.. . (c) Histologic grade: 3/3 (tubule formation:. 3/3, nu...
760
Case 5
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 36 37 38. 39. Y. Kwon et al.. 447. . . . HR(−) HER2(+) Breast Cancer. 448. . 5.3. 
766
Case 5
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected mass lesion on upper inner. portion of left breast 8 o’clock.. No family history.. S/P myomectomy, dyslipidemia.. 5.2. 
753
Case 5
Courses of Treatment
HR(−) HER2(−) Breast Cancer
5.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide + #4. cycles of docetaxel) + Operation + Post-. operative radiation therapy + Adjuvant. capecitabine (refuse).. 5.3.1. . Operation. 35. 5.3.2. . Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy st...
761
Case 5
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 27 28 29. 30. E. S. Lee et al.. 589. . . . HR(−) HER2(−) Breast Cancer. 590. . 5.2.1. . After Neoadjuvant. Chemotherapy. 31 32 33. 34. 5.3. 
767
Case 5
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/57 years old, post-menopause.. Screen detected a mass lesion on left breast 9. o’clock direction.. Family history of breast cancer, sister and. niece.. Family history of ovarian cancer, mother.. S/P. Hysterectomy,. s/o. bilateral. salpingo-oophorectomy.. BRCA 1 mutation carrier.. 5....
754
Case 5
Courses of Treatment
Local Recurrence
5.1. . Courses of Treatment. Left breast IDC → Operation → Adjuvant ther­. apy → Right breast recurrence (IDC).. 5.2.1. . Primary Treatment. 30 31. 32. Operation. 33. Y. Kim et al.. 729. . ­. . . . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.0 cm (pT1c).. 2. Histologic grade: 3/3 (tubule format...
768
Case 5
Patient History
Local Recurrence
Patient History and Progress. Female/69 years old, post-menopause.. Screen detected mass lesion on left breast. . 2 o’clock direction.. No family history.. No other history of disease, operation, or. medication.. BRCA 1 VUS (variant of uncertain).. 5.2. 
755
Case 5
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Neoadjuvant chemother­. apy → Operation → Adjuvant therapy → Lung. and liver metastasis.. 5.2.1. . Primary Treatment. Jun. 2015 breast, left, needle biopsy:. Invasive ductal carcinoma, histologic grade 2. with apocrine differentiation.. Result. Intensity. Positive %. Estrogen...
769
Case 5
Patient History
Metastatic Breast Cancer
5.2. 
770
Case 50
Courses of Treatment
Local Recurrence
50.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy → Right breast recurrence (IDC).. Primary Treatment. 334 335. 336. Operation. 337. 338. Pathology Report. <Right>. . 1. Invasive Ductal Carcinoma. . (a) Size of tumor: 1.8 cm (pT1c).. . (b) Histologic grade: 2/3 (tubule formation:. 2/3, ...
772
Case 50
Patient History
Local Recurrence
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast 12. o’clock and 8 o’clock direction, left breast 12. o’clock direction.. No family history.. Hypertension, hepatitis B virus carrier,. claustrophobia.. 50.2. 
771
Case 50
Courses of Treatment
Metastatic Breast Cancer
50.1. . Courses of Treatment. Left breast cancer with lung metastasis →. Palliative therapy.. See Figs. 150 and 151.. Left invasive ductal carcinoma, stage IV. (metastasis. in. ovary,. s/p. bilateral. salpingo-oophorectomy).. Result. Intensity Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. recepto...
773
Case 50
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/47 years old, post-menopause.. No family history.. S/p bilateral salpingo-oophorectomy, diabetes. mellitus.. 50.2. 
774
Case 6
Courses of Treatment
Benign and Proliferative
6.1. . Courses of Treatment. → 2021-12-31 excision, both.. Benign and Proliferative Case Series. 24. . . 6.3.1. . Pathology Report. • Breast, right, excision:. –. – Intraductal papilloma with (1) usual ductal. hyperplasia, (2) microcalcification.. • Breast, left, excision:. –. – Intraductal papilloma with (1) usual...
782
Case 6
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 9. 10. 6.3. 
788
Case 6
Patient History
Benign and Proliferative
Patient History and Progress. Female/48 years old, pre-menopause.. Bloody discharge from right nipple.. No family history.. Hypertension.. 6.2. 
775
Case 6
Courses of Treatment
Carcinoma In Situ
6.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. E. S. Lee et al.. 65. 6.3.1. . Operation. 28. 29. 6.3.2. . Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.3 cm (pTis).. . 2. Nuclear grade: low.. . 3. Nec...
783
Case 6
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 27. 6.3. 
789
Case 6
Patient History
Carcinoma In Situ
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected microcalcification on left. breast upper outer.. No family history.. s/p Lt mammotome biopsy in 2018 (result:. benign).. 6.2. 
776
Case 6
Courses of Treatment
HR(+) HER2(+) Breast Cancer
6.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 35. 6.3.1. . Pathology Report. . 1. Invasive ductal carcinoma.. . (a) Size of tumor: 1.5 cm (pT1c).. . (b) Histologic ...
784
Case 6
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 29 30 31 32 33. 34. 6.3. 
790
Case 6
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. No family history.. Hypertension.. 6.2. 
777
Case 6
Courses of Treatment
HR(+) HER2(-) Breast Cancer
6.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. 6.3.1. . Operation. Right breast conserving surgery, sentinel lymph. moral/extratumoral (60%) (nuclear grade:. low, necrosis: present, architectural pattern:. solid/comedo, extensive intraductal compo­. nent: presen...
785
Case 6
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 26, 27, 28 and 29.. 6.3. 
791
Case 6
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/51 years old, pre-menopause.. Screen detected mass lesion on right breast 2. o’clock direction.. No family history.. S/P Thyroid benign mass, excision.. 6.2. 
778
Case 6
Courses of Treatment
HR(−) HER2(+) Breast Cancer
Courses of Treatment. Neoadjuvant. chemotherapy. (#1. cycle. of. docetaxel and carboplatin and #6 cycles of trastu­. zumab and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab  +. Letrozole 2.5 mg.. 6.4.1. . Operation. 47. 6.4.2. . Pathology Report. . 1. No residual tumor with stroma...
786
Case 6
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 41 42. 43. HR(−) HER2(+) Breast Cancer. . Y. Kwon et al.. 451. 6.3. . After Neoadjuvant. Chemotherapy. 44 45. . HR(−) HER2(+) Breast Cancer. 452. 6.4. 
792
Case 6
Patient History
HR(−) HER2(+) Breast Cancer
S/P. cholecystectomy,. hypertension,. dyslipidemia.. BRCA 1 and 2 mutation: Not detected.. 6.2. 
779
Case 6
Courses of Treatment
HR(−) HER2(−) Breast Cancer
6.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Letrozole. 2.5 mg + Adjuvant capecitabine.. 6.3.1. . Operation. 43. . E. S. Lee et al.. 597. . 6.3.2. . Pathology Report. Ductal...
787
Case 6
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 36 37 38. 39. . HR(−) HER2(−) Breast Cancer. 594. . . . E. S. Lee et al.. 595. . ­. . . 6.2.1. . After Neoadjuvant. Chemotherapy. 40 41. 42. HR(−) HER2(−) Breast Cancer. 596. 6.3. 
793
Case 6
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. Panic disorder, lumbar spine disc.. 6.2. 
780
Case 6
Courses of Treatment
Local Recurrence
6.1. . Courses of Treatment. Both breasts IDC→ Operation → Adjuvant. therapy → Left breast recurrence (IDC).. 6.2.1. . Primary Treatment. 38 39 40 41 42. 43. Operation. ­. 44. 45. Local Recurrence. 732. . . ­. . . . ­. Pathology Report. <Right>. Invasive Ductal Carcinoma. 1. Size of tumor: 1.2 cm (pT1c).. 2. Histol...
794
Case 6
Patient History
Local Recurrence
Patient History and Progress. Female/60 years old, post-menopause.. Bloody nipple discharge on left breast.. Screen detected mass lesion on right breast 6. o’clock direction and left breast 12 o’clock. direction.. No family history.. Hypertension.. 6.2. 
781
Case 6
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Neoadjuvant chemother­. apy → Operation → Adjuvant therapy →. Ipsilateral breast and chest wall recurrence →. Palliative therapy → Progression on the skin. and contralateral axillary lymph nodes.. 6.2.1. . Primary Treatment. Aug. 2017 breast, left, needle biopsy:. Invasive d...
795
Case 6
Patient History
Metastatic Breast Cancer
6.2. 
796
Case 7
Courses of Treatment
Benign and Proliferative
7.1. . Courses of Treatment. →2021-10-29 Rt upper, stereotactic biopsy.. 7.3.1. . Pathology Report. Diagnosis. • Breast, right upper, stereotactic biopsy:. –. – Atypical ductal hyperplasia (#1. Ca++). with microcalcification.. –. – Flat epithelial atypia (#2. no Ca++) with. microcalcification.. →2021-11-26 excision,...
804
Case 7
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 11. 7.3. 
810
Case 7
Patient History
Benign and Proliferative
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected microcalcification on upper. portion of right breast.. No family history.. No comorbidities.. 7.2. 
797
Case 7
Courses of Treatment
Carcinoma In Situ
7.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. 7.3.1. . Operation. 32. 33. 7.3.2. . Pathology Report. Ductal carcinoma in situ. . 1. Post-mammotome excision status.. . 2. Size of tumor: 0.3 cm, residual.. . . . Carcinoma In Situ. 68. . 3. Nuclear grad...
805
Case 7
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 30. 31. E. S. Lee et al.. 67. 7.3.