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811
Case 7
Patient History
Carcinoma In Situ
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass lesion on right breast 1. and 9 o’clock direction.. Outside result of mammotome excision:. Right breast 1 o’clock, DCIS.. Right breast 9 o’clock, intraductal papilloma. with atypical ductal hyperplasia.. No family history.. No comor...
798
Case 7
Courses of Treatment
HR(+) HER2(+) Breast Cancer
7.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. emtansine + Tamoxifen 20 mg/day.. 42. 7.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy statu...
806
Case 7
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 36 37 38 39 40. 41. 7.3. 
812
Case 7
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction.. No family history.. Paroxysmal supraventricular tachycardia, s/p. atrial septal defect closure.. S/P thyroid lobectomy (thyroid cancer).. 7.2. 
799
Case 7
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. 7.3.1. . Operation. Left breast conserving surgery, sentinel lymph. (a) superior margin: 10 mm,. . (b) inferior margin: (see note),. . (c) medial margin: 10 mm,. . (d) lateral margin: 5 mm,. . (e) deep margin: <1 mm fr...
807
Case 7
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 31, 32, 32, 33, 34 and 35.. 7.3. 
813
Case 7
Patient History
HR(+) HER2(-) Breast Cancer
Depression.. 7.2. 
800
Case 7
Courses of Treatment
HR(−) HER2(+) Breast Cancer
7.1. . Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy.. 7.4.1. . Operation. 53. 7.4.2. . Pathology Report. No residual tumor with stromal degeneration.. . 1. Post-chemotherapy status.. . 2. Lymph nodes: no metasta...
808
Case 7
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 48. 49. . . HR(−) HER2(+) Breast Cancer. 454. 7.3. . After Neoadjuvant. Chemotherapy. 50 51. 52.
814
Case 7
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected mass lesion on upper outer. portion of left breast.. No family history.. S/P Nodules of vocal cord, operation.. 7.2. 
801
Case 7
Courses of Treatment
HR(−) HER2(−) Breast Cancer
7.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. 7.3.1. . Operation. 51. 7.3.2. . Pathology Report. Metaplastic Carcinoma with sarcomatous. differentiat...
809
Case 7
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 44 45. 46. HR(−) HER2(−) Breast Cancer. 598. . . ­. 7.2.1. . After Neoadjuvant. Chemotherapy. 47 48 49. 50. 7.3. 
815
Case 7
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/56 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 7.2. 
802
Case 7
Courses of Treatment
Local Recurrence
7.1. . Courses of Treatment. Left breast microinvasive ductal carci­. noma + DCIS → Operation → Adjuvant therapy. → Right breast recurrence (DCIS).. 7.2.1. . Primary Treatment. 51 52. 53. Operation. ­. 54. Local Recurrence. 736. . ­. . . . ­. Pathology Report. Microinvasive Ductal Carcinoma. 1. Size of invasive comp...
816
Case 7
Patient History
Local Recurrence
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. . 4 o’clock direction.. Family history of breast cancer, mother.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 7.2. 
803
Case 7
Courses of Treatment
Metastatic Breast Cancer
Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral breast and chest wall. recurrence → Chemotherapy → Progression on. the skin and contralateral axillary lymph. nodes.. 7.2.1. . Primary Treatment. Intensity. Positive %. Estrogen. receptor. Negative. (2/8). 1. <1%. Progesterone. receptor. Negative. (2/8)....
817
Case 8
Courses of Treatment
Benign and Proliferative
8.1. . Courses of Treatment. →2021-11-12 excision, Lt.. Benign and Proliferative Case Series. 26. . ­. ­. C. W. Lee et al.. 27. 8.3.1. . Pathology Report. Diagnosis. • Breast, left, excision:. –. – Atypical. ductal. hyperplasia. with. micro­. calcification.. 9. 
825
Case 8
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 12. 8.3. 
831
Case 8
Patient History
Benign and Proliferative
Patient History and Progress. Female/54 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of left breast.. No family history.. No comorbidities.. 8.2. 
818
Case 8
Courses of Treatment
Carcinoma In Situ
8.1. . Courses of Treatment. Operation + Postoperative radiation therapy. (right side)  +  Tamoxifen 20  mg/day for. 5 years.. 8.3.1. . Operation. 36. 37. 8.3.2. . Pathology Report. Right.. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.3 cm (pTis)....
826
Case 8
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 34. 35. 8.3. 
832
Case 8
Patient History
Carcinoma In Situ
Patient History and Progress. Female/41 years old, pre-menopause.. Detected bloody discharge in left nipple.. No family history.. No comorbidities.. ATM VUS (variant of uncertain).. 8.2. 
819
Case 8
Courses of Treatment
HR(+) HER2(+) Breast Cancer
8.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 47. 8.3.1. . Pathology Report. . 1. No residual tumor with foreign body. reaction.. . (a) Post-excision status.. . (b)...
827
Case 8
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 43 44 45. 46. . HR(+) HER2(+) Breast Cancer. 324. . . . S. Park et al.. 325. 8.3. 
833
Case 8
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. No family history.. Hypertension,. s/p. cholecystectomy,. arrhythmia.. 8.2. 
820
Case 8
Courses of Treatment
HR(+) HER2(-) Breast Cancer
Right nipple–areolar complex sparing mastec­. tomy, sentinel lymph node biopsy, Left nipple–. areolar complex sparing mastectomy, sentinel. lymph node biopsy (Figs. 41 and 42).. 8.3.2. . Pathology Report. [Right]. Invasive Ductal Carcinoma. micropapillary/cribriform/solid/comedo,. extensive intraductal component: pres...
828
Case 8
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 37, 38, 39 and 40.
834
Case 8
Patient History
HR(+) HER2(-) Breast Cancer
o’clock and left breast 2 o’clock direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: not detected.. 8.2. 
821
Case 8
Courses of Treatment
HR(−) HER2(+) Breast Cancer
8.1. . 8.3.1. . Operation. ­. 58. 59. 8.3.2. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of invasive component: 1.1 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:. 3/3, 5/HPF).. 4. Intraductal component...
829
Case 8
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 54 55 56. 57. . . Y. Kwon et al.
835
Case 8
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/53 years old, peri-menopause.. Screen detected microcalcification on right. breast 1 and 10 o’clock direction.. No family history.. No comorbidities.. 8.2. 
822
Case 8
Courses of Treatment
HR(−) HER2(−) Breast Cancer
8.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of paclitaxel)  +  Operation  +  Post-. operative radiation therapy.. 8.3.1. . Operation. 58. 59. 8.3.2. . Pathology Report. <Right>. Microinvasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2....
830
Case 8
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic. Findings. 52 53. 54. 8.2.1. . After Neoadjuvant. Chemotherapy. 55 56. 57. 8.3. 
836
Case 8
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/56 years old, peri-menopause.. Screen detected a mass lesion on right breast 7. o’clock direction and left breast 4 o’clock. direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 8.2. 
823
Case 8
Courses of Treatment
Local Recurrence
8.1. . Courses of Treatment. Right breast IDC/Left breast intraductal papil­. loma, sclerosing → Operation → Adjuvant ther­. apy → Left breast recurrence (DCIS).. 8.2.1. . Primary Treatment. 59. 60. Operation. 61. 62. Pathology Report. <Right>. Y. Kim et al.. 739. . 1. Invasive Ductal Carcinoma involving scleros­. i...
837
Case 8
Patient History
Local Recurrence
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass lesion on right breast. . 12 o’clock direction and left 6 o’clock direction.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 8.2. 
824
Case 8
Courses of Treatment
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph nodes. recurrence.. 8.2.1. . Primary Treatment. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2. Negative (0). Ki-67. Positive in. 61% of tumor. cells. Oncotype Dx RS Score: ...
838
Case 8
Patient History
Metastatic Breast Cancer

839
Case 9
Courses of Treatment
Benign and Proliferative
9.1. . Courses of Treatment. → 2021-11-12 Excision, Rt.. 9.3.1. . Pathology Report. Diagnosis. • Breast, right, excision:. –
847
Case 9
Important Radiologic
Benign and Proliferative
Important Radiologic. Findings. 13 14. 15. 9.3. 
853
Case 9
Patient History
Benign and Proliferative
Patient History and Progress. Female/32 years old, pre-menopause.. Screen detected mass lesion on right breast. 8 o’clock direction.. Family history of breast cancer, mother and. maternal aunt.. No comorbidities.. 9.2. 
840
Case 9
Courses of Treatment
Carcinoma In Situ
9.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. 9.3.1. . Operation. 41. 42. E. S. Lee et al.. 71. . 9.3.2. . Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 1.2 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: pre...
848
Case 9
Important Radiologic
Carcinoma In Situ
Important Radiologic. Findings. 38 39. 40. 9.3. 
854
Case 9
Patient History
Carcinoma In Situ
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected microcalcification on inner. portion of left.. Outside result of biopsy: Ductal carcinoma in. situ, left.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not examination.. 9.2. 
841
Case 9
Courses of Treatment
HR(+) HER2(+) Breast Cancer
9.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. therapy + Trastuzumab.. 51. 9.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.3 cm (pT1c).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nu...
849
Case 9
Important Radiologic
HR(+) HER2(+) Breast Cancer
Important Radiologic. Findings. 48 49. 50. 9.3. 
855
Case 9
Patient History
HR(+) HER2(+) Breast Cancer
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected mass lesion on left breast 7. o’clock direction.. Family history of breast cancer, two sisters.. Family history of pancreatic cancer, mother.. No other history of disease, operation, or. medication.. BRCA 1 and 2 mutation: Not detected,....
842
Case 9
Courses of Treatment
HR(+) HER2(-) Breast Cancer
9.1. . Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4  cycles of docetaxel & cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Tamoxifen 20 mg/day.. 9.3.1. . Operation. Left breast conserving surgery, sentinel lymph. moral/extratumoral (25%) (nuclear grade:. high, necrosis: present, ar...
850
Case 9
Important Radiologic
HR(+) HER2(-) Breast Cancer
Important Radiologic. Findings. See Figs. 43, 44, 45 and 46.. 9.3. 
856
Case 9
Patient History
HR(+) HER2(-) Breast Cancer
Patient History and Progress. Female/55 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. Family history of Prostate cancer, paternal. uncle.. No comorbidities.. 9.2. 
843
Case 9
Courses of Treatment
HR(−) HER2(+) Breast Cancer
9.1. . docetaxel and carboplatin and trastuzumab and. pertuzumab after followed #4 cycles of docetaxel. and. trastuzumab. and. ­. pertuzumab). +. Operation  +  Post-operative radiation ther­. apy + Trastuzumab and pertuzumab.. 9.4.1. . Operation. 68. 9.4.2. . Pathology Report. . 1. No residual tumor with stromal fi...
851
Case 9
Important Radiologic
HR(−) HER2(+) Breast Cancer
Important Radiologic. Findings. 60 61 62. . ­. 9.3. . After Neoadjuvant. Chemotherapy. 64 65 66. 67. Y. Kwon et al.
857
Case 9
Patient History
HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/51 years old, pre-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. No family history.. Hypothyroidism.. 9.2. 
844
Case 9
Courses of Treatment
HR(−) HER2(−) Breast Cancer
9.1. . Courses of Treatment. Operation  +  adjuvant chemotherapy (#4. cycles of docetaxel and cyclophosphamide) +. Operation + Post-operative radiation therapy.. 9.3.1. . Operation. 65. 9.3.2. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.3 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation...
852
Case 9
Important Radiologic
HR(−) HER2(−) Breast Cancer
Important Radiologic Findings. 60 61 62 63. 64. 9.3. 
858
Case 9
Patient History
HR(−) HER2(−) Breast Cancer
Patient History and Progress. Female/65 years old, post-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. No family history.. S/P right salpingectomy (due to ectopic. pregnancy).. 9.2. 
845
Case 9
Courses of Treatment
Local Recurrence
9.1. . Courses of Treatment. Right breast mucinous carcinoma → Operation. → Adjuvant therapy → Left breast recurrence. (IDC + DCIS)/Right breast ADH.. 9.2.1. . Primary Treatment. 66 67. 68. Operation. ­. 69. Local Recurrence. 742. . . . . ­. Pathology Report. Mucinous Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. ...
859
Case 9
Patient History
Local Recurrence
Patient History and Progress. Female/51 years old, pre-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. Outside result of biopsy: Mucinous carcinoma.. Family history of colon cancer, father.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 9.2. 
846
Case 9
Courses of Treatment
Metastatic Breast Cancer
. Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph nodes. recurrence.. 9.2.1. . Primary Treatment. Estrogen. receptor. Strong (7/8). 2. >2/3. Progesterone. receptor. Negative (2/8). 1. <1%. C-erbB2. Negative (0). Ki-67. Positive in. 23% of tumor. cells. Adjuvant T...
860
Case 9
Patient History
Metastatic Breast Cancer
Patient History and Progress. Female/57 years old, post-menopause.. No family history.. S/p. Myomectomy. &. bilateral. salpingo-oophorectomy.. 9.2. 
861
Important Radiologic Findings
Important Radiologic Findings
Benign and Proliferative
– Atypical ductal hyperplasia, focal.Fig. 13. Fig. 13  Mammography. shows no discernable. abnormality. Benign and Proliferative Case Series. 28. 10. . 10.1. . Patient History and Progress. Female/33 years old, pre-menopause.
862
Important Radiologic Findings
Important Radiologic Findings
Carcinoma In Situ
52Fig. 2. Fig. 2  MRI revealed. regional heterogeneous. non-mass enhancement. in the left upper inner. breast. a. b. . . 1.3. . (c) medical margin: 10 mm,Fig. 15. Fig. 15  Mammogram. shows no suspicious. mass in both breasts,. except 1 cm sized. circumscribed iso-dense. nodule in right upper. outer breast, pre-­. mam...
863
Important Radiologic Findings
Important Radiologic Findings
HR(+) HER2(+) Breast Cancer
HR(+) HER2(+) Breast Cancer. Soojin Park, Ran Song, Yunju Kim, Bo Hwa Choi,. Eun Sook Lee, Chan Wha Lee, and Eun-Gyeong Lee. 1. Fig. 5  PET-CT shows. (a) a hypermetabolic. mass in the left lower. outer breast. (mSUV = 9.9) and (b). hypermetabolic lymph. node in the left axilla. level I (mSUV = 3.7). . S. Park et al.. 3...
864
Important Radiologic Findings
Important Radiologic Findings
HR(+) HER2(-) Breast Cancer
biopsy (Fig. 4).. 1.3.2. . Pathology Report. Invasive Ductal Carcinoma. Associated. with. encapsulated. papillary. carcinoma.. 1. Size of tumor: 2.5 cm (pT2).. tumor cellsFig. 1 [BB:51.259;245.417;246.379;658.808]. Fig. 1  Left mammography (Nov. 2020): an irregular. mass with nipple retraction at subareolar areaFig. ...
865
Important Radiologic Findings
Important Radiologic Findings
HR(−) HER2(+) Breast Cancer
Fig. 4  PET-CT shows. (a) hypermetabolic. nodule in right upper. breast (mSUV = 5.5). and (b) prominent right. axillary LN with. hypermetabolism. (mSUV = 3.1). HR(−) HER2(+) Breast Cancer. 430. 1.3. Fig. 6. Fig. 6  Breast MRI (Dec. 2020): MRI after treatment. shows complete resolution of enhancement in the right. breas...
866
Important Radiologic Findings
Important Radiologic Findings
HR(−) HER2(−) Breast Cancer
634Fig. 118. Fig.. 118  Mammography:. An irregular hyperdense. mass at the upper outer. quadrant of the left. breast. The other. circumscribed oval mass. at the inner portion was. identified as a cyst on. ultrasound.
867
Important Radiologic Findings
Important Radiologic Findings
Local Recurrence
Fig. 71. Fig. 71  MRI (2021):. An enhancing mass in. the left breast (white. arrow = proven IDC).. Another enhancing mass. in the right breast (black. arrow). . . Local Recurrence. 744. Fig. 120. Fig. 120  MRI for. evaluation of left nipple. eczema (2018): Strongly. enhanced left nipple.. Punch biopsy = Paget’s. diseas...
868
Important Radiologic Findings
Important Radiologic Findings
Metastatic Breast Cancer
See Fig. 1.. Feb. 2014 Left chest well excisional biopsy.. Pathology: Invasive ductal carcinoma, clini­. cally recurrent.. Result. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. Letrozole 2.5 mg/day re-start.Fig. 1. Fig. 1  PET-CT (Feb. 2014): A hypermetabolic lesion at. the left chest wallFig. 2 [BB:51.28...