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Locally advanced breast carcinoma

Case contributed by Yangsean Choi
Diagnosis certain

Presentation

The patient knew of her right breast mass but was unable to get evaluation due to poor socio-economic status.

Patient Data

Age: 40
Gender: Female

Chest PA

x-ray

An irregular shaped dense, mass-like lesion in the right breast.

CHEST CT

ct

On chest CT scans, an 8.0 cm irregular shaped exophytic mass with heterogeneous enhancement is seen in the right breast. Internal calcification and necrotic portion are visible within the mass. There was no evidence of metastatic nodule in both lung fields. Multiple enlarged metastatic lymph nodes are seen in the right axillary region. These findings are suggestive of locally advanced fungating breast cancer.

ultrasound

A huge necrotic mass involving most of the right breast tissue is seen.

PET-CT

Nuclear medicine

A huge mass in the right breast with avid FDG uptake. A few focal FDG uptakes in the Rt. axillary level I region. No other FDG uptakes suspicious of distant metastasis is found.

Case Discussion

Locally advanced breast cancer is not commonly diagnosed in developed countries as breast cancer screening is widely available. Unfortunately, patients with low socioeconomic status as in this case miss appropriate early screening and show up in an advanced stage.

Pathology finding: Invasive ductal carcinoma (grade 3) with metastatic axillary lymph nodes

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