Breast Service, Hospital for Maternal and Child Healthcare, Goiânia, Brazil.
Gynecol Endocrinol. 2013 Apr;29(4):301-4. doi: 10.3109/09513590.2012.754875. Epub 2013 Jan 18.
We present a case of a 72-year-old woman referred to the breast disorder service due to abnormalities on mammography and breast ultrasound. The patient reported using different hormone therapy (HT) formulations during 25 years and had stopped taking HT for 4 years. Physical examination showed no alterations in the breasts or axilla. Mammography from 2012 detected asymmetry at the 3 o'clock position in the anterior right breast. Ultrasound revealed an irregular, hypoechoic mass with indistinct margins, and posterior acoustic shadowing. A retrospective analysis of mammographies from 2007, 2009 and 2010 showed that a very subtle asymmetry had existed since 2007. Follow-up imaging demonstrated no change in asymmetry during 4.5 years. The patient underwent breast-conserving therapy and sentinel lymph node biopsy. Histopathologic examination demonstrated classic invasive lobular carcinoma. There were no sentinel node metastases. The patient received radiotherapy and endrocrine therapy. This case demonstrates that breast cancer may remain stable and not grow for many years. This aspect should be kept in mind by all professionals dealing with women's healthcare, in particular HT users who may develop breast cancer with a less aggressive behavior. Any suspicious finding on mammography, despite being unchanged for a number of years, must be investigated.
我们报告了一例 72 岁女性,因乳房 X 线摄影和乳房超声异常而转至乳腺疾病科。该患者报告称在 25 年内使用了不同的激素治疗(HT)制剂,并已停用 HT 4 年。体格检查未发现乳房或腋窝有任何改变。2012 年的乳房 X 线摄影显示右乳房前 3 点钟位置存在不对称。超声显示边界不清的不规则低回声肿块,伴有后方声影。对 2007 年、2009 年和 2010 年的乳房 X 线摄影进行回顾性分析显示,自 2007 年以来一直存在非常细微的不对称。4.5 年的随访影像学检查显示不对称无变化。患者接受了保乳治疗和前哨淋巴结活检。组织病理学检查显示经典浸润性小叶癌。无前哨淋巴结转移。患者接受了放疗和内分泌治疗。该病例表明,乳腺癌可能在多年内保持稳定且不生长。所有处理女性健康的专业人员,特别是可能患有侵袭性较弱的乳腺癌的 HT 用户,都应牢记这一点。任何可疑的乳房 X 线摄影发现,即使多年来没有变化,也必须进行调查。