Tower Amelia, Hughes Jonathan, Moore Lauren, Srivastava Kumaraman
Texas Health Breast Specialists, Texas Health Harris Methodist Hospital, Fort Worth, TX 76104, USA.
Texas Health Harris Methodist Hospital, Fort Worth, TX 76104, USA.
J Surg Case Rep. 2023 Mar 14;2023(3):rjad144. doi: 10.1093/jscr/rjad144. eCollection 2023 Mar.
A 68 year-old woman with no significant medical history discovered a lump incidentally in her left breast. The patient's initial imaging revealed a 4.6-cm irregular mass at 11:00 categorized as a BI-RADS 5 as well as an enlarged axillary lymph node and an area of 2.5 cm of heterogeneous calcifications in the 3 o'clock position. The 4.6-cm lesion was revealed to be infiltrating ductal carcinoma with a squamous component, mixed metaplastic carcinoma, which was strongly ER (100+)/PR (100+) positive, HER-2/Neu negative on FISH. The 2.5-cm calcifications were ductal carcinoma . The patient completed neoadjuvant chemotherapy, and had an excellent response. After further discussion, the patient elected for breast conservation therapy and underwent a left wireless localized partial mastectomy with a left axillary dissection. Surgical pathology revealed a near complete pathologic response with only 8-mm residual tumour as well as a negative conversion of the clipped axillary node.
一名68岁无重大病史的女性偶然发现左乳有一个肿块。患者最初的影像学检查显示，在11点位置有一个4.6厘米的不规则肿块，分类为BI-RADS 5级，还有一个腋窝淋巴结肿大，以及在3点位置有一个2.5厘米的异质性钙化区域。4.6厘米的病变被诊断为浸润性导管癌伴鳞状成分，即混合性化生癌，雌激素受体（ER，100+）/孕激素受体（PR，100+）强阳性，荧光原位杂交（FISH）检测HER-2/Neu阴性。2.5厘米的钙化灶为导管癌。患者完成了新辅助化疗，反应良好。经过进一步讨论，患者选择了保乳治疗，接受了左乳无导线局部部分乳房切除术及左腋窝淋巴结清扫术。手术病理显示几乎完全病理缓解，仅残留8毫米肿瘤，且夹取的腋窝淋巴结转为阴性。
