Case No. 96/07
Patient Age: 50
Submitted by: Dr J Boyages
Institution: Westmead Hospital
Date: 21 OCT 1996
Underwent a routine screening mammogram at a private centre
Not aware of any symptoms, two previous 'screening' mammograms were normal
Menarche - 12 years old
Aged 22 at first pregnancy
HRT since 1992
Family history:Maternal cousin developed breast cancer at age 48
No significant past history
8/5/96: Private Diagnostic Breast Centre
1cm "non-specific increase in density" left breast12 o'clock position9cm from nipple
Ultrasound:no lesion identified
Recommendation: Referral for diagnostic open biopsy
21/5/96: Needle localised excision biopsy at a local private hospital
No frozen section.
Specimen A. Labelled "Wire localised right breast lump". Specimen consists of an ovoid portion of fatty breast tissue measuring 90x55x20mm with a localising wire projecting from one edge. No macroscopic lesion is seen.
Specimen B. Labelled "Extra breast tissue". Specimen consists of an ovoid portion of fatty breast tissue measuring 45 x 50mm x up to 12mm in thickness. No macroscopic lesion is seen.
Specimen C. Labelled "Excision lower breast cavity". Specimen consists of an irregular portion of fibrofatty breast tissue measuring 50x30x15mm. This portion of tissue is firm and nodular and the cut surface shows a firm white nodule which measures 10mm in diameter.
Specimens A and B. Both specimens show predominantly fatty breast tissue showing no significant abnormality. No evidence of malignancy is seen.
Specimen C. The lesion is a tubular carcinoma of the breast (infiltrating ductal carcinoma of the breast, grade 1). The tumour is composed of radiating tubular structures lined by cells which show mild to moderate cytological atypia. There is focal coarse microcalcification within some of the tubular structures. The lesion appears to be completely excised by a margin of approximately 2mm. There is a mild lymphocytic inflammatory infiltrate at the periphery of the lesion. No intraduct component is identified. There is possible perineural invasion at one edge of the tumour nodule.
Conclusion: Right breast lump, tubular carcinoma of the breast, local excision close but appears clear of the tumour.
ER: Not known
PR: Not known
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Initially referred to a medical oncologist and radiation oncologist from an inner city teaching hospital and then to Radiation Oncology Department at Westmead Hospital because of geographic reasons.
Clinical examination - negative apart from 5cm scar in the upper outer quadrant. An axillary dissection was performed and 1/15 nodes were positive.
Recall histopathology slides and review at Westmead Hospital by specialist breast pathologist
Microscopic: Sections show infiltrating duct carcinoma grade 1 without a DCIS component.
Breast: Infiltrating duct carcinoma Grade 1.
Radiation Therapy to the right breast.
Adjuvant CMF chemotherapy.Last Updated on Monday, 15 February 2010 10:58