This document summarizes a case of carcinoma in a 30-year-old female patient. She presented with a 1-year history of a left breast lump. Various tests were performed, including ultrasounds and biopsies. Initial tests showed proliferative breast disease without atypia. A recent trucut biopsy revealed invasive ductal carcinoma, grade II in the left breast. The working diagnosis is carcinoma of the right breast, stage IIA. The treatment plan is a wide local excision of the breast lump along with axillary staging and adjuvant chemotherapy and radiation therapy.

1. A CASE OF CARCINOMA
BREAST
PROF.DR SIVAKUMAR SIR’S UNIT –S1

2. CASE CAPSULE
• 30 year old patient with h/o left breast lump x1 Year.
• No H/o pain
• No h/o skin changes or recent nipple retraction/discharge.
• No h/o fever
• No h/o loss of weight or appetite/ swellings elsewhere
• No history s/o Metastasis
• No h/o prior surgeries

3. • P2L2, prev 2 LSCS ,completed family(PS not done)
• k/c/o T2DM/Hypothyroid on medication
• Patient was evaluated for breast lump one year back with FNAC done
which revealed Proliferative breast disease without Atypia. USG s/o
BIRADS IV
• Patient wishes for breast conservation

4. Examination
• ECOG-0
• well built
• No pallor, pitting pedal edema.
• Solitary lump in the left breast 3x3cm,firm,mobile, ill defined margins,
at upper inner quadrant at 9 to 10 ‘o’clock position.
• Not fixed to pectoralis major
• Skin over swelling free
• No palpable axillary lymphadenopathy.
• No palpable supraclavicular lymph nodes

5. USG BREAST (21/06/2021)
• Hypoechoic leion with irregular margins measuring 1.2 x 1.0cm noted
in the Zone II at 9’O’Clock position of Left breast – BIRADS IV
• Right breast appears normal.
• Both axillae appear normal.

6. USG BREAST (24/03/22)
• Well defined hypoechoic lesion with irregular margins measuring 9 x
11mm noted in the Zone II at 9 to 10’O’Clock position of L breast
• NAC-Normal
• Axilla-Normal
• Left breast lesion BIRADS III

7. USG ABDOMEN
• No significant abnormality

8. FNAC ( CY 1557/21 )
• Smear studied shows clusters of benign ductal epithelial cells admixed
with base nuclei in a background of hemorrhage.
• FNAC Left breast lump – Proliferative breast disease without atypia.

9. HPE 1377/22 (26/03/22)
• Trucut biopsy of Left Breast – Invasive ductal carcinoma of Left breast
– NST – Grade II.
• IHC Study revealed – ER,PR, Her2Neu ( +1) and Ki67- 40%

10. WORKING DIAGNOSIS
• CARCINOMA RIGHT BREAST cT2N0M0, Stage IIA(stage II B according
to clinical prognostic staging)

13. Plan
• Wide local excision +axillary staging+adjuvant chemo+RT

14. TUMOUS BOARD CONSENSUS