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Submitted Case

2023
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Patient Information: (Do not provide name of the patient)
Age
  67
Diagnosis
  Infiltrating carcinoma consistent with breast primary involving R axilla skin.
Imaging
  MRI: Right Breast: 23 mm mass in the right axilla. Findings are consistent with the known malignancy. At least 3 suspicious level 1 axillary lymph nodes. PET: Mass in the right axilla measures 1.8 x 1.5 cm, SUV 9. Several enlarged hypermetabolic right axillary lymph nodes(level I and II).
Pathology
  SKIN, RIGHT AXILLA BIOPSY #1&2: Infiltrating carcinoma consistent with breast primary involving skin. Breast markers: ER: Positive; >90% of tumor cells with strong intensity. PR: Positive; 10% of tumor cells with moderate intensity. HER2 by IHC: Negative staining. The findings are most consistent with an infiltrating breast carcinoma involving the dermis of skin. Paget's disease or lymphatic invasion is not seen. RIGHT AXILLA, LYMPH NODE, CORE NEEDLE BIOPSY: Positive for metastatic carcinoma.
Stage
  T3N1. Exam: 6cm indurated, smooth, dermal plaque in R axilla with overlying retention hyperkeratosis and tethering in the middle.
Overall Oncology Management Plan
Surgery (biopsy)
  Likely local
Chemotherapy (if given, what is the regimen)
  dose dense Adriamycin and cyclophosphamide followed by weekly paclitaxel
Hormone Therapy
  endocrine Rx post RT
Radiation Therapy (fields, dose)
  This is the question.
Images
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Session Name
  Breast Specialist Dr. Abe Recht – September 22, 2023
Session ID
  13495
created_by
  6949
post_id
  13495
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