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Courses of Treatment
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Important Radiologic
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Patient History
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Case 20
HR(−) HER2(+) Breast Cancer
20.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab.. Operation. 147. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.1 cm (ypT1c...
Important Radiologic. Findings. 141 142. 143. HR(−) HER2(+) Breast Cancer. 508. . . . Y. Kwon et al.. 509. 20.3. . After Neoadjuvant. Chemotherapy. 144 145. 146. . . . HR(−) HER2(+) Breast Cancer. 510. 20.4. 
Patient History and Progress. Female/54 years old, post-menopause.. Screen detected mass lesion on left breast 11. o’clock direction.. Family history of breast cancer, aunt. (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 20.2. 
Case 20
HR(−) HER2(−) Breast Cancer
20.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy.. Operation. 143. Pathology Report. No residual tumor with stromal fibrosis. E. S. Lee et al.. 645. . . . HR(−) HER2(−) Breast Cancer...
Important Radiologic. Findings. 135 136 137. 138. E. S. Lee et al.. 643. . . . ­. HR(−) HER2(−) Breast Cancer. 644. . After Neoadjuvant. Chemotherapy. 139 140 141. 142. 20.3. 
Patient History and Progress. Female/59 years old, post-menopause.. Screen detected mass lesion on left breast 9:30. o’clock direction.. Family history of breast cancer, aunt. (maternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 20.2. 
Case 20
Local Recurrence
20.1. . Courses of Treatment. Right breast DCIS → Operation → Adjuvant. therapy → Right breast recurrence (microinva­. sive ductal carcinoma).. Primary Treatment. 140. Operation. Jul. 2017 Right breast conserving surgery, senti­. nel lymph node biopsy (outside).. Pathology Report. Ductal Carcinoma In Situ. 1. Size of...
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Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. s/p Right breast conserving surgery (Breast. cancer), s/p parotidectomy, Panic disorder.. BRCA 1 VUS (variant o...
Case 20
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Operation. Sep. 1998 Left breast conserving surgery, axil­. lary lymph node dissection.. Pathology: Invasive ductal carcinoma, stage. pT1aN0.. Size of tumor: N.A, lymph node: 0/16....
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Family history of breast cancer, maternal. cousin.. BRCA 1 & 2 mutation: Not detected.. 20.2. 
Case 21
Benign and Proliferative
21.1. . Courses of Treatment. →2021-07-07 excision, both.. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Intraductal papilloma.. –. – Sclerosing. adenosis. with. microcal-. cification.. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. –. – Sclerosing adenosis with microcalcification...
Important Radiologic. Findings. 39 40. 41. 21.3. 
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 7. o’clock direction and left 1 o’clock direction.. Outside result of biopsy: both papillary. neoplasm.. No family history.. s/p Right breast mammotome biopsy (result:. fibroadenoma).. 21.2. 
Case 21
Carcinoma In Situ
21.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. . . E. S. Lee et al.. 99. Operation. 98. 99. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0 (sn). . 1. Size of tumor: 3.0 cm (pTis).. . 2. Nuclear grade: low.. ....
Important Radiologic. Findings. 95 96. 97. 21.3. 
Patient History and Progress. Female/37 years old, pre-menopause.. Screen detected mass lesion on right breast. 9 o’clock direction.. Outside result of biopsy: Right 9 o’clock, duc­. tal carcinoma in situ.. No family history.. Thyroid papillary carcinoma: follow-up at. outside hospital.. BRCA 1 and 2: not detected, POL...
Case 21
HR(+) HER2(+) Breast Cancer
21.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Letrozole. 2.5 mg/day.. 117. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.1 cm (...
Important Radiologic. Findings. 111 112 113 114 115. 116. 21.3. 
Patient History and Progress. Female/69 years old, post-menopause.. Screen detected mass lesion on right breast 6. o’clock direction.. Family history of breast cancer, paternal aunt,. cousin (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 21.2. 
Case 21
HR(+) HER2(-) Breast Cancer
21.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation (1st, Dec. 2020). nent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 5 mm.. . (b) inferior margin: 20 mm.. . (c) medial margin: 10 mm.. . (d) lateral mar...
Important Radiologic. Findings. See Figs. 114, 115, 116 and 117.. 21.3. 
Patient History and Progress. Female/78 years old, post-menopause.. Screen detected mass lesion on left breast 12. o’clock direction.. No family history.. Hypertension, s/p hysterectomy.. 21.2. 
Case 21
HR(−) HER2(+) Breast Cancer
21.1. . Operation. 156. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.0 cm (ypT1b).. 3. Histologic grade: 3/3 (tubule formation: 2/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 49/10HPF).. 4. Intraductal component: absent.. Y. Kwon et al.. 515. a. b. . 5. Sur...
Important Radiologic. Findings. 148 149 150. 151. . HR(−) HER2(+) Breast Cancer. 512. . . . ­. Y. Kwon et al.. 513. 21.3. . After Neoadjuvant. Chemotherapy. 152 153 154. 155. . HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/55 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. S/P Tuberculosis.. 21.2. 
Case 21
HR(−) HER2(−) Breast Cancer
21.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Letrozole. 2.5 mg + Adjuvant capecitabine.. Operation. 152. Pathology Report. Microinvasive Ductal Carcinoma. 1. Post-chemothera...
Important Radiologic Findings. 144 145 146. 147. . HR(−) HER2(−) Breast Cancer. 648. . . . . . E. S. Lee et al.. 649. . After Neoadjuvant. Chemotherapy. 148 149 150. 151. 21.3. 
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, STK11. VUS (variant of uncertain).. 21.2. 
Case 21
Local Recurrence
21.1. . Courses of Treatment. Right breast DCIS→ → Operation → Right. breast recurrence (DCIS).. Y. Kim et al.. 775. Primary Treatment. 146. Operation. ­. 147. 148. Pathology Report. Ductal Carcinoma In Situ. . 1. Size of tumor: 5.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: present.. . 4. Architectural ...
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Patient History and Progress. Female/55 years old, peri-menopause.. Screen detected calcification on upper portion. of right breast.. Outside result of biopsy: suggestive ductal. carcinoma in situ.. No family history.. S/p hysterectomy.. 21.2. 
Case 21
Metastatic Breast Cancer
Left breast cancer → Operation → Adjuvant. therapy → Neck node recurrence → Lymph. nodes, bone metastasis → Skull, brain. metastasis.. Primary Treatment. Operation. Apr. 2002 Left breast conserving surgery, senti­. nel lymph node biopsy.. Y. Kwon et al.. 895. Pathology: Microinvasive infiltrating duct car­. cinoma, sta...
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Case 22
Benign and Proliferative
22.1. . Courses of Treatment. →2021-07-07 excision, Rt.. Diagnosis. • Breast, right, excision:. –. – Atypical. ductal. hyperplasia. with. microcalcification.. . C. W. Lee et al.. 45. . ­. . 23. 
Important Radiologic. Findings. 42. 22.3. 
Patient History and Progress. Female/50 years old, peri-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. No family history.. Hypertension (taking medication), carotid. atherosclerosis.. 22.2. 
Case 22
Carcinoma In Situ
22.1. . Courses of Treatment:. Operation. Operation. 103. 104. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis(Paget)N0(sn). . 1. Size of tumor: 0.5 cm (pTis(Paget)).. . 2. Nuclear grade: high.. . 3. Necrosis: absent.. . 4. Architectural pattern: micropapillary.. . 5. Nip...
Important Radiologic. Findings. 100 101. 102. 22.3. 
Patient History and Progress. Female/57 years old, post-menopause.. Visible detected redness on Left nipple.. Outside result of biopsy: Paget’s disease.. Family history of breast cancer, sister at her. 45 years old.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 22.2. 
Case 22
HR(+) HER2(+) Breast Cancer
22.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab) + Operation + Trastuzumab. + Letrozole 2.5 mg/day.. 125. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.5 cm (ypT1a).. S. Park et al.. 369. ...
Important Radiologic. Findings. 118 119 120 121 122 123. 124. 22.3. 
Patient History and Progress. Female/54 years old, post-menopause.. Self-detected nipple retraction on left breast.. No family history.. Hepatitis B carrier.. 22.2. 
Case 22
HR(+) HER2(-) Breast Cancer
. Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin & cyclophosphamide followed by. #4  cycles of docetaxel)  +  Operation  +  Post-­. operative radiation therapy  +  Letrozole. 2.5 mg/day.. Operation. tumor.. 6. Surgical margins:. . (a) deep margin: positive for invasive carci­. noma (slide...
Important Radiologic. Findings. See Figs. 119, 120, 121, 122, 123 and 124.. 22.3. 
Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on entire left. breast.. No family history.. Diabetes mellitus, Spinal stenosis.. 22.2. 
Case 22
HR(−) HER2(+) Breast Cancer
22.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of doxorubicin and cyclophosphamide)  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 161. . a. b. . HR(−) HER2(+) Breast Cancer. 518. Pathology Report. Invasive Ductal Carcinoma with apocrine dif­. ferentiation and medullary...
Important Radiologic Findings. 157 158 159. 160. . . . Y. Kwon et al.. 517. 22.3. 
Patient History and Progress. Female/53 years old, peri-menopause.. Self-detected palpable mass lesion on right. breast 4 o’clock direction.. No family history.. S/P hemorrhoids operation.. 22.2. 
Case 22
HR(−) HER2(−) Breast Cancer
22.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 161. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of ...
Important Radiologic. Findings. 153 154 155. 156. HR(−) HER2(−) Breast Cancer. 652. . . . . ­. E. S. Lee et al.. 653. . After Neoadjuvant. Chemotherapy. 157 158 159. 160. 22.3. 
Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. Family history of breast cancer, uncle. (paternal).. s/p retinal detachments operation.. BRCA 1 and 2 mutation: Not detected, PALB2. PV, STK11 VUS (variant of uncertain).. 22.2. 
Case 22
Local Recurrence
22.1. . Courses of Treatment. Left breast mucinous carcinoma→ Adjuvant. therapy → Right breast recurrence (mucinous. carcinoma).. Primary Treatment. 152. Operation. Apr. 2007 Left breast mass excision (outside).. Pathology Report. Mucinous Carcinoma. . 1. Size of tumor: 2.0 cm.. . 2. Margin involved.. Result. Intens...
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Patient History and Progress. Female/80 years old, post-menopause.. Screen detected mass lesion on upper outer. portion of Left breast.. Outside. result. of. biopsy:. Mucinous. carcinoma.. No family history.. Dementia.. BRCA 1 and 2 mutation: No examination.. 22.2. 
Case 22
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Right axillary lymph node recur­. rence → Right breast recurrence → Chest wall. → Bone → Pleural effusion metastasis.. Primary Treatment. mide #3 → Doxorubicin + Docetaxel #3).. Operation. Mar. 2008 Left total mastectomy, axillary lymph. node di...
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Case 23
Benign and Proliferative
23.1. . Courses of Treatment. →2021-07-13 Excision, Lt.. Benign and Proliferative Case Series. 46. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia involving intra­. ductal papilloma with microcalcification.. 24. 
Important Radiologic. Findings. 43 44. 45. 23.3. 
Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. Outside result of biopsy: atypical papilloma.. No family history.. No comorbidities.. 23.2. 
Case 23
Carcinoma In Situ
23.1. . Courses of Treatment:. Operation. Operation. 107. 108. Pathology Report. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. Size of tumor: 0.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Skin: no involvement of tumor.. . ...
Important Radiologic. Findings. 105. 106. 23.3. 
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. No family history.. No comorbidities.. 23.2. 
Case 23
HR(+) HER2(+) Breast Cancer
23.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. HR(+) HER2(+) Breast Cancer. 374. . ­. . operative radiation therapy + Trastuzumab +. Tamoxifen 20 mg/day.. ­. ­. 132. 133. Pathology Report. . 1. No residual tumo...
Important Radiologic. Findings. 126 127 128 129 130. 131. 23.3. 
Patient History and Progress. Female/46 years old, pre-menopause.. Self-detected palpable mass lesion on both. breast.. Family history of breast cancer, sister.. Hypertension, S/P varicose veins operation.. BRCA 1 and 2 mutation: Not detected. (BRCAPRO mutation probability 0.118).. 23.2. 
Case 23
HR(+) HER2(-) Breast Cancer
2.5 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. . (d) Histologic grade: 3/3 (tubule formation:. 3/3, nuclear pleomorphism: 3/3, mitotic. count: 2/3, 10/10 HPF). . (e) Intraductal component: present, intratu­. moral/extratumoral. (99%). (nuclear. grade: high, necrosis: present, architec­. tura...
Important Radiologic. Findings. See Figs. 126, 127, 128, 129 and 130.. Y. Kim et al.
sister.. Diabetes mellitus, s/p right thyroidectomy. (thyroid cancer), s/p cholecystectomy, s/p. hysterectomy.. BRCA 1 and 2 mutation: Not detected.. 23.2. 
Case 23
HR(−) HER2(+) Breast Cancer
23.1. . Courses of Treatment. Operation + Operation + Adjuvant paclitaxel and. trastuzumab.. Operation. ­. 166. Pathology Report. Breast, right, nipple-sparing mastectomy:. Microinvasive Ductal Carcinoma. 1. Size of invasive component: <0.1  cm. (pT1mi).. 2. Size of intraductal component: 6.0 cm.. 3. Histologic gra...
Important Radiologic. Findings. 162 163 164. 165. . Y. Kwon et al.. 519. . . ­. . 23.3. 
Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected bloody discharge on nipple of. right breast.. No family history.. No comorbidities.. 23.2. 
Case 23
HR(−) HER2(−) Breast Cancer
23.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy.. Operation. 169. E. S. Lee et al.. 657. . . ­. . HR(−) HER2(−) Breast Cancer. 658. . . . Pathology Report. No residual tumor with fo...
Important Radiologic Findings. 162 163. 164. After Neoadjuvant. Chemotherapy. 165 166 167. 168. 23.3. 
Patient History and Progress. Female/56 years old, post-menopause.. Self-detected mass lesion on right breast.. Family history of breast cancer, aunt. (maternal).. s/p Right knee fracture operation.. BRCA 1 and 2 mutation: Not detected,. POLD1 VUS (variant of uncertain).. 23.2. 
Case 23
Local Recurrence
23.1. . Courses of Treatment. Left breast medullary carcinoma → Operation. → Adjuvant therapy → Left breast recurrence. (IDC)/Right breast intraductal papilloma.. Primary Treatment. Operation. 2003 Left breast conserving surgery, axillary. lymph node dissection (outside).. Pathology Report. Medullary Carcinoma.. Y. Ki...
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Patient History and Progress. Female/49 years old, pre-menopause.. Palpable mass lesion on left breast 2 o’clock. direction.. Family history of breast cancer, maternal. grandmother.. s/p Left breast conserving surgery (breast can­. cer), s/p Bilateral salpingo-oophorectomy.. BRCA 1 mutation carrier.. 23.2. 
Case 23
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Neoadjuvant chemother­. apy → Operation → Adjuvant therapy →. Pericardial effusion, Metastatic lymph nodes. → Bone, brain metastasis.. Primary Treatment. Docetaxel #4).. Result. Intensity. Positive. %. Estrogen. receptor. Negative (0/7). 0. 0. Progesterone. receptor. Negative ...
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Case 24
Benign and Proliferative
24.1. . Courses of Treatment. →2021-07-14 excision, both.. . . C. W. Lee et al.. 47. . . Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. Post-excision status.. Usual ductal hyperplasia.. Apocrine metaplasia.. –. – Sclerosing adenosis with microcalcification.. Diagnosis. • Breast...
Important Radiologic. Findings. 46 47. 48. 24.3. 
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected mass lesion in both breasts.. No family history.. s/p total thyroidectomy (thyroid cancer), s/p. right breast excision (intraductal papilloma).. 24.2. 
Case 24
Carcinoma In Situ
24.1. . Courses of Treatment:. Operation. Operation. 112. 113. E. S. Lee et al.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Surgical margins:. . (a) superior margin: 11 mm,. . (b) inferior margin: 3 mm,. . (c) medial margin: 15 mm,. . (d) lateral margin: 15 mm,. ...
Important Radiologic. Findings. 109 110 111. 24.3. 
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of biopsy: Left breast 2 o’clock,. fibroadenoma, favor lobular carcinoma in situ.. No family history.. S/P Retinal detachment operation 15  years. ago.. 24.2. 
Case 24
HR(+) HER2(+) Breast Cancer
24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 140. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-chemotherapy status.. . 2. Size ...
Important Radiologic. Findings. 134 135 136 137 138. 139. 24.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected palpable mass lesion and nipple. discharge on right breast.. No family history.. S/P appendectomy, s/p hepatitis A.. 24.2. 
Case 24
HR(+) HER2(-) Breast Cancer
24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin & cyclophosphamide followed by. #4 cycles of docetaxel) & letrozole 2.5 mg/day. with leuprolide acetate  +  Operation  +  Post-­. operative radiation therapy.. Operation (1st, Jan. 2021). Right breast conserving surgery, axillary lymph....
Important Radiologic. Findings. See Figs. 132, 133, 134, 135 and 136.. 24.3. 
Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected mass lesion on right breast 9. o’clock direction and right axillary LN.. No family history.. No comorbidities.. 24.2. 
Case 24
HR(−) HER2(+) Breast Cancer
24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#3 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab and pertuzumab.. Operation. 176. . . HR(−) HER2(+) Breast Cancer. 526. Pathology Report. . 1. No residual tumor with stromal ...
Important Radiologic. Findings. 168 169 170. 171. HR(−) HER2(+) Breast Cancer. 522. . . . Y. Kwon et al.. . After Neoadjuvant. Chemotherapy. 172 173 174
Patient History and Progress. Female/55 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 10–12 o’clock direction.. No family history.. Hypertension.. 24.2. 
Case 24
HR(−) HER2(−) Breast Cancer
24.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of paclitaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 177. HR(−) HER2(−) Breast Cancer. 660. . . ­. ­. . E. S. Lee et al.. 661. . . ­. . ­. HR(−) ...
Important Radiologic. Findings. 170 171. 172. After Neoadjuvant. Chemotherapy. 173 174 175. 176. 24.3. 
Patient History and Progress. Female/44 years old, pre-menopause.. Self-detected mass lesion on right breast.. Family history of breast cancer, aunt. (paternal).. Family history of ovarian cancer, sister.. No comorbidities.. BRCA 1 and 2 mutation: Not detected,. EPCAM and MLH1 VUS (variant of uncertain).. 24.2. 
Case 24
Local Recurrence
24.1. . Courses of Treatment. Left breast IDC → Neoadjuvant chemotherapy. → Operation → Adjuvant therapy → Left chest. wall recurrence (IDC).. Primary Treatment. 160 161 162. 163. Neoadjuvant Chemotherapy. #4 cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel.. Operation. 164. Pathology Rep...
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Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected mass lesion on upper outer. portion of left breast.. Outside result of biopsy: Invasive ductal. carcinoma.. Family history of breast cancer, maternal aunt,. another aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 24.2. 
Case 24
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Lung metastasis.. Primary Treatment. Estrogen. receptor. Strong (7/7). 3. >2/3. Result. Intensity. Positive %. Progesterone. receptor. Strong (7/7). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in. 30% of tumor. cells. Adjuvant Therapy. Adj...
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24.2. 
Case 25
Benign and Proliferative
25.1. . Courses of Treatment. →2021-07-27 excision, Lt.. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia involving. intraductal papilloma.. –. – Tubular adenoma.. 26. 
Important Radiologic. Findings. 49. 50. Benign and Proliferative Case Series. 48. . . 25.3. 
Patient History and Progress. Female/46 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction.. Outside result of biopsy: Intraductal papilloma.. No family history.. No comorbidities.. 25.2. 
Case 25
Carcinoma In Situ
25.1. . Courses of Treatment. Operation + Postoperative radiation therapy. (Left) + Tamoxifen 20 mg/day for 5 years.. Operation. 116. 117. Pathology Report. Right.. Lobular carcinoma in situ. . 1. Size of tumor: 0.3 cm.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Sk...
Important Radiologic. Findings. 114. 115. 25.3. 
Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on left breast. 1 o’clock direction.. Outside result of biopsy: Left breast 1 o’clock,. ductal carcinoma in situ, r/o invasion.. No family history.. S/P Robotic cholecystectomy (GB stone).. BRCA 1 and 2: Not examination.. 25....
Case 25
HR(+) HER2(+) Breast Cancer
25.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel and. ­. trastuzumab) + Post-operative radiation ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. ­. 145. 146. Pathology Report. [Right].. . 1. Invasive Ductal Carcinom...
Important Radiologic. Findings. 141 142 143. 144. 25.3. 
Patient History and Progress. Female/62 years old, post-menopause.. Screen detected mass lesion on right breast 5. o’clock direction and left breast subareolar area.. No family history.. Hypertension, dyslipidemia.. 25.2. 
Case 25
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Neoadjuvant therapy (giredestrant 30  mg/day. with palbociclib 100  mg/day) + Operation +. Adjuvant chemotherapy (#4 cycles of doxorubi­. cin & cyclophosphamide followed by #4 cycles of. docetaxel) + Post-­. operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation. Left breast conserving ...
Important Radiologic. Findings. See Figs. 139, 140, 141, 142 and 143.. 25.3. 
o’clock direction and left axillary LN.. No family history.. No comorbidities.. 25.2. 
Case 25
HR(−) HER2(+) Breast Cancer
25.1. . Courses of Treatment. Operation  +  Post-operative radiation therapy. (adjuvant chemotherapy refuse).. Operation. 180. Pathology Report. Invasive Ductal Carcinoma. 1. Size of invasive component: 2.5 cm (pT2).. 2. Size of intraductal component: 4.0 cm.. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nucle...
Important Radiologic Findings. 177 178. 179. . Y. Kwon et al.. 527. . . ­. 25.3. 
Patient History and Progress. Female/82 years old, post-menopause.. Screen detected mass lesion on left breast 2:30. o’clock direction.. No family history.. S/P Left hemiplegia (due to brain hemor­. rhage), hypertension, S/P spinal stenosis opera­. tion, s/p Tuberculosis.. 25.2. 
Case 25
HR(−) HER2(−) Breast Cancer
25.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of doxo­. rubicin and cyclophosphamide + #4 cycles of. docetaxel) + Operation + Post-operative radia­. tion therapy + Adjuvant capecitabine.. Operation. 185. Pathology Report. Invasive Ductal Carcinoma with (a) focal squa­. mous differentiation, (b) foc...
Important Radiologic. Findings. 178 179. 180. 25.3. . After Neoadjuvant. Chemotherapy. 181 182 183. 184. 25.4. 
Patient History and Progress. Female/70 years old, post-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. Family history of breast cancer, cousin. (paternal).. Macular degeneration.. BRCA 1 and 2 mutation: Not tested.. 25.2. 
Case 25
Local Recurrence
25.1. . Courses of Treatment. Left breast IDC → Operation → Adjuvant ther­. apy → Left breast recurrence (DCIS).. Primary Treatment. Operation. Nov. 2007 Left breast conserving surgery, axil­. lary lymph node dissection (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 1.1 cm (pT1c).. . 2. ...
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Patient History and Progress. Female/69 years old, post-menopause.. For chemotherapy after left breast cancer. surgery.. No family history.. s/p Left breast conserving surgery, s/p total. Thyroidectomy (thyroid cancer).. s/p. Hysterectomy. and. bilateral. salpingo-oophorectomy.. 25.2. 
Case 25
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral breast skin metastasis.. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 7% of tumor. cells. Adjuvant Therapy. Tamoxifen 20 mg/day for 0.75 year.. T...
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Hyperthyroidism,. s/p. bilateral. salpingo-oophorectomy.. 25.2. 
Case 26
Benign and Proliferative
26.1. . Courses of Treatment. →2021-06-16 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma with usual ductal. hyperplasia.. . . Benign and Proliferative Case Series. 50. 27. 
Important Radiologic. Findings. 51. 52. 26.3. 
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected nodular asymmetry on outer. central portion of right breast.. No family history.. s/p Total thyroidectomy (thyroid cancer).. C. W. Lee et al.. 49. 26.2. 
Case 26
Carcinoma In Situ
26.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 121. 122. Pathology Report. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. Size of tumor: up to 0.6 cm (pTis).. . 2. Nuclear grade: low.. . . ­. Carcinoma In Situ. 110. . 3. Necrosis: absent.. . 4. ...
Important Radiologic. Findings. 118 119. 120. 26.3. 
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass and microcalcification. on upper portion of right breast.. No family history.. No comorbidities.. 26.2. 
Case 26
HR(+) HER2(+) Breast Cancer
26.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy + Trastuzumab +. Letrozole 2.5 mg/day.. 153. 154. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size o...
Important Radiologic. Findings. 147 148 149 150 151. 152. . S. Park et al.. 387. 26.3. 
Patient History and Progress. Female/61 years old, post-menopause.. Self-detected palpable mass lesion on right. breast 11 o’clock direction.. No family history.. S/P. Tuberculosis,. diabetes. mellitus,. dyslipidemia.. 26.2. 
Case 26
HR(+) HER2(-) Breast Cancer
26.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of doxorubicin & cyclophosphamide) + Post-. operative radiation therapy + Tamoxifen. 20 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 25 m...
Important Radiologic. Findings. See Figs. 145, 146, 147 and 148.. 26.3. 
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 26.2. 
Case 26
HR(−) HER2(+) Breast Cancer
26.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of doxorubicin  +  cyclophosphamide)  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 184. Pathology Report. Invasive Ductal Carcinoma with medullary. pattern. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histologic grade: 3/3 (tub...
Important Radiologic. Findings. 181 182. 183. Y. Kwon et al.. 529. . . . 26.3. 
Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast 1 o’clock direction.. No family history.. No comorbidities.. 26.2. 
Case 26
HR(−) HER2(−) Breast Cancer
26.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #3. cycles of docetaxel + Trastuzumab) + Operati. on + Adjuvant capecitabine + Trastuzumab.. Operation. 193 194. 195. Pathology Report. <Right>. No residual tumor with stromal fibrosis. . 1. Post-chemotherapy s...
Important Radiologic Findings. 186 187. 188. Breast, right, needle biopsy: Invasive ductal car­. cinoma, histologic grade 3 with medullary pattern.. Result. Intensity Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (1+). Ki-67. Positive in 51%. of tu...
Patient History and Progress. Female/53 years old, post-menopause.. Self-detected mass lesion on right breast.. Family history of breast cancer, grandmother.. Family history of ovarian cancer, sister.. S/P appendectomy, s/p bilateral salpingo-­. oophorectomy, s/p left shoulder operation.. BRCA 1 mutation carrier.. 26.2...
Case 26
Local Recurrence
26.1. . Courses of Treatment. Right breast DCIS→ Operation → Adjuvant. therapy → Right breast recurrence (IDC).. Primary Treatment. 170. 171. Local Recurrence. 786. a. b. . . Operation. 172. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-excisional biopsy status.. . 2. Size of tumor: 2.0 cm, residual.. . 3. ...
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Patient History and Progress. Female/40 years old, post-menopause.. Bloody nipple discharge from right breast.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 26.2. 
Case 26
Metastatic Breast Cancer
26.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Stomach and bone metastasis.. Primary Treatment. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in. 29% of tumor. cells. Left> Invasive lobular carcinoma, stage. pT1c(m)N1mi.. Size of tumor: up to 1.5 cm, mult...
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Patient History and Progress. Female/54 years old, post-menopause.. No family history.. S/p cholecystectomy, s/p total gastrectomy (gas­. tric cancer), s/p bilateral salpingo-oophorectomy.. 26.2. 
Case 27
Benign and Proliferative
27.1. . Courses of Treatment. →2021-06-07 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma with usual ductal. hyperplasia.. . C. W. Lee et al.. 51. © The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023. E. S. Lee (ed.), A Practical Guide ...
Important Radiologic. Findings. 53. 27.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected mass lesion on right breast 4. o’clock direction.. Outside result of biopsy: Papillary neoplasm.. No family history.. No comorbidities.. 27.2. 
Case 27
Carcinoma In Situ
27.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 126. 127. Pathology Report. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. Size of tumor: 1.5 cm(pTis).. . 2. Nuclear grade: low.. Carcinoma In Situ. 113. . 3. Necrosis: absent.. . 4. Architectural ...
Important Radiologic. Findings. 123 124. 125. 27.3. 
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of mammotome biopsy:. Lobular carcinoma in situ.. No family history.. 27.2. 
Case 27
HR(+) HER2(+) Breast Cancer
27.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. ­. 160. 161. Pathology Report. [Right].. . 1. Ductal carcinoma in situ involving sclerosing....
Important Radiologic. Findings. 155 156 157 158. 159. . S. Park et al.. 391. . ­. 27.3. 
Patient History and Progress. Female/52 years old, peri-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. Family history of breast cancer, cousin. (maternal).. s/p Ovarian cyst excision.. BRCA 1 and 2 mutation: Not detected, NBN. VUS (variant of uncertain).. 27.2. 
Case 27
HR(+) HER2(-) Breast Cancer
27.1. . ductal component: present).. 4. Surgical margins:. . (a) superior margin: positive for ductal car­. cinoma in situ (Fro 1) (see note 1).. . (b) inferior margin: 25 mm.. . (c) medial margin: (see note 2).. . (d) lateral margin: 15 mm.. . (e) deep margin: <1 mm from invasive duc­. tal carcinoma (slide 7).....
Important Radiologic. Findings. See Figs. 150, 151, 152 and 153.. Y. Kim et al.
Patient History and Progress. Female/60 years old, post-menopause.. Screen detected mass lesion on left breast 10. o’clock direction.. No family history.. No comorbidities.. 27.2. 
Case 27
HR(−) HER2(+) Breast Cancer
27.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Adjuvant paclitaxel and trastuzumab.. Operation. 188. Pathology Report. . 1. Invasive ductal carcinoma with medullary. pattern.. . (a) Size of tumor: 0.8 cm (pT1b).. . (b) Histologic grade: 3/3 (tubule formation:. 3/3, nuclear pleomor...
Important Radiologic. Findings. 185 186. 187. . . . HR(−) HER2(+) Breast Cancer. 532. 27.3. 
Patient History and Progress. Female/69 years old, post-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. Family history of breast cancer, sister.. Hypertension, dyslipidemia.. BRCA 1 and 2 mutation: Not examination.. 27.2. 
Case 27
HR(−) HER2(−) Breast Cancer
27.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 203. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of ...
Important Radiologic. Findings. 196 197 198. 199. . HR(−) HER2(−) Breast Cancer. 672. . . . ­. E. S. Lee et al.. 673. . After Neoadjuvant. Chemotherapy. 200 201. 202. 27.3. 
Patient History and Progress. Female/36 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast.. Family history of breast cancer, aunt. (maternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected,. RAD50 VUS (variant of uncertain).. 27.2. 
Case 27
Local Recurrence
27.1. . Courses of Treatment. Right breast tubular carcinoma → Operation. → Adjuvant therapy → Left breast recurrence. (IDC).. Primary Treatment. 176 177 178. 179. Operation. ­. 180. Pathology Report. Tubular Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histologic grade: 1/3 (tubule formation: 1/3,. nuclear pleom...
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Patient History and Progress. Female/57 years old, post-menopause.. Screen detected mass lesion on right breast 1. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. Family history of breast cancer, younger. sister.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 27.2. 
Case 27
Metastatic Breast Cancer
Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy. →. Right. shoulder. soft. tissue. metastasis.. Primary Treatment. Estrogen. receptor. Strong (6/7). 3. 1/3–2/3. Progesterone. receptor. Weak (2/7). 1. <10%. C-erbB2. Equivocal. (2+). Ki-67. Positive in. 15% of tumor. cells. FISH. Negative. Adjuva...
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27.2. 
Case 28
Carcinoma In Situ
28.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 131. 132. Pathology Report. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. Size of tumor: 0.7 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. ...
Important Radiologic. Findings. 128 129. 130. 28.3. 
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. Outside result of stereotactic excisional. biopsy: Lobular carcinoma in situ.. No family history.. No comorbidities.. 28.2. 
Case 28
HR(+) HER2(+) Breast Cancer
28.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#3. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 166. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of invasive component: 1.6  cm. (pT1c).. . (b) Size...
Important Radiologic. Findings. 162 163 164. 165. 28.3. 
Patient History and Progress. Female/47 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast 6 o’clock direction.. No family history.. Hepatitis B carrier.. 28.2. 
Case 28
HR(+) HER2(-) Breast Cancer
. Courses of Treatment. Operation  +  Post-operative radiation ther­. apy  +  Letrozole 2.5  mg/day with palbociclib. 100 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. ponent: absent).. 4. Skin: no involvement of tumor.. HR(+) HER2(−) Breast Cancer. . (e) deep margin: 5 mm.. . (f) superficial...
Important Radiologic. Findings. See Figs. 155, 156, 157 and 158.. 28.3. 
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. No family history.. S/p cholecystectomy, hypertension.. 28.2. 
Case 28
HR(−) HER2(+) Breast Cancer
28.1. . docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab and pertuzumab.. Operation. 196. Pathology Report. Ductal Carcinoma In Situ. 1. Post-chemotherapy status.. 2. Size of tumor: 0.2 cm (ypTis).. 3. Nuclear grade: high.. 4. Necrosis: abse...
Important Radiologic. Findings. 189 190 191. 192. . HR(−) HER2(+) Breast Cancer. 534. . . ­. F. ig. 192. Chemotherapy. 193 194. 195. . ­.
Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. No family history.. Hypertension.. 28.2. 
Case 28
HR(−) HER2(−) Breast Cancer
28.1. . Courses of Treatment. Operation + Post-operative radiation therapy. (Adjuvant chemotherapy refuse).. Operation. 207. Pathology Report. Malignant Adenomyoepithelioma (Epithelial-­. Myoepithelial Carcinoma). 1. Size of tumor: 2.0 cm (pT1c).. HR(−) HER2(−) Breast Cancer. 676. . . . ­. E. S. Lee et al.. 677. . 2....
Important Radiologic Findings. 204 205. 206. 28.3. 
Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion on right.. No family history.. S/P. right. neck. excision. (due. to. lymphadenitis).. 28.2. 
Case 28
Local Recurrence
28.1. . Courses of Treatment. Left breast DCIS → Operation → Adjuvant. therapy → Left breast recurrence (microinva­. sive ductal carcinoma).. Primary Treatment. 185 186 187. 188. Local Recurrence. 792. . . ­. . Operation. ­. 189. Pathology Report. Ductal carcinoma in situ. 1. Post mammotome biopsy status.. 2. Size o...
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Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. Outside result of mammotome excision:. Ductal carcinoma in situ.. No family history.. No comorbidities.. 28.2. 
Case 28
Metastatic Breast Cancer
28.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy. →. Right. shoulder. soft. tissue. metastasis.. Primary Treatment. receptor. Strong (7/8). 2. >2/3. Progesterone. receptor. Strong (7/8). 2. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in 7%. of tumor cells. Adjuvant Therapy. Post-oper...
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Patient History and Progress. Female/51 years old, post-menopause.. No family history.. BRCA 1 & 2 mutation: Not detected, ATM. VUS (variant of uncertain).. Metastatic Breast Cancer. 908. 28.2. 
Case 29
Carcinoma In Situ
29.1. . Courses of Treatment. Operation + Adjuvant chemotherapy #4  cycles. (Doxorubicin and Cyclophosphamide) + Postope. rative radiation therapy (both)  +  Letrozole. 2.5 mg/day for 5 years.. Operation. 136. 137. Pathology Report. Right.. Lobular carcinoma in situ, pathological TN. category (AJCC 2017): pTis. . 1. ...
Important Radiologic. Findings. 133 134. 135. 29.3. 
Patient History and Progress. Female/50 years old, post-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of biopsy: Left breast 2 o’clock,. invasive ductal carcinoma.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, MSH6. VUS (variant of uncertain)...
Case 29
HR(+) HER2(+) Breast Cancer
29.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of docetaxel and cyclophosphamide and. trastuzumab) + Post-operative radiation ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 171. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.1 cm (pT2).. 2. Histologic grade: 2/3 (t...
Important Radiologic. Findings. 167 168 169. 29.3. 
Patient History and Progress. Female/80 years old, post-menopause.. Self-detected mass lesion on right breast 8. o’clock direction.. No family history.. Hypertension, dyslipidemia, s/p tympano­. plasty.. 29.2. 
Case 29
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Y. Kim et al.. 265. Operation. Left breast conserving surgery, sentinel lymph. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 20 mm.. . (b) inferior margin: 10 mm.. . (c) medial margin:...
Important Radiologic. Findings. See Figs. 160, 161, 162 and 163.. 29.3. 
S/P hysterectomy, hypertension, s/p left cere­. bral infarction, s/p transient ischemic attack.. 29.2. 
Case 29
HR(−) HER2(+) Breast Cancer
29.1. . Courses of Treatment. Operation (adjuvant chemotherapy refuse).. Operation. 200. 201. Pathology Report. Microinvasive Ductal Carcinoma. 1. Size of invasive component: <0.1 cm (pT1mi).. 2. Size of intraductal component: 5.0 cm.. 3. Histologic grade: not applicable.. 4. Intraductal component: present, intrat...
Important Radiologic. Findings. 197 198. 199. . . ­. . HR(−) HER2(+) Breast Cancer. 538. 29.3. 
Patient History and Progress. Female/39 years old, pre-menopause.. Self-detected palpable mass lesion on upper. outer portion of left breast.. No family history.. S/P Left salpingo-oophorectomy.. BRCA 1 and 2 mutation: Not detected.. 29.2. 
Case 29
HR(−) HER2(−) Breast Cancer
29.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of doxo­. rubicin and cyclophosphamide + #4 cycles of. docetaxel) + Operation + Post-operative radia­. tion therapy + Adjuvant capecitabine.. Operation. 215. Pathology Report. Microinvasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tu...
Important Radiologic Findings. 208 209 210. 211. . E. S. Lee et al.. 679. . . ­. . HR(−) HER2(−) Breast Cancer. 680. . After Neoadjuvant. Chemotherapy. 212 213. 214. 29.3. 
Patient History and Progress. Female/27 years old, pre-menopause.. Self-detected mass lesion on left breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. HR(−) HER2(−) Breast Cancer. 678. 29.2. 
Case 29
Local Recurrence
29.1. . Courses of Treatment. Left breast IDC→ Operation → Adjuvant ther­. apy → Left breast recurrence (IDC).. Primary Treatment. 194 195 196. 197. Operation. ­. 198. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 3.0 cm (pT2).. . . . ­. Local Recurrence. 796. 2. Histologic grade: 2/3 (tubule format...
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Patient History and Progress. Female/46 years old, pre-menopause.. Screen detected mass lesion on left breast 7:30. o’clock direction.. Outside result of biopsy: (1) Invasive ductal. carcinoma, (2) Atypical ductal hyperplasia.. Family history of breast cancer, mother.. Asthma.. BRCA 1 VUS (variant of uncertain).. 29.2....
Case 29
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Neoadjuvant chemother­. apy → Operation → Adjuvant therapy → Lung. metastasis.. Primary Treatment. receptor. Strong. (6/7). 3. 1/3–2/3. Progesterone. receptor. Strong. (6/7). 3. 1/3–2/3. C-erbB2. Negative. (1+). Ki-67. N.A. Clinical stage: cT3N1M0.. Operation. Oct. 2007 Right...
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Case 3
Benign and Proliferative
3.1. . Courses of Treatment. → 2021-12-10 Excision, Rt.. C. W. Lee et al.. 21. . ­. . ­. 3.3.1. . Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. 4. 
Important Radiologic. Findings. 4. 5. 3.3. 
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected nodular lesion on right breast. 9 o’clock direction.. No family history.. Hypertension.. 3.2. 
Case 3
Carcinoma In Situ
Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. 3.3.1. . Operation. 13. 14. 3.3.2. . Pathology Report. <First operation>. Lobular carcinoma in situ. . 1. Size of tumor: 0.3 cm.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Surgical margins:. . (a)...
3.1. . Important Radiologic. Findings. 11. 12. 3.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected microcalcifications on right. breast upper outer.. Outside result of biopsy: Right 10 o’clock. 1.. Usual ductal hyperplasia, 2. duct ectasia.. No family history.. S/P Hallux valgus operation.. 3.2. 
Case 3
HR(+) HER2(+) Breast Cancer
3.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. . . S. Park et al.. 307. . 18. 3.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.8 cm (pT1c).. ...
Important Radiologic. Findings. 13 14 15 16. 17. 3.3. 
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected mass lesion on right breast 7. o’clock direction.. No family history.. Dyslipidemia.. 3.2. 
Case 3
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Y. Kim et al.. moral/extratumoral (5%) (nuclear grade:. low, necrosis: absent, architectural pattern:. cribriform, extensive intraductal component:. absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a)...
Important Radiologic. Findings. See Figs. 10, 11, 12 and 13.. 3.3. 
No family history.. L-spine disc herniation.. 3.2. 
Case 3
HR(−) HER2(+) Breast Cancer
3.1. . Courses of Treatment. Palliative chemotherapy (#7 cycles of docetaxel. and. trastuzumab. and. pertuzumab). +. Operation. +. Post-operative. radiation. ther­. apy + Palliative trastuzumab and pertuzumab.. 3.4.1. . Operation. 26. 3.4.2. . Pathology Report. Ductal Carcinoma In Situ. 1. Post-chemotherapy status....
Important Radiologic. Findings. 18 19 20. 21. . HR(−) HER2(+) Breast Cancer. 438. . . ­. Y. Kwon et al.. 439. F. i. g. . 21. . . ­. ­. . ­. ­. 3.3. . After Neoadjuvant. Chemotherapy. 22 23 24. 25. Y. Kwon et al.. 441. 3.4. 
Patient History and Progress. Female/61 years old, post-menopause.. Self-detected nipple retraction on right breast.. Family history of breast cancer, cousin. (maternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 3.2. 
Case 3
HR(−) HER2(−) Breast Cancer
3.1. . Courses of Treatment. Operation + operation, Transfer.. 3.3.1. . Operation. 20. 3.3.2. . Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.3 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation: 2/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 82/10HPF).. 3. Intraductal component: pres...
Important Radiologic. Findings. 16 17 18. 19. 3.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction.. No family history.. No comorbidities.. 3.2. 
Case 3
Local Recurrence
3.1. . Courses of Treatment. Left breast IDC + DCIS → Operation → Left. breast recurrence (DCIS).. 14. 15. 3.2.1. . Operation. 16. 3.2.2. . Pathology Report. Ductal Carcinoma In Situ. . 1. Size of tumor: 1.5 cm.. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural pattern: solid/comedo.. . 5. ...
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Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected microcalcification on upper. portion of left breast.. Family history of colon cancer, father.. No comorbidities.. 3.2. 
Case 3
Metastatic Breast Cancer
Courses of Treatment. Left. breast. cancer. →. Neoadjuvant. Chemotherapy → Operation → Adjuvant therapy. → Bone, lung, and brain metastasis.. 3.2.1. . Primary Treatment. Docetaxel #4).. Operation. Mar. 2018 Left modified radical mastectomy.. Pathology: Invasive ductal carcinoma, stage. ypT2N1.. Size of tumor: 2.7 * 2....
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Case 30
Carcinoma In Situ
30.1. . Courses of Treatment. Operation + Postoperative Radiation therapy.. Operation. 142. 143. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 2.0 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural pattern: micro...
Important Radiologic. Findings. 138 139 140. 141. 30.3. 
Patient History and Progress. Female/60 years old, post-menopause.. Screen detected mass and microcalcification. on left breast 10 o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. Claustrophobia, hypertension.. 30.2. 
Case 30
HR(+) HER2(+) Breast Cancer
30.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy.. 179. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-chemotherapy status.. . 2. Size of tumor: 2.0 cm (ypTis).. . 3. Nuclear ...
Important Radiologic. Findings. 172 173 174 175 176 177. 178
Patient History and Progress. Female/31 years old, pre-menopause.. Self-detected palpable mass lesion on outer. inner portion of right breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 30.2. 
Case 30
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. ponent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 15 mm.. . (b) inferior margin: 15 mm.. . (c) medial margin: 1...
Important Radiologic. Findings. See Figs. 165, 166, 167 and 168.. 30.3. 
s/p Left optic nerve palsy, hypertension, s/p. right rotator cuff tear operation.. 30.2. 
Case 30
HR(−) HER2(+) Breast Cancer
30.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab and pertuzumab.. 3. Histologic grade: not applicable.. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor....
Important Radiologic. Findings. 202 203. 204. HR(−) HER2(+) Breast Cancer. 540. . ­. Y. Kwon et al.. 541. 30.3. . After Neoadjuvant. Chemotherapy. 205 206. 207. 30.4. 
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected palpable mass and nipple dis­. charge on left breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 30.2. 
Case 30
HR(−) HER2(−) Breast Cancer
30.1. . Courses of Treatment. Neoadjuvant chemotherapy (#2  cycles of. doxorubicin and cyclophosphamide  +  #3. cycles of paclitaxel) + Operation + Adjuvant. capecitabine.. Operation. 224. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 3.5 cm (ypT2).. 3. Histologic grad...
Important Radiologic. Findings. 216 217. 218. . E. S. Lee et al.. 683. After Neoadjuvant. Chemotherapy. 219 220 221 222. 223. 30.3. 
Patient History and Progress. Female/69 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. h/o Tuberculosis, s/p thoracic vertebra com­. pression fracture.. 30.2. 
Case 30
Local Recurrence
30.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy → Left breast recurrence (IDC).. Primary Treatment. 203 204 205. 206. . . . . Local Recurrence. 800. a. b. c. d. . Operation. 207. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.2 cm (pT2).. 2. Histologic grade: 2/3 (tub...
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Patient History and Progress. Female/89 years old, post-menopause.. Screen detected mass lesion on right breast 1. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. No family history.. Hypertension, Hypothyroidism, s/p Cardiac. stent insertion (angina).. s/p Shoulder ligament rupture operation....
Case 30
Metastatic Breast Cancer
30.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Bone metastasis.. Positive %. Estrogen. receptor. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2. Negative (0). Ki-67. Positive in. 5% of tumor. cells. Adjuvant Therapy. Tamoxifen 20 mg/day.. Treatm...
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Patient History and Progress. Female/50 years old, pre-menopause.. No family history.. Hepatitis B virus carrier, s/p myomectomy.. 30.2. 
Case 31
Carcinoma In Situ
31.1. . Courses of Treatment:. Operation. Operation. 146. 147. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 2.0 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary/micropapil­. lary/cribriform.. E. S. ...
Important Radiologic. Findings. 144. 145. 31.3. 
Patient History and Progress. Female/31 years old, pre-menopause.. Screen detected calcification on left breast. 11 o’clock direction.. Outside result of mammotome biopsy: Ductal. carcinoma in situ.. No family history.. No comorbidities.. BRCA 1 and 2: Not detected.. 31.2. 
Case 31
HR(+) HER2(+) Breast Cancer
31.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel and trastu­. zumab)  +  Post-operative radiation ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 184. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1...
Important Radiologic. Findings. 180 181 182. 183. 31.3. 
Patient History and Progress. Female/69 years old, post-menopause.. Self-detected nipple retraction on left breast.. No family history.. Hypertension.. 31.2. 
Case 31
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of docetaxel & ­. cyclophosphamide) +. Post-operative radiation therapy + Letrozole. 2.5 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. . (c) medial margin: 10 mm.. . (d) lateral margin: 10 mm.. . (e) deep margin: <1 mm from...
Important Radiologic. Findings. See Figs. 170, 171, 172 and 173.. 31.3. 
niece.. S/P. Hysterectomy. and. salpingo-oophorectomy.. BRCA 1 exon 9-13 deletion, exon 2-6. deletion.. 31.2. 
Case 31
HR(−) HER2(+) Breast Cancer
31.1. . Operation. 213. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.1 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 5/HPF).. 3. Intraductal component: present, intratu­. moral/extratumoral (50%) (nuclear grade:. high, necrosis: pres...
Important Radiologic. Findings. 209 210 211. 212. . HR(−) HER2(+) Breast Cancer
Patient History and Progress. Female/74 years old, post-menopause.. Screen detected mass lesion on left breast 1. o’clock direction.. No family history.. Hypertension.. 31.2. 
Case 31
HR(−) HER2(−) Breast Cancer
31.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 233. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of ...
Important Radiologic. Findings. 225 226 227. 228. E. S. Lee et al.. 687. . . ­. . HR(−) HER2(−) Breast Cancer. 688. . After Neoadjuvant. Chemotherapy. 229 230 231. 232. 31.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected mass lesion on right breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, STK11. VUS (variant of uncertain).. 31.2. 
Case 31
Local Recurrence
31.1. . Courses of Treatment. Right breast Papillary carcinoma in situ→. Operation → Right breast recurrence (DCIS).. Primary Treatment. 212 213 214. 215. Operation. ­. ­. 216 217. 218. Pathology Report. <Right>. Y. Kim et al.. 803. . . . ­. . Papillary carcinoma in situ. . 1. Size of tumor: 5.0 cm (pTis).. . 2. Nuc...
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Patient History and Progress. Female/49 years old, pre-menopause.. Screen detected mass lesion on right breast 1. o’clock direction.. No family history.. No comorbidities.. 31.2. 
Case 31
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Lung metastasis.. Primary Treatment. receptor. Negative (0/8). 0. 0. C-erbB2. Negative (0). Ki-67. Positive in. 85% of tumor. cells. Adjuvant Therapy. Adjuvant chemotherapy #6 cycles (Fluorouracil. & Doxorubicin & Cyclophosphamide).. Post-opera...
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BRCA 1: positive for deleterious mutation.. S/p bilateral salpingo-oophorectomy.. 31.2. 
Case 32
Carcinoma In Situ
32.1. . Courses of Treatment. Operation + Postoperative radiation therapy.. Operation. 151. 152. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 4.0 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural pattern: ­. micropap...
Important Radiologic. Findings. 148 149. 150. 32.3. 
Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast. 8 o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. 32.2. 
Case 32
HR(+) HER2(+) Breast Cancer
32.1. . Courses of Treatment. Neoadjuvant chemotherapy (#3 cycles of. docetaxel. and. trastuzumab. and. pertu­. zumab)  +  Operation  +  Post-operative radia­. tion therapy  +  Trastuzumab emtansine +. Letrozole 2.5 mg/day.. Operation:. Left. axillary. lymph. node. ­. dissection.. Pathology Report. Metastatic Ductal C...
Important Radiologic. Findings. 185 186 187 188. 189. 32.3. 
Patient History and Progress. Female/74 years old, post-menopause.. Self-detected mass lesion on left axillary.. No family history.. S/P Tuberculosis, asthma.. 32.2. 
Case 32
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Letrozole 2.5 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. ponent: absent).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 20 mm.. . (b) inferior margin: 40 mm.. . (c) medial margin: ...
Important Radiologic. Findings. See Figs. 175, 176, 177 and 178.. 32.3. 
o’clock direction.. No family history.. Hypertension, s/p bronchiectasis, s/p left hip. arthroplasty.. 32.2. 
Case 32
HR(−) HER2(+) Breast Cancer
32.1. . Courses of Treatment. Neoadjuvant chemotherapy (#5 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab after followed #1 cycle of trastu­. zumab and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 220. Pathology Report. No residual tumor with stroma...
Important Radiologic. Findings. 214 215. 216. 32.3. . After Neoadjuvant. Chemotherapy. 217 218. 219. Y. Kwon et al.. 547. . . ­. . HR(−) HER2(+) Breast Cancer. 548. . . 32.4. 
Patient History and Progress. Female/55 years old, post-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. No family history.. Hypertension, thyroid nodules.. 32.2.