Case string | Patient History string | Important Radiologic string | After Neoadjuvant Chemotherapy string | Courses of Treatment string | Pathology Report string | Label string | Cluster string |
|---|---|---|---|---|---|---|---|
Case 20 | 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. | Report 1: Mammography (Oct. 2020): irregular hyperdense mass in the upper mid portion of left breast (marked by BB
marker). Enlarged lymph node in left axilla. Report 2:Breast US (Oct. 2020): irregular hypoechoic
mass at the 12 o’clock direction of left breast. Report 3: Breast MRI (Oct. 2020): irregular enhancing
mass... | Report 1: Mammography (Mar. 2021): mammography after treatment demonstrates residual focal asymmetry that is decreased in the longest diameter (marked by radiopaque marker). Report 2: Breast MRI (Mar. 2021): MRI after treatment
demonstrates residual non-mass enhancement (white
arrow) that is decreased in the longest di... | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab) + Operation + Post-operative radiation therapy + Trastuzumab.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with diff... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 1.1 cm (ypT1c).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 3/HPF).
4. Intraductal component: present, intratumoral/extratumoral (10%) (nuclear grade:
high, necrosis: absent, architectural patter... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 21 | Female/55 years old, pre-menopause.
Self-detected palpable mass lesion on right
breast.
No family history.
S/P Tuberculosis. | Report 1: Mammography (Apr. 2021): irregular hyperdense mass in the upper outer quadrant of right breast. Enlarged lymph nodes in right axilla. Report 2: Breast US (Apr. 2021): irregular hypoechoic
mass at the 11 o’clock direction of right breast. Report 3:Breast MRI (Apr. 2021): irregular enhancing
mass (white arrow) ... | Report 1: Mammography (Sept. 2021): mammography after treatment demonstrates residual mass that is decreased in
the longest diameter. Decrease in size of enlarged lymph nodes in right axilla. Report 2: Breast US (Sept. 2021): US after treatment
demonstrates residual hypoechoic mass that is decreased
in the longest diam... | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab) + Operation + Post-operative radiation therapy + Trastuzumab and Pertuzumab.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy. Fig. 156 (a) Gross pathology of lumpectomy specimen. (b) The margins get ma... | 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. 5. Surgical margins:
(a) superior margin: 15 mm,
(b) inferior margin: 35 mm,
(c) medial ma... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 22 | 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. | Report 1: Magnifcation (Mar. 2021): irregular mass with fne pleomorphic microcalcifcations in the lower inner of right breast. Report 2: Breast US (Mar. 2021): irregular hypoechoic
mass with microcalcifcations at the 4 o’clock direction of
right breast. Report 3:Breast MRI (Mar. 2021): irregular enhancing
mass at the 4... | null | Operation + Adjuvant chemotherapy (#4 cycles
of doxorubicin and cyclophosphamide) + Postoperative radiation therapy + Trastuzumab.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b, c) The margins get marked and sliced with different colors on each ... | Invasive Ductal Carcinoma with apocrine differentiation and medullary pattern
1. Size of invasive component: 1.3 cm (pT1c).
2. Size of intraductal component: 3.0 cm.
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 15/10HPF).
4. Intraductal component: present, extratumoral... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 23 | Female/49 years old, pre-menopause.
Self-detected bloody discharge on nipple of
right breast.
No family history.
No comorbidities. | Report 1: Magnifcation (Aug. 2020): regional fne pleomorphic microcalcifcations in right upper outer quadrant. Report 2: Breast US (Aug. 2020): irregular hypoechoic
mass with microcalcifcations at the 10 o’clock direction
of right breast. Report 3:Breast MRI (Aug. 2020): regional heterogeneous non-mass enhancement in t... | null | Operation + Operation + Adjuvant paclitaxel and
trastuzumab.
Operation
Right nipple–areolar complex sparing mastectomy+ implant reconstruction, sentinel lymph
node biopsy (1st, Sept. 2020). (a) Gross pathology of lumpectomy specimen. (b–d) The margins get marked and sliced with different colors
on each direction.Second... | First 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 grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 3/10HPF).
4. Intraductal component: present, i... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 24 | Female/55 years old, pre-menopause.
Self-detected palpable mass lesion on left
breast 10–12 o’clock direction.
No family history.
Hypertension. | Report 1: Mammography (Apr. 2021): irregular hyperdense mass with fne pleomorphic microcalcifcations in the upper inner quadrant of left breast (marked BB marker). Enlarged lymph nodes in left axilla. Report 2: Breast US (Apr. 2021): irregular hypoechoic
mass with microcalcifcations at the 11 o’clock direction
of left ... | Report 1: Mammography:
mammography after
treatment demonstrates
residual mass that is
decreased in the longest
diameter. Report 2: Breast US: US after treatment demonstrates
residual hypoechoic mass that is decreased in the longest
diameter. Report 3: Breast MRI: MRI after treatment demonstrates
residual non-mass enhan... | Neoadjuvant chemotherapy (#3 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab) + Operation + Post-operative radiation therapy + Trastuzumab and pertuzumab. Operation Left breast conserving surgery, sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and s... | 1. No residual tumor with stromal fbrosis.
(a) Post-chemotherapy status.
(b) Lymph nodes: no metastasis in two axillary lymph nodes (ypN0(sn)) (sentinel
LN: 0/2).
2. Sclerosing adenosis with microcalcifcation. | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 25 | 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 hemorrhage), hypertension, S/P spinal stenosis operation, s/p Tuberculosis. | Report 1:Mammography (Apr. 2021): irregular hyperdense mass with fne pleomorphic microcalcifcations in the
upper outer quadrant of left breast. Report 2:Breast US (Apr. 2021): irregular hypoechoic
mass with echogenic halo and microcalcifcations at the 2
o’clock direction of left breast. Report 3:Breast MRI (Apr. 2021):... | null | Operation + Post-operative radiation therapy
(adjuvant chemotherapy refuse).
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on each direction. | 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,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 11/10HPF).
4. Intraductal component: present, intratumoral/extratumoral (50%) (nuclear grade:
high, necrosis: p... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 26 | Female/49 years old, pre-menopause.
Self-detected palpable mass lesion on right
breast 1 o’clock direction.
No family history.
No comorbidities. | Report 1:Breast US (May 2021): irregular hypoechoic
mass at the 2 o’clock direction of right breast. Report 2: Breast MRI (May 2021): irregular enhancing
mass at the 2 o’clock direction of right breast. Report 3:Lymphoscintigraphy shows visualized sentinel
lymph nodes in the right axilla. | null | Operation + Adjuvant chemotherapy (#4 cycles
of doxorubicin + cyclophosphamide) + Postoperative radiation therapy + Trastuzumab.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on each dir... | Invasive Ductal Carcinoma with medullary
pattern
1. Size of tumor: 1.5 cm (pT1c).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 12/10HPF).
3. Intraductal component: present, intratumoral/extratumoral (5%) (nuclear grade:
high, necrosis: absent, architectural pattern:
so... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 27 | 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. | Report 1: Breast US (May 2021): irregular hypoechoic
mass with microcalcifcations at the 9 o’clock direction of
right breast. Report 2: Breast MRI (May 2021): irregular enhancing
mass at the 9 o’clock direction of right breast. Report 3: Lymphoscintigraphy shows visualized sentinel
lymph nodes in the right axilla. | Operation + Post-operative radiation therapy + Adjuvant paclitaxel and trastuzumab.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on each direction | 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 pleomorphism: 3/3, mitotic
count: 3/3, 4/HPF).
(c) Intraductal component: present, intratumoral/extratumoral (50%) (nuclear grade:
high, necrosis: absent, architectural patter... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes | |
Case 28 | Female/61 years old, post-menopause.
Screen detected mass lesion on right breast 9
o’clock direction.
No family history.
Hypertension. | Report 1: Mammography (June 2021): irregular hyperdense mass in the upper outer quadrant of right breast (marked by BB marker). Enlarged lymph nodes in right axilla. Report 2: Breast US (June 2021): irregular heterogeneous echoic mass at the 9 o’clock direction of right breast. Report 3: Breast MRI (June 2021): irregul... | Report 1: Mammography
(Oct. 2021): mammography after treatment demonstrates residual mass (white arrow) that is decreased in the longest diameter and no change of associated fne linear microcalcifcations. Decrease in size of enlarged lymph nodes in right axilla. Report 2: Breast US (Oct. 2021): US after treatment demon... | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab) + Operation + Post-operative radiation therapy + Trastuzumab and pertuzumab.
Operation Right breast conserving surgery, sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and... | Ductal Carcinoma In Situ
1. Post-chemotherapy status.
2. Size of tumor: 0.2 cm (ypTis).
3. Nuclear grade: high.
4. Necrosis: absent.
5. Architectural pattern: solid.
6. Skin: no involvement of tumor.
7. Surgical margins:
(a) superior margin: 20 mm,
(b) inferior margin: 10 mm,
(c) medial margin: 30 mm,
(d) lateral margi... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 29 | 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. | Report 1: Breast US (May 2021): irregular hypoechoic
masses with microcalcifcations in the upper portion of
left breast. Report 2: Breast MRI (May 2021): regional heterogeneous non-mass enhancement in the upper portion of left
breast. Report 3: Lymphoscintigraphy shows visualized sentinel
lymph nodes in the right axill... | null | Operation (adjuvant chemotherapy refuse).
Operation
Left nipple–areolar complex sparing mastectomy
with implant reconstruction, sentinel lymph node
biopsy. (a) Preoperative and (b) immediate post-operative appearance. (a) Gross pathology of mastectomy specimen. (b, c) The margins get marked and sliced with different c... | 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, intratumoral/extratumoral (99%) (nuclear grade:
high, necrosis: present, architectural pattern:
micropapillary/cribriform/comed... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 30 | Female/41 years old, pre-menopause.
Self-detected palpable mass and nipple discharge on left breast.
No family history.
No comorbidities.
BRCA 1 and 2 mutation: Not detected. | Report 1:Breast US (June 2021): irregular heterogeneous
echoic mass at the 9 o’clock direction of left breast. Report 2: Breast MRI (June 2021): regional heterogeneous non-mass enhancement in the inner portion of left breast. Report 3:PET-CT shows (a)
known breast cancer with
uptake, Lt 8´ (mSUV = 7.3),
(b) another hyp... | Report 1:Breast US (Nov. 2021): US after treatment
demonstrates residual hypoechoic mass that is decreased
in the longest diameter. Report 2: Breast MRI (Nov. 2021): MRI after treatment
shows complete resolution of enhancement in the left
breast. Report 3: Lymphoscintigraphy shows
visualized sentinel lymph nodes in the... | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab) + Operation + Post-operative radiation therapy + Trastuzumab and pertuzumab. | Microinvasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: <0.1 cm (ypT1mi).
3. Histologic grade: not applicable.
4. Intraductal component: absent.
5. Skin: no involvement of tumor.
6. Surgical margins:
(a) superior margin: 10 mm,
(b) inferior margin: (see note),
(c) medial margin: 10 mm,
(d) lateral... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 31 | Female/74 years old, post-menopause.
Screen detected mass lesion on left breast 1
o’clock direction.
No family history.
Hypertension. | Report 1:Mammography (May 2021): Focal asymmetry with fne linear microcalcifcations in the upper mid portion
of left breast (marked by BB marker) . Report 2: Breast US (May 2021): irregular hypoechoic
mass with microcalcifcations at the 1 o’clock direction of
left breast. Report 3: Breast MRI (May 2021): irregular enha... | null | Operation + Adjuvant chemotherapy (#4 cycles
of doxorubicin and cyclophosphamide) + Postoperative radiation therapy + Trastuzumab.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b, c) The margins get marked and sliced with different colors
on each d... | 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, intratumoral/extratumoral (50%) (nuclear grade:
high, necrosis: present, architectural pattern:
solid/comedo, extensive int... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 32 | Female/55 years old, post-menopause.
Screen detected mass lesion on right breast 8
o’clock direction.
No family history.
Hypertension, thyroid nodules. | Report 1:Mammography (Feb. 2021): irregular hyperdense mass in the upper outer quadrant of right breast
(marked BB marker). Spiculated hyperdense mass (white
arrow) with pleomorphic microcalcifcations in the lower
outer portion of right breast. Enlarged lymph nodes in
right axilla. Report 2: Breast US (Feb. 2021): irre... | Report 1: Mammography (June 2021): mammography
after treatment demonstrates residual masses that are
decreased in the longest diameter in lower outer and upper
outer portion of right breast. Decrease in size of enlarged
LNs in right axilla. Report 2:Breast MRI (June 2021): MRI after treatment
shows complete resolution ... | Neoadjuvant chemotherapy (#5 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab after followed #1 cycle of trastuzumab and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab.
32.4.1 Operation
Right breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lump... | No residual tumor with stromal degeneration.
1. Post-chemotherapy status.
2. Lymph nodes: no metastasis in three axillary
lymph nodes (ypN0(sn)) (sentinel LN: 0/3). | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 33 | Female/63 years old, post-menopause.
Self-detected palpable mass lesion on left
breast 2 o’clock direction.
No family history | Report 1:Mammography
(Feb. 2021): irregular
hyperdense mass in the
upper outer quadrant of
left breast. Enlarged
lymph nodes in left axilla. Report 2:Breast US (Feb. 2021): irregular hypoechoic
mass at the 2 o’clock direction of left breast. Report 3:Breast MRI (Feb. 2021): irregular enhancing
mass (white arrow) with a... | Report 1:Mammography (May 2021): mammography after treatment demonstrates no residual mass that is decreased
in the longest diameter. Report 2:Breast US (May 2021): US
after treatment demonstrates residual
hypoechoic mass that is decreased in the
longest diameter. Report 3:Lymphoscintigraphy shows
visualized sentinel l... | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab and
pertuzumab) + Operation + Post-operative radiation therapy + Trastuzumab.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with diffe... | 1. No residual tumor with foamy histiocytic
collection.
(a) Post-chemotherapy status.
(b) Lymph nodes: no metastasis in four axillary lymph nodes (ypN0(sn)) (sentinel
LN: 0/4).
(c) Microcalcifcation: present, tumoral/
non-tumoral.
(d) Related slides: C21-518.
2. Intraductal papilloma. | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 34 | Female/54 years old, post-menopause.
Self-detected palpable mass lesion on left
breast.
No family history.
S/P unilateral salpingo-oophorectomy,
dyslipidemia. | Report 1:Mammography (June 2021): irregular hyperdense mass in the upper inner quadrant of left breast. Report 2:Breast US (Feb. 2021): irregular hypoechoic
mass with microlobulated margin at the 9 o’clock direction of left breast. Report 3:Breast MRI (Feb. 2021): irregular enhancing
masses (white arrow) in the inner p... | null | Operation + Adjuvant chemotherapy (#4 cycles
of doxorubicin + cyclophosphamide) +
Operation + Trastuzumab.
34.3.1 Operation
Left modifed radical mastectomy, sentinel lymph
node biopsy (a) Gross pathology of mastectomy specimen. (b, c) The margins get marked and sliced with different colors
on each direction | Invasive Ductal Carcinoma
1. Size of tumor: 1.5 cm (pT1c(Paget)).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 11/10HPF).
3. Intraductal component: absent.
4. Nipple: Paget disease.
5. Skin: no involvement of tumor. 6. Surgical margins: deep margin: 2 mm.
7. Lymph node... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 35 | Female/73 years old, post-menopause.
Self-detected palpable mass lesion on right
breast.
Family history of breast cancer, cousin
(maternal).
s/p cholecystectomy, s/p unilateral salpingooophorectomy, hypertension, diabetes mellitus.
BRCA 1 and 2 mutation: Not detected. | Report 1:Mammography (July 2021): irregular hyperdense mass in the upper mid portion of right breast (marked by
BB marker). Enlarged lymph nodes in right axilla. Report 2: Breast US (July 2021): irregular
heterogeneous echoic mass with microcalcifcations at the 12 o’clock direction of right
breast. Report 3: Breast MRI... | Report 1:Mammography (Nov. 2021): mammography after treatment demonstrates residual mass that is decreased in
the longest diameter. Decrease in size of enlarged LNs in right axilla. Report 2: Breast US (Nov. 2021): US after treatment
demonstrates residual hypoechoic mass that is decreased
in the longest diameter. Repor... | Neoadjuvant chemotherapy (#5 cycles of
docetaxel and trastuzumab and pertuzumab) + Operation + Post-operative radiation
therapy + Trastuzumab and pertuzumab.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of mastectomy specimen. (b) The margins get marked and sliced with d... | Microinvasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of invasive component: <0.1 cm
(ypT1mi).
3. Size of intraductal component: 0.8 cm.
4. Histologic grade: not applicable 5. Intraductal component: present, intratumoral/extratumoral (99%) (nuclear grade:
low, necrosis: present, architectural pattern:
so... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 36 | Female/63 years old, post-menopause.
Screen detected mass lesion on left breast 2
o’clock direction.
No family history.
Hypertension, chronic renal failure, ventricular premature contraction.
S/P cholecystectomy (due to stone). | Report 1: PET-CT
shows (
a) a
hypermetabolic mass in
the left breast
(mSUV = 14.8), (
b)
small hypermetabolic
lesions in the left upper
outer breast
(mSUV = 1.6), and (
c)
small lymph nodes in
the left axilla level I–II
(mSUV = 1.3). Report 2:Lymphoscintigraphy
shows visualized sentinel lymph
nodes in the left axilla. | null | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy ( | 1. No residual tumor with foamy histiocytic
collection.
(a) Post-chemotherapy status.
(b) Lymph nodes: no metastasis in four axillary lymph nodes (ypN0(sn)) (sentinel
LN: 0/4).
(c) Microcalcifcation: present, tumoral/
non-tumoral.
2. Intraductal papilloma. | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 37 | Female/63 years old, post-menopause.
Self-detected nipple discharge on left breast.
No family history.
S/P Total hysterectomy, s/p right lung lobectomy (benign), diabetes mellitus. | Report 1: Mammography: segmental fne pleomorphic microcalcifcations with focal asymmetries in the upper outer
quadrant of left breast, irregular hypoechoic mass with microcalcifcations at the 2 o’clock direction of left breast. Report 2: 7 Breast US: irregular hypoechoic mass with
microcalcifcations at the 2 o’clock di... | Report 1:Mammography (Dec. 2020): no change of segmental fne pleomorphic microcalcifcations and decrease in size of focal asymmetries in the upper outer quadrant of left breast. Report 2:Breast US (Dec. 2020): US after treatment
demonstrates residual hypoechoic mass that is decreased
in the longest diameter. Report 3:B... | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy 3 (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with... | Ductal Carcinoma In Situ
1. Post-chemotherapy status.
2. Size of tumor: 0.5 cm (ypTis).
3. Nuclear grade: high.
4. Necrosis: present.
5. Architectural pattern: solid/comedo.
6. Skin: no involvement of tumor.
7. Surgical margins:
(a) superior margin: 10 mm,
(b) inferior margin: 10 mm,
(c) medial margin: 30 mm, (d) late... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 38 | Female/55 years old, post-menopause.
Self-detected palpable mass lesion on right
breast.
Family history of breast cancer, sister.
Dyslipidemia.
BRCA 1 and 2 mutation: Not detected,
MUTYH and RAD50 VUS (variant of
uncertain). | Report 1:Magnifcation (Jan. 2021): indistinct hyperdense mass with microcalcifcations in right upper outer
quadrant. Report 2:Breast US (Jan. 2021): irregular hypoechoic
mass with microcalcifcations at the 11 o’clock direction
of right breast. Report 3:Breast MRI (Jan. 2021): irregular enhancing
mass at the 11 o’clock ... | null | Operation + Adjuvant chemotherapy (#4
cycles of docetaxel and cyclophosphamide) +
Post-operative radiation therapy +
Trastuzumab.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors
on each dire... | Invasive Ductal Carcinoma with medullary
pattern
1. Size of tumor: 1.1 cm (pT1c).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 30/10HPF).
3. Intraductal component: present, intratumoral/extratumoral (60%) (nuclear grade:
high, necrosis: present, architectural pattern:
... | HR(−) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 1 | Female/87 years old, post-menopause.
Screen detected mass lesion on left breast subareolar area.
No family history.
Hypertension, diabetes mellitus, arrhythmia,
total knee replacement, cerebrovascular accident. | Report 1:1 Left mammography (Nov. 2020): an irregular
mass with nipple retraction at subareolar area. Report 2: Left breast US (Dec. 2020): a hypervascular irregular mass at subareolar area. US-CNB = IDC. Report 3:Lymphoscintigraphy shows visualized sentinel
lymph nodes in the left axilla. | null | Operation + Letrozole 2.5 mg/day
Operation
Left total mastectomy, sentinel lymph node
biopsy (a) Gross pathology of mastectomy specimen. (b, c) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
Associated with encapsulated papillary
carcinoma.
1. Size of tumor: 2.5 cm (pT2).
2. Histologic grade: 2/3 (tubule formation: 2/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 11/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (30%) (nuclear grade:
low, necrosis: absent... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 2 | Female/61 years old, post-menopause.
Screen detected mass lesion on left breast 2
o’clock direction.
No family history.
Hepatitis B virus carrier, dyslipidemia | Report 1:Left CC mammography (Oct. 2018, Sept. 2020):
negative fnding in 2018. A developing asymmetry at
outer breast in 2020. Report 2:Left breast US (Nov. 2020): a hypoechoic mass at
upper outer quadrant. US-CNB = IDC. Report 3:Breast MRI
(Dec. 2020): an irregular
enhancing mass in the
left breast. Report 4:Lymphosci... | null | Operation + Post-operative radiation therapy + Anastrozole 1 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
1. Size of tumor: 0.8 cm (pT1b).
2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 11/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (20%) (nuclear grade:
low, necrosis: absent, architectural pattern:
cribriform, extensive in... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 3 | Female/78 years old, post-menopause.
Screen detected mass lesion on right breast 10
o’clock direction.
No family history.
L-spine disc herniation. | Report 1:Right mammography (Nov. 2020): two irregular
masses at subareolar area (white arrow) and upper outer
quadrant (black arrow). Report 2: Right breast US (Nov. 2020): two irregular masses at subareolar area (white arrow, US-CNB = IDC) and upper
outer quadrant (black arrow, US-CNB = IDC). Report 3:Breast MRI (Dec.... | null | Operation + Post-operative radiation therapy + Letrozole 2.5 mg/day.Operation
Right breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen (10 o’ clock direction). (c) Gross pathology of lumpectomy
specimen (subareolar area). (b, d) The margins get marked and sliced with diff... | Breast, right 10 o’clock:
Invasive Ductal Carcinoma
1. Size of tumor: 0.9 cm.
2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 11/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (5%) (nuclear grade:
low, necrosis: absent, architectural pattern:
cribri... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 4 | Female/57 years old, post-menopause.
Screen detected mass lesion on right breast 10
o’clock direction.
No family history.
Dyslipidemia.v | Report 1:Right mammography (Nov. 2020): a focal asymmetry at upper outer quadrant. Report 2:Right breast US (Dec. 2020): an irregular hypoechoic mass at upper outer quadrant (white arrow,
US-CNB = IDC). An enlarged lymph node at the right axillary fossa (black arrow). Report 3:Breast MRI (Dec. 2020): an irregular enhan... | null | Right breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
1. Size of tumor: 1.8 cm (pT1c).
2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 17/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (10%) (nuclear grade:
high, necrosis: present, architectural pattern:
solid/comedo, extensiv... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 5 | Female/58 years old, post-menopause.
Screen detected mass lesion on right breast 4
o’clock direction.
No family history.
No comorbidities. | Report 1:. Report 2:Right mammography (Nov. 2020): a focal asymmetry with fne pleomorphic microcalcifcations at lower
inner quadrant. Report 3:Right breast US (Dec. 2020): an irregular
hypoechoic mass. US-CNB = IDC with mucinous
component. Report 4:Breast MRI
(Dec. 2020): a focal
non-mass enhancement
in the right bre... | null | Operation + Adjuvant chemotherapy
(#4 cycles of docetaxel & cyclophosphamide) + Post-operative radiation therapy + Letrozole 2.5 mg/day.
Operation (1st, Dec. 2020)
Right breast conserving surgery, sentinel lymph
node biopsy . 4 (a) Gross pathology of lumpectomy specimen (black arrow). (b) The margins get marked a... | Operation 1: Invasive Ductal Carcinoma
1. Size of tumor: 2.1 cm (pT2).
2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 14/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (20%) (nuclear grade:
low, necrosis: present, architectural pattern:
micropapill... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 6 | Female/51 years old, pre-menopause.
Screen detected mass lesion on right breast 2
o’clock direction.
No family history.
S/P Thyroid benign mass, excision. | Report 1:Right mammography (Oct. 2020): a spiculated
mass with microcalcifcations at upper inner quadrant. Report 2:Right breast US (Oct. 2020): an irregular
hypoechoic mass (white arrow, US-CNB = IDC) with
adjacent smaller masses (not shown). Report 3:Breast MRI
(Nov. 2020): an irregular
enhancing mass (white
arrow)... | null | Operation + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
1. Size of invasive component: 1.8 cm (pT1c).
2. Size of intraductal component: 4.0 cm.
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 11/10 HPF).
4. Intraductal component: present, intratumoral/extratumoral (60%) (nuclear grade:
low, necrosis: ... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 7 | Female/42 years old, pre-menopause.
Screen detected mass lesion on left breast 2:30
and 3 o’clock direction.
No family history.
Depression. | Report 1:Left mammography (Nov. 2020): an irregular
palpable mass (white arrow) and another smaller mass
(black arrow) at upper outer quadrant. Report 2:Left breast US (Nov. 2020): an irregular mass
(white arrow, US-CNB = Mucinous carcinoma) with adjacent smaller masses (black arrows). Report 3:Breast MRI (Nov. 2020): ... | null | Operation + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. 6 (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Mucinous Carcinoma
1. Size of invasive component: 1.8 cm (pT1c).
2. Size of intraductal component: 3.0 cm.
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 6/10 HPF). 4. Intraductal component: present, intratumoral/extratumoral (60%) (nuclear grade:
low, necrosis: absent, ... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 8 | Female/46 years old, pre-menopause.
Screen detected mass lesion on right breast 12
o’clock and left breast 2 o’clock direction.
No family history.
No comorbidities.
BRCA 1 and 2 mutation: not detected. | Report 1:Both mammography (Nov. 2020): irregular mass at upper inner quadrant of the right breast (white arrow) and
upper outer quadrant of the left breast (black arrow). Report 2:Both breast US (Nov. 2020): irregular masses at upper inner quadrant of the right breast (white arrow) and
upper outer quadrant of the left ... | null | Operation + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Right nipple–areolar complex sparing mastectomy, sentinel lymph node biopsy, Left nipple–
areolar complex sparing mastectomy, sentinel
lymph node biopsy.(a) Gross pathology of right mastectomy specimen. (b, c) The margins get marked and sli... | [Right Breast]
Invasive Ductal Carcinoma
1. Size of invasive component: 1.5 cm (pT1c). 2. Size of intraductal component: 3.5 cm.
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 18/10 HPF).
4. Intraductal component: present, intratumoral/extratumoral (60%) (nuclear grade:
... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 9 | Female/55 years old, pre-menopause.
Self-detected palpable mass lesion on left
breast 11 o’clock direction.
Family history of Prostate cancer, paternal
uncle.
No comorbidities. | Report 1:Left mammography (Dec. 2020): an irregular
mass with microcalcifcations at upper inner quadrant. Report 2:Left breast US (Dec. 2020): an irregular
hypoechoic mass with angular margins. US-CNB = IDC. Report 3:Breast MRI (Dec. 2020): an irregular enhancing mass in the left breast. Report 4:Lymphoscintigraphy sho... | null | Operation + Adjuvant chemotherapy
(#4 cycles of docetaxel & cyclophosphamide) + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
ea... | Invasive Ductal Carcinoma
1. Size of tumor: 3.0 cm (pT2).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
3/3, 40/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (25%) (nuclear grade:
high, necrosis: present, architectural pattern:
solid/comedo, extensive... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 10 | Female/50 years old, pre-menopause.
Screen detected mass lesion on left breast 12
o’clock direction.
No family history.
No comorbidities. | Report 1:Left mammography (Nov. 2020): an irregular
hyperdense mass at upper center. Report 2:Left breast US (Nov. 2020): an irregular
hypoechoic mass with spiculated margins. US-CNB = IDC. Report 3:Breast MRI (Dec. 2020): an irregular enhancing mass in the left breast. Enlarged lymph nodes at the left axilla
(white ar... | null | Operation + Adjuvant chemotherapy
(#4 cycles of docetaxel & cyclophosphamide) + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Left breast conserving surgery, axillary lymph
node dissection. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors o... | Invasive Ductal Carcinoma
1. Size of tumor: 2.7 cm (pT2). 2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
3/3, 24/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (20%) (nuclear grade:
high, necrosis: present, architectural pattern:
cribriform/solid/comedo... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 11 | Female/60 years old, post-menopause.
Screen detected mass lesion on upper outer
portion of left breast.
No family history.
Dyslipidemia. | Report 1:Left CC mammography (Nov. 2016, Nov. 2020):
negative fnding in 2016. A new mass at the outer breast in
2020. Report 2:Left breast US (Dec. 2020): an irregular
hypoechoic mass at upper outer quadrant. US-CNB = IDC. Report 3:Breast MRI (Dec. 2020): a rim-enhancing mass in the left breast. Report 4:Lymphoscintigr... | null | Operation + Adjuvant chemotherapy
(#4 cycles of docetaxel & cyclophosphamide) + Post-operative radiation therapy + Letrozole 2.5 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
ea... | Invasive Ductal Carcinoma
1. Size of tumor: 2.5 cm (pT2). 2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
3/3, 29/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (10%) (nuclear grade:
low, necrosis: absent, architectural pattern:
cribriform, extensive int... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 12 | Female/55 years old, pre-menopause.
Screen detected mass lesion on right breast 5
o’clock direction.
No family history.
S/P hysterectomy, dyslipidemia, diabetes mellitus, s/p cervical spine disc operation. | Report 1:Right mammography (Nov. 2020): a spiculated
mass with architectural distortion at lower inner quadrant. Report 2:Right breast US (Dec. 2020): an irregular
hypoechoic mass with non-parallel orientation.
US-CNB = IDC. Report 3:Breast MRI (Dec. 2020): an irregular enhancing mass in the right breast. Report 4:Lymp... | null | Operation + Adjuvant chemotherapy
(#4 cycles of docetaxel & cyclophosphamide) + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
... | Invasive Ductal Carcinoma
1. Size of tumor: 2.3 cm (pT2). 2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 1/3, mitotic count:
1/3, 5/10 HPF).
3. Intraductal component: present, intratumoral/
extratumoral (30%) (nuclear grade: low,
necrosis: present, architectural pattern: solid,
extensive intradu... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 13 | Female/64 years old, post-menopause.
Screen detected mass lesion on left breast 10
o’clock direction.
No family history.
S/P Tuberculosis, S/P appendectomy | Report 1: Mammography (Nov. 2020): an irregular mass
with microcalcifcations at upper inner quadrant of the left
breast. Associated global asymmetry and thickening of
the nipple–areolar complex (black arrow). Enlarged
lymph nodes at the left axilla (white arrows). Report 2:Left breast US (Nov. 2020): an irregular
hypoe... | null | Operation + Adjuvant chemotherapy
(#4 cycles of doxorubicin & cyclophosphamide
followed by #4 cycles of docetaxel) + Postoperative radiation therapy + Letrozole
2.5 mg/day.
Operation
Left modifed radical mastectomy | Invasive Ductal Carcinoma
1. Size of tumor: 5.2 cm (pT3). 2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 10/10 HPF).
3. Intraductal component: present, intratumoral
(5%) (nuclear grade: high, necrosis: present,
architectural pattern: solid/comedo, extensive intraductal c... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 14 | Female/43 years old, pre-menopause.
Screen detected mass lesion on left breast 1
and 3 o’clock direction.
No family history.
No comorbidities. | Report 1:Left mammography (Dec. 2020): a focal asymmetry with microcalcifcations (black arrows) at outer
subareolar area. Report 2: Left breast US (Dec. 2020): an oval isoechoic
mass with microcalcifcations. US-CNB = IDC with
mucinous component. Report 3:Breast MRI (Dec. 2020): a rim-enhancing mass in the left breast... | null | Neoadjuvant therapy (Palbociclib 125 mg/day
& tamoxifen 20 mg/day with goserelin) + Operation + Post-operative radiation
therapy + Letrozole 2.5 mg/day with
goserelin.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and ... | Mucinous Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 2.0 cm (ypT1c).
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 6/10 HPF). 4. Intraductal component: present, intratumoral/extratumoral (30%) (nuclear grade:
low, necrosis: absent, architectural pattern:
cr... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 15 | Female/58 years old, post-menopause.
Screen detected mass lesion on left breast 12
o’clock direction.
No family history.
Hypertension, dyslipidemia, s/p transobturator tape for stress urinary incontinence. | Report 1:Left mammography (Dec. 2020): negative
fnding. Report 2:Left breast US (Dec. 2020): a hypoechoic mass
with non-parallel orientation at upper outer quadrant.
US-CNB = IDC. Report 3:Breast MRI (Dec. 2020): an irregular enhancing mass in the left breast. Report 4:Lymphoscintigraphy shows visualized sentinel
lymph... | null | Operation + Post-operative radiation therapy + Anastrozole 1 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction. | Invasive Ductal Carcinoma
1. Size of tumor: 0.9 cm (pT1b).
2. Histologic grade: 2/3 (tubule formation: 2/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 10/10 HPF).
3. Intraductal component: absent.
4. Skin: no involvement of tumor.
5. Surgical margins:
(a) superior margin: 35 mm.
(b) inferior margin: 10 mm.
(c) medi... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 16 | Female/51 years old, peri-menopause.
Screen detected mass lesion on left breast 2
o’clock direction.
No family history.
No comorbidities. | Report 1:Left mammography (Oct. 2020): one-view
asymmetry at outer breast. Outside US-VABE = IDC (no
available image). Report 2:Left breast US (Dec. 2020): an irregular
hypoechoic area at the VABE site. Report 3:Breast MRI (Dec. 2020): some enhancing foci at the VABE site. Report 4:Lymphoscintigraphy shows visualized s... | null | Operation + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
1. Post-mammotome excision status.
2. Size of tumor: 0.6 cm, residual.
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 1/10 HPF).
4. Intraductal component: present, intratumoral/extratumoral (40%) (nuclear grade:
low, necrosis: absent, architectu... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 17 | Female/50 years old, peri-menopause.
Screen detected mass lesion on left breast 4
o’clock direction.
No family history.
S/P Lumbar spine disc herniation operation,
s/p pain block in lumbar spine.
S/p hormone replacement due to amenorrhea. | Report 1:Left mammography, MLO view (Dec. 2020):
negative fnding. Report 2:Left breast US (Dec. 2020): a small hypoechoic
mass at lower outer quadrant. US-CNB = IDC. Report 3:Breast MRI (Dec. 2020): no suspicious fnding in both breasts. Report 4:Lymphoscintigraphy shows visualized sentinel
lymph nodes in the left axill... | null | Operation + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. 8 (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
1. Size of invasive component: 0.4 cm (pT1a).
2. Size of intraductal component: 3.0 cm.
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 1/10 HPF).
4. Intraductal component: present, extratumoral
(80%) (nuclear grade: low, necrosis: absent,
archit... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 18 | Female/61 years old, post-menopause.
Screen detected microcalcifcation of upper
outer portion on left breast.
No family history.
S/P unilateral salpingo-oophorectomy, s/p
hysterectomy, Hypertension. | Report 1:Left mammography (July 2010): regional amorphous microcalcifcations at upper outer quadrant. Report 2:Breast MRI (Aug. 2010): regional non-mass enhancement at the operative site (white arrow). A benign appearing mass in the right breast (black arrow). Report 3:Lymphoscintigraphy shows visualized sentinel
lymph... | null | Operation (1st & 2nd, Aug. 2010) + Postoperative radiation therapy + Tamoxifen
20 mg/day.
Operation (3rd, Jan. 2021) + Adjuvant chemotherapy (docetaxel & cyclophosphamide) +
Letrozole 2.5 mg/day.
Operation (1st, Aug. 2010)
Left breast excision .(a) Gross pathology of right mastectomy specimen. (b, c and d) The mar... | [Right Breast]
1. Fibroadenoma
2. Sclerosing adenosis with microcalcifcation.
[Left Breast]
Invasive Ductal Carcinoma
1. Post-lumpectomy status.
2. Size of tumor: 2.0 cm (rpT1c). 3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 3/10 HPF).
4. Intraductal component: present,... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 19 | Female/43 years old, pre-menopause.
Screen detected mass lesion of lower inner on
left breast.
No family history.
No comorbidities. | Report 1:Left mammography (Jan. 2021): an irregular
mass at lower inner quadrant. Report 2:Left breast US (Jan. 2021): a hypoechoic mass
with angular margins at lower inner quadrant.
US-CNB = IDC. Report 3:Breast MRI (Jan. 2021): an irregular enhancing mass at lower inner quadrant of the left breast (white arrow,
prove... | null | Operation + Tamoxifen 20 mg/day with leuprolide acetate.
19.3.1 Operation
Left nipple–areolar complex sparing mastectomy
with immediate implant reconstruction, sentinel
lymph node biopsy. (a) Preoperative and (b) immediate post-operative appearance. (a) Gross pathology of mastectomy specimen. (b, c) The margins get mar... | Invasive Ductal Carcinoma
1. Size of tumor: 1.7 cm and 0.5 cm (pT1c(2)).
2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 11/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (20%) (nuclear grade:
low, necrosis: present, architectural pattern:
cribrifor... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 20 | 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). | Report 1:Mammography
(Aug. 2020): An irregular
hyperdense mass in the
center portion of the left
breast. Report 2:Breast US (Aug. 2020): An irregular hypoechoic
mass with microlobulated margins in the left subareolar
area. Enlarged LN of left axilla level I and interpectoral
space (level II). Report 3:Breast MRI (Aug. ... | Report 1:Breast US (Dec. 2020): Mammography (Mar. 2021): mammography after treatment demonstrates residual mass that is decreased in the longest diameter. Report 2:Breast US (Mar. 2021): US after treatment
demonstrates residual isoechoic mass that is decreased in
the longest diameter. Report 3:Breast MRI (Mar. 2021): M... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy. Operation
Left breast conserving surgery, axillary lymph
node sampling. (a) A schematic illustration of tumor location
and axillary lymph node metastasis and (b) breast... | No residual tumor with stromal fbrosis 1. Post-chemotherapy status.
2. Lymph nodes: no metastasis in seven axillary
lymph nodes (ypN0) (sentinel LN: 0/1, nonsentinel LN: 0/6).
3. Microcalcifcation: present, tumoral/
non-tumoral. | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 21 | Female/50 years old, pre-menopause.
Screen detected mass lesion on left breast 1
o’clock direction.
No family history | Report 1: Mammography
(Mar. 2021): grouped
microcalcifcations with
subtle architectural
distortion in left upper outer
quadrant. Enlarged LN, left
axilla. Report 2: Breast US (Mar. 2021): An irregular mass at the
2 o’clock direction of the left breast. Report 3:Breast MRI (Mar. 2021): focal heterogeneous
non-mass enhan... | Report 1:Mammography
(Oct. 2021):
mammography after
treatment demonstrates
residual
microcalcifcations in the
left upper outer quadrant. Report 2:Breast US (Oct. 2021): US after treatment demonstrates residual hypoechoic mass that is decreased in
the longest diameter. Report 3:Breast MRI (Oct. 2021): MRI after treatmen... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy + Letrozole
2.5 mg + Adjuvant capecitabine. Operation
Left breast conserving surgery, axillary lymph
node dissection(a) A schematic illustration of tumor location
and ... | Microinvasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of invasive component: <0.1 cm
(ypT1mi).
3. Size of intraductal component: 2.0 cm.
4. Histologic grade: not applicable.
5. Intraductal component: present, intratumoral/extratumoral (>95%) (nuclear grade:
high, necrosis: present, architectural pattern:... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 22 | 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). | Report 1:Mammography
(Mar. 2021): An oval
hyperdense mass in the upper
outer quadrant of the right
breast. Enlarged lymph nodes in
the right axilla. Report 2:Breast US (Mar. 2021): An irregular hypoechoic
mass at the 10 o’clock direction of the right breast. Report 3:Breast MRI (Mar. 2021): An irregular enhancing mass ... | Report 1: Mammography
(Sep. 2021):
mammography after
treatment demonstrates
residual mass that is
decreased in the longest
diameter. A clip marker
(black arrow) was seen
within the residual mass. Report 2:Breast US (Sep. 2021): US after treatment demonstrates residual hypoechoic mass that is decreased in
the longest di... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy + Adjuvant
capecitabine. Operation
Right breast conserving surgery, sentinel lymph
node biopsy. (a) A schematic illustration of tumor location
and axillary lymph node ... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 0.9 cm (ypT1b).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 11/10HPF).
4. Intraductal component: absent.
5. Skin: no involvement of tumor.
6. Surgical margins:
(a) Superior margin: 25 mm.
(b) Inf... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 23 | 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). | Report 1:Mammography
(Aug. 2020): An irregular
hyperdense mass in the
upper portion of the right
breast (marked by BB
marker). Enlarged lymph
nodes in the right axilla. Report 2:Breast US (Aug. 2020): An irregular hypoechoic
mass at the 12 o’clock direction of the right breast. Report 3:Breast MRI (Aug. 2020): An irreg... | Report 1:Mammography
(Mar. 2021):
mammography after
treatment demonstrates no
residual mass. A clip
marker (white arrow) was
seen at the tumor bed. Report 2:Breast US (Mar. 2021): US after treatment
demonstrates residual hypoechoic mass that is decreased
in the longest diameter. A clip marker (arrow) was seen
around th... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy. Operation
Right breast conserving surgery, sentinel lymph
node biopsy (a) A schematic illustration of tumor location
and (b) breast and axillary incision lines on right... | No residual tumor with foamy histiocytic
collection
1. Post-chemotherapy status.
2. Lymph nodes: no metastasis in one axillary
lymph node (ypN0(sn)) (sentinel LN: 0/1).
Note: Histologic mapping has been done | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 24 | 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). | Report 1:Mammography
(Apr. 2021): An oval
isodense mass in the upper
outer quadrant of right
breast (marked by BB
marker). Report 2:Breast US (Apr. 2021): An oval hypoechoic
mass at the 10 o’clock direction of the right breast. Report 3:Breast MRI (Apr. 2021): An irregular heterogeneous enhancing mass with associated n... | Report 1:Mammography
(Sep. 2021): An irregular
hyperdense mass in the
upper outer quadrant of
the right breast, showing
interval increase in size. Report 2:Breast US (Sep. 2021): US after treatment demonstrates the irregular hypoechoic mass that is increased
in the longest diameter. Report 3:Breast MRI (Sep. 2021): MRI... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of paclitaxel) + Operation + Postoperative radiation therapy + Adjuvant
capecitabine. Operation
Right breast conserving surgery, sentinel lymph
node biopsy (a) A schematic illustration of tumor location
and (b) breast and axill... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 2.7 cm (ypT2).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 54/10HPF).
4. Intraductal component: present, intratumoral/extratumoral (5%) (nuclear grade:
high, necrosis: absent, architectural patte... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 25 | 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. | Report 1: Mammography
(Apr. 2021): An irregular
isodense mass in the
upper outer quadrant of
the left breast. Report 2:Breast US (Apr. 2021): An irregular hypoechoic
mass at the 2 o’clock direction of the left breast. Report 3:Breast MRI (Apr. 2021): An irregular enhancing mass at the 2 o’clock direction of the left br... | Report 1:Mammography
(Oct. 2021):
mammography after
treatment demonstrates the
residual mass that is
decreased in the longest
diameter. Report 2:Breast US (Oct. 2021): US after treatment demonstrates the residual hypoechoic mass that is decreased
in the longest diameter. Report 3:Breast MRI (Oct. 2021): MRI after treat... | Neoadjuvant chemotherapy (#4 cycles of doxorubicin and cyclophosphamide + #4 cycles of
docetaxel) + Operation + Post-operative radiation therapy + Adjuvant capecitabine. Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) A schematic illustration of tumor location
and (b) breast and axillary incis... | Invasive Ductal Carcinoma with (a) focal squamous differentiation, (b) focal papillary pattern.
1. Post-chemotherapy status.
2. Size of tumor: 1.2 cm (ypT1c).
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
1/3, <1/10HPF).
4. Intraductal component: present, intratumoral/
extra... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 26 | 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 salpingooophorectomy, s/p left shoulder operation.
BRCA 1 mutation carrier. | Breast, right, needle biopsy: Invasive ductal carcinoma, histologic grade 3 with medullary pattern.. Report 1:Mammography
(Apr. 2021): An irregular
hyperdense mass in the upper
outer quadrant of the right
breast. Report 2:Breast US (Apr. 2021): An irregular hypoechoic
mass at the 10 o’clock direction of the right breas... | Report 1:Mammography
(Oct. 2021):
mammography after
treatment demonstrates no
residual mass. Report 2:Breast US (Oct. 2021): US after treatment demonstrates no residual mass. Report 3:Breast MRI (Jun. 2021): MRI after treatment
shows complete resolution of enhancement in the right
breast. | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #3
cycles of docetaxel + Trastuzumab) + Operati
on + Adjuvant capecitabine + Trastuzumab. Operation
Robotic bilateral nipple-areolar complex sparing
mastectomy, bilateral sentinel lymph node biopsy. (a) Preoperative and (b) postoperative appea... | <Right Breast>
No residual tumor with stromal fbrosis
1. Post-chemotherapy status.
2. Lymph nodes: no metastasis in two axillary
lymph nodes (ypN0(sn)) (sentinel LN: 0/2).
<Left Breast>
Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 1.8 cm (ypT1c).
3. Histologic grade: 2/3 (tubule formation: 3... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 27 | 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). | Report 1:Mammography
(May. 2021): An irregular
hyperdense mass in the
upper outer quadrant of
left breast (marked by BB
marker). Enlarged lymph
nodes in the left axilla. Report 2:Breast US (May. 2021): An irregular hypoechoic
mass at the 2 o’clock direction of the left breast. Report 3:Breast MRI (May. 2021): Two irreg... | Report 1:Mammography (Nov. 2021): mammography after treatment demonstrates residual mass that is decreased in
the longest diameter. A clip marker (black arrow) was seen within the residual mass. Report 2:Breast MRI (Nov . 2021): MRI after treatment
demonstrates residual enhancing mass (white arrow) that
is decreased in... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy + Adjuvant
capecitabine. Operation
Left breast conserving surgery, axillary lymph
node sampling. (a) A schematic illustration of tumor location
and lymph node metastas... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 2.8 cm (ypT2).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 14/10HPF).
4. Intraductal component: absent.
5. Skin: no involvement of tumor.
6. Surgical margins:
(a) Superior margin: 5 mm.
(b) Infer... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 28 | Female/57 years old, post-menopause.
Self-detected palpable mass lesion on right.
No family history.
S/P right neck excision (due to
lymphadenitis). | Report 1:Mammography
(Sep. 2020): An irregular
hyperdense mass in the upper
outer quadrant of the right
breast. Report 2:Breast US (Sep. 2020): An irregular hypoechoic
mass in the upper outer quadrant of the right breast. Report 3:Breast MRI (Apr. 2021): An irregular enhancing mass in the upper outer quadrant of the ri... | null | Operation + Post-operative radiation therapy
(Adjuvant chemotherapy refuse). Operation
Right breast conserving surgery. (a) A schematic illustration of tumor location. (b) Breast and axillary incision lines on right breast. (c) Gross
pathology of lumpectomy specimen. (d) The margins get marked and sliced with different... | Malignant Adenomyoepithelioma (EpithelialMyoepithelial Carcinoma)
1. Size of tumor: 2.0 cm (pT1c). 2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
3/3, 23/10HPF).
3. Intraductal component: absent.
4. Skin: no involvement of tumor.
5. Surgical margins:
(a) Superior margin: 10 m... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 29 | 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. | Report 1:Mammography
(May. 2021): An irregular
hyperdense mass with fne
pleomorphic
microcalcifcations in the
upper center portion of the left
breast. Report 2:Breast US (May. 2021): An irregular hypoechoic
mass with microcalcifcations at the 11 o’clock direction
of the left breast. Report 3:Breast MRI (May. 2021): An ... | Report 1:Mammography
(Nov. 2021): mammography
after treatment demonstrates
residual microcalcifcations. Report 2:Breast MRI (Nov. 2021): MRI after treatment
shows complete resolution of enhancement in the left
breast. Report 3:Lymphoscintigraphy shows visualized sentinel
lymph nodes in the left axilla. | Neoadjuvant chemotherapy (#4 cycles of doxorubicin and cyclophosphamide + #4 cycles of
docetaxel) + Operation + Post-operative radiation therapy + Adjuvant capecitabine. Operation
Left breast conserving surgery, axillary lymph
node dissection. (a) A schematic illustration of tumor location
and lymph node metastasis. (b... | Microinvasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: <0.1 cm (ypT1mi).
3. Histologic grade: not applicable.
4. Intraductal component: absent.
5. Skin: no involvement of tumor.
6. Surgical margins:
(a) Superior margin: 10 mm.
(b) Inferior margin: 10 mm.
(c) Medial margin: 10 mm.
(d) Lateral marg... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 30 | Female/69 years old, post-menopause.
Self-detected palpable mass lesion on left
breast.
No family history. h/o Tuberculosis, s/p thoracic vertebra compression fracture. | Report 1:Mammography (Apr. 2021): An obscured hyperdense mass in the upper portion of the left breast (marked by BB marker). Report 2:Breast US (Apr. 2021): An irregular hypoechoic
mass at the 12 o’clock direction of the left breast. Report 3:Breast MRI (Apr. 2021): An irregular rim enhancing mass at the 12 o’clock dir... | Report 1:PET-CT
shows a hypermetabolic
mass in left breast
(mSUV = 11.6). Report 2:Mammography (Aug. 2021): Mammography after treatment demonstrates the hyperdense mass that shows
interval increase in size. Report 3:Breast US (Aug. 2021): US after treatment
demonstrates the irregular hypoechoic mass that is
increased i... | Neoadjuvant chemotherapy (#2 cycles of
doxorubicin and cyclophosphamide + #3
cycles of paclitaxel) + Operation + Adjuvant
capecitabine. Operation
Left modifed radical mastectomy, sentinel lymph
node biopsy (a) Gross pathology of mastectomy specimen. (b, c) The margins get marked and sliced with different colors on e... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 3.5 cm (ypT2).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 4/1HPF).
4. Intraductal component: present, extratumoral
(5%) (nuclear grade: high, necrosis: absent,
architectural pattern: solid, exte... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 31 | 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). | Report 1:Mammography
(Oct. 2020): An obscured
mass in the upper outer
quadrant of the right breast. Report 2:Breast US (Oct. 2020): An irregular heterogeneous echoic mass with posterior acoustic enhancement at
the 9 o’clock direction of the right breast. Report 3:Breast MRI (Oct. 2020): An irregular rim
enhancing mass ... | Report 1:Mammography (Apr. 2021): mammography after treatment demonstrates residual mass that is decreased in
the longest diameter. Report 2:Breast US (Apr. 2021): US after treatment demonstrates residual hypoechoic mass that is decreased in
the longest diameter. Report 3:Breast MRI (Apr. 2021): MRI after treatment
dem... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy + Adjuvant
capecitabine. Operation
Right breast conserving surgery, axillary lymph
node sampling. (a) Gross pathology of lumpectomy specimen. (b) The margins get marke... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 0.9 cm (ypT1b).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 18/10HPF).
4. Intraductal component: absent.
5. Skin: no involvement of tumor.
6. Surgical margins:
(a) Superior margin: 38 mm.
(b) Inf... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 32 | Female/49 years old, pre-menopause.
Self-detected mass lesion on left breast.
Family history of breast cancer, aunt and
cousin (paternal).
Family history of prostate cancer, father. Hyperthyroidism.
BRCA 1 and 2 mutation: Not detected. | Report 1:4 Mammography
(Nov. 2020): A huge
hyperdense mass in left
breast. Enlarged lymph
node in the left axilla. Report 2:Breast US (Nov. 2020): A huge irregular heterogeneous echoic mass with direct skin invasion (white
arrow) in the left breast. Report 3:Breast MRI (Nov. 2020): A huge irregular heterogeneous enhanc... | null | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4 cycles
of docetaxel) + Operation + Post-operative
radiation therapy + Adjuvant capecitabine. Operation
Left modifed radical mastectomy, axillary lymph
node dissection. (a) Gross pathology of lumpectomy specimen. (b, c) The margins get mar... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 2.7 cm (ypT2).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 20/10HPF).
4. Intraductal component: absent.
5. Skin: dermal involvement of tumor. 6. Nipple: no involvement of tumor.
7. Surgical margi... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 33 | Female/79 years old, post-menopause.
Screen detected mass lesion on left breast 12
o’clock direction.
No family history.
S/P paraffn injection, s/p appendectomy, s/p
hysterectomy, s/p hemicolectomy (colon cancer).
S/P radical total gastrostomy (advanced gastric cancer).
BRCA 1 and 2 mutation: Not detected,
BARD1 VUS (v... | Report 1:Mammography: multiple rim calcifcations and hyperdense masses in the left breast (patient with history of foreign body injection for cosmetic augmentation. Report 2:Breast MRI: irregular heterogeneous enhancing masses in the upper portion of the left breast. Report 3:Lymphoscintigraphy shows visualized sentine... | null | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy. Operation
Left breast conserving surgery, sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different c... | Atypical ductal hyperplasia, focal
1. Post-chemotherapy status.
2. Lymph nodes: no metastasis in one axillary
lymph node (ypN0(sn)) (sentinel LN: 0/1). | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 34 | Female/79 years old, post-menopause.
Screen detected mass lesion on left breast 12
o’clock direction.
No family history.
S/P paraffn injection, s/p appendectomy, s/p
hysterectomy, s/p hemicolectomy (colon cancer).
S/P radical total gastrostomy (advanced gastric cancer).
BRCA 1 and 2 mutation: Not detected,
BARD1 VUS (v... | Report 1:Mammography: multiple rim calcifcations and hyperdense masses in the left breast (patient with history of foreign body injection for cosmetic augmentation. Report 2:Breast MRI: irregular heterogeneous enhancing masses in the upper portion of the left breast. Report 3:Lymphoscintigraphy shows visualized sentine... | null | Operation + Adjuvant chemotherapy (#1
cycles of docetaxel and cyclophosphamide,
stop d/t mucositis). Operation
Left modifed radical mastectomy, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b, c, d) The margins get marked and sliced with different colors on each direction. | Invasive Ductal Carcinoma associated with
paraffnoma
1. Size of tumor: 3.0 cm (pT2). 2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 8/10HPF).
3. Intraductal component: absent.
4. Skin and nipple: no involvement of tumor.
5. Surgical margins:
(a) Deep margin: 10 mm.
(b) S... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 35 | Female/75 years old, post-menopause. Screen detected mass lesion on left breast 2 o’clock direction. No family history. Hypertension, Hyperlipidemia, s/p hysterectomy, arrhythmia (s/p operation). | Report 1:Mammography (May 2021): A focal asymmetry at the 3 o’clock direction of the left breast. Report 2:Breast US (May. 2021): An irregular hypoechoic
mass with echogenic halo at the 3 o’clock direction of the
left breast. Report 3: Breast MRI (May. 2021): An irregular enhancing mass at the 3 o’clock direction of th... | null | Left breast conserving surgery (nautilus trial:
sentinel lymph node biopsy skip arm) (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colorson each direction | Invasive Ductal Carcinoma with apocrine
differentiation
1. Size of tumor: 1.1 cm (pT1c).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 6/10HPF).
3. Intraductal component: present, extratumoral
(10%) (nuclear grade: high, necrosis: present, architectural pattern: cribrif... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 36 | Female/46 years old, pre-menopause.
Self-detected palpable mass lesion on left
axillary.
Family history of breast cancer, aunt
(maternal).
Hepatitis B virus carrier.
BRCA 1 and 2 mutation: Not detected, RET
VUS (variant of uncertain). | Report 1:Mammography (Jun. 2021): A focal asymmetry with microcalcifcations in the upper outer quadrant of left breast (marked by BB marker). Multiple lymph nodes (black arrow) in left axilla. Report 2: Breast US (Jun. 2021): An irregular hypoechoic mass with microcalcifcations at the 2 o’clock direction of the left br... | Report 1: 4 Mammography
(Nov. 2021): mammography
after treatment demonstrates
residual mass that is
decreased in size. Decrease in
size of previously enlarged
lymph nodes in the left axilla
(black arrow). Report 2:Breast MRI (Nov. 2021): MRI after treatment
shows complete resolution of enhancement in the left
breast. R... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4 cycles
of docetaxel) + Operation + Post-operative
radiation therapy. Operation Left breast conserving surgery, sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different co... | 1. No residual tumor with foamy histiocytic
collection.
(a) Post-chemotherapy status.
(b) Lymph nodes: no metastasis in two axillary lymph nodes (ypN0(sn)) (sentinel
LN: 0/2).
(c) Related slides: S21–10541, S21–10544.
2. Adenomyoepithelial hyperplasia with
microcalcifcation. | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 37 | Female/46 years old, pre-menopause.
Self-detected palpable mass lesion on right breast.
Family history of breast cancer, aunt (maternal).
s/p myomectomy.
BRCA 1 and 2 mutation: Not detected. | Report 1: Mammography (Jun. 2021):
An irregular hyperdense mass with
microcalcifcations in the upper outer
quadrant of the right breast (marked
by BB marker). Report 2:Breast US (Jun. 2021): An irregular hypoechoic
mass with microcalcifcation at the 10 o’clock direction of
the right breast. Report 3: Breast MRI (Jun. 2... | Report 1: Mammography
(Dec. 2021): Mammography
after treatment demonstrates
residual mass that is decreased
in the longest diameter. Report 2: Breast US (Dec. 2021): US after treatment
demonstrates residual hypoechoic mass with microcalcifcations that is decreased in the longest diameter. Report 3:Breast MRI (Dec. 2021... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy + Adjuvant
capecitabine. Operation
Right breast conserving surgery, sentinel lymph
node biopsy. | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of invasive component: up to 0.3 cm,
multifocal (ypT1a).
3. Size of intraductal component: 2.0 cm.
4. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 3/HPF).
5. Intraductal component: present, intratumoral/extra... | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 38 | Female/52 years old, post-menopause.
Self-detected palpable mass lesion on right
breast.
No family history.
s/p bilateral salpingo-oophorectomy.
BRCA 1 mutation carrier. | Report 1: Mammography
(Jun. 2021): An irregular
hyperdense mass with fne
pleomorphic in the upper
portion of the right breast. Report 2: Breast US (Jun. 2021): An irregular hypoechoic
mass with microcalcifcation at the 12 o’clock direction of
the right breast. Report 3: Breast MRI (Jun. 2021): An irregular enhancing ma... | Report 1: Mammography
(Dec. 2021): mammography
after treatment demonstrates
residual mass that is decreased
in the longest diameter. Report 2: Breast US (Dec. 2021): US after treatment
demonstrates residual hypoechoic mass that is decreased
in the longest diameter. Report 3: Breast MRI (Dec. 2021): MRI after treatment
... | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin and cyclophosphamide + #4
cycles of docetaxel) + Operation + Postoperative radiation therapy. Operation
Bilateral nipple-areolar complex sparing mastectomy+ implant reconstruction, sentinel lymph
node biopsy (right)(a) Preoperative and (b) postoperative appearan... | No residual tumor with stromal degeneration
1. Post-chemotherapy status.
2. Lymph nodes: no metastasis in one axillary
lymph node (ypN0(sn)) (sentinel LN: 0/1).
3. Microcalcifcation: present. | HR(−) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 1 | Female/47 years old, pre-menopause.
Screen detected mass lesion on left breast 5
o’clock direction.
No family history.
No comorbidities. | Report 1: Left mammography (Dec. 2020): an irregular
mass with microcalcifcations at lower outer quadrant . Report 2: Left breast US (Dec. 2020): multiple hypoechoic
masses at lower outer quadrant. US-CNB = IDC. Report 3: Breast MRI (Dec. 2020): an irregular enhancing mass in the left breast. Report 4: Post-NAC breast ... | null | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Tamoxifen
20 mg/day.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sl... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of invasive component: 0.2 cm (pT1a).
3. Size of intraductal component: 1.0 cm.
4. Histologic grade:1/3 (tubule formation: 2/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 4/10 HPF).
5. Intraductal component: present, extratumoral
(99%) (nuclear grade: h... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 2 | Female/42 years old, pre-menopause.
Screen detected mass lesion on left breast
1:30 and 2 o’clock direction.
No family history.
S/P Cervical spine disc operation. | Report 1: Left mammography (Dec. 2020): no discernible
focal lesion at the palpable area at upper outer quadrant. Report 2: Left breast US (Jan. 2021): multiple masses with
microlobulated margins at upper outer quadrant.
US-CNB = IDC. Report 3: Breast MRI (Jan. 2021): multiple enhancing masses in the left breast. Repor... | null | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab
emtansine + Tamoxifen 20 mg/day.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen (black arr... | 1. Microinvasive ductal carcinoma.
(a) Post-chemotherapy status.
(b) Size of tumor: <0.1 cm (ypT1mi). (c) Histologic grade: 2/3 (tubule formation:
3/3, nuclear pleomorphism: 2/3, mitotic
count: 2/3, 11/10 HPF).
(d) Intraductal component: absent.
(e) Skin: no involvement of tumor.
(f) Surgical margins:
• superior margin... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 3 | Female/58 years old, post-menopause.
Screen detected mass lesion on right breast 7
o’clock direction.
No family history.
Dyslipidemia. | Report 1: Right mammography (Dec. 2020): an irregular
mass at lower outer quadrant. Report 2: Right breast US (Dec. 2020): an irregular
hypoechoic mass. US-CNB = IDC. Report 3: Breast MRI (Jan. 2021): an irregular enhancing mass in the right breast. Report 4: Lymphoscintigraphy shows visualized sentinel
lymph nodes in ... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Letrozole 2.5 mg/day. | Invasive Ductal Carcinoma
1. Size of tumor: 1.8 cm (pT1c).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 10/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (10%) (nuclear grade:
high, necrosis: present, architectural pattern:
solid/comedo, extensiv... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 4 | Female/56 years old, post-menopause.
Screen detected mass lesion on right breast 12
o’clock direction.
No family history.
S/P Thyroid radiofrequency ablation. | Report 1: Right mammography (Dec. 2020): grouped fnepleomorphic microcalcifcations (white arrow) and an asymmetry (black arrow) at upper center. Report 2: Right breast US (Dec. 2020): a hypoechoic mass
with non-parallel orientation (black arrow) and adjacent
microcalcifcations (white arrows). US-CNB = IDC. Report 3: Br... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation therapy + Letrozole 2.5 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors... | Invasive Ductal Carcinoma
1. Size of tumor: 0.6 cm (pT1b).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 10/10 HPF).
HR(+) HER2(+) Breast Cancer
310
Fig. 19 Right mammography (Dec. 2020): grouped fnepleomorphic microcalcifcations (white arrow) and an
asymmetry (black ar... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 5 | Female/53 years old, peri-menopause.
Screen detected mass lesion on right breast 12
o’clock direction.
No family history.
Hypothyroidism, dyslipidemia, s/p cold knife
conization of cervix. | Report 1: Right mammography (Jan. 2021): a focal asymmetry at upper inner quadrant. Report 2: Right breast US (Jan. 2021): a hypoechoic mass
with microlobulated margins. US-CNB = IDC. Report 3: Breast MRI (Jan. 2021): an irregular enhancing mass in the right breast. Report 4: Lymphoscintigraphy shows visualized sentine... | null | Operation + Adjuvant chemotherapy (#4
cycles of docetaxel and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Tamoxifen 20 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with diffe... | Invasive Ductal Carcinoma
1. Size of tumor: 1.5 cm (pT1c).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 3/HPF).3. Intraductal component: present, intratumoral/extratumoral (20%) (nuclear grade:
high, necrosis: present, architectural pattern:
solid/comedo, extensive int... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 6 | Female/42 years old, pre-menopause.
Screen detected mass lesion on right breast 12
o’clock direction.
No family history.
Hypertension. | Report 1:Left mammography (Dec. 2020): an obscured
mass at upper outer quadrant. Report 2: Left breast US (Dec. 2020): an irregular
hypoechoic mass. US-CNB = IDC. Report 3: Breast MRI (Dec. 2020): an irregular enhancing mass in the left breast. Report 4: PET-CT shows
(a) a hypermetabolic
mass in the left upper
outer br... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Tamoxifen 20 mg/day. Operation: Left breast conserving surgery,
sentinel lymph node biopsy. Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with differen... | 1. Invasive ductal carcinoma.
(a) Size of tumor: 1.5 cm (pT1c).
(b) Histologic grade: 3/3 (tubule formation:
3/3, nuclear pleomorphism: 3/3, mitotic
count: 3/3, 5/HPF).(c) Intraductal component: present, intratumoral/extratumoral (10%) (nuclear grade:
high, necrosis: present, architectural pattern: solid/comedo, extens... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 7 | Female/50 years old, pre-menopause.
Screen detected mass lesion on left breast 3
o’clock direction.
No family history.
Paroxysmal supraventricular tachycardia, s/p
atrial septal defect closure.
S/P thyroid lobectomy (thyroid cancer). | Report 1: Left mammography (Aug. 2020): a focal asymmetry at outer breast. Report 2: Left breast US (Sep. 2020): an irregular hypoechoic mass. US-CNB = IDC. Report 3: Breast MRI (Sep. 2020): an enhancing mass with central necrosis in the left breast. Report 4: Post-NAC breast MRI (Feb. 2021): a residual focal non-mass ... | null | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab
emtansine + Tamoxifen 20 mg/day.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy. ) Gross pathology of lumpectomy specimen. (b) The mar... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 1.1 cm (ypT1c).
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 6/10 HPF).
HR(+) HER2(+) Breast Cancer
320
Fig. 36 Left mammography (Aug. 2020): a focal asymmetry at outer breast
Fig. 37 Left breast ... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 8 | Female/61 years old, post-menopause.
Screen detected mass lesion on right breast 9
o’clock direction.
No family history.
Hypertension, s/p cholecystectomy,
arrhythmia. | Report 1: Right mammography (Dec. 2020): negative
fnding. Report 2: Right breast US (Jan. 2021): an irregular
hypoechoic mass at 9 o’clock direction. Outside
US-CNB = ADH. Excision = IDC. Report 3: Lymphoscintigraphy shows visualized sentinel
lymph nodes in the left axilla. Report 4: Breast MRI (Mar. 2021): post-operat... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Letrozole 2.5 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with di... | 1. No residual tumor with foreign body
reaction.
(a) Post-excision status.
(b) Lymph nodes: no metastasis in one axillary lymph node (pN0(sn)) (sentinel LN:
0/1).
2. Intraductal papilloma. | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 9 | Female/44 years old, pre-menopause. Screen detected mass lesion on left breast 7 o’clock direction. Family history of breast cancer, two sisters. Family history of pancreatic cancer, mother. No other history of disease, operation, or medication. BRCA 1 and 2 mutation: Not detected, RAD50 VUS (variant of uncertain). | Report 1: Left mammography (Jan. 2021): an irregular
mass at lower inner quadrant. Report 2: Left breast US (Jan. 2021): a hypoechoic mass
with microlobulated margins. US-CNB = IDC. Report 3: Breast MRI (Jan. 2021): an irregular enhancing mass in the left breast. | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation
therapy + Trastuzumab.
Operation: Left breast conserving surgery. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on
each direction | Invasive Ductal Carcinoma
1. Size of tumor: 1.3 cm (pT1c).
2. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
3/3, 4/HPF).
3. Intraductal component: present, intratumoral/extratumoral (30%) (nuclear grade:
high, necrosis: present, architectural pattern:
solid/comedo, extensive in... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 10 | Female/32 years old, pre-menopause.
Self-detected skin changes and mass lesion on
left breast.
Family history of breast cancer, maternal aunt.
No comorbidities.
BRCA 1 and 2 mutation: Not detected, NBN
and PALB2 VUS (variant of uncertain). | Report 1: Left mammography (Mar. 2021): an irregular
mass with microcalcifcations at upper inner quadrant. Report 2: Left breast US (Mar. 2021): an oval breast mass
(white arrow, US-CNB = IDC) with multiple enlarged
lymph nodes at ipsilateral axilla (US-CNB = metastatic
ductal carcinoma), internal mammary chain, and ... | null | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab
emtansine + Letrozole 2.5 mg/day with
goserelin. Operation: Left modifed radical mastectomy. Gross pathology of mastectomy specimen. (b, c) The margins ge... | 1. Invasive Ductal Carcinoma.
(a) Post-chemotherapy status.
(b) Size of tumor: 3.0 cm (ypT2).
(c) Histologic grade: 2/3 (tubule formation:
3/3, nuclear pleomorphism: 3/3, mitotic
count: 1/3, 3/10 HPF).
(d) Intraductal component: present, intratumoral/extratumoral (5%) (nuclear grade:
high, necrosis: present, architectu... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 11 | Female/60 years old, post-menopause.
Screen detected microcalcifcation on upper
outer portion of right breast.
No family history.
Hypertension. | Report 1: Right mammography (Oct. 2020): an irregular
mass (white arrow) with adjacent microcalcifcations
(black arrow). Report 2: MG-guided needle localization and excision
(Jan. 2021): retrieval of the microcalcifcations (black
arrow) and mass (white arrow) in the surgical specimen. Report 3: Breast MRI (Feb. 2021): ... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Letrozole 2.5 mg/day.
Operation: Right breast conserving surgery
(frst operation), sentinel lymph node biopsy
(second operation) (a) Gross pathology of lumpectomy specimen. (b) The ma... | 1. Invasive Ductal Carcinoma.
(a) Size of tumor: 1.1 cm (pT1c).
(b) Histologic grade: 2/3 (tubule formation:
3/3, nuclear pleomorphism: 2/3, mitotic
count: 1/3, 2/10HPF).
(c) Intraductal component: present, intratumoral (20%) (nuclear grade: low, necrosis: absent, architectural pattern:
cribriform, extensive intraducta... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 12 | Female/63 years old, post-menopause.
Screen detected mass lesion on left breast 10
o’clock direction.
No family history.
s/p Idiopathic thrombocytopenic purpura
(2020). | Report 1: Left mammography (Sep. 2020): an irregular
mass at upper inner quadrant. Report 2: Left breast US (Oct. 2020): an irregular
hypoechoic mass. US-CNB = IDC. Report 3: Breast MRI (Oct. 2020): an irregular enhancing mass in the left breast. Report 4: Post-NAC breast MRI and US (Mar. 2021): decreased size of the t... | null | Neoadjuvant chemotherapy (#1 cycle of
docetaxel and carboplatin and trastuzumab
and pertuzumab followed by #5 cycles of
docetaxel and carboplatin) + Operation +
Adjuvant chemotherapy (doxorubicin and
cyclophosphamide) + Post-operative radiation
therapy + Letrozole 2.5 mg/day.
Operation: Left breast conserving surger... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 0.3 cm (ypT1a).
3. Histologic grade: 3/3 (tubule formation: 3/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 11/10HPF).
4. Intraductal component: present, intratumoral/extratumoral (50%) (nuclear grade:
high, necrosis: absent, architectural pat... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 13 | Female/51 years old, peri-menopause.
Screen detected mass lesion on portion of
lower of right breast.
Family history of breast cancer, sister.
Hypothyroidism (taking on synthroid).
BRCA 1 and 2 mutation: Not detected. | Report 1: Right mammography (Mar. 2021): an irregular
mass with microcalcifcations at lower outer quadrant. Report 2: Right breast US (Mar. 2021): an irregular
enhancing mass at 7 o’clock direction (white arrow,
US-CNB = IDC). Two isoechoic masses with non-parallel
orientation at 12 o’clock direction (black arrows,
US-... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide
followed by #4 cycles of docetaxel and trastuzumab) + Post-operative radiation therapy + Trastuzumab + Tamoxifen 20 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy Right mammography (Mar. 2021): an irregu... | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide
followed by #4 cycles of docetaxel and trastuzumab) + Post-operative radiation therapy + Trastuzumab + Tamoxifen 20 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 14 | Female/51 years old, peri-menopause.
Screen detected mass lesion on portion of
lower of right breast.
Family history of breast cancer, sister.
Hypothyroidism (taking on synthroid).
BRCA 1 and 2 mutation: Not detected. | Report 1: Right mammography (Mar. 2021): an irregular
mass with microcalcifcations at lower outer quadrant. Report 2: Right breast US (Mar. 2021): an irregular
enhancing mass at 7 o’clock direction (white arrow,
US-CNB = IDC). Two isoechoic masses with non-parallel
orientation at 12 o’clock direction (black arrows,
US-... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide
followed by #4 cycles of docetaxel and trastuzumab) + Post-operative radiation therapy + Trastuzumab + Tamoxifen 20 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy | Invasive Ductal Carcinoma
1. Size of tumor: 1.5 cm (pT1c(m)).
2. Histologic grade: 2/3 (tubule formation: 2/3,
nuclear pleomorphism: 3/3, mitotic count:
2/3, 11/10 HPF). 3. Intraductal component: present, intratu- lymph nodes in the right axilla
moral/extratumoral (50%) (nuclear grade:
high, necrosis: present, architec... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 15 | Female/42 years old, pre-menopause.
Self-detected palpable mass lesion on right
breast 6 o’clock direction.
Family history of breast cancer, maternal aunt.
No comorbidities.
BRCA 1 and 2 mutation: Not detected. | Report 1: Right mammography (Mar. 2021): linear distributed microcalcifcations (black arrows) with an asymmetry (white arrow). Report 2: Right breast US (Mar. 2021): an irregular
hypoechoic mass (white arrow) with microcalcifcations
(black arrow). US-CNB = IDC. Report 3: Breast MRI (Mar. 2021): an irregular enhancing m... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Tamoxifen 20 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy. Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with differe... | 1. Invasive Ductal Carcinoma with apocrine
differentiation.
(a) Size of tumor: 1.3 cm (pT1c).
(b) Histologic grade: 2/3 (tubule formation:
3/3, nuclear pleomorphism: 2/3, mitotic
count: 1/3, 5/10 HPF).
(c) Intraductal component: present, intratumoral/extratumoral (15%) (nuclear grade:
low, necrosis: absent, architectur... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 16 | Female/54 years old, peri-menopause.
Self-detected palpable mass lesion on right
breast 6 o’clock direction.
No family history.
Diabetes mellitus, S/P hysterectomy,
agoraphobia. | Report 1: Right mammography (Mar. 2021): an irregular
mass at lower outer quadrant. Report 2: Right breast US (Apr. 2021): an irregular
hypoechoic mass. US-CNB = IDC. Report 3:Breast MRI (Apr. 2021): an irregular enhancing mass in the right breast. Report 4: Lymphoscintigraphy shows visualized sentinel
lymph nodes in t... | null | Operation + Adjuvant chemotherapy (#4
cycles of docetaxel and cyclophosphamide) + Post-operative radiation therapy + Trastuzumab + Letrozole 2.5 mg/day.
Operation: Right breast conserving surgery,
sentinel lymph node biopsy . (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with dif... | 1. Invasive Ductal Carcinoma.
(a) Size of tumor: 1.1 cm (pT1c).
(b) Histologic grade: 3/3 (tubule formation:
3/3, nuclear pleomorphism: 3/3, mitotic
count: 2/3, 10/10 HPF).
(c) Intraductal component: present, extratumoral (30%) (nuclear grade: high, necrosis: present, architectural pattern:
papillary/cribriform, extens... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 17 | Female/38 years old, post-menopause.
Self-detected palpable mass lesion on left
breast 1 o’clock direction.
Family history of prostate cancer, maternal
father.
S/P salpingo-oophorectomy (2022).
BRCA 2 mutation carrier. | Report 1: Left mammography (Apr. 2021): a focal asymmetry with microcalcifcations at upper outer quadrant. Report 2: Left breast US (Apr. 2021): an irregular mass
with angular margins. US-CNB = IDC. Report 3: Breast MRI (Apr. 2021): an irregular enhancing mass in the left breast (white arrow). Linear non-mass
enhanceme... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide) + Trastuzumab + Tamoxifen 20 mg/day.
Operation: Left nipple–areolar complex sparing mastectomy with immediate implant reconstruction, sentinel lymph node biopsy, Right
prophylactic nipple–areolar complex sparing
mastectomy with immediat... | [Right Breast].
1. Ductal carcinoma in situ.
(a) Size of tumor: 0.7 cm (pTis). Note: 1. The nearest resection margin of the
excision specimen (slides A1 and A2) is close to
ductal carcinoma in situ (<1 mm) but this margin
submitted for frozen diagnosis (Fro 13) is free of
tumor.
[Left Breast].
1. Invasive Ductal Carcin... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 18 | Female/38 years old, pre-menopause.
Self-detected palpable mass lesion on portion
of outer half of left breast.
No family history.
Lumbar spine disc.
BRCA 1 and 2 mutation: Not examination. | Report 1: Left mammography (Apr. 2021): regional fnelinear microcalcifcations with architectural distortion at outer breast. Report 2: Left breast US (Apr. 2021): an irregular
hypoechoic mass with microcalcifcations
(US-CNB = IDC). Microcalcifcations in subareolar ducts
(white arrow). An axillary lymph node with loss o... | null | Operation + Adjuvant chemotherapy (#4
cycles of doxorubicin and cyclophosphamide
followed by #4 cycles of docetaxel and trastuzumab) + Post-operative radiation therapy + Trastuzumab + Letrozole 2.5 mg/day
with goserelin.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy. (a) Gross pathology... | Invasive Ductal Carcinoma
1. Size of tumor: up to 3.0 cm, multifocal
(pT2(Paget)). papillary/solid/comedo, extensive intraductal
component: absent).
4. Nipple: Paget’s disease.
5. Skin: no involvement of tumor.
6. Surgical margins:
(a) superior margin: 12 mm,
(b) inferior margin: (see Note 1),
(c) medial margin: 15 mm... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 19 | Female/71 years old, post-menopause.
Self-detected palpable mass lesion on left
breast 11 o’clock direction.
No family history.
Hypertension, dyslipidemia, s/p
appendectomy. | Report 1: Left mammography (Nov. 2020): an irregular
mass at upper inner quadrant. Report 2: Left breast US (Nov. 2020): an irregular
hypoechoic mass. US-CNB = IDC. Report 3: Breast MRI (Nov. 2020): an irregular enhancing mass in the left breast. Report 4: Post-NAC breast MRI (Apr. 2021): decreased
size of the tumor af... | null | Neoadjuvant chemotherapy (#6 cycles of
docetaxel and carboplatin and trastuzumab
and pertuzumab) + Operation + Postoperative radiation therapy + Trastuzumab +
Letrozole 2.5 mg/day.
Operation: Left breast conserving surgery,
sentinel lymph node biopsy | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 1.5 cm (ypT1c). (a) superior margin: 20 mm,
(b) inferior margin: 20 mm,
(c) medial margin: 25 mm,
(d) lateral margin: 10 mm,
(e) deep margin: 13 mm,
(f) superfcial margin: 18 mm.
7. Lymph nodes: no metastasis in one axillary
lymph node (ypN0(sn)) ... | HR(+) HER2(+) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 20 | Female/49 years old, pre-menopause.
Screen detected mass lesion on left breast 2
o’clock direction.
No family history.
S/P Tuberculosis, S/P duodenal adenoma
excision. | Report 1:Left mammography (Nov. 2020): an irregular
mass at upper outer quadrant. Report 2:Left breast US (Nov. 2020): an irregular mass
with non-parallel orientation. US-CNB = IDC, Report 3:Breast MRI (Nov. 2021): an irregular enhancing mass in the left breast. Report 4:1 Lymphoscintigraphy shows visualized sentinel
l... | null | Operation + Post-operative radiation therapy + Tamoxifen 20 mg/day.
Operation
Left breast conserving surgery, sentinel lymph
node biopsy. (a) Gross pathology of lumpectomy specimen. (b) The margins get marked and sliced with different colors on each direction | Invasive Ductal Carcinoma
1. Size of tumor: 0.9 cm (pT1b).
2. Histologic grade: 1/3 (tubule formation: 2/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 1/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (40%) (nuclear grade:
low, necrosis: absent, architectural pattern:
micropapillary/cribriform... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 21 | Female/78 years old, post-menopause.
Screen detected mass lesion on left breast 12
o’clock direction.
No family history.
Hypertension, s/p hysterectomy. | Report 1:Left CC mammography (June 2019, Nov.
2020): negative fnding in 2019. A new mass at the central
breast in 2020. Report 2:Left breast US (Nov. 2020): a hypoechoic mass
with microlobulated margins at 12 o’clock direction.
Outside US-CNB = DCIS, Report 3:Breast MRI (Nov. 2020): an irregular enhancing mass in the l... | null | Invasive Ductal Carcinoma
1. Size of tumor: 1.2 cm (pT1c).
2. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
2/3, 11/10 HPF).
3. Intraductal component: present, intratumoral/extratumoral (20%) (nuclear grade:
low, necrosis: present, architectural pattern:
solid/comedo, extensive... | No metastasis in two axillary lymph nodes
1. Post-lumpectomy status. | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 22 | Female/61 years old, post-menopause.
Screen detected mass lesion on entire left
breast.
No family history.
Diabetes mellitus, Spinal stenosis. | Report 1: Mammography (June 2020): global asymmetry with edema in the left breast. Report 2:Left breast US (July 2020): irregular hypoechoic lesion with posterior acoustic shadowing involving the
entire left breast (partly shown). US-CNB = IDC, Report 3:Breast MRI (Aug. 2020): diffuse non-mass enhancement with involvem... | null | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin & cyclophosphamide followed by
#4 cycles of docetaxel) + Operation + Postoperative radiation therapy + Letrozole
2.5 mg/day.
22.3.1 Operation
Left modifed radical mastectomy (a) Gross pathology of mastectomy specimen. (b, c and d) The margins get marked and sli... | Invasive Micropapillary Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 11.0 cm (ypT3).
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 2/10HPF).
4. Intraductal component: absent.
5. Skin and nipple: dermal involvement of
tumor.
6. Surgical margins:
(a) deep marg... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 23 | Female/53 years old, post-menopause.
Screen detected mass lesion on right breast 7
o’clock direction.
Family history of breast cancer, younger
sister.
Diabetes mellitus, s/p right thyroidectomy
(thyroid cancer), s/p cholecystectomy, s/p
hysterectomy.
BRCA 1 and 2 mutation: Not detected. | Report 1:Right mammography (July 2020): an irregular
mass with microcalcifcations at lower center. Another
oval mass at the upper outer quadrant (black arrow).
Multiple enlarged lymph nodes at the right axilla (white
arrows). Report 2:Right breast US (July 2020): an irregular
hypoechoic mass with microcalcifcations at ... | null | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin & cyclophosphamide followed by
#4 cycles of docetaxel) + Operation + Postoperative radiation therapy + Letrozole
2.5 mg/day.
Operation
Right breast conserving surgery, sentinel lymph
node biopsy (a) Gross pathology of lumpectomy specimen. (b) The margins get ma... | 1. Microinvasive ductal carcinoma
(a) Post-chemotherapy status.
(b) Size of invasive component: <0.1 cm
(ypT1mi).
(c) Size of intraductal component: 1.5 cm.
(d) Histologic grade: 3/3 (tubule formation:
3/3, nuclear pleomorphism: 3/3, mitotic
count: 2/3, 10/10 HPF)
(e) Intraductal component: present, intratumoral/extra... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
Case 24 | 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. | Report 1:Breast MRI (July 2020): an irregular enhancing
mass in the right breast (white arrow). Enlarged lymph
node at the right axilla (black arrow). Report 2:Right breast US (June 2020): an irregular mass with microcalcifcations at outer center (white arrow,
US-CNB = IDC). Another irregular mass at the lower outer qu... | null | Neoadjuvant chemotherapy (#4 cycles of
doxorubicin & cyclophosphamide followed by
#4 cycles of docetaxel) & letrozole 2.5 mg/day
with leuprolide acetate + Operation + Postoperative radiation therapy.
Operation (1st, Jan. 2021)
Right breast conserving surgery, axillary lymph
node dissection 7 (a) Gross pathology o... | Invasive Ductal Carcinoma
1. Post-chemotherapy status.
2. Size of tumor: 2.0 cm (ypT1c).
3. Histologic grade: 2/3 (tubule formation: 3/3,
nuclear pleomorphism: 2/3, mitotic count:
1/3, 1/10 HPF)
4. Intraductal component: present, intratumoral/
extratumoral (5%) (nuclear grade: low, necrosis: absent, architectural patte... | HR(+) HER2(−) Breast Cancer | Cluster 2: Invasive Breast Cancer Subtypes |
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