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Breast Cancer Case Studies

Case Studies: A Case of Estrogen-Driven Metastatic Breast Cancer

Breast cancer expert Komal Jhaveri, MD, FACP, reviews the case of a 65-year-old woman who is diagnosed with de novo ER+ metastatic breast cancer.

A Case of Estrogen-Driven Metastatic Breast Cancer

A 65-Year-Old Woman With Metastatic ER+/PR+ Breast Cancer

December 2013

  • A 65-year-old woman was examined by her gynecologist after discovering a right-sided lump in her upper inner breast; she reported feeling exhausted lately, requiring frequent rest
  • PE showed a grape-sized right palpable mass at 3 o’clock
  • Diagnostic ultrasound showed a spiculated and hypoechoic mass measuring 26 x 23 x 21 mm; imaging in the left breast was unremarkable
  • Core biopsy showed high-grade infiltrating ductal carcinoma
    • Hormone receptor status: ER+/ PR+
    • HER2, IHC 1+
  • She underwent lumpectomy and axillary lymph node dissection that revealed a 2.3-cm infiltrating ductal carcinoma, 4 of 12 nodes were positive for disease
  • CT of the chest, abdomen, and pelvis showed that the disease had spread to her bones and biopsy confirmed metastatic disease
  • ECOG 1
  • She was started on ribociclib + fulvestrant
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