This is a 33-year old pre-menopausal woman who, after palpating a mass in her left breast, was referred for a mammogram by her primary care physician. Family history includes a sister who died of breast cancer at age 43 years.
Her mammogram revealed a spiculated mass in the upper outer quadrant of the left breast. Targeted ultrasound showed a 2.6 x 3.4 x 2.1 cm irregular mass with an indistinct margin. Prominent appearing right axillary lymph nodes.
Pathology: core biopsy revealed an invasive ductal carcinoma, poorly differentiated, lymphovascular invasion present. The tumor sample was mammaglobin-positive, ER/PR-negative, and HER2 3+ by IHC. Axillary ultrasound with fine-needle aspiration which was also positive for nodal involvement.
The case was presented at the breast cancer multidisciplinary tumor board. The team recommended neoadjuvant therapy before surgery.