Case Scenario: Breast

History

64 year old female attended routine breast screening and the screening mammogram identified a small irregular mass lesion. Assessment included a needle core biopsy procedure which showed invasive carcinoma. She elected to have a Wide Local Excision (images from this specimen are represented).

Histology

The histology reported a 16mm invasive carcinoma of no special type, minimal glandular formation, average nuclear pleomorphism and low mitotic frequency indicating a histological grade 2 tumour. There is some adjacent ductal carcinoma in situ, no evidence of vascular invasion and the sentinel lymph node (not shown) was negative for metastatic carcinoma.

Outcome

She has a Nottingham Prognostic Index of 3.32, indicating a good prognosis with expected 10 year survival of greater than 80%. Further studies demonstrated positive expression of Oestrogen and Progesterone receptors with no evidence of Her2 over-expression. The primary tumour was completely excised and she subsequently underwent local radiotherapy to reduce the risk of local recurrence and adjuvant hormonal therapy to reduce the risk of systemic recurrence.

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Slides and diagnosis kindly provided by Prof. Ian Ellis and Source BioScience.