Patient with large breasts and bilateral multifocal breast cancer
Preoperative photographs are not available.
54 year old with large-sized breast and bilateral breast cancer.
- Symptomatic right lower outer quadrant 2 cm breast lump (February 2019)– core biopsy shows Grade 1 Invasive Ductal Carcinoma, ER+ve, PR+ve, HER2-ve. Subsequent MRI showed right breast cancer measured 26mm and also showed an incidental 5mm left upper outer quadrant breast cancer- core biopsy of left breast showed Grade 1 invasive ductal carcinoma ER+ve, PR+ve, HER2-ve with DCIS. Axillary ultrasound showed axillary lymph nodes were normal.
- Pre-operative bra cup-size – 36DD
- Fast-track pre-operative gene test – negative for BRCA1and BRCA2 gene mutations.
- Bilateral wire guided therapeutic mammoplasty + bilateral sentinel node biopsy (mid-March 2019)- Final histology: Right side (501g excised) – 30mm mixed Grade 1 and Grade 2 Invasive Ductal Carcinoma + intermediate grade DCIS, all margins clear, 1 micrometastasis (0.45mm) out of 2 lymph nodes. Left side (450g excised)- 5mm Grade 1 Invasive Ductal Carcinoma with clear margins, All 2 lymph nodes were normal.
- Post-op bra cup size- 36C.
- Oncotype Dx test – recurrence score of 4. Chemotherapy not recommended.
- Bilateral whole breast radiotherapy.
- Currently on Tamoxifen.