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BREAST CANCER CASE STUDY FRAZER BELL STUDENT BMS BSc APPLIED BIOMEDICAL SCIENCE
PATIENT HISTORY 70 YEAR OLD FEMALE PRESENTED AT GP SURGERY 02/OCT/2012 EXAMINATION: RIGHT NIPPLE DRAWING IN & FIRM PALPABLE LUMP REFERRED TO THE BREAST CLINIC
BREAST CLINIC ATTENDED 18/OCT/2012 EXAMINATION: INVERTED NIPPLE RETRACTION AND PALPABLE LUMP ? PALPABLE LUMP RIGHT AXILLA GRADED P5: MALIGNANT FURTHER INVESTIGATIONS: MAMMOGRAM, ULTRASOUND & BREAST CORE BIOPSY
MAMMOGRAPHY AREA OF SUSPICIOUS ABNORMALITY ON RIGHT BREAST GRADED M4: PROBABLY MALIGNANT
ULTRASOUND ULTRASOUND : CORRESPONDING 2CM AREA GRADED U4: PROBABLY MALIGNANT
BIOPSY ULTRASOUND GUIDED BREAST CORE BIOPSIES FROM THE RIGHT BREAST ONE 13MM FIBROFATTY CORE PLUS 4 FIBROFATTY FRAGMENTS
NORMAL BREAST TISSUE
PATHOLOGY GRADED: B5b Infiltrating Breast Carcinoma
IMMUNOCYTOCHEMISTRY E-CAD NEGATIVE
RECEPTOR STATUS OESTROGEN RECEPTOR & HER-2 STATUS DETERMINE RECEPTOR STATUS FOR HORMONE THERAPY
OESTROGEN RECEPTOR STATUS NEGATIVE CONTROL OESTROGEN POSITIVE
PROGESTERONE REC. STATUS NEGATIVE CONTROLPROG POSITIVE
HER-2 STATUS NEGATIVE CONTROLHER2 NEGATIVE
TREATMENT PLAN BREAST MDT MEETING MASTECTOMY WITHOUT NEOADJUVANT TREATMENT SENTINEL LYMPH NODE BIOPSY SURGERY DATE 06/NOV/2012
PRE-OP ASSESSMENT ADMITTED PRE-OP CLINIC 01/NOV/2012 LABS TESTS: PRE-OP BLOODS HYPERTENSIVE MEDICAL WARD: ECG CONFIRMED LVH SURGERY CANCELLED
TREATMENT PLAN REDUCE BLOOD PRESSURE VIA ACE INHIBITORS CHEST X-RAY & U/S OF KIDNEYS STARTED ON LETROZOLE 2.5mg DAILY BP MONITORED FORTNIGHTLY RE-ASSESSMENT FOR SURGERY IN JANUARY
SURGERY BP STABILISED ADMITTED TO SURGICAL WARD 13/FEB/13 SURGERY 25/FEB/13 RIGHT BREAST MASTECTOMY SENTINEL LYMPH NODE BIOPSY
MASTECTOMY 19MM AND 7MM FIRM NODULES UPON DISSECTION NO LYMPHOVASCULAR INVASION 12MM CLEARANCE DEEP MARGIN
HISTOPATHOLOGY TUMOUR GRADE 2 INVASIVE LOBULAR CARCINOMA
SENTINEL LYMPH NODE FIVE SENTINEL NODES FOUR NEGATIVE ONE POSITIVE DEPOSIT OF METASTATIC TUMOUR ICC: AE1/AE3 CYTOKERATIN
SENTINEL LYMPH NODE AE1/AE3 POSITIVEH&E SENTINEL NODE
POST-OPERATIVE GRADE 2 INVASIVE LOBULAR CARCINOMA CLOSEST RELEVANT MARGIN 12MM SINGLE NODE POSITIVITY STAGING INVESTIGATIONS REQUIRED
STAGING INVESTIGATIONS STAGING INVESTIGATIONS TO EXCLUDE METASTASES CT SCAN - NEGATIVE BONE SCAN - NEGATIVE
FUTURE PATIENT DECLINED CHEMOTHERAPY WILL ATTEND THE BEATSON CANCER CENTRE RADIOTHERAPY TREATMENT CONTINUE LETROZOLE
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