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Case 1
Benign and Proliferative
Courses of Treatment. → 2022-02-11 Excision, Lt. (8H and 5H).. C. W. Lee · B. H. Choi (*). Department of Radiology, National Cancer Center,. Goyang, Republic of Korea. e-mail: cwlee@ncc.re.kr; iawy82@ncc.re.kr. Y. Kwon. Department of Radiology, Center for Breast Cancer, National. Cancer Center, Goyang, Gyeonggi, Republ...
Important Radiologic. Findings. 1. 2. 1.3. 
Patient History and Progress. Female/37 years old, pre-menopause.. Screen detected mass lesion on left breast. 8 o’clock and 5 o’clock direction.. Outside result of biopsy: Papillary neoplasm.. No family history.. No comorbidities.. 1.2. 
Case 1
Carcinoma In Situ
Carcinoma In Situ. Eun Sook Lee, Chan Wha Lee, Youngmi Kwon,. Yunju Kim, and Bo Hwa Choi. 1. . 1.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. 1.3.1. . Operation. 5. 6. 1.3.2. . Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJC...
Important Radiologic. Findings. 1 2 3. 4. E. S. Lee. Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. C. W. Lee (*) · B. H. Choi. Division of Diagnostic Radiology, Center for Breast. Cancer, National Cancer Center,. Goyang, Republic of Korea. e-mail: cwl...
Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected a mass lesion on left breast in. 10 o’clock direction.. No family history of breast cancer or other. cancers.. S/P Uterine myomectomy.. 1.2. 
Case 1
HR(+) HER2(+) Breast Cancer
. 1.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Tamoxifen. 20 mg/day.. 7. 1.3.1. . Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of invasi...
Important Radiologic. Findings. 1 2 3 4 5. 6. 1.3. 
Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected mass lesion on left breast 5. o’clock direction.. No family history.. No comorbidities.. 1.2. 
Case 1
HR(+) HER2(-) Breast Cancer
HR(+) HER2(−) Breast Cancer. Yunju Kim, Bo Hwa Choi, Eun-Gyeong Lee,. Ji Young You, and Youngmi Kwon. 1. . 1.1. . Courses of Treatment. Operation + Letrozole 2.5 mg/day. 1.3.1. . Operation. Left total mastectomy, sentinel lymph node. 2. Histologic grade: 2/3 (tubule formation: 2/3,. nuclear pleomorphism: 2/3, mitot...
Important Radiologic. Findings. See Figs. 1, 2 and 3.. 1.3. 
Patient History and Progress. Female/87 years old, post-menopause.. Screen detected mass lesion on left breast sub­. areolar area.. No family history.. Hypertension, diabetes mellitus, arrhythmia,. total knee replacement, cerebrovascular accident.. 1.2. 
Case 1
HR(−) HER2(+) Breast Cancer
HR(−) HER2(+) Breast Cancer. Youngmi Kwon, Yunju Kim, Bo Hwa Choi,. Ji Young You, Ran Song, Jeayeon Woo,. and Soojin Park. 1. . 1.1. . pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab.. Result. Intensity. Positive %. Estrogen. receptor. Negative (0/8). 0. 0. Progesterone. receptor. Negative...
Important Radiologic Findings. 1 2 3. 4. Y. Kwon. Department of Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Gyeonggi,. Republic of Korea. e-mail: ymk@ncc.re.kr. Y. Kim. Department of Pathology, National Cancer Center,. Goyang, Gyeonggi, Republic of Korea. e-mail: radkyj@ncc.re.kr. B. H. Choi. ...
Patient History and Progress. Female/59 years old, post-menopause.. Self-detected mass lesion on right breast 12. o’clock direction.. No family history.. S/P Tuberculosis.. 1.2. 
Case 1
HR(−) HER2(−) Breast Cancer
HR(−) HER2(−) Breast Cancer. Eun Sook Lee, Chan Wha Lee, Youngmi Kwon,. Jeayeon Woo, and Yunju Kim. 1. . 1.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin. and. cyclophosphamide. +. #4  cycles of docetaxel) + Operation + Post-. operative radiation therapy.. 1.3.1. . Operation. 7. 1.3....
Important Radiologic Findings. 1 2. 3. E. S. Lee. Center for Breast Cancer, National Cancer Center,. Goyang, Kyonggi-do, Republic of Korea. e-mail: eslee@ncc.re.kr. C. W. Lee. Division of Diagnostic Radiology, Center for Breast Cancer,. National Cancer Center, Goyang, Republic of Korea. e-mail: drlee4958@gmail.com. Y. ...
Patient History and Progress. Female/40 years old, pre-menopause.. Screen detected a mass lesion at 1 o’clock. direction of the left breast.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: Not detected,. CHEK2 VUS (variant of uncertain).. 1.2. 
Case 1
Local Recurrence
Local Recurrence. Yunju Kim, Eun-Gyeong Lee, Ran Song,. and Eun Sook Lee. 1. . 1.1. . Courses of Treatment. Right breast IDC → Neoadjuvant chemotherapy. → Operation → Adjuvant therapy → Right. breast recurrence (IDC).. 1.2.1. . Primary Treatment. 1 2 3. 4. Neoadjuvant Chemotherapy. Neoadjuvant chemotherapy #4 cycles...
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Patient History and Progress. Female/41 years old, pre-menopause.. Screen detected mass lesion on lower medial. and lower outer portion of right breast.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 1.2. 
Case 1
Metastatic Breast Cancer
Metastatic Breast Cancer. Youngmi Kwon, Yunju Kim, Bo Hwa Choi,. Eun-Gyeong Lee, Ji Young You, and Eun Sook Lee. 1. . 1.1. . Courses of Treatment. Left breast cancer  →  Operation  +  Adjuvant. therapy → Chest wall recurrence → Palliative. therapy. →. Pleural. fissure. recur­. rence → Palliative therapy.. 1.2.1. . P...
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Patient History and Progress. Female/49 years old, post-menopause.. No family history.. 1.2. 
Case 10
Benign and Proliferative
Courses of Treatment. →2021-11-09 excision (Lt. 3H SA, Lt. nipple. mass).. Pathology Report. • Breast, “left subareolar 3 o’clock”, excision:. –. – Atypical ductal hyperplasia.. • Breast, “left nipple mass,” excision:. –. – Nipple adenoma (florid papillomatosis).. . . C. W. Lee et al.. 29. . . 11. 
Important Radiologic. Findings. 16. 17. 10.3. 
Bloody discharge from left nipple.. No family history.. No comorbidities.. 10.2. 
Case 10
Carcinoma In Situ
10.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 47. 48. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 2.0 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. ....
Important Radiologic. Findings. 43 44 45. 46. 10.3. 
Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected microcalcification on mid. inner portion left breast.. Outside result of biopsy:. Left 9:30 o’clock, ductal carcinoma in situ.. Right 11  o’clock, flat epithelial atypia with. microcalcification.. No family history.. BRCA 1 and 2 mutatio...
Case 10
HR(+) HER2(+) Breast Cancer
10.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. emtansine  +  Letrozole 2.5  mg/day with. goserelin.. S. Park et al.. 329. . . ­. HR(+) HER2(+) Breast Cancer. 330. . 5...
Important Radiologic. Findings. 52 53 54 55 56. 57. 10.3. 
Patient History and Progress. Female/32 years old, pre-menopause.. Self-detected skin changes and mass lesion on. left breast.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected, NBN. and PALB2 VUS (variant of uncertain).. 10.2. 
Case 10
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4  cycles of docetaxel & cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, axillary lymph. 5. Surgical margins:. . (a) superior margin: 10 mm,. . (b) inferior margin: 30 mm,. ...
Important Radiologic. Findings. See Figs. 48, 49, 50 and 51.. 10.3. 
No comorbidities.. 10.2. 
Case 10
HR(−) HER2(+) Breast Cancer
10.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab)  +  Operation  +  Trastuzumab and. pertuzumab.. Operation. 77. a. b. . . Y. Kwon et al.. 469. Pathology Report. No residual tumor with stromal degeneration.. . 1. Post-chemotherapy status.....
Important Radiologic. Findings. 69 70 71. 72. . . . HR(−) HER2(+) Breast Cancer. 466. . Y. Kwon et al.. 467. 10.3. . After Neoadjuvant. Chemotherapy. 73 74 75. 76. . ­. . ­. . HR(−) HER2(+) Breast Cancer. 468. 10.4. 
Patient History and Progress. Female/36 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 9 o’clock direction.. Family history of breast cancer, aunt. (paternal).. S/P Tuberculosis, s/p salpingectomy.. BRCA 1 and 2 mutation: Not detected, ATM. VUS (variant of uncertain).. 10.2. 
Case 10
HR(−) HER2(−) Breast Cancer
10.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of paclitaxel and cisplatin) + Operation. + Post-operative radiation therapy  +  ada­. gloxad simolenin plus capecitabine.. Operation. 73. E. S. Lee et al.. 609. . . . HR(−) HER2(−) Breast Cancer. 610...
Important Radiologic. Findings. 66 67. 68. After Neoadjuvant. Chemotherapy. 69 70 71. 72. 10.3. 
Patient History and Progress. Female/56 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. Asthma.. 10.2. 
Case 10
Local Recurrence
10.1. . Courses of Treatment. Right breast IDC→ Operation → Adjuvant ther­. apy → Right breast recurrence (IDC).. Primary Treatment. 76 77. 78. Operation. ­. ­. 79. 80. Pathology Report. . 1. Invasive ductal carcinoma.. . (a) Size of tumor: 1.8 cm (pT1c).. . (b) Histologic grade: 2/3 (tubule formation:. 3/3, nuclea...
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Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 5. o’clock direction.. Outside result of biopsy: Invasive ductal. carcinoma.. No family history.. s/p myomectomy.. 10.2. 
Case 10
Metastatic Breast Cancer
10.1. . Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral breast and lung recur­. rence → Palliative therapy → Progression on. lung, left breast.. Primary Treatment. See Figs. 31, 32, and 33.. Operation. Dec. 2020 Left breast conserving surgery, senti­. nel lymph node biopsy.. Path...
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Patient History and Progress. Female/53 years old, post-menopause.. No family history.. S/p cholecystectomy, s/p knee giant cell tumor. excision, s/p interstitial mammoplasty.. S/p otitis media operation.. 10.2. 
Case 11
Benign and Proliferative
11.1. . Courses of Treatment. →2021-10-29 excision, Rt.. Benign and Proliferative Case Series. 30. . ­. . . Pathology Report. Diagnosis. • Breast, right, excision:. –. – Intraductal papilloma.. 12. 
Important Radiologic. Findings. 18. 11.3. 
Patient History and Progress. Female/39 years old, pre-menopause.. Serous discharge from right nipple.. No family history.. Asthma, hyperthyroidism.. 11.2. 
Case 11
Carcinoma In Situ
11.1. . Courses of Treatment:. Operation. Operation. ­. 50. 51. Pathology Report. <First operation>. . 1. Ductal Carcinoma In Situ, Pathological TN. Category (AJCC 2017): pTis. . (a) Size of tumor: 0.3 cm (pTis).. . (b) Nuclear grade: low.. . (c) Necrosis: absent.. . (d) Architectural pattern: micropapillary/. cr...
Important Radiologic. Findings. 49. 11.3. 
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. Outside result of biopsy:. Right breast, 8 o’clock, (1) adenosis, (2) fibro­. cystic change, (3) flat epithelial atypia.. Family history, Father: Prostate cancer.. S/P Percutaneous closu...
Case 11
HR(+) HER2(+) Breast Cancer
11.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 63. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of tumor: 1.1 cm (pT1c).. . (b) Histologic grade: 2...
Important Radiologic. Findings. 59 60 61. 62. HR(+) HER2(+) Breast Cancer. 334. . . 11.3. 
Patient History and Progress. Female/60 years old, post-menopause.. Screen detected microcalcification on upper. outer portion of right breast.. No family history.. Hypertension.. 11.2. 
Case 11
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4  cycles of docetaxel & cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Letrozole 2.5 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. 5. Surgical margins:. . (a) superior margin: 5 mm,. . (b) inferior margin: 15 mm,. ...
Important Radiologic. Findings. See Figs. 53, 54, 55 and 56.. 11.3. 
Dyslipidemia.. 11.2. 
Case 11
HR(−) HER2(+) Breast Cancer
11.1. . operative radiation therapy + Trastuzumab.. Operation. 86. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.5 cm (ypT1c).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 5/HPF).. 4. Intraductal component: prese...
Important Radiologic. Findings. 78 79 80. 81. . ­. HR(−) HER2(+) Breast Cancer. 470. . After Neoadjuvant. Chemotherapy. 82 83 84. 85. . . Y. Kwon et al.
Patient History and Progress. Female/56 years old, post-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. Diabetes mellitus, hepatitis C virus carrier.. 11.2. 
Case 11
HR(−) HER2(−) Breast Cancer
11.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of doxo­. rubicin and cyclophosphamide + #4 cycles of. docetaxel) + Operation + Post-operative radia­. tion therapy + Adjuvant capecitabine.. Operation. 82. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0...
Important Radiologic. Findings. 74 75 76. 77. E. S. Lee et al.. 613. . . . HR(−) HER2(−) Breast Cancer. 614. . After Neoadjuvant. Chemotherapy. 78 79 80. 81. 11.3. 
Patient History and Progress. Female/50 years old, pre-menopause.. Screen detected mass lesion on upper outer. portion of right breast.. Family history of breast cancer, mother and. aunt (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 11.2. 
Case 11
Local Recurrence
11.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy → Right breast recurrence (IDC).. Primary Treatment. Operation. Nov. 2008 Right breast conserving surgery, senti­. nel lymph node biopsy (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 1.3 cm (pT1c).. . 2. Lym...
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Patient History and Progress. Female/45 years old, post-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. No family history.. S/P bilateral salpingo-oophorectomy (right. ovary borderline tumor).. BRCA 1 and 2 mutation: Not detected.. 11.2. 
Case 11
Metastatic Breast Cancer
Courses of Treatment. Both breasts cancer → Operation → Adjuvant. therapy → Right axillary lymph node. Intensity. Positive %. Estrogen. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Weak (3/8). 2. <1%. C-erbB2. Equivocal. (2+). Result. Intensity. Positive %. Ki-67. Positive in. 22% of. tumor cells. SISH. Equ...
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Case 12
Benign and Proliferative
12.1. . Courses of Treatment. →2021-10-29 excision, Lt.. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Intraductal papilloma (#1. 2  o’clock, #2.. 5  o’clock & #3. 9  o’clock) with (1) usual. ductal hyperplasia, (2) apocrine metaplasia.. C. W. Lee et al.. 31. 13. 
Important Radiologic. Findings. 19. 20. 12.3. 
Patient History and Progress. Female/70 years old, post-menopause.. Screen detected mass lesion on left breast. 2 o’clock and 5 o’clock and 9 o’clock direction.. No family history.. s/p Right breast conserving surgery (right. breast cancer), hypertension, diabetes mellitus.. 12.2. 
Case 12
Carcinoma In Situ
12.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. ­. ­. 55. 56. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTisN0(sn). . 1. Size of tumor: 1.0 cm (pTis).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural. pattern:....
Important Radiologic. Findings. 52 53. 54. 12.3. 
Patient History and Progress. Female/49 years old, pre-menopause.. Screen detected mass lesion on right breast. 4:30 and 9 o’clock direction.. Outside result of biopsy:. Left breast 4: 30 o’clock, ductal carcinoma in. situ.. Left breast 9 o’clock, intraductal papilloma.. Family history of breast cancer, sister at her. ...
Case 12
HR(+) HER2(+) Breast Cancer
12.1. . Courses of Treatment. Neoadjuvant chemotherapy (#1 cycle of. docetaxel and carboplatin and trastuzumab. and pertuzumab followed by #5 cycles of. docetaxel and carboplatin)  +  Operation  +. Adjuvant chemotherapy (doxorubicin and. cyclophosphamide) + Post-­. operative radiation. therapy + Letrozole 2.5 mg/day.....
Important Radiologic. Findings. 64 65 66 67. 68. S. Park et al.. 337. . . 12.3. 
Patient History and Progress. Female/63 years old, post-menopause.. Screen detected mass lesion on left breast 10. o’clock direction.. No family history.. s/p Idiopathic thrombocytopenic purpura. (2020).. 12.2. 
Case 12
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4  cycles of docetaxel & cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Tamoxifen 20 mg/day.. Operation. Right breast conserving surgery, sentinel lymph. extratumoral (30%) (nuclear grade: low,. necrosis: present, architectural pattern: sol...
Important Radiologic. Findings. See Figs. 58, 59, 60 and 61.. 12.3. 
S/P hysterectomy, dyslipidemia, diabetes mel­. litus, s/p cervical spine disc operation.. 12.2. 
Case 12
HR(−) HER2(+) Breast Cancer
12.1. . Invasive Ductal Carcinoma with medullary. pattern. 1. Size of tumor: 2.9 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 5/HPF).. 3. Intraductal component: present, intratu­. moral/extratumoral (30%) (nuclear grade:. high, necrosis: present, archi...
Important Radiologic. Findings. 87 88 89
Patient History and Progress. Female/66 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. Hypertension, thyroidectomy (hyperthyroid­. ism), s/p salpingectomy.. 12.2. 
Case 12
HR(−) HER2(−) Breast Cancer
12.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4 cycles of doxo­. rubicin and cyclophosphamide  +  #4 cycles of. docetaxel) + Operation + Adjuvant capecitabine.. Operation. ­. ­. ­. 89. 90. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 0.5 cm (ypT1a).. 3. His...
Important Radiologic. Findings. 83 84. 85. . . . HR(−) HER2(−) Breast Cancer. 618. . ­. . . After Neoadjuvant. Chemotherapy. 86 87. 88. 12.3. 
Patient History and Progress. Female/47 years old, post-menopause.. Screen detected a mass lesion on right breast. 10 o’clock direction.. Family history of breast cancer, aunt (mater­. nal) and cousin.. Family history of ovarian cancer, aunt.. Lupus (follow-up), s/p bilateral salpingo-­. oophorectomy, s/p unilateral th...
Case 12
Local Recurrence
12.1. . Courses of Treatment. Right breast DCIS → Operation → Right breast. recurrence (microinvasive ductal carcinoma).. Primary Treatment. 89 90. 91. Operation. ­. 92. Pathology Report. Ductal carcinoma in situ. . 1. Size of tumor: 2.3 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectu...
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Patient History and Progress. Female/55 years old, peri-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. Family history of prostate cancer, father.. s/p hysterectomy, HPV infection.. 12.2. 
Case 12
Metastatic Breast Cancer
12.1. . Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence → Contralateral breast cancer.. Primary Treatment. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Intermediate. (6/8). 2. 1/3–2/3. C-erbB2. Equivocal (2+). Ki-67. Positive in 26%. of...
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Patient History and Progress. Female/78 years old, post-menopause.. No family history.. Hypertension, diabetes mellitus.. 12.2. 
Case 13
Benign and Proliferative
13.1. . Courses of Treatment. →2021-10-26 excision, Rt.. . Benign and Proliferative Case Series. 32. . Pathology Report. • Breast, right 12 o’clock, excision:. –. – Flat. epithelial. atypia. with. microcalcification. • Breast, right 2 o’clock, excision:. –. – Atypical. ductal. hyperplasia. with. microcalcification.....
Important Radiologic. Findings. 21. 22. 13.3. 
Patient History and Progress. Female/45 years old, pre-menopause.. Screen detected microcalcification on upper. center of right breast.. No family history.. No comorbidities.. 13.2. 
Case 13
Carcinoma In Situ
. Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 58. 59. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.5 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: pa...
Important Radiologic. Findings. 57. 13.3. 
Patient History and Progress. Female/61 years old, post-menopause.. Screen detected mass lesion on left breast. 10 o’clock direction.. Outside result of biopsy: Left breast. 10 o’clock, papillary neoplasm.. Family history of breast cancer, sister.. No comorbidities.. BRCA 1 and 2: Not check.. 13.2. 
Case 13
HR(+) HER2(+) Breast Cancer
13.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles. of. docetaxel. and. cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 73. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.1 cm (pT2).. 2. Histologic grade: 2/3 (tubule f...
Important Radiologic. Findings. 70 71. 72. 13.3. 
Patient History and Progress. Female/53 years old, post-menopause.. Screen detected mass lesion on left breast 1:30. o’clock direction.. No family history.. Hypertension, arrhythmia, s/p myomectomy.. 13.2. 
Case 13
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation. +. Adjuvant. chemotherapy. (#4 cycles of doxorubicin & cyclophosphamide. followed by #4  cycles of docetaxel)  +  Post-­. operative radiation therapy  +  Letrozole. 2.5 mg/day.. Operation. sive intraductal component: absent).. 4. Skin and nipple: dermal involvement of. tumor.. 5. Surg...
Important Radiologic. Findings. See Figs. 63, 64, 65 and 66.. 13.3. 
S/P Tuberculosis, S/P appendectomy.. 13.2. 
Case 13
HR(−) HER2(+) Breast Cancer
13.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. 2. Size of tumor: 0.3 cm (ypT1a).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 3/3, 4/HPF).. 4. Intra...
Important Radiologic. Findings. 92 93. 94. . Y. Kwon et al.. 479. 95 96 97. 98. 13.4. 
Patient History and Progress. Female/44 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. No family history.. No comorbidities.. 13.2. 
Case 13
HR(−) HER2(−) Breast Cancer
13.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 98. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of t...
Important Radiologic. Findings. 91 92. 93. After Neoadjuvant. Chemotherapy. 94 95 96. 97. 13.3. 
Patient History and Progress. Female/67 years old, post-menopause.. Self-detected mass lesion on left breast.. No family history.. Hepatitis C virus carrier, arrhythmia.. 13.2. 
Case 13
Local Recurrence
13.1. . Courses of Treatment. Right breast microinvasive ductal carcinoma →. Operation → Right breast recurrence (DCIS).. Primary Treatment. 96 97. 98. . . . Local Recurrence. 754. a. b. . a. b. . Operation. ­. 99. 100. Pathology Report. Microinvasive Ductal Carcinoma. 1. Size of invasive component: <0.1  cm. (pT1mi)...
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Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on right breast 3. o’clock direction and bloody discharge from. right nipple.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. BRCA 1 and 2 mutation: not detected.. 13.2. 
Case 13
Metastatic Breast Cancer
13.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Estrogen. receptor. Intermediate. (6/8). 1. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 18% of tumor. cells. Adjuvant ...
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Patient History and Progress. Female/39 years old, post-menopause.. Family history of ovarian cancer, paternal. aunt.. BRCA. 1. mutation: VUS. (variant. of. uncertain).. S/p bilateral salpingo-oophorectomy.. 13.2. 
Case 14
Benign and Proliferative
14.1. . Courses of Treatment. →2021-10-15 excision, Rt.. Pathology Report. • Breast, right, excision:. –. – Atypical ductal hyperplasia involving. intraductal papilloma with marked cautery. artifact.. C. W. Lee et al.. 33. . . 15. 
Important Radiologic. Findings. 23. 24. 14.3. 
Patient History and Progress. Female/60 years old, post-menopause.. Screen detected mass lesion on right breast. 9 o’clock direction.. Family history of breast cancer, mother.. s/p Total hysterectomy (leiomyoma) and Left. salpingo-oophorectomy.. 14.2. 
Case 14
Carcinoma In Situ
14.1. . Courses of Treatment:. Operation. Operation. 61. 62. Pathology Report. <First operation>. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 0.3 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: papillary.. . 5. Surgical mar...
Important Radiologic. Findings. 60. 14.3. 
Patient History and Progress. Female/54 years old, pre-menopause.. Screen detected microcalcification on upper. inner portion of left.. No family history.. Taking medication for bladder dysfunction.. 14.2. 
Case 14
HR(+) HER2(+) Breast Cancer
14.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel and trastu­. zumab)  +  Post-operative radiation ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 77. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5...
Important Radiologic. Findings. 74 75. 76. 14.3. 
Patient History and Progress. Female/51 years old, peri-menopause.. Screen detected mass lesion on portion of. lower of right breast.. Family history of breast cancer, sister.. Hypothyroidism (taking on synthroid).. BRCA 1 and 2 mutation: Not detected.. 14.2. 
Case 14
HR(+) HER2(-) Breast Cancer
14.1. . Courses of Treatment. Neoadjuvant therapy (Palbociclib 125 mg/day. &. tamoxifen. 20. mg/day. with. gosere­. lin)  +  Operation  +  Post-operative radiation. therapy. +. Letrozole. 2.5. mg/day. with. goserelin.. Operation. Left breast conserving surgery, sentinel lymph. . (a) superior margin: 5 mm.. . (b) inf...
Important Radiologic. Findings. See Figs. 68, 69, 70, 71 and 72.. 14.3. 
Patient History and Progress. Female/43 years old, pre-menopause.. Screen detected mass lesion on left breast 1. and 3 o’clock direction.. No family history.. No comorbidities.. 14.2. 
Case 14
HR(−) HER2(+) Breast Cancer
14.1. . Courses of Treatment. Neoadjuvant chemotherapy (#3 cycles of. docetaxel and trastuzumab and pertuzumab after. followed #3 cycles of trastuzumab and pertu­. zumab #4) + Operation + Post-operative radia­. tion therapy + Trastuzumab emtansine.. Operation. Microinvasive Ductal Carcinoma. 1. Size of invasive compo...
Important Radiologic. Findings. 100 101 102. 103. . HR(−) HER2(+) Breast Cancer. After Neoadjuvant. Chemotherapy. 104 105 106. 107. HR(−) HER2(+) Breast Cancer. 486. 14.4. 
Patient History and Progress. Female/74 years old, post-menopause.. Screen detected mass lesion on right breast 12. o’clock direction.. No family history.. S/P retroperitoneum, excision (paragang­. lioma).. 14.2. 
Case 14
HR(−) HER2(−) Breast Cancer
14.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. + #12 cycles of paclitaxel)  +  Post-­. operative. radiation therapy.. Operation. 103. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 3.0 cm (pT2).. 2. Histologic grade: 3/3 (tubule form...
Important Radiologic. Findings. 99 100 101. 102. 14.3. 
Patient History and Progress. Female/43 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast.. Family history of breast cancer, grandmother.. s/p Right breast, mammotome excision, s/p. right ear, benign excision.. BRCA 1 and 2 mutation: Not detected.. 14.2. 
Case 14
Local Recurrence
14.1. . Courses of Treatment. Right breast infiltrating ductal carcinoma →. Operation → Left breast recurrence (IDC).. Primary Treatment. 103. 104. Operation. Aug. 2003 Right breast conserving surgery, axil­. lary lymph node dissection, left breast mass. excision.. Pathology Report. <Right>. Infiltrating Ductal Carcin...
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Patient History and Progress. Female/72 years old, post-menopause.. Screen detected mass lesion on right breast 1. o’clock direction and left 9 o’clock direction.. No family history.. Diabetes mellitus.. BRCA 1 and 2 mutation: Not detected, ATM. and POLE VUS (variant of uncertain).. . . ­. Local Recurrence. 756. 14.2. ...
Case 14
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Estrogen. receptor. Intermediate. (6/8). 2. 1/3–2/3. Progesterone. receptor. Strong (7/8). 2. >2/3. C-erbB2. Negative (0). Ki-67. Positive in. 35% of tumor. cells. Adjuvant Therap...
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Hepatitis B carrier.. 14.2. 
Case 15
Benign and Proliferative
15.1. . Courses of Treatment. →2021-10-12 excision, Lt.. Benign and Proliferative Case Series. 34. . . Pathology Report. • Breast, left, excision:. –. – Atypical ductal hyperplasia, focal. –. – Fibroadenomatous change.. 16. 
Important Radiologic. Findings. 25. 26. 15.3. 
Patient History and Progress. Female/33 years old, pre-menopause.. Screen detected mass lesion on left breast. 3 o’clock direction.. Family history of pancreatic cancer, maternal. grandmother.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 15.2. 
Case 15
Carcinoma In Situ
15.1. . Courses of Treatment. Operation + Postoperative radiation therapy +. Tamoxifen 20 mg/day for 5 years.. Operation. 67. 68. E. S. Lee et al.. 83. 2. Nuclear grade: high.. 3. Necrosis: present.. 4. Architectural pattern: micropapillary/cribri­. form/solid/comedo.. 5. Skin: no involvement of tumor.. 6. Surgic...
Important Radiologic. Findings. 63 64 65. 66. 15.3. 
Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on right breast. 1 o’clock direction.. No family history.. No comorbidities.. 15.2. 
Case 15
HR(+) HER2(+) Breast Cancer
15.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Tamoxifen 20 mg/day.. 82. . ­. ­. . HR(+) HER2(+) Breast Cancer. 346. . . Pathology Report. . 1. Invasive Ductal Carcinoma with apocrine. diff...
Important Radiologic. Findings. 78 79 80. 81. 15.3. 
Patient History and Progress. Female/42 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast 6 o’clock direction.. Family history of breast cancer, maternal aunt.. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 15.2. 
Case 15
HR(+) HER2(-) Breast Cancer
15.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Anastrozole 1 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. (a) superior margin: 35 mm.. . (b) inferior margin: 10 mm.. . (c) medial margin: 15 mm.. . (d) lateral margin: 5 mm.. . (e) deep margin: 12 mm.. . (f)...
Important Radiologic. Findings. See Figs. 74, 75, 76 and 77.. 15.3. 
Patient History and Progress. Female/58 years old, post-menopause.. Screen detected mass lesion on left breast 12. o’clock direction.. No family history.. Hypertension, dyslipidemia, s/p transobtura­. tor tape for stress urinary incontinence.. 15.2. 
Case 15
HR(−) HER2(+) Breast Cancer
15.1. . 116. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tumor: 1.9 cm (ypT1c).. 3. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 2/3, 12/10HPF).. 4. Intraductal component: absent.. 5. Skin: no involvement of tumor.. 6. Surgica...
Important Radiologic. Findings. 109 110 111. . After Neoadjuvant. Chemotherapy. 113 114. 115. . HR(−) HER2(+) Breast Cancer. 492
Patient History and Progress. Female/61 years old, post-menopause.. Self-detected palpable mass lesion on right. breast 12 o’clock direction.. No family history.. Hypertension.. HR(−) HER2(+) Breast Cancer. 488. . Y. Kwon et al.. 489. 15.2. 
Case 15
HR(−) HER2(−) Breast Cancer
15.1. . Courses of Treatment. Operation + operation.. Operation. ­. 107. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of invasive component: 0.4  cm. (pT1a).. . (b) Size of intraductal component: 4.0 cm.. . (c) Histologic grade: 3/3 (tubule formation:. 3/3, nuclear pleomorphism: 3/3, mitotic. coun...
Important Radiologic. Findings. 104 105. 106. 15.3. 
Patient History and Progress. Female/74 years old, post-menopause.. Self-detected bloody discharge on the nipple. of the left breast.. No family history.. S/P hysterectomy (due to myoma), hyperten­. sion, s/p shoulder calcific tendinitis operation.. 15.2. 
Case 15
Local Recurrence
15.1. . Courses of Treatment. Right breast IDC → Operation → Adjuvant. therapy →Left breast and axillary lymph node. recurrence (IDC) → Left axillary lymph node. recurrence.. Primary Treatment. 109. 110. Operation. 111. Pathology Report. Invasive Ductal Carcinomas (×2).. 1. Size of tumor: 2.1 cm, 0.7 cm (pT2(m)).. 2....
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Patient History and Progress. Female/63 years old, post-menopause.. Self-detected mass lesion on right breast 9. o’clock direction.. Family history of breast cancer, mother.. Hypertension, s/p Left leg fracture operation.. BRCA 1 and 2 mutation: Not detected.. 15.2. 
Case 15
Metastatic Breast Cancer
15.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. receptor. Strong (8/8). 3. >2/3. Progesterone. receptor. Strong (8/8). 3. >2/3. C-erbB2. Negative (1+). Ki-67. Positive in. 31% of tumor. cells. Adjuvant Therapy. Tamoxif...
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Patient History and Progress. Female/74 years old, post-menopause.. No family history.. Hypertension.. 15.2. 
Case 16
Benign and Proliferative
16.1. . Courses of Treatment. →2021-09-13 needle biopsy.. Pathology Report. Diagnosis. • Breast, right, needle biopsy:. –. – Ductal carcinoma in situ.. Nuclear grade: low.. Necrosis: present.. C. W. Lee et al.. 35. . ­. . Benign and Proliferative Case Series. 36. . Architectural pattern: micropapillary/. cribriform/c...
Important Radiologic. Findings. 27 28. 29. 16.3. 
Patient History and Progress. Female/59 years old, post-menopause.. Screen detected mass lesion on right breast. 7 o’clock direction.. No family history.. s/p Total hysterectomy, s/p left nephrectomy. (donor), s/o cholecystectomy.. 16.2. 
Case 16
Carcinoma In Situ
16.1. . Courses of Treatment:. Operation. Operation. 73. 74. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis(Paget)N0 (sn). . 1. Size of tumor: 1.5 cm (pTis(Paget)).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. Carcinoma In Situ. 4. Architectural. pattern:. cribrif...
Important Radiologic. Findings. 69 70 71. 72. E. S. Lee et al.. 85. . . . ­. 16.3. 
Patient History and Progress. Female/75 years old, post-menopause.. Screen detected microcalcification on left. breast 12 o’clock direction.. Outside result of biopsy: Left breast 12 o’clock,. fibrosis.. Family history of breast cancer, mother.. Hypertension.. BRCA 1 and 2: Not examination.. 16.2. 
Case 16
HR(+) HER2(+) Breast Cancer
16.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles. of. docetaxel. and. cyclophospha­. mide). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 87. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Size of tumor: 1.1 cm (pT1c).. . (b) Histologic grade:...
Important Radiologic. Findings. 83 84 85. 86. 16.3. 
Patient History and Progress. Female/54 years old, peri-menopause.. Self-detected palpable mass lesion on right. breast 6 o’clock direction.. No family history.. Diabetes. mellitus,. S/P. hysterectomy,. agoraphobia.. 16.2. 
Case 16
HR(+) HER2(-) Breast Cancer
16.1. . Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. cribriform/solid, extensive intraductal com­. ponent: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 20 mm.. ...
Important Radiologic. Findings. See Figs. 79, 80, 81 and 82.. 16.3. 
Patient History and Progress. Female/51 years old, peri-menopause.. Screen detected mass lesion on left breast 2. o’clock direction.. No family history.. No comorbidities.. 16.2. 
Case 16
HR(−) HER2(+) Breast Cancer
16.1. . Courses of Treatment. Operation + adjuvant chemotherapy (#4 cycles of. docetaxel and cyclophosphamide)  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 121. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.5 cm (pT1c).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nucle...
Important Radiologic. Findings. 117 118 119. 
Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. Hypothyroidism (taking on synthroid).. 16.2. 
Case 16
HR(−) HER2(−) Breast Cancer
16.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel)  +  Operation  +  Post-. operative radiation therapy.. Operation. 117. Pathology Report. No residual tumor with foamy histiocytic. collection. . 1. Post-chemotherapy status.. . 2. Lymp...
Important Radiologic. Findings. 109 110 111. 112. HR(−) HER2(−) Breast Cancer. 630. . . . ­. E. S. Lee et al.. 631. . After Neoadjuvant. Chemotherapy. 113 114 115. 116. 16.3. 
Patient History and Progress. Female/42 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast.. No family history.. s/p Cholecystectomy, s/p appendectomy, s/p. vocal cord operation.. 16.2. 
Case 16
Local Recurrence
16.1. . Courses of Treatment. Left breast DCIS → Operation → Adjuvant. therapy → Left breast recurrence (DCIS).. Primary Treatment. 116. 117. Operation. 118. Pathology Report. Ductal Carcinoma In Situ. . 1. Size of tumor: 3.0 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: present.. . 4. Architectural pattern...
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Patient History and Progress. Female/43 years old, pre-menopause.. Screen detected mass lesion on left breast 7. o’clock direction.. Outside result of biopsy: Ductal carcinoma in. situ.. No family history.. No comorbidities.. 16.2. 
Case 16
Metastatic Breast Cancer
16.1. . Courses of Treatment. Left breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. pT2N1a(sn).. Size of tumor: 2.5  cm and 1.0  cm, lymph. node: 1/2, size of metastatic carcinoma: 2.1 mm.. Result. Intensity Positive %. Estrogen. receptor. Strong (8/8). 3...
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Patient History and Progress. Female/46 years old, post-menopause.. No family history.. S/p myomectomy & bilateral salpingo-. oophorectomy.. 16.2. 
Case 17
Benign and Proliferative
17.1. . Courses of Treatment. →2021-09-17 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Atypical ductal hyperplasia involving. mammary cyst.. –. – Usual ductal hyperplasia, focal with. microcalcification.. 18. 
Important Radiologic. Findings. 30. 31. . Benign and Proliferative Case Series. 38. . 17.3. 
Patient History and Progress. Female/39 years old, pre-menopause.. Screen detected mass lesion on right breast 9. o’clock direction.. No family history.. s/p appendectomy (cecal cancer), s/p hyster­. ectomy, and bilateral salpingo-oophorectomy.. s/p partial hepatectomy.. 17.2. 
Case 17
Carcinoma In Situ
17.1. . Courses of Treatment. Operation + Tamoxifen 20 mg/day for 5 years.. Operation. 79. 80. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis(Paget)N0(sn). . 1. Size of tumor: 1.5 cm (pTis(Paget)).. . 2. Nuclear grade: high.. . 3. Necrosis: present.. . 4. Architectural. p...
Important Radiologic. Findings. 75 76 77. 78. 17.3. 
Patient History and Progress. Female/40 years old, pre-menopause.. Screen detected nodule and microcalcification. on upper outer portion of right breast.. No family history.. No comorbidities.. 17.2. 
Case 17
HR(+) HER2(+) Breast Cancer
17.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide) + Trastuzumab + Tamoxifen 20 mg/day.. ­. ­. ­. 92 93. 94. Pathology Report. [Right].. . 1. Ductal carcinoma in situ.. . (a) Size of tumor: 0.7 cm (pTis).. . (b) Nuclear grade: low.. . (c) Necrosis:...
Important Radiologic. Findings. 88 89 90. 91. 17.3. 
Patient History and Progress. Female/38 years old, post-menopause.. Self-detected palpable mass lesion on left. breast 1 o’clock direction.. Family history of prostate cancer, maternal. father.. S/P salpingo-oophorectomy (2022).. BRCA 2 mutation carrier.. 17.2. 
Case 17
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. sive intraductal component: present).. 5. Skin: no involvement of tumor.. 6. Surgical margins:. . (a) superior margin: 5 mm.. . (b) inferior margin: (see note 1)...
Important Radiologic. Findings. See Figs. 84, 85, 86 and 87.. 17.3. 
o’clock direction.. No family history.. S/P Lumbar spine disc herniation operation,. s/p pain block in lumbar spine.. S/p hormone replacement due to amenorrhea.. 17.2. 
Case 17
HR(−) HER2(+) Breast Cancer
17.1. . Courses of Treatment. Operation + Adjuvant chemotherapy (#4 cycles. of doxorubicin and cyclophosphamide  +  #4. cycles of docetaxel and trastuzumab)  +  Post-­. operative radiation therapy + Trastuzumab.. Operation. 126. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.8 and 1.5 cm (pT1c(2)).....
Important Radiologic. Findings. 122 123 124. 125. . HR(−) HER2(+) Breast Cancer. 498. . . . 17.3. 
Patient History and Progress. Female/41 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast.. Family history of breast cancer, aunt. (maternal).. S/P Lumbar spine disc operation.. BRCA 1 and 2 mutation: Not detected,. MUTYH VUS (variant of uncertain).. 17.2. 
Case 17
HR(−) HER2(−) Breast Cancer
17.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#2. cycles of doxorubicin and cyclophosphamide,. refuse) + Post-operative radiation therapy.. Operation. 122. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.3 cm (pT1c).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear ple...
Important Radiologic. Findings. 118 119 120. 121. 17.3. 
Patient History and Progress. Female/70 years old, post-menopause.. Screen detected mass at the upper outer quad­. rant of the left breast.. Family history of breast cancer, niece.. h/o Tuberculosis, s/p appendectomy, s/p. myomectomy.. BRCA 1 and 2 mutation: Not tested.. 17.2. 
Case 17
Local Recurrence
17.1. . Courses of Treatment. Right breast DCIS → Operation → Adjuvant. therapy → Right breast recurrence (mucinous. carcinoma).. Primary Treatment. 122. Operation. 123. Pathology Report. Ductal Carcinoma In Situ. . 1. Post-excisional biopsy status.. . 2. Size of tumor: 1.5 cm, residual.. . 3. Nuclear grade: high.....
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Patient History and Progress. Female/43 years old, pre-menopause.. Screen detected mass lesion on right breast 7. o’clock direction.. Outside result of mammotome biopsy: ductal. carcinoma in situ.. No family history.. s/p Total thyroidectomy (thyroid cancer).. BRCA 2 VUS (variant of uncertain).. 17.2. 
Case 17
Metastatic Breast Cancer
17.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence.. Primary Treatment. Estrogen. receptor. Strong. (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong. (7/8). 2. >2/3. C-erbB2. Negative. (0). Ki-67. Positive in. 15% of. tumor. cells. Adjuvant ...
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Patient History and Progress. Female/69 years old, post-menopause.. Family history of breast cancer, daughter.. BRCA. 1. mutation: VUS. (variant. of. uncertain).. 17.2. 
Case 18
Benign and Proliferative
18.1. . Courses of Treatment. →2021-08-27 excision, Rt.. Pathology Report. Diagnosis. • Breast, right, excision:. –. – Atypical ductal hyperplasia with micro-. calcification.. Post-excision status.. –. – Intraductal papilloma.. C. W. Lee et al.. 39. . . 19. 
Important Radiologic. Findings. 32. 33. 18.3. 
Patient History and Progress. Female/57 years old, pre-menopause.. Screen detected mass lesion on right breast. 9 ~ 10 o’clock direction.. No family history.. No comorbidities.. s/p Right breast excision.. 18.2. 
Case 18
Carcinoma In Situ
18.1. . Courses of Treatment. Operation + Postoperative radiation therapy.. Operation. 83. 84. Pathology Report. Ductal carcinoma in situ, pathological TN cat­. egory (AJCC 2017): pTis. . 1. Size of tumor: 1.1 cm (pTis).. . 2. Nuclear grade: low.. . 3. Necrosis: present.. . 4. Architectural pattern: micropapillary...
Important Radiologic. Findings. 81. 82. 18.3. 
Patient History and Progress. Female/64 years old, post-menopause.. Screen detected mass lesion on right breast. 8 o’clock direction.. Outside result of biopsy:. Right breast 8  o’clock, atypical intraductal. papillary neoplasm, favor ductal carcinoma in. situ.. No family history.. Hypertension, diabetes mellitus.. 18....
Case 18
HR(+) HER2(+) Breast Cancer
18.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #4 cycles of docetaxel and trastu­. zumab)  +  Post-operative radiation ther­. apy  +  Trastuzumab  +  Letrozole 2.5  mg/day. with goserelin.. 99. Pathology Report. Invasive Ductal Carcinoma. ...
Important Radiologic. Findings. 95 96 97. 98. 18.3. 
Patient History and Progress. Female/38 years old, pre-menopause.. Self-detected palpable mass lesion on portion. of outer half of left breast.. No family history.. Lumbar spine disc.. BRCA 1 and 2 mutation: Not examination.. 18.2. 
Case 18
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation (1st & 2nd, Aug. 2010)  +  Post-­. operative radiation therapy  +  Tamoxifen. 20 mg/day.. Operation (3rd, Jan. 2021) + Adjuvant che­. motherapy (docetaxel & cyclophosphamide) +. Letrozole 2.5 mg/day.. Operation (1st, Aug. 2010). comedo.. . 5. Surgical margins:. . (a) superior margin: 3...
Important Radiologic. Findings. See Figs. 89, 90, 91, 92, 93, 94, 95 and 96.. 18.3. 
S/P unilateral salpingo-oophorectomy, s/p. hysterectomy, Hypertension.. 18.2. 
Case 18
HR(−) HER2(+) Breast Cancer
18.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab) + Operation + Post-operative radia­. tion therapy + Trastuzumab.. . Y. Kwon et al.. 503. 3/3, 3/1HPF).. 4. Intraductal component: absent.. 5. Surgical margins:. . (a) superior margin: 40 ...
Important Radiologic. Findings. 127 128 129. 130. . Y. Kwon et al.. 501. . . . HR(−) HER2(+) Breast Cancer. 502. 18.3. . After Neoadjuvant. Chemotherapy. 131 132 133. 134. 18.4. 
Patient History and Progress. Female/61 years old, post-menopause.. Self-detected bloody discharge on nipple of. left breast.. No family history.. S/p hysterectomy.. 18.2. 
Case 18
HR(−) HER2(−) Breast Cancer
18.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide  +  #4. cycles of paclitaxel)  +  Operation  +  Post-. operative radiation therapy  +  Adjuvant. capecitabine.. Operation. 130. Pathology Report. . 1. Invasive Ductal Carcinoma.. . (a) Post-chemotherapy status.. ....
Important Radiologic Findings. 123 124. 125. After Neoadjuvant. Chemotherapy. 126 127 128. 129. 18.3. 
Patient History and Progress. Female/57 years old, post-menopause.. Self-detected palpable mass lesion and skin. change on left breast.. Family history of breast cancer, aunt. (paternal).. No comorbidities.. BRCA 1 and 2 mutation: Not detected.. 18.2. 
Case 18
Local Recurrence
18.1. . Courses of Treatment. Left breast IDC→ Operation → Adjuvant. . therapy → Right breast recurrence (IDC).. Primary Treatment. Operation. May 2001 Left modified radical mastectomy. (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 3.0 cm (pT2).. . 2. Lymph nodes: two metastases in 24 ...
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Patient History and Progress. Female/71 years old, post-menopause.. Screen detected mass lesion on right breast.. No family history.. Diabetes mellitus, Grave’s disease.. BRCA 2 mutation carrier.. 18.2. 
Case 18
Metastatic Breast Cancer
18.1. . Courses of Treatment. Left breast cancer → Operation → Ipsilateral. chest wall recurrence → Neoadjuvant chemo­. therapy → operation → targeted therapy →. Ipsilateral lymph node recurrence.. Primary Treatment. Negative (0/8). 0. 0. Progesterone. receptor. Negative (0/8). 0. 0. C-erbB2. Positive (3+). Ki-67. Pos...
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Patient History and Progress. Female/64 years old, post-menopause.. No family history.. Hypertension, diabetes mellitus.. 18.2. 
Case 19
Benign and Proliferative
19.1. . Courses of Treatment. →2021-08-03 excision, Lt.. Pathology Report. Diagnosis. • Breast, left 1 o’clock, excision:. –. – Fibroadenoma.. –. – Intraductal papilloma with usual ductal. hyperplasia.. • Breast, left 8 o’clock, excision:. –. – Intraductal papilloma with (1) usual ductal. hyperplasia, (2) microcalci...
Important Radiologic. Findings. 34 35. 36. Benign and Proliferative Case Series. 40. . . . C. W. Lee et al.. 41. 19.3. 
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. 8 o’clock direction.. Outside result of biopsy: papillary neoplasm.. No family history.. No comorbidities.. 19.2. 
Case 19
Carcinoma In Situ
19.1. . Courses of Treatment:. Operation. Operation. ­. 89. 90. Carcinoma In Situ. 92. Pathology Report. Right.. Ductal carcinoma in situ. . 1. Post-mammotome status.. . 2. Size of tumor: 0.3 cm, residual.. . 3. Nuclear grade: high.. . 4. Necrosis: absent.. . 5. Architectural pattern: cribriform/solid.. . 6. Ski...
Important Radiologic. Findings. 85 86 87. 88. 19.3. 
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected diffuse non-mass lesions on. upper, central, and lower portion of left breast.. Screen detected microcalcification on inner. subareolar of right breast.. Outside result of excisional biopsy: bilateral. ductal carcinoma in situ.. No famil...
Case 19
HR(+) HER2(+) Breast Cancer
19.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy + Trastuzumab +. Letrozole 2.5 mg/day.. 105. Pathology Report. Invasive Ductal Carcinoma. 1. Post-chemotherapy status.. 2. Size of tum...
Important Radiologic. Findings. 100 101 102 103. 104. 19.3. 
Patient History and Progress. Female/71 years old, post-menopause.. Self-detected palpable mass lesion on left. breast 11 o’clock direction.. No family history.. Hypertension,. dyslipidemia,. s/p. appendectomy.. 19.2. 
Case 19
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation + Tamoxifen 20 mg/day with leup­. rolide acetate.. Operation. Left nipple–areolar complex sparing mastectomy. with immediate implant reconstruction, sentinel. lymph node biopsy (Figs. 106 and 107).. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 1.7 cm and 0.5 cm (pT1c(2...
Important Radiologic. Findings. See Figs. 101, 102, 103, 104 and 105.. 19.3. 
No comorbidities.. 19.2. 
Case 19
HR(−) HER2(+) Breast Cancer
19.1. . Operation. 140. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.1 cm (pT2).. 2. Histologic grade: 3/3 (tubule formation: 3/3,. nuclear pleomorphism: 3/3, mitotic count:. 12/3, 2/10HPF).. 3. Intraductal component: present, extratumoral. (5%) (nuclear grade: high, necrosis: present,. architec...
Important Radiologic. Findings. 136 137 138. 139
Patient History and Progress. Female/52 years old, pre-menopause.. Self-detected palpable mass lesion on left. breast 1 and 2 o’clock direction.. No family history.. Hepatitis B virus carrier, liver cirrhosis.. Y. Kwon et al.. 505. 19.2. 
Case 19
HR(−) HER2(−) Breast Cancer
19.1. . Courses of Treatment. Operation  +  adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophospha­. mide + #3 cycles of paclitaxel-stop d/t drug-­. induced. pneumonitis). +. Post-operative. radiation therapy.. Operation. 134. Pathology Report. Invasive Ductal Carcinoma. 1. Size of tumor: 2.2 cm (pT2).. 2....
Important Radiologic Findings. 131 132. 133. 19.3. 
Patient History and Progress. Female/63 years old, post-menopause.. Screen detected mass lesion on right breast 10. o’clock direction.. No family history.. Hepatitis B virus carrier, h/o Tuberculosis.. 19.2. 
Case 19
Local Recurrence
19.1. . Courses of Treatment. Left breast IDC → Adjuvant therapy.. Primary Treatment. 133 134 135 136. 137. Neoadjuvant Chemotherapy. Neoadjuvant chemotherapy #4 cycles of doxoru­. bicin and cyclophosphamide followed by. #4 cycles of docetaxel and trastuzumab.. Operation. ­. ­. 138. 139. Pathology Report. <Right>. Com...
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Patient History and Progress. Female/52 years old, pre-menopause.. Screen detected mass lesion on right breast. subareolar area and left breast subareolar area.. No family history.. Hypertension.. 19.2. 
Case 19
Metastatic Breast Cancer
19.1. . Courses of Treatment. Right breast cancer → Operation → Adjuvant. therapy → Ipsilateral axillary lymph node. recurrence → Operation → Endocrine therapy. → Progressive disease.. Primary Treatment. Positive %. Estrogen. receptor. Strong (7/8). 3. 1/3–2/3. Progesterone. receptor. Strong (7/8). 3. 1/3–2/3. C-erbB2...
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Patient History and Progress. Female/45 years old, post-menopause.. No family history.. S/p bilateral salpingo-oophorectomy.. 19.2. 
Case 2
Benign and Proliferative
2.1. . Courses of Treatment. → 2022-02-14 Excision, Lt.. 2.3.1. . Pathology Report. • Breast, left, excision:. –. – Atypical ductal hyperplasia with micro­. -. calcification.. –. – Intraductal papilloma with usual ductal. hyperplasia.. 3. 
Important Radiologic. Findings. 3. 2.3. 
Patient History and Progress. Female/47 years old, pre-menopause.. Screen detected mass lesion on left breast. 2 o’clock direction.. Outside result of biopsy: Intraductal papilloma.. No family history.. No comorbidities.. 2.2. 
Case 2
Carcinoma In Situ
2.1. 
Important Radiologic. Findings. 7. 8. 2.3. . Course of Treatment:. Operation. 2.3.1. . Operation. 9. 10. 2.3.2. . Pathology Report. Lobular carcinoma in situ. . 1. Size of tumor: 0.2 cm2.. . 2. Nuclear grade: low.. . 3. Necrosis: absent.. . 4. Architectural pattern: solid.. . 5. Surgical margin: 2 mm from neare...
Patient History and Progress. Female/47 years old, pre-menopause.. Nipple discharge on left breast.. Family history of breast cancer, mother and. sister, aunt, cousin sister.. Thrombocytopenia (Follow-up at outside. hospital).. BRCA 2 VUS (variant of uncertain).. 2.2. 
Case 2
HR(+) HER2(+) Breast Cancer
2.1. . Courses of Treatment. Neoadjuvant chemotherapy (#6 cycles of. docetaxel and carboplatin and trastuzumab. and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. emtansine + Tamoxifen 20 mg/day.. 12. 2.3.1. . Pathology Report. . 1. Microinvasive ductal carcinoma.. . (a) Post-che...
Important Radiologic. Findings. 8 9 10. 11. 2.3. 
Patient History and Progress. Female/42 years old, pre-menopause.. Screen detected mass lesion on left breast. 1:30 and 2 o’clock direction.. No family history.. S/P Cervical spine disc operation.. 2.2. 
Case 2
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Anastrozole 1 mg/day.. 2.3.1. . Operation. Left breast conserving surgery, sentinel lymph. low, necrosis: absent, architectural pattern:. cribriform, extensive intraductal component:. absent).. 4. Skin: no involvement of tumor.. 5. Surgical ma...
Important Radiologic. Findings. See Figs. 5, 6, 7 and 8.. HR(+) HER2(−) Breast Cancer. 3. >2/3. C-erbB2. Negative (0). Ki-67. Positive in 5% of tumor cells. 2.3. 
Hepatitis B virus carrier, dyslipidemia.. 2.2. 
Case 2
HR(−) HER2(+) Breast Cancer
2.1. . Courses of Treatment. Neoadjuvant chemotherapy (#2 cycles of. docetaxel and carboplatin and trastuzumab and. pertuzumab + #4 cycles of docetaxel and trastu­. zumab and pertuzumab)  +  Operation  +  Post-­. operative radiation therapy  +  Trastuzumab. emtansine.. 2.4.1. . Operation. 17. 2.4.2. . Pathology Repo...
Important Radiologic Findings. 9 10 11. 434. 2.3. . After Neoadjuvant. Chemotherapy. 13 14 15. 16. . Y. Kwon et al.. 435. . ­. . . HR(−) HER2(+) Breast Cancer. 436. 2.4. 
Patient History and Progress. Female/68 years old, post-menopause.. A self-detected skin change and nipple retrac­. tion on left breast.. No family history.. Hypothyroidism.. 2.2. 
Case 2
HR(−) HER2(−) Breast Cancer
2.1. . Courses of Treatment. Neoadjuvant chemotherapy (#4  cycles of. doxorubicin and cyclophosphamide + #4. cycles of docetaxel) + Operation + Post-. operative radiation therapy.. 2.3.1. . Operation. 15. 2.3.2. . Pathology Report. No residual tumor with stromal fibrosis. . 1. Post-chemotherapy status.. . 2. Lymph...
Important Radiologic. Findings. 8 9 10. 11. E. S. Lee et al.. 579. . . . HR(−) HER2(−) Breast Cancer. 580. . 2.2.1. . After Neoadjuvant. Chemotherapy. 12 13. 14. 2.3. 
Patient History and Progress. Female/49 years old, pre-menopause.. Self-detected palpable mass lesion on right. breast.. No family history.. No comorbidities.. 2.2. 
Case 2
Local Recurrence
2.1. . Courses of Treatment. Left breast IDC → Operation → Adjuvant. . therapy → Left breast recurrence (IDC).. 2.2.1. . Primary Treatment. 10. Operation. Nov. 2008 Left breast conserving surgery, senti­. nel lymph node biopsy (outside).. Pathology Report. Invasive Ductal Carcinoma. . 1. Size of tumor: 0.4 cm (pT1a)...
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Patient History and Progress. Female/54 years old, peri-menopause.. Screen detected mass lesion on left breast. . 2 o’clock direction.. No family history.. No comorbidities.. 2.2. 
Case 2
Metastatic Breast Cancer
Courses of Treatment. Right breast cancer  →  Operation  +  Adjuvant. therapy → Lung metastasis → Palliative therapy. → Progression on rib and lung  →  Palliative. therapy → Progression on liver  →  Palliative. therapy.. 2.2.1. . Primary Treatment. Radiologic Finding. Estrogen. receptor. Strong (6/7). 2. >2/3. Progest...
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Case 20
Benign and Proliferative
20.1. . Courses of Treatment. →2021-05-10 excision, Lt.. Pathology Report. Diagnosis. • Breast, left, excision:. –. – Atypical ductal hyperplasia.. –. – Fibrocystic change with microcalcification.. 21. 
Important Radiologic. Findings. 37. 38. . Benign and Proliferative Case Series. 42. . 20.3. 
Patient History and Progress. Female/44 years old, pre-menopause.. Screen detected microcalcification on upper. outer portion of left breast.. Family history of breast cancer, sister.. No comorbidities.. 20.2. 
Case 20
Carcinoma In Situ
20.1. . Courses of Treatment. First Operation + Tamoxifen 20  mg/day for. 4 months.. Second Operation.. Carcinoma In Situ. 96. . ­. . Operation. First operation: Breast conserving surgery, senti­. nel lymph node biopsy (left).. Second operation: Skin sparing mastectomy. with latissimus dorsi flap reconstruction (left)...
Important Radiologic. Findings. 91. 92. 20.3. 
Patient History and Progress. Female/48 years old, pre-menopause.. Screen detected mass lesion on left breast 3. o’clock direction at first visit.. Pain on right breast at second visit.. No family history.. No comorbidities.. NGS: negative.. 20.2. 
Case 20
HR(+) HER2(+) Breast Cancer
20.1. . Courses of Treatment. Operation  +  Adjuvant chemotherapy (#4. cycles of doxorubicin and cyclophosphamide. followed by #11 cycles of weekly pacli­. taxel). +. Post-operative. radiation. ther­. apy + Trastuzumab + Letrozole 2.5 mg/day.. 110. Pathology Report. Invasive Ductal Carcinoma. 1. Post-mammotome excisi...
Important Radiologic. Findings. 106 107 108. 109. 20.3. 
Patient History and Progress. Female/75 years old, post-menopause.. Screen detected mass lesion on right breast 8. o’clock direction.. No family history.. Asthma (follow-up).. 20.2. 
Case 20
HR(+) HER2(-) Breast Cancer
Courses of Treatment. Operation  +  Post-operative radiation ther­. apy + Tamoxifen 20 mg/day.. Operation. Left breast conserving surgery, sentinel lymph. extensive intraductal component: present).. 4. Skin: no involvement of tumor.. 5. Surgical margins:. . (a) superior margin: 15 mm.. . (b) inferior margin: 20 mm....
Important Radiologic. Findings. See Figs. 108, 109, 110, 111 and 112.. 20.3. 
o’clock direction.. No family history.. S/P Tuberculosis, S/P duodenal adenoma. excision.. 20.2. 
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