Breast ductal carcinoma

[alasri]

I am a female Dr aged 69 yrs and i noticed a small 1 mm lump in the rt breast in the midline just 1 cm below the nipple 2 yrs back. It was round with clear margins and firm in consistency. I thought it as fibroadenoma and neglected. It was slowly growing in size and attained 1 cm size and i underwent excision biopsy and the HP exmn revealed ductal cell carcinoma invasive.no lymph nodes are palpable. No skin involvement.i will attach a HP report from care hospital, Banjara hills, Hyderabad.

I want the opinion of surgical oncologist and radiTion oncologist to give opinion regarding further management.

I will be highly thankful

Dr

[roxboxfox RadiationOncologist]

Dear Dr,

The excisiom Biopsy has confirmed the Malignancy.

Unsure If SonoMammography has been done..But if not that needs to be done to rule out Multicentricity of this disease.

You need basic Metastatic Workup like Chest X-ray and USG A/P.

The Standard Recommended Guidelines would be to undergo Wide Local Excision with Sentinel Lymph node Biopsy (SLNB)

Few Centres practice SLNB, but instead do Axillary Clearance.

The Biopsy specimwn needs to be sent for IHC staining for ER/PR/Her2 status. Reporting.

Once you undergo Surgical staging, we would assign you Surgical Pathological Final Staging based on Final size, Presence of any node metastasis.

Following this Breast Conserving Surgery, it is mandatory to undergo Adjuvant Radiotherapy to the Breast

Your Other option is Modified Radical Mastectomy which if Nodes are negative, will help u avoid Radiotherapy.

Please see Surgical Oncologist

There are Plenty of Cancer centres in Hyderabad.

All the best

[alasri in reply to roxboxfox]

Thank you Doctor

I am undergoing wide excision and axillary clearence in two days followed by radio therapy.

MRI and mammography did not show multicentric origin.

Chest xray and US of abdomen are normal

I am thankful for your advise

[sumeet_shah Administrator]

Dr. Rohit has answered this well. Nothing much for me to add.