Breast Surgery MDT

15/12/2020

Prepared by: Dr. Mazin Alsheikhly

GS R1
 1- HC06176028
IMAN M
54 years old

• Post-op:
Initial diagnosis / date Left invasive ductal
carcinoma, 23/06/2020

Initial TNM cT2(m)N0M0 

Neoadjuvant chemotherapy Yes
Chemotherapy Dates (19/07/2020 – 02/11/2020)
Chemotherapy protocol/ No. of cycles  NAC FEC x 3 + Docetaxel x 3
Surgery Left breast wire guided wide
local excision+ SLNB on
02/12/2020 (GM,SA)

Significant PMH NA

To discuss postop pathology and further management plan

 
 2- HC04664935
SAIDA D
48 years old
• Post-op:
Initial diagnosis / date Right invasive ductal
carcinoma, 03/11/2020

Initial TNM  cT2N0M0

Neoadjuvant chemotherapy No
Chemotherapy Dates -
Chemotherapy protocol/ No. of cycles -
Surgery right breast wide local excision
with therapeutic round block
mammoplasty +SLNB on
03/12/2020 (SS/SA)
Significant PMH Asthma
ex-smoker

To discuss postop pathology and further management plan

 
3- HC04222284
MARY JANE S
42 years old
• Post-op:
Initial diagnosis / date Left invasive ductal
carcinoma, 11/08/2020
Initial TNM  cT2N0M0
Neoadjuvant chemotherapy Yes
Chemotherapy Dates 07/092020 – 10/11/2020
Chemotherapy protocol/ No. of cycles  Neoadjuvant HP x 4 cycle)
Docetaxel omitted due to high
LFTs
Surgery Left breast Mastectomy +SLN
on 06/12/2020 (AS/SS)
Significant PMH -
Genetic testing Negative for BRCA1 and
BRCA2 mutations on
sequencing analysis only

To discuss postop pathology and further management plan

 
 4- HC04268164
NIVITHA A
39 years old
• Post-op:
Initial diagnosis / date Left invasive ductal
carcinoma, 24/11/2020

Initial TNM  cT2N0M0

Neoadjuvant chemotherapy No
Chemotherapy Dates -
Chemotherapy protocol/ No. of cycles - 
Surgery Wide local excision + sentinel
lymph node biopsy on
06/12/2020 (AA / WA)

Significant PMH asthma

Genetic test none

To discuss postop pathology and further management plan

 
 5- HC01287720
HAWA O
77 years old
• Post-op:
Initial diagnosis / date Left invasive ductal
carcinoma,
Initial TNM  cT1N0M0
Neoadjuvant chemotherapy No
Chemotherapy Dates -
Chemotherapy protocol/ No. of cycles -
Surgery Left Breast Wire Guided wide
local excision and SLNB on
06/12/2020 (AA)
Significant PMH hypertension. and is a known case
of non-hodgkin lymphoma, in
remission. PSH of lung lobectomy
because of non-small cell lung
cancer

To discuss postop pathology and further management plan

 
 6- HC06141266
SHEEBA G
42 years old
• Post-op:
Initial diagnosis / date Right invasive ductal
carcinoma, 2/06/2020

Initial TNM  cT2(m) N1 Mx

Neoadjuvant chemotherapy Yes
Chemotherapy Dates (01/07/2020 – 03/12/2020)
Chemotherapy protocol/ No. of cycles  TCHPx6 cycles
Surgery Modified radical mastectomy
on 07/12/2020 (SG / WA)
Significant PMH -

To discuss postop pathology and further management plan

 
 7- HC00223591
NAHLA M
50 years old
• Post-op:
Initial diagnosis / date Left invasive ductal carcinoma
+DCIS , 10/11/2020

Initial TNM  cT1N0M0

Neoadjuvant chemotherapy No
Chemotherapy Dates -
Chemotherapy protocol/ No. of cycles -
Surgery Wire guided wide local
excision + sentinel lymph node
biopsy on 07/12/2020
(SG/WA)
Significant PMH -
Genetic testing Pending

To discuss postop pathology and further management plan

 
Pre-Neoadjuvant /
Preoperative Cases
10- HC04458466
FATOUM S
78 years old
• New:
1. INCIDENTAL FINDING OF BREAST LESION ON ROUTINE CT SCAN
PATIENT IS ASYMPTOMATIC

2. Risk Factors: Menarche age -

Menopause  Yes
Number of children  7
Age at first child  -
Breast-feeding history  -
Hormonal intake  no
Smoking -
Alcohol -
Previous chemo or no
radiotherapy
Previous breast cancer no
Family history -
10-HC04458466
FATOUM S
78 years old

3. Significant medical/surgical history

-

4. ECOG performance status

0
10-HC04458466
FATOUM S
78 years old

5. Physical examination:
Cup size B/C
Ptosis grade -
Lump (size, location, attachment) PALPABLE 2 CM P/4 MASS AT 3
OCLOCK LEFT BREAST 5 CM
AWAY FROM THE NAC

Skin intact
Nipple/Areola intact
Lymph Nodes  none felt
11-HC06494335
CRISLORNA V
39 years old
• New:
1. Presenting: left breast fungating mass for 6 months, enlarged rapidly in
size with minimal bleeding from skin.
Menarche age  -
2. Risk Factors: Menopause no 
Number of children 2 
Age at first child  -
Breast-feeding history  -
Hormonal intake - 
Smoking -
Alcohol -
Previous chemo or radiotherapy -
Previous breast cancer No
Family history maternal aunt
diagnosed with breast
cancer above 40
11-HC06494335
CRISLORNA V
39 years old
3. Significant medical/surgical history
none

4. ECOG performance status

-
11-HC06494335
CRISLORNA V
39 years old
5. Physical examination:
Cup size B
Ptosis grade -
Lump (size, location, attachment) large fungating central mass
15x10cm with area of necrosis
and minimal oozing

Skin As mentioned above

Nipple/Areola  -
Lymph Nodes  palpable left axillary lymph
node
12-HC00168878
BIBIROZAH L
66 years old
• New:
1. Presenting: left breast swelling, and skin tethering associated with
pain Menarche age - 
2. Risk Factors: Menopause  yes
Number of children - 
Age at first child  -
Breast-feeding history  -
Hormonal intake  -
Smoking -
Alcohol -
Previous chemo or -
radiotherapy
Previous breast cancer -
Family history nill
12-HC00168878
BIBIROZAH L
66 years old

3. Significant medical/surgical history

history of stroke with neurological deficit ( right side hemiplegia ) ( 2 Years )
DM
HTN

4. ECOG performance status

-
12-HC00168878
BIBIROZAH L
66 years old

5. Physical examination:
Cup size DD
Ptosis grade -
Lump (size, location, attachment) Left breast palpable mass 2x3
cm

Skin skin tethering and peau

d'orange
Nipple/Areola  -
Lymph Nodes  No palpable LN
13-HC00128413
SOUD A
70 years old
• Follow up:
Previous MDT date 01/12/2020
Diagnosis (and TNM if applicable) Left DCIS

Previous MDT recommendation   MRI breast. Bilateral stereotactic

biopsies of the microcalcifications.
MDT re-discussion

Previous Treatments received (if -

applicable)

Reason for re-discussion To discuss latest pathology findings

and further management plan
Pre-Neoadjuvant / Preoperative
Cases (Triple AssessmentnClinic)
14- HC02312824
MAGDALENE S
47 years old
• New:
1. Presenting: Had mammogram done in private hospital on 2/12/2020
showed right breast suspicious mass BIRADS 4 , left breast fibroadenoma
2. Risk Factors: Menarche age
Menopause
- 
Pre-menopausal  
Number of children  -
Age at first child -
Breast-feeding history -
Hormonal intake -
Smoking -
Alcohol -
Previous chemo or -
radiotherapy
Previous breast cancer No

Family history nill

 14- HC02312824
MAGDALENE S
47 years old

3. Significant medical/surgical history

Nill

4. ECOG performance status

0
14- HC02312824
MAGDALENE S
47 years old

5. Physical examination:
Cup size A
Ptosis grade 2
Lump (size, location, attachment) 2 CM lump IN UOQ p4

Skin No changes
Nipple/Areola  Normal
Lymph Nodes  no palpable LN
15- HC00038703
ELIZABETH N
56 years old
• New:
1. Presenting: left breast pain > 1 year on& off
2. Risk Factors: Menarche age  -
Menopause Post-menopausal  
Number of children 3
Age at first child  -
Breast-feeding history -
Hormonal intake -
Smoking -
Alcohol -
Previous chemo or -
radiotherapy
Previous breast cancer no
Family history breast cancer
sister at 55
 15- HC00038703
ELIZABETH N
56 years old

3. Significant medical/surgical history

Hypertension

4. ECOG performance status

0
15- HC00038703
ELIZABETH N
56 years old

5. Physical examination:
Cup size C
Ptosis grade 2
Lump (size, location, attachment) Both breast no obvious palpable
masses

Skin Normal
Nipple/Areola  Normal
Lymph Nodes No palpable LN
16- HC02741924
RAJNI K
54 years old
1. Presenting asymptomatically
2. Risk Factors:
Menarche age 14
Menopause Post-
menopausal
Number of children 2
Age at first child  -
Breast-feeding history  2 years only
Hormonal intake  no
Smoking -
Alcohol -
Previous chemo or -
radiotherapy
Previous breast cancer No
Family history nill
 16- HC02741924
RAJNI K
54 years old

3. Significant medical/surgical history

BILATERAL OOPHERICTOMY AND HYSTERECTOMY 2018 FOR HEAVY BLEEDING

4. ECOG performance status

0
 16- HC02741924
RAJNI K
54 years old

5. Physical examination:
Cup size C
Ptosis grade -
Lump (size, location, attachment) No palpable lesions

Skin -
Nipple/Areola -
Lymph Nodes -
17- HC00040170
HANOUF B
42 years old
• New:
1. Presenting asymptomatically
2. Risk Factors: Menarche age  12
Menopause Pre-menopausal  
Number of children  3
Age at first child  -
Breast-feeding history  2-8 months
Hormonal intake  nill
Smoking -
Alcohol -
Previous chemo or -
radiotherapy
Previous breast cancer No
Family history nill
 17- HC00040170
HANOUF B
42 years old

3. Significant medical/surgical history

-

4. ECOG performance status

0
17- HC00040170
HANOUF B
42 years old

5. Physical examination:
Cup size C
Ptosis grade -
Lump (size, location, attachment) No palpable mass

Skin -
Nipple/Areola -
Lymph Nodes -
18- HC03880055
SIRJANA S
36 years old
• New/ screening:
1. Presenting:
RIGHT BREAST PAIN FOR 3 WEEKS WITH ABNORMAL U/S DONE IN PRIVATE

2. Risk Factors: Menarche age - 

Menopause Pre-menopausal  
Number of children No children 
Age at first child -
Breast-feeding history -
Hormonal intake -
Smoking -
Alcohol -
Previous chemo or -
radiotherapy
Previous breast cancer -
Family history Nill
18- HC03880055
SIRJANA S
36 years old

3. Significant medical/surgical history

-
4. ECOG performance status
0
18- HC03880055
SIRJANA S
36 years old
5. Physical examination:
Cup size c
Ptosis grade -
Lump (size, location, attachment) No palpable mass, bilaterally
nodular
Skin -
Nipple/Areola -
Lymph Nodes No palpable LN
19- HC00032580
AMEERA A
47 years old

• Follow up:
Previous MDT date 24/11/2020

Diagnosis (and TNM if applicable) Papillary neoplasm with atypical

Previous MDT recommendation
Previous Treatments received (if
applicable)
Reason for re-discussion
features (ADH vs. Papillary DCIS)
  Vacuum biopsy from the 3 o'clock
palpable lump
-
To discuss latest pathology findings
and further management plan
20- HC00131535
AMNAH A
54 years old
• Follow up:
Previous MDT date 02/12/2014
Diagnosis (and TNM if applicable) Invasive ductal carcinoma.
TNM: T1N1M0
Previous MDT recommendation  Adjuvant chemotherapy
Hormone Therapy
Radiotherapy.
Previous Treatments received (if Wide local excision in Jordan on
applicable) 05/11/2014, chemotherapy, Radiotherapy,
and 5 years of tamoxifen

Reason for re-discussion To discuss latest radiology / pathology

findings and further management plan
Probable local recurrence
21- HC00086865
NEMA K
54 years old
• Follow up:
Previous MDT date 17/11/2020

Diagnosis (and TNM if applicable) Atypical ductal hyperplasia

Previous MDT recommendation  Vacuum excision of the left breast lesion

at 12 - 1 o'clock.

Previous Treatments received (if -

applicable)
Reason for re-discussion To discuss latest radiology / pathology
findings and management plan
-Vacuum excision done
22- HC03707081
TAHANI I
41 years old
1. Presenting:
Bilateral breast pain for 3 months
2. Risk Factors: Menarche age  -
Menopause Perimenopa
use
Number of children 3
Age at first child - 
Breast-feeding history - 
Hormonal intake  -
Smoking -
Alcohol -
Previous chemo or radiotherapy -
Previous breast cancer -
Family history nill
22- HC03707081
TAHANI I
41 years old

3. Significant medical/surgical history

Nill

4. ECOG performance status

0
22- HC03707081
TAHANI I
41 years old
5. Physical examination:
Cup size D
Ptosis grade 2
Lump (size, location, attachment) No palpable mass

Skin Normal
Nipple/Areola -
Lymph Nodes No palpable LN
23- HC00011668
RIMA A
55 years old
• Follow up:
Previous MDT date 01/12/2020

Diagnosis (and TNM if Left breast lump (Atypical mammary gland)

applicable)
Previous MDT  Vacuum excision. MDT re-discussion
recommendation Concordant findings in the right breast
Previous Treatments None
received (if applicable)
Reason for re-discussion To discuss latest radiology / pathology
findings and management plan
Thank you.