CARCINOMA BREAST

-SRIVARDHINI S
PSG IMSR
CLINICAL DATA

A 61 year old menopausal woman with no known comorbidities came with

complaints of lump in left breast for one year with post excision biopsy status.
Lump was small initially and it progressed to attain the size of 3x3 cm
No associated h/o pain , nipple discharge , nipple retraction
No h/o of fever, loss of weight and loss of appetite
She attained menarche at 13 years – cycles regular
Attained menopause at 50 years.
Her obstetric score is p3L3 – normal vaginal delivery
age of first child birth is 19 years
adequately breastfed.
 INVESTIGATION REPORTS
• Mammography – BIRADS 4 (3.5cm x 3 cm left upper quadrant) with
internal vascularity and macrocalcification
• FNAC – minimal atypical with mucoid material – low grade mucinous /
colloid carcinoma
• Excision biopsy – Mucinous carcinoma
• PET-CT – irregular hypodense collection 2.2x3.7x4 cm with minimal FDG
uptake left breast subareolar region and upper outer quadrants , FDG avid left
axillary nodes
 EXAMINATION
• Conscious, oriented, afebrile
• ECOG – 1
Local examination – left breast
10 – 2 O’ clock cicrumareolar post excision biopsy wound – healthy, no
discharge, induration + at retro areolar region, nipple areolar
Complex- normal.
No skin changes
Right breast and axilla - normal
 HPE report
• Histological type : Mucinous carcinoma
• Histological grade : Grade II
• Tumour focality : unifocal
• DCIS : present
• LCIS : not identified
• Lymphovascular invasion : present
• Pathological stage classification : pN1
 MANAGEMENT
Completion mastectomy with axillary dissection
DIFFERENTIAL DIAGNOSIS

• Fibroadenoma
• Intraductal papilloma
• Lipoma
• Fat necrosis
• Cyst
• Phyllodes tumor
MUCINOUS CARCINOMA OF BREAST

• Rare form of invasive ducal carcinoma

• Incidence : 3% of invasive carcinoma
• Seen in elderly population
• The infiltrating cells secrete copious amounts of mucin and appear to float in
this material
• Usually low grade (grade 1) lesions
• Better prognosis
• Over 90% of mucinous carcinomas display hormone receptors
THANK YOU