Ultrasound scan of the chest wall showed a round, homogeneous hypoechoic and avascular mass of approximately 1 cm. in the 4th intercostal right space, close to the costal cartilage. The appearances are suspicious for a metastasis to the internal mammary lymph node, given the history of breast cancer.
Two years previously, the patient underwent a right modified radical mastectomy with adjuvent chemotherapy (AC x 4 plus Taxol) and hormonal therapy (anastrozole), for a grade 3 invasive ductal carcinoma, stage pT2 (48 mm) pN3a (10/23) M0.
The tumour was positive for oestrogen and progesterone receptors and negative for HER2, with a Ki-67 proliferation rate of 35% (Luminal B breast cancer).
Radiotherapy on the chest wall was not performed.