Invasive ductal carcinoma and inflammatory breast carcinoma

Case contributed by Dr Garth Kruger

Presentation

A morbidly obese woman complains of a " heavy" feeling in her left breast.

Patient Data

Age: 55 years
Gender: Female

Patchwork mammography of both breasts shows a suspicious lesion centrally in the right breast.

Diffuse skin thickening and subtle suspicious microcalcifications in the left breast.

Ultrasound of the left axilla shows multiple enlarged nodes the largest of which is 3 cm in length.

Bone scan

Nuclear medicine

Diffuse increased uptake at the left breast.

Case Discussion

The large invasive ductal carcinoma of the right breast was not clinically palpable due to the size of the patient's breasts. The skin biopsy of the left breast confirmed an inflammatory carcinoma left breast.

The nodes in the left axilla were pathological and confirmed metastatic malignant cells. 

The increased isotope uptake in the left breast is a coincidental finding related to the diagnosis of an inflammatory carcinoma. 

The microcalcifications in the left breast were highly suggestive of DCIS but histology is not yet available.

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