THE BREAST - cases for discussion per group

Prepare powerpoint presentation for Saturday, March 19, 2022

Case # 1
51 year old female diagnosed with right breast carcinoma.

Histopathology Report:

Invasive Breast Carcinoma, No Special Type, Nottingham Histologic Grade 2 with Metastasis to
four of 11 axillary lymph nodes

Lymphovascular space invasion, observed

Nipple and skin, positive for tumor.

Basal margin, negative for tumor

Tumor greatest dimension = 9.2 cm (ulcerated)

Estrogen and progesterone receptor = negative : Her2 = negative.

1. What is the tumor stage of the patient?

2. Discuss the prognostic and predictive factors in this particular case.

3. Discuss the molecular subtype of this particular patient.

Case # 2
47 year old female diagnosed with left breast carcinoma.

Histopathology Report :

Invasive Breast Carcinoma, No Special Type, Nottingham Histologic Grade 3 with Metastasis to
10 of 12 axillary lymph nodes

Lymphovascular space invasion, observed

Nipple and basal margin, negative for tumor

Tumor Greatest Dimension = 3.2 cm

Estrogen and progesterone receptor = negative ; Her2 = negative.

1. What is the tumor grade of the patient.

2. Discuss the prognostic and predictive factors in this particular case.

3. Discuss the molecular subtype of this particular patient.

Case # 3
68 year old female recently diagnosed with left breast cancer.

Histopathology Report:

Mucinous Carcinoma, Nottingham Histologic Grade 1

Lymphovascular space invasion, not observed

22 axillary lymph nodes, negative for tumor

Nipple and basal margin, negative for tumor.

Tumor Greatest Dimension = 4.5 cm

Estrogen and progesterone receptor = positive ; Her2 = negative.

1. What is the tumor stage of the patient?

2. Discuss the prognostic and predictive factors in this particular case.

3. Discuss the molecular subtype of this particular patient.

Case # 4
56 year old female recently diagnosed with right breast cancer.

Histopathology Report:

Invasive Breast Carcinoma, No Special Type, Nottingham Histologic Grade 3 with metastasis to
12 of 12 axillary lymph nodes

Lymphovascular space invasion, observed

Nipple and basal margin, negative for tumor.

Tumor Greatest Dimension = 5.0 cm

Estrogen and progesterone receptor = negative; Her2 = positive.

1. What is the tumor stage of the patient?

2. Discuss the prognostic and predictive factors in this particular case.

3. Discuss the molecular subtype of this particular patient.

Case # 5
29 year old female recently diagnosed with left breast cancer.

Histopathology Report:

S/P Neoadjuvant Chemotherapy, No residual Carcinoma

2 of 12 axillary lymph nodes positive for metastatic carcinoma

Lymphovascular space invasion, not observed

Nipple and basal margin, negative for tumor.

Estrogen and progesterone receptor = negative ; Her2 = negative.

1. What is the tumor stage of the patient?

2. Discuss the prognostic and predictive factors in this particular case.

3. Discuss the Residual Cancer Burden Scoring.

Case # 6
64 year old female diagnosed with left breast cancer.

Histopathology Report:
S/P Neoadjuvant Chemotherapy, 2.8 cm ill-de ned rm mass, Invasive Breast Carcinoma, No
Special Type, Nottingham Histologic grade 2

10 axillary lymph nodes, negative for tumor

Lymphovascular space invasion, not observed

Nipple and basal margin, negative for tumor.

Estrogen and progesterone receptor and Her2 positive.

1. What is the tumor stage of the patient?

2. Discuss the prognostic and predictive factors in this particular case.

3. Discuss the Residual Cancer Burden Scoring.

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Case # 7
68 year old female diagnosed with Invasive Papillary Carcinoma of the right breast on core
needle biopsy. Estrogen and progesterone receptor positive; Her2 negative. Patient was
scheduled for wide excision of the mass (1.8 cm partly solid partly cystic) with frozen section of
the sentinel lymph nodes. Sentinel lymph nodes were negative. No lymphovascular invasion.

1. What is the tumor stage of the patient?

2. Discuss the prognostic and predictive factors in this particular case.

3. What is a sentinel lymph node? What is the importance of this lymph node in the
management of this particular patient.

Case # 8
70 year old female diagnosed with Invasive Breast Carcinoma of the right breast on core
needle biopsy. Estrogen and progesterone receptor are positive; Her2 negative. Patient
was scheduled for wide excision of the mass with frozen section of the sentinel lymph nodes.
Sentinel lymph nodes turned out to be positive.

1. At this point, can you give the tumor stage the patient? Why?

2. Discuss the prognostic and predictive factors in this particular case.

3. What is a sentinel lymph node? What is the importance of this lymph node in the
management of this particular patient.