CME INFORMATION

FACULTY AFFILIATIONS AND DISCLOSURES

Case Studies

Case 1: A 65-year-old, overweight woman with previously treated hypertension, a history of viral myocarditis and an LVEF of 50 percent who presented with a 1.2-cm, Grade III, strongly ER-positive, PR-positive, HER2-positive, node-negative infiltrating lobular and ductal carcinoma with a high Ki-67 (from the practice of Dr Sushil Bhardwaj)

Case 2: A 60-year-old woman with a family history of BRCA2 mutation who was diagnosed with a two-cm, ER-positive, PR-positive, HER2-positive, node-negative breast tumor after a routine mammography following a prophylactic oophorectomy. After bilateral mastectomies, FAC and tamoxifen, biopsy revealed ER-negative, PR-negative, HER2-negative left supraclavicular and axillary lymph nodes (from the practice of Dr Samuel N Bobrow)

Case 3: A 62-year-old woman who was initially diagnosed at age 45 with Stage III, moderately differentiated, ER-positive, PR-positive breast cancer and underwent a modified radical mastectomy (MRM) followed by doxorubicin-based chemotherapy. Investigation of upper leg and hip pain with X-ray and CT scan 16 years later revealed ER-positive, PR-positive bone metastases (from the practice of Dr Kenneth R Hoffman)

Case 4: A 61-year-old woman who underwent a left MRM without chemotherapy or hormonal therapy at age 45 for a 0.4-cm, ER-positive, PR-positive, node-negative comedocarcinoma with multifocal LCIS and DCIS. She underwent a total hysterectomy at age 47. Thirteen years after treatment of her primary, she developed a 1.5 x 1.5-cm, ER-positive, PR-negative, HER2-negative recurrence in the reconstructed breast (from the practice of Dr Stephen M Lichter)

Case 5: A 55-year-old woman who received a mastectomy, a modified AC paclitaxel regimen, tamoxifen and chest wall radiation therapy for a 6.5-cm, ER-positive, PR-positive, HER2-negative lobular carcinoma with 25 positive nodes at age 48. She presented four years later with upper abdominal pain, nausea and vomiting. Endoscopy demonstrated a partial obstruction of the gastric outlet area and biopsy revealed an infiltrating carcinoma, consistent with her previous primary breast cancer (from the practice of Dr K M Steve Lo)

Case 6: A 32-year-old woman who underwent right (and left prophylactic) mastectomy for a T2/N1, poorly differentiated, ER-positive, PR-positive, HER2-positive ductal carcinoma at age 29. She was treated with dose-dense ACpaclitaxel and discontinued tamoxifen after six months to become pregnant. Recently she developed right upper quadrant abdominal discomfort. Ultrasound and biopsy revealed multiple ER-positive, PR-positive, HER2-positive hepatic metastases. She is 26 weeks pregnant (from the practice of Dr Jeffrey L Vacirca)

Case 7: A 64-year-old woman who presented in December 2001 with a 2.7-cm, strongly ER-positive, PR-positive, HER2-negative infiltrating ductal carcinoma with 1/19 positive nodes and was treated with an MRM and FAC₁₀₀. She has nearly completed five years of an aromatase inhibitor (from the practice of Dr Leonard R Farber)

Case 8: A 41-year-old woman who had a negative mammogram and ultrasound after complaints of ill-defined fullness in her left breast. After several months, she developed pain in her left breast, with a palpable eight-cm mass in the upper outer quadrant and matted axillary nodes up to 1.5 centimeters. Core biopsies revealed an ER-negative, PR-negative, HER2-negative carcinoma with papillary features and dense infiltration of tumor emboli within the lymphatics and blood vessels (from the practice of Dr Charles M Farber)

Case 9: A 69-year-old woman with a history of hypertension, hypercholesterolemia and COPD who underwent a mastectomy for a 1.5-cm focus of ER-positive, PR-positive, HER2-positive DCIS and a 0.5-cm, ER-negative, PR-negative, HER2-positive invasive breast cancer (from the practice of Dr Carl T Henningson Jr)