Skip to main content

A 53 Year Old Woman with Ductal Carcinoma of Right Breast with Axillary Node Metastasis

This is a 53-year-old hypertensive/hypothyroidism woman who recently underwent FNAC of the axillary lymph nodes (2 months back) after a follow-up USG showed enlarged lymph nodes and multiple cysts in the right breast. She had been noticing an inverted right breast nipple from the last 4-5 months associated with skin thickening.

She had this cyst initially in both right and left breast, detected 5 years (2014) back, in a tertiary care hospital, during routine master health check-up and was reassured as it was thought to be a benign fibrocystic breast disease. However, 2 years later, she started to get on/off galactorrhea associated with intermittent right breast pain for the last 4 years. She was treated with cabergoline for her galactorrhea which used to subside the galactorrhea. She has a history of hysterectomy 3 years back. She does not have parental history of breast or any other cancer. Her grandmother died of non-breast cancer.

She was being routinely assessed for the cyst from time to time and was reassured about it. But she was worried this time due to the recent clinical breast features and opted to go for the FNAC which raised the suspicion of ductal carcinoma of the right breast with axillary node metastasis. This is was followed by trucut biopsy, repeat FNAC, PET-CT scan and other investigations which are shown below.

Patient evaluation summary



The first FNAC report: 


Repeat USG 

Repeat FNAC 

Trucut biopsy 

PET CT Scan 










Coagulation profile: 

Offline consultation with Breast Surgeon and Medical Oncologist  





Breast Panel IHC 4: 



Neoadjuvent Chemotherapy Plan  

Comments

Popular posts from this blog

55 years Old male with Bipolar affected disorder moving from depression to Manic to depression phase

Disclaimer:- This is a HIPAA de-identified open-online-patient-record with initial information in patient's voice, posted here December 2017 after collecting informed patient consent (form downloadable Click Here) This is a case of a 55 years old, diabetic, hypertensive patient who was diagnosed with Bipolar affected disorder since 1995. In 1995 due to financial loss he was attacked by this condition. He was seen by Dr. D. K Agarwala and diagnosed as BPAD-Depression phase and treated with lithium, sodium valporate, propranolol, Zeptol cr, Nitrosum - S.  With the treatment he was reasonably well but every 6 months of interval he appeared to have some disturbance like didn't want to talk to anybody, forgot to smile etc. They went to the doctor and treated accordingly and was continuing the treatment.  In the year of 2013, August he was diagnosed with BPAD-severe depression phase but, he was not responding well to the medications and then they went to NIMHANS for

Consent Forms

Hindi BMJ Consent form   Bengali BMJ Consent form English BMJ Consent form   Telegu BMJ Consent Form Telegu BMJ Consent Form   UDHC Consent Form                

drugs to avoid or use in terms of their pregnancy category

The optimal AEDs therapy of women with epilepsy who are of childbearing age is unclear because of a lack of conclusive data on the comparative teratogenicity of different antiseizure drugs and no antiepileptic drug has proven safe in pregnancy in terms of teratogenesis. Data on the comparative efficacy of various antiseizure drugs for controlling seizures during pregnancy are also quite limited, and there are no randomized trials in this setting. Treatment must be individualized for all patients. Women with epilepsy are classified as high risk during pregnancy and as there are no clear data indicating that any drug is without risk in pregnancy therefore, the antiseizure drug regimen should be optimized six months prior to planned conception.  Choice of antiepileptic drugs in women of childbearing age and  pregnant women with epilepsy:  1. T he antiseizure drug that stops seizures in a given patient is the one that should be used with an exception of valproate. 2.