Case Number 15

A 64 year old white female reported a history of being aware of "something abnormal in the right breast for many years". She had had a mammogram done 2 years prior, which revealed only cystic changes. However, a more recent mammogram showed a mass 1.5 x 2.5 cm in size in the upper outer quadrant of the right breast, which was suspicious of malignancy.

The patient had taken Premarin 0.3 mg daily for years until about 3 weeks prior to referral to the surgeon. Since discontinuing the hormone, the patient reported that she felt that her breasts were "just different", although she felt that the mass recently noted on mammogram was about the same size. Physical exam revealed slight skin dimpling over the mass. Clinically, the mass was felt to be suspicious, but not diagnostic, of a malignancy.

At surgery, the mass excised was 5 cm in diameter, with much residual tumor found in the remaining breast tissue. The diagnosis was: Infiltrating duct cell carcinoma and the patient had 2 lymph nodes with metastasis.

The receptor values were as follows: Estrogen- 283 Femoles, Progesterone- 23 Femoles.