Case Number 12

A 58 year old white female noticed a sudden onset of pain and swelling in the left breast on 6/14/83. Both the breast and axilla were sore to touch. The patient thought that trauma had caused the soreness and swelling. The patient had been taking Premarin 21 out of 28 days for twenty years as hormone replacement therapy.

Exam revealed a very broad, indefinite firm area occupying an area from 12 o'clock to 3 o'clock with large axillary nodes in the left breast. The patient also had an indurated area in the upper outer quadrant of the right breast with no nodes felt on the right.

The patient's history included left breast tenderness found by her local medical doctor, with no mass felt, 1 year prior to the sudden onset of pain and swelling in the left breast. Both nipples had been noted to be retracted for many years.

Surgery revealed infiltrating duct cell carcinoma in the left breast with 17 of 17 lymph nodes positive. Receptor values were- Estrogen-2 Femoles, Progesterone-0.3 Femoles,