Case Number 4

A 56 year old white female was seen 12/30/82. She presented with a history of a left breast mass found 8 days before examination. The patient had symptoms of brachial plexus irritation for 8 months. She had been seeing a local medical doctor, then was referred to an orthopedist, who had x-rays taken. No abnormality was found on x-ray. The patient continued to have left arm and forearm pain.

A mammogram done in December of 1982 was suggestive of inflammation without tumor.

An exam revealed that the entire breast was involved. The breast felt firm, extending into the axilla.

The patient had been taking Premarin 1.25mg on a cyclic basis. Surgery was done on 1/3/83 and revealed extensive infiltrating moderately differentiated duct cell carcinoma with numerous metastatic lymph nodes found. It was noted that some nodes were adherent to the subclavian vessels.

The estrogen receptors were 0.