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Palpable right breast mass in a pregnant woman

Abstract

Background A 29-year-old female presented with a palpable right breast mass at a 12-week prenatal visit. She had no family history of breast or ovarian cancer. Ultrasound revealed a 3 cm lobulated mass, which was confirmed to be malignant by a core biopsy. Postmastectomy pathology at 15 weeks' gestation demonstrated this mass to be a stage T2N0M0 high-grade invasive ductal carcinoma with 0/20 axillary nodes involved. A staging CT scan postpartum showed an enlarged right internal mammary lymph node, confirmed by MRI as suspicious for malignancy.

Investigations Physical examination, breast ultrasound, core biopsy, mastectomy, CT scan, MRI.

Diagnosis Pregnancy-associated breast carcinoma.

Management Mastectomy, chemotherapy and radiotherapy.

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Figure 1: Postpartum contrast-enhanced helical chest CT scan showing an enlarged internal mammary lymph node (white arrow).
Figure 2: Breast MRI with ultrasmall superparamagnetic iron oxide demonstrates both the enlarged right internal mammary node (white arrow) and right chest wall lesion (black arrow) with hyperintensity, indicating a tumor.

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Correspondence to Matthew S Katz.

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The authors declare no competing financial interests.

Glossary

ULTRASMALL SUPERPARAMAGNETIC IRON OXIDE (USPIO)

MRI contrast used to detect functional, rather than architectural, changes to identify nodal metastases from solid tumors

ACT

Doxorubicin, cyclophosphamide and paclitaxel

IPSILATERAL SUPRACLAVICULAR FOSSA

Regional lymph nodes on the same side of the body as the tumor that are a potential site of nodal drainage from the internal mammary or axillary lymph nodes

AJCC STAGING SYSTEM

A clinical and pathological staging system established by the American Joint Committee on Cancer to reflect prognostic factors for survival in most solid tumors, including breast cancer

SENTINEL LYMPH-NODE MAPPING

Minimally invasive surgery to assess lymph nodes most likely to be affected by the spread of a primary solid tumor

EORTC

European Organization for Research and Treatment of Cancer

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Katz, M., Schapira, L., Harisinghani, M. et al. Palpable right breast mass in a pregnant woman. Nat Rev Clin Oncol 2, 218–221 (2005). https://doi.org/10.1038/ncponc0135

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  • DOI: https://doi.org/10.1038/ncponc0135

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