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Palpable right breast mass in a pregnant woman


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


Doxorubicin, cyclophosphamide and paclitaxel


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


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


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


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).

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