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Abstract: In this 65-year-old female patient, a lump was found in the right breast, which was diagnosed as invasive carcinoma of the breast, a common clinical malignant tumor of the breast. Based on the pathology and the patient’s own condition, modified radical surgery for right breast cancer and axillary lymph node dissection were performed, and after oral medication for endocrine therapy, the patient’s quality of survival was improved, and no tumor recurrence or metastasis was seen.
Basic information】Female, 65 years old
Disease Type】Invasive breast cancer
Hospital】The First Hospital of Harbin Medical University
Date of consultation】March 2022
Treatment plan】Surgery (modified radical surgery of right breast cancer + axillary lymph node dissection) + oral medication (Letrozole tablets)
Treatment Period】Hospitalization for 8 days, review 2 months after discharge
Treatment effect] No recurrence of tumor metastasis, patient returned to normal life
I. Initial consultation
The patient was 65 years old and found a lump in the right breast unintentionally 1 week ago. The patient’s mammogram showed that the right breast clock at point 7 was 3.9 cm from the nipple, and a 1.6 cm × 0.9 cm hypoechoic nodule with poorly defined borders and a still regular contour was seen. The color Doppler flow imaging indicated that dotted-stripe blood flow signal was visible at the margins and inside, with an elasticity score of 2. The mammogram diagnosis was 4a, and the mammogram showed a slightly dense oval nodule of approximately 12 mm × 10 mm in size with blurred margins in the lower outer quadrant of the right breast. After full communication with the patient, ultrasound-guided mammography was performed, and the pathological result was invasive carcinoma of the breast, which was confirmed as invasive carcinoma of the breast by combining with the patient’s medical history and relevant examinations.
II. Treatment process
The patient had undergone ultrasound-guided breast aspiration, and the clinical manifestations and pathological diagnosis were clear that the patient had invasive carcinoma of the breast. Considering the patient’s age and unsuitability for breast-conserving surgery, after full communication with the patient and her family, she underwent a modified radical surgery for right-sided breast cancer, removing the right breast and removing the axillary lymph nodes.
III. Treatment effect
We are glad that the patient underwent modified radical surgery and axillary lymph node dissection for right breast cancer, which effectively prevented the continued growth of malignant tumor, reduced the risk of further metastasis, and significantly improved the patient’s survival quality. After 8 days of hospitalization, the patient recovered well from the incision, no infection or bleeding occurred, and no significant adverse reactions occurred during the drug administration, so the patient was discharged home. The patient was re-examined 2 months after discharge, and perfected mammography ultrasound, axillary lymph nodes, supraclavicular lymph nodes ultrasound and whole body bone scan, the results showed no tumor recurrence and metastasis throughout the body, and the patient’s normal life is not affected at present.
IV. Precautions
We are glad that the patient’s condition has improved, and we should pay attention to the following points.
1. Incision care: It is recommended that patients should apply pressure fixation with lap band to avoid fluid in the incision after discharge until the incision is fully recovered, and they still need to come to the outpatient clinic regularly for review and incision care after discharge, and follow the doctor’s orders for extubation and removal of stitches according to the drainage fluid or incision healing.
2. Moderate activities: After discharge, we should avoid long-term bed rest and actively move to the ground to avoid thrombosis, while the affected arm should also have moderate activities to avoid axillary adhesions and shoulder and neck pain.
V. Personal insight
For elderly women, if a breast lump is found on self-examination, they should be alerted to the possibility of breast cancer and undergo standard surgical treatment in a regular hospital. Patients should also undergo regular outpatient review every year to monitor the recurrence and metastasis of breast cancer for early detection and treatment.
In this case, breast cancer was detected early, so early surgery and letrozole treatment effectively reduced the risk of tumor recurrence and metastasis, improved the quality of life and prolonged the patient’s life.