PMC6759282_01
Breast ultrasound of patients taken preoperatively and during postoperative follow-up.. Notes: (A) Pre-operation: left breast (27 x 12 mm) mass, right breast (5 x 4 mm) mass. (B) At 9 months after mastectomy, no mass was found under the chest wall, but a new (5 x 3 mm) nodule was found in the right breast. (C) At 16 months after surgery, there was no change on the left, and no nodule was found in the right breast. Red arrows indicate localization of masses and nodules.
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Breast ultrasonography revealed a 27 x 12-mm primary lesion in the left breast at the 3 o'clock position and assessed as category 5 by the Breast Imaging-Reporting and Data System (BI-RADS) and a 5 x 4-mm primary lesion in the right breast at the 12 o'clock position assessed as category 4B by the BI-RADS (Figure 1A).
Analysis of primary breast lesion tissue.. Notes: (A-B) Hematoxylin and eosin staining of the left (A) And right (B) Breast lesions (100x magnification); (C) Immunohistochemistry for HER2 3+; (D) Immunohistochemistry for Ki-67 accounting for 30% of cells in the primary left breast lesion.
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IDC grade III with ~30% high-grade ductal carcinoma in situ (DCIS), and 3/25 left axillary lymph nodes had evidence of metastasis. Immunohistochemistry (IHC) showed an estrogen receptor positive (ER +) frequency of 50%, progesterone receptor positive (PR +) frequency of 50%, human epidermal growth factor receptor 2 positive (HER2 +) status of 3 +, and Ki-67 index frequency of 30% (Figure 2).