Abstract
A 35-year-old woman presented to her primary care physician for evaluation of a palpable left breast mass. Diagnostic mammography revealed 2 separate masses: a 1.4-cm mass at the 3 o’clock position, 10 cm from the nipple; and a 1.3-cm mass in the lateral breast, 4 cm from the nipple. Ultrasound of the axilla revealed an enlarged lymph node found to be malignant on fine-needle aspiration cytology. Image-guided core biopsies of both masses revealed a poorly differentiated invasive ductal adenocarcinoma. Estrogen receptor (ER) was strongly positive in 95% of tumor cells, progesterone receptor (PR) was positive in less than 5% of tumor cells, and human epidermal growth factor receptor 2 (ERBB2 [HER2]) by immunohistochemistry (IHC) was scored as 1+
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