Watchful Waiting: Well Behaved Breast Cancers Non-Surgical Management of Breast Cancer

Abstract

In December 2007, a 71 year old female with no family history of breast cancer had a screening mammogram showing a new subcentimeter mass along the 3 o’clock axis of the left breast, posterior depth. Follow up ultrasound in February of 2008 showed an 8 mm solid mass at 3 o'clock, 9 cm from the nipple, which correlated with the mammographic mass. Ultrasound of the axilla was unremarkable. Biopsy of the mass showed: moderately differentiated invasive ductal carcinoma, grade 2, ER+ (90%), PR+ (50%), her2neu- (1+), Ki-67 10% (low proliferative rate). The patient was referred to surgical oncology, radiation oncology, and medical oncology for consultation; however, she declined any surgical intervention or radiation therapy. Furthermore, the patient stated that she was only willing to take oral therapy, so aromatase inhibitors were thoroughly discussed with the patient including the side effects of osteoporosis.