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Case Records of the Massachusetts General Hospital
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Volume 353:2177-2185 November 17, 2005 Number 20
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Case 35-2005 — A 56-Year-Old Woman with Breast Cancer and Isolated Tumor Cells in a Sentinel Lymph Node
Nancy E. Davidson, M.D., Monica Morrow, M.D., Daniel B. Kopans, M.D., and Frederick C. Koerner, M.D.

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Presentation of Case

Dr. Barbara L. Smith (Surgical Oncology): A 56-year-old woman was referred to the multidisciplinary breast clinic, part of the cancer center of this hospital, for management of invasive breast cancer with a minimal tumor burden in a sentinel lymph node.

Four months earlier, screening mammography at another hospital revealed an ill-defined nodule, 0.8 cm in diameter, containing a few calcifications, in the upper outer quadrant of the right breast; the nodule had not been present two years previously. In a follow-up screening, magnification views of the nodule revealed a 1-cm mass in the outer quadrant of the right breast with . . . [Full Text of this Article]

Radiological Discussion

Pathological Discussion

Discussion of Management

The Axilla in a Patient with Minimal Disease in the Sentinel Lymph Node

Risk of Additional Nodal Metastases

Risk of Axillary Recurrence

Effect of Axillary Treatment on Survival

Sequelae of Axillary Dissection

Systemic Therapy

Defining the Risk of Recurrence

Efficacy and Toxicity of Adjuvant Systemic Therapy

Anatomical Diagnosis


Source Information

From the Johns Hopkins University School of Medicine, Baltimore (N.E.D.).; the Fox Chase Cancer Center, Philadelphia (M.M.); and the Departments of Radiology (D.B.K.) and Pathology (F.C.K.), Massachusetts General Hospital and Harvard Medical School — both in Boston.



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