Case 30-2008 -- A 47-Year-Old Woman with a Mass in the Breast and a Solitary Lesion in the Spine

doi:10.1056/NEJMcpc0805308

Volume 359:1382-1391		September 25, 2008		Number 13

Case 30-2008 — A 47-Year-Old Woman with a Mass in the Breast and a Solitary Lesion in the Spine

William J. Gradishar, M.D., Jennifer R. Bellon, M.D., Michele A. Gadd, M.D., Helen Anne D'Alessandro, M.D., and Kristina Braaten, M.D.

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Presentation of Case

Dr. Barbara L. Smith (Surgical Oncology): A 47-year-old premenopausalwoman came to this hospital for treatment of breast cancer.

The patient had been well until 8 months earlier, when she felta lump in the upper outer quadrant of her left breast, nearthe 2 o'clock position. A diagnostic mammogram obtained at anotherhospital revealed two nodular densities in the left upper portionof the breast, close to the palpable abnormality. The same day,an ultrasonographic examination showed a cluster of cysts betweenthe 12 o'clock position and the 1 o'clock position and a thick-walledcyst, 1.8 cm in diameter, . . . [Full Text of this Article]

Differential Diagnosis

Pathological Discussion

Discussion of Management

Systemic Therapy for Metastatic Breast Cancer

Local Therapy for the Primary Breast Cancer

Surgical Management

Radiation Therapy

Management of the Metastasis

Anatomical Diagnosis

Source Information

From the Department of Medicine, Northwestern University, and the Feinberg School of Medicine (W.J.G.) — both in Chicago; and the Department of Radiation Oncology, Brigham and Women's Hospital, and the Dana–Farber Cancer Institute (J.R.B.); the Departments of Surgical Oncology (M.A.G.), Radiology (H.A.D.), and Pathology (K.B.), Massachusetts General Hospital; and the Departments of Radiation Oncology (J.R.B.), Surgery (M.A.G.), Radiology (H.A.D.), and Pathology (K.B.), Harvard Medical School — all in Boston.