Expert: Claes-Gustaf Nordquist, M.D. - 9/24/2008

Question
QUESTION: Recently my mother had a USG and FNAC done. The report reads as follows:

Report of FNAC

Site:          Breast Nodule

Aspirate:          Aspirate, Particulate

Microscopical Examination:   Cellular smear showing plenty of pleomorphic breast epithelial cells in loose clumps and individual arrangements. A few giant cells are also seen

Impression:          Duct carcinoma breast

(Advice: Urgent surgical biopsy and histopathology)  


USG of Left Breast

Procedure:          Left breast was evaluated by 12 MHz transducer

Findings:   A hypoechoic lesion measuring 1.9 cm x 1.8 cm is seen in left breast above nipple (12 o’ clock position) with irregular infiltrating superior outline. The axis of the lesion is perpendicular to the long axis of skin. No significant vascularity is seen.

Rest of the breast appears normal.

Axilla:          No evidence of enlarged lymph node is seen.

Impression:          Large mass in left breast above nipple --? Malignant.
Suggested correlation with FNAC study.


ANSWER: This is most probably a breast cancer based on both the ultrasound findings and the cytological biopsy result. Was any mammography done and if so what did it show? The lesion seems rather too big for a lumpectomy so I do suggest a mastectomy followed by radiation therapåy and maybe - depending on other findings - chemotherapy. A surgical biopsy with frozen section studies should be done during the mastectomy before that surgery is concluded. Good luck!


---------- FOLLOW-UP ----------

QUESTION: There was no mammography done. Can u based on the reports answer the following questions for me please:

- how serious is this.
- How much time do we have before going for the operation
- what are the survival chances in this case.
- what is the recovery period after operation.
- is this going to be life threatening
- which stage is this in based on the above reports.
- should an MRI be done on this.

Anything specific which you think the doctors should look at either before operating or during operating

Answer
Why not? A mammography should always be done. Cancer is ALWAYS a serious disease. It MUST be taken care of urgently! So it should be taken care of as quickly as possible! If taken care of promptly survival chances are probably good, but we will not know that better until after surgery. And as always with cancers there are no guarantees! That depends on a number of surgical factors. You will have to ask her surgeon about that (recovery time). It is not life threatening right now as far as we know but it may become if not taken care of promptly and with cancers you can never be sure. With the information given it seems to be a stage 1 or 2. But that can not really be known until after surgery. An MRI could give some more information on her tumour but is not more important than a mammography. If done they should be done together.
Actually no more suggestions at present!