63 year old female c/o ulcer in ant aspect of chest pain in both the breast. lower back ache and Rt shoulder joint pain patient is in distress quak had given some local medication since 3 year hw to proceed further poor destitute patient in govt setup



Dear Pradeep, This is an example how quacks are spoiling the patients and the disease process. Innocent people fall prey for these quacks. Coming to the case, I think Biopsy is the answer for this question. Keeping more than 3 yrs duration, could that be a malignant lesion. HPE only reveals whether malignant or not. The irregular margins indicate malignant. But with out the proper history like Fixation Involvement of nodes. Breast seems to be normal. Only age related changes. There are no signs of Cachexia. May be something like BCC OR SCC. Had it been malignant, it would have involved Breasts in these long 3 yrs duration. Backache and shoulder pain indicate spread or metastasis. I am not an expert to pass on comments but I am talking about the probabilities Pradeep. Let me wait for experts comments @Dear Rohan. Your expert opinion is required.

dear sir you used word quack in your answer. could you please explain for whom you used this word????

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Dr pradeep consider patient for hiopsy from the UPG and also trucut biopsy from the breast lump, get a CECT thorax , USG abdomen and pelvis done.

biopsy from lesion, clinical examination of both breast axilla scf, sonomammogram, chest xray. it can be a benign cause, wait for biopsy report. we can do further imaging ct thorax and metastatic workup later.

Appears to be Ca.Breast medial quadrant of the breast ulcerating through the skin, but scc of the chest wall is a DD. Edge biopsy to confirm the pathology and plan the treatment accordingly.

Advised biopsy, squamous cell carcinoma.

confirm the diagnosis of CA breast by taking a wedge biopsy. this ulcer cud be a malignant internal mammary lymph node. mammogram of both breasts. if the diagnosis is confirmed, then as it's a locally advanced if not metastatic, neoadjuvant chemo can be tried.

fulminent basal cell carcinoma

kese sir

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d/d infected keloid sqamous cell carcinoma Adv .biopsy CT chest and both axilla. Adv. Wide excision if malignant and further treatment with adv. of onco physician . if infected ulcerative keloid medical management. Excision may lead to recurrance

Looks more like a keloid. A 3year history makes me feel it is unlikely to be malignant.

first we have to confirm that it is ca breast by a wedge biopsy then we have to do workup to look for spread to other organs If is proved that it is a locally advanced ca breast then downstaging with neoadjuvant chemotherapy

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