A 50 years old female patient presente,d with painless , slow growing lump rt. breast for the last one year. O/E T4N3 M?. with opacity in rt. Iung lower zone. Management?



Trucut biopsy of breast and ct guided fnac of lung opacity. Followed by complete metastatic workup to rule out other possible Mets. If affordable PETCT will be helpful.i f lung opacity is positive Sir then the intent in management will differ but chemotherapy with anfhracyclines is to be given. Followed by toilet mastectomy for better palliation. If pt is er pr positive then after palliative chemo advice tamoxifen . If Her2u is positive and pt affordable then go for trastuzumab until disease progression or cardiac fitness permits.

B/l mammography, core biopsy. Since Rt. lung opacity is present , it is suggestive of metastatic disease. CECT abdomen, bone scan. M 1 disease so chemotherapy.

CT guided FNAC of lung opacity is done .If metastatic lesion it ia stage 4 disease. Here treatment will be chemotherapy. IN ER and PR positive cases Tamoxifen is given. In HER 2 protein positive cases Targeted drug Trastuzumab ,supplemented with Pertuzumab is given. If lung opacity is non metastatic it is stage 3 disease. Here either targeted drug Trastuzumab is given before surgery to shrink the size of tumour and then mastectomy with axillary clearance is done followed by chemotherapy and radiotherapy. Other option is surgery first followed by chemotherapy and radiotherapy

It's inflammatory Ca Bteast Needs palliative chemoradiation

Biopsy in the form of Trucut biopsy for hormonal status Too apart from histological diagnosis. Staging in the form of CECT thorax, abdomen n bone scan or whole body Pet CT scan. Ct guided FNAC from lung lesion to stamp it as a metastatic case. May then proceed with toilet mastectomy or pal chemo or hormonal therapy.

stage 4 CA.breast needs palliative treatment

Initial workup....trucut for diagnosis and hormonal status with metastatic workup ie CT abd n chest, bone scan.ideally chemo radio if inv confirm advanced Ca breast. If pt is from rural setting and difficult follow up then surgery primarily. Pt to be counseled regarding treatment being palliative n not curative. pls look into brain Mets too

It is inflammatory CA. CT scan, hormonal assay,Trucut biopsy req for diagnosis and m/t

Opacity in lower jone lungs Or breast , one can't see an opacity . But what you are describing and picture posted looks very ominous. It looks like a case malignant breast. Treatment is preoperative investigation,get pt.ready For frozen section and total Mastectomy followed by radiotherapy.

Sir, probably neoadjuvant n then surgery

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