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Noticed swelling in breast. Report shows few clusters of cells with large, coarse chromatin and prominent nucleoli. Meaning?

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Oncologist, Surgical
Practicing since : 2008
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My mother is aged 87 years old. Though she is frail, physically active. One month back she reported a swelling measuring 3*2 her left breast.The clinical report says - Smears shows few clusters of cells with large, coarse chromatin and prominent nucleoli. The background shows occasional clusters of benign ductal cells and extensive areas of necrosis.
IMPRESSION: Cytological features are suggestive of Carcinoma Breast.
Advised histopathological examination for confirmation.
My question is - what type of treatment we should undertake. Whether she will be able to withstand surgery and radiothraphy at this age.
Posted Wed, 14 Aug 2013 in Breast Cancer
Answered by Dr. Rohan Khandelwal 3 hours later
Dear Sir,

Sorry to hear about your mother's condition. There are two ways of proceeding in such a case:

1. Is to do a MRM (modified radical mastectomy; removal of the breast and the lymph nodes) , if she is fit from the anaesthesia point of view. This would require 3-4 days of hospital admission. This can be followed by hormonal treatment, if the tumor is positive for ER, PR receptors. At her age chemotherapy and radiotherapy are usually not given.

2. Other option, if she is not fit for surgery is to get a tru-cut or a core needle biopsy of the lump and send it for hormone receptors (ER, PR) and if they are positive, just put her on hormonal treatment - aromatase inhibitors (anastrozole, letrozole) or tamoxifen. This would not be curative treatment but would control the disease and would have the least amount of toxicity.

I would advise you to take her to a breast cancer surgeon and discuss these options at length with the team.

Hoping for the best. Please feel free to clarify any other query.

Dr. Rohan Khandelwal
Breast Cancer Surgeon
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