Sir,


My wife is 52 years old. Of late she has been diagnosed with moderately Differentiated Ductal Carcinoma in my left breast through FNAC on 21.12.2013

Prior to FNAC she has undergone Bilateral Mammogram and Ultra Sonography of Breast on 17.12.2013.
The finding of the Tests is given here under.
Bilateral Mammogram:
Right Breast: Fibroglandular breast tissues show heterogeneous Nodular pattern. Fibroadenoma with supero- medial aspect BI -RADS - 2 .
Left Breast Fibroglandular breast tissues show heterogeneous Nodular pattern.
One Nodular density (1.8*2.3) is seen in infero- medial aspect without any microcalcification inside.nature- indeterminate BI- RADS-4B
Axillary lymph node is seen on left side.
Skin and nipple outlines on both sides are normal.

ULTRA SONOGRAPHY OF BREASTS:

Right Breast: A nodule with posterior acoustic shadowing is noted in right Breast in upper middle quadrant.Parenchymal echopattern of right breast otherwise appears to be within normal limits.

Left Breast: A lobulated hypoechoic SOL measuring1.4*1.3*1.3 cm in size is noted in lower medial quadrent.
Both axllae- No enlarged lymph Node seen.
Impression: SOL in lower medial quadrent of left breast-? Fibroadenoma.
Involuting fibroadenoma in upper middle quadrent of right breast.


FNAC:

Smear show scattered as well as in groups pleomorphic epithelial cells.
The cells have coarse chromatin,prominent nucleoli and variable amount of cytoplasm.
Diagnosis: Moderately Differenciated Ductal Carcinoma.

Followed by such report consultation has been made with an oncology surgeon. He advised the following tests for next course of treatment.

1)     Complete Blood test including LFT,CA-15.3,
2)     Whole body bone scan
3)     Ultrasound of whole abdomen
4)     Chest x ray PA view
5)     Electrocardiogram

Report of the above tests has indicated within normal range.

Finally she has undergone Breast Conservation Surgery on 13.01.2014.

Histo pathology reports is as under:-

1) Invasive ductal carcinoma of breast-grade-lll
2) Surgical cut margins and deep plane of resection-free of lesion
3) Axillary lymph nodes-reactive. No Metastasis.
4) No definite lymphovascular or perineural invasion found.

ER, PR&Her-2/neu report is as under: -

ER- Negative

PR- Negative

C erb B2 – Negative

The Mib-1(Ki-67)labeling Index is approximately 60-70%.



This is in nutshell the present status of disease of my wife.
Kindly favor me with your advice as regards her next management of treatment as well as her survival possibility.

Regards


Snehanshu kar chaudhuri
E mail: YYYY@YYYY