J Korean Med Sci.  2023 May;38(18):e138. 10.3346/jkms.2023.38.e138.

Case 10: A 30-Year-Old Woman With Breast Mass and Family History of Cancer

• Shin K
• Lee J
• Kang J
• Yoo TK
• Lee J

• KMID: 2542030
• DOI: http://doi.org/10.3346/jkms.2023.38.e138

Figure

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  Fig. 1 The pedigree of the patient’s family. The numbers in parentheses represent the age of onset of the disease.

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  Fig. 2 (A) Mammography shows indistinct hyperdense mass upper central region of right breast (arrow) and segmental distributed multifocal grouped amorphous microcalcifications at upper outer quadrant of right breast (arrowheads). (B) Another grouped amorphous microcalcifications is noted at lower central region of left breast (arrows). (C) Indistinct hypoechoic malignant mass at 12 o’clock of right breast (arrow). Segmental ductal changes with hypoechoic nodularities (arrowheads). (D) Small but prominent lymph nodes with cortical thickening are detected in right axillary level I, which are suspicious for metastatic lymph nodes. (E) Dynamic contrast enhanced breast MRI. MRI shows irregular shaped heterogeneously enhancing malignant mass at 12 o’ clock of right breast (arrow) on early dynamic phase. Along with this mass, segmental distributed clumped NME with segmental distribution is noted at upper outer quadrant of right breast (arrowheads). (F) Multifocal clumped or clustered ring pattern NME (hollow arrows) is noted at outer region of left breast. This finding is suspected to be bilateral malignancy, which is correlated with grouped microcalcifications at left breast in mammography.MRI = magnetic resonance imaging, NME = non-mass enhancement.

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  Fig. 3 Pathological findings of the brain biopsy. (A) The tumor cells showed a lack of tubule or gland formation, moderate nuclear pleomorphism, and frequent mitosis. (B) The tumor cells were homogeneous, dark circumferential pattern in HER immunostaining. (C) HER2 amplification was identified based on silver in situ hybridization. (D, E) The tumor cells were negative in estrogen receptor and progesterone receptor immunostainings.

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