Breast Cancer Staging and management surgical

staging of breast Ca

1. left breast birads 4a lesion

2. 28years old/single/ indian lady, nkmi HOPI left breast lump for 1year o/e right breast : NAD left breast : 3x2cm lump at 12o clock perioareolar region, firm, mobile, no skin changes, no nipple retraction no axillary LN palpable bilaterally Ultrasound Bilateral Breasts 21.05.2024 Left: There is a circumscribed, macroand microlobulated hypoechoic lesion seen at 12:00 periareolar region measuring 1.4x3.0x2.1cm( APxWxCC ) associated with mild posterior enhancement. Internal vascularity seen within this lesion.No other focal solid or cystic lesion.Retroareolar region is clear.Subcentimeter axillary lymph node with thickened cortex of 0.6cm seen. This could be reactive lymph node. Right: Normal fibroglandular breast tissue.Retroareolar region is clear..No focal solid or cystic lesion. Subcentimeter axillary lymph node with thickened cortex of 0.5cm seen. This could be reactive lymph node. Impression: 1. Left 12:00 benign appearing breast lesion. However, due to its size,suggest for HPE correlation. 2. Bilateral subcentimeter axillary lymph nodes with thickened cortices. Overall BIRADS 4a

3. FNAC left breast : Atypia of indetermined significance These smears show small fragments with scant and no myoepithelial cells with minimal nuclear atypia . Underlying premalignant lesion could not be excluded explained to patient regarding FNAC finding which is inconclusive will do excision biopsy of left breast lump if HPE is malignant, might need left mastectomy in view of lesion is at periaoreolar region Pre op : pending