A 48-year-old woman presented with a palpable right breast mass. Case presentation Medical exam Physical examination indicated a lump on the upper outer quadrant of her right breast. Radiologic examination Mammogram showed bilateral dense breasts with abnormal micro-calcifications. Ultrasound of the right breast revealed a 3.6-cm hypoechoic area, along with some abnormal-appearing axillary lymph nodes.
Ultrasound-guided biopsy of the right breast lesion and one of the axillary lymph nodes showed an invasive ductal carcinoma, negative for estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2)/ neu receptors ( Figure 1 ). Staging workup with positron emission tomography (PET)/CT confirmed the right breast lesion, with a maximum standardized uptake value (SUV) of 12, and multiple loci of right axillary nodal involvement, with an SUV of 4. There was no other uptake in…