Breast Cancer of an Accessory Nipple
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《新英格兰医药杂志》
A 42-year-old woman presented to the breast clinic with a mass posterior to an accessory nipple (arrow) that had been progressively enlarging over the past year. On physical examination, the patient had an irregular, hard mass, 3 cm by 4 cm, overlying the chest wall. The mass was inferior to the right inframammary fold and directly posterior to the accessory nipple. There were focal erythematous skin changes, suggesting local skin involvement. The patient also had a palpable right axillary lymph node. A punch biopsy of the mass was performed, which revealed a poorly differentiated adenocarcinoma, consistent with invasive ductal carcinoma of the female mammary gland; there was invasion of the dermis. The cells did not express estrogen or progesterone receptors, but HER2/neu overexpression was identified. The right axillary lymph node was aspirated, and metastatic breast carcinoma was identified. A metastatic workup revealed metastases to the liver, chest wall, and bone. The patient is receiving neoadjuvant chemotherapy with vinorelbine, trastuzumab, and zoledronic acid.
Leah S. Gendler, M.D.
Kathie-Ann Joseph, M.D., M.P.H.
Columbia University Medical Center
New York, NY 10032
Leah S. Gendler, M.D.
Kathie-Ann Joseph, M.D., M.P.H.
Columbia University Medical Center
New York, NY 10032