Images in Radiology - Ptuitary Metastases in Carcinoma Breast

A fifty-one-year-old postmenopausal woman presented with a history of an ulcerated lump in the right peast of one-year duration. It was 4 cm x 3 cm in size, in the central quadrant of the right peast. There were no nodes palpable in the right axilla but she had a right supraclavicular node. The left peast and left axilla were normal. Fine needle aspiration cytology confirmed the lesion to be a carcinoma. Her baseline haematological and biochemical investigations, X-ray chest, bone scan and ultrasound abdomen were normal. She received two cycles of neo-adjuvant chemotherapy consisting of CMF regimen (cyclophosphamide, methotrexate, 5-flourouracil). There was partial regression of the tumour. This was followed by a right modified radical mastectomy. The histopathology report was infiltrating duct carcinoma, with 11/11 axillary nodes positive for metastases. Post-operatively, she was put on tamoxifen. She also received further four cycles of chemotherapy (CMF) regimen and radiotherapy (RT) to the peast. She was asymptomatic for two years following radiotherapy.