MICROINVASIVE BREAST-CARCINOMA WITH EXTENSIVE INVOLVEMENT OF LEVEL-III AXILLARY LYMPH-NODES - A CASE-REPORT

A 44-year-old woman presented with a right huge axillary mass. Both ma mmography and ultrasonography revealed a primary cancer of 2.8 cm maxi mum diameter in the right breast and metastases in the axillary lymph nodes, both being confirmed by aspiration cytology as ductal carcinoma . Right standard radical mastectomy with level III axillary lymph node dissection was carried out. Pathologically, the tumor was diagnosed a s ductal carcinoma in situ with microinvasion (DCISM), histologic grad e 3. The area of stromal invasion measured 1 mm at its widest point. S ixteen of the 17 resected axillary lymph nodes contained metastases, i ncluding six level III lymph nodes. Immunohistochemical studies of the tumor revealed overexpression of p53 protein, but not that of c-erbB- 2 protein. The frequency of lymph node metastases from DCISM is report ed to be very low. Therefore, the present case with extensive involvem ent of level III lymph nodes was unusual.