case_images: PMC10601781_01
case_images: Irregular breast mass with suspicious axillary lymph nodes. Mammogram right mediolateral oblique projection.
case_images: cro-2023-0016-0001-534146_F01.jpg
case_images: PMC10601781_01_cro-2023-0016-0001-534146_F01.jpg
case_images: F1
case_images: The mass was described as high density and irregular with associated dystrophic calcifications, as seen in Figure 1. In addition, suspicious lymph nodes were located adjacent to the mass in the axilla, also seen in Figure 1.
case_images: a Photomicrograph showing malignant spindle cells embedded within a chondromyxoid strom (H&E, original magnification x100). b Poorly differentiated carcinoma with necrosis (H&E, original magnification x100). c Lymphovascular invasion (H&E, original magnification x100). d Poorly differentiated carcinoma with marked cytologic atypia (H&E, original magnification x100).
case_images: cro-2023-0016-0001-534146_F02.jpg
case_images: PMC10601781_01_cro-2023-0016-0001-534146_F02.jpg
case_images: F2
case_images: The patient underwent ultrasound-guided core biopsy which showed a poorly differentiated (high-grade) carcinoma with necrosis and areas of malignant spindle cells embedded within a chondromyxoid stroma, suggesting metaplastic carcinoma (shown in Fig. 2).
case_images: Immunohistochemical testing for PD-L1 shows a Tumor Proportion Score (TPS) of 70% (x200 original image), performed using PD-L1 IHC 22C3 pharmDx on Dako Omnis.
case_images: cro-2023-0016-0001-534146_F03.jpg
case_images: PMC10601781_01_cro-2023-0016-0001-534146_F03.jpg
case_images: F3
case_images: Immunohistochemical testing for PD-L1 showed a Tumor Proportion Score (TPS) of 70% (shown in Fig. 3).
case_images: Radiographic response to neoadjuvant chemotherapy. a Mammogram image at time of diagnosis showing an irregularly shaped mass. b Mammogram after conclusion of neo-adjuvant chemotherapy (clip and seed in place immediately prior to lumpectomy). Concentric shrinkage of the mass is apparent by a mammogram.
case_images: cro-2023-0016-0001-534146_F04.jpg
case_images: PMC10601781_01_cro-2023-0016-0001-534146_F04.jpg
case_images: F4
case_images: When compared with imaging at diagnosis (shown in Fig. 4a), repeat mammographic imaging after completion of neoadjuvant chemotherapy demonstrated excellent radiographic response with mild residual post-treatment architectural distortion and concentric shrinkage of the primary breast mass (shown in Fig. 4b).