To Treat or Not to Treat? A Postmastectomy Question

A 47-year-old premenopausal woman with no known family history of breast cancer and an unremarkable medical history presented to her primary care physician after palpating a mass in her left breast. A mammogram and ultrasound demonstrated a 3.2 × 1.3-cm mass at 3 o'clock, 4 cm from the nipple, in her left breast. A biopsy showed invasive ductal carcinoma, intermediate nuclear grade, with associated high-grade ductal carcinoma in situ (DCIS). Estrogen and progesterone receptors stained positive, HER2 was negative by FISH, and Ki67 was 25%.

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