A difficult diagnosis of asynchronous both side breast cancers

A 53-years-old woman was diagnosed with left breast cancer (T2N0M0, Stage HA) and underwent breast conserving surgery and axillary lymph nodes resection. She was administered 2 courses of chemotherapy consisting of cyclophosphamide, methotrexate, and fluorouracil (CMF) and received a total of 50 Gy of radiation therapy as adjuvant therapy. Ultrasonography of the right breast, performed 2 years after the first operation, detected a tumor 7 mm in diameter. A core needle biopsy of the tumor was performed. The pathological diagnosis was fibroadenoma. The patient's whole body was checked for metastatic legions, but none were found. Right axillary lymph node swelling was detected 9 years after her first operation, and a surgical biopsy was performed. Frozen section analysis indicated that it was metastasis from the breast cancer. A further surgical biopsy was performed on the right breast mass. Frozen section analysis indicated the tumor was invasive ductal carcinoma within a fibroadenoma. Breast conserving surgery and axillary lymph node dissection were performed for the right breast cancer. The final permanent pathological diagnosis of the right breast was invasive ductal carcinoma within fibroadenoma (T2N1M0, Stage IIB), negative for estrogen receptor, negative for progesterone receptor, and negative for epidermal growth factor receptor 2 (ErbB-2). The patient was administered 3 courses of chemotherapy consisting of taxotere and cyclophosphamide (TC) and received a total of 50 Gy of radiation therapy. The patient is alive without metastases 3 years after the second surgery.