Invasive breast carcinoma of no special type

Case contribution: Dr Radhiana Hassan


  • A 49-year old single, mute and deaf
  • Presented with left breast lump a few months ago, recently increased in size
  • Only informed caretaker when the lesion is feels uncomfortable
  • Mass felt in the left breast and enlarged left axillary nodes
Bilateral mammogram
Bilateral mammogram
Enlarged focused image at mass lesion

Mammogram findings:

  • A large mass seen at left upper inner quadrant (yellow arrows)
  • Suspicious clustered microcalcifications are seen within the mass
  • No speculated margin or architectural distortion
  • No skin thickening or nipple retraction
Ultrasound of mass lesion
Ultrasound of axillary nodes

Ultrasound findings:

  • A large mass occupying whole upper inner quadrant measuring about 6x5x4 cm.
  • It shows well circumscribed border with heterogenous echogenicity
  • No posterior shadowing seen
  • There is increased intralesional vascularity and also presence of penetrating vessels
  • A large mass at left axilla measuring about 2.0 x 1.8 x 2.7 cm.
  • No other lesion in both breasts.

Progress of patient:

  • Biopsy done shows invasive carcinoma
  • Mastectomy done. A 70x45x35 mm mass.
  • HPE: invasive carcinoma Grade III with tumour necrosis, pleomorphic nuclei and cytoplasm, no vascular invasion, one axillary node replaced by tumour cells. T3N1
  • CT staging shows no distant metastasis

Diagnosis: Invasive carcinoma of the breast


  • Invasive breast carcinoma or also known as ductal carcinoma of no special type (NOS) is the most common type of breast cancer representing 65% to 75% of cases.
  • Peak age of presentation is about 50 to 60 years.
  • Staging of cancer is usually done using TNM classification
  • Assessment of primary tumour:
    • Tx: primary tumour cannot be assessed
    • T0: no evidence of primary tumour
    • T1: ≤20 mm
    • T2: >20mm ≤ 50 mm
    • T3: >50 mm
    • T4: any size with direct extension to chest wall and/or skin


Author: radhianahassan