Tumor

Solid Infiltrating ductal ca (IDC) by biopsy

Staging
T4 = tumor 8x8cm and involve the skin and chest wall N1= involve 11 lymph nodes Mo= no distant metastase T4 N1 M0 = stage IIIb

Perfomance Status
Karnofsky performance 60% Requires occasional assistance but is able to care for certain personal needs

Management
Stabilize the pt Plan for radical mastectomy Not all lymph nodes can be resect due to near axillary vein

 Follow up Application of Therapy

After radical mastectomy
6 cycles of chemotherapy 15 cycles of radiotherapy 6 cycles of chemotherapy

IHC (ER,PR,HER2 ve) CT scan = no metastases

Reconstruction
Not done 17 cm scar up to left axillary