OCCULT BREAST CANCER – WHERE DOES THE FUTURE TAKE US? beatrizcordeiro8@hotmail.com

PW04-05

OCCULT BREAST CANCER – WHERE DOES THE FUTURE TAKE US?

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Daniela Rosado daniela.rosado@ulsaale.min-saude.pt Unidade Local de Saúde do Alto Alentejo - Hospital Doutor José Maria Grande General Surgery Portalegre Portugal

Amélia Coelho amelia.maldito@ulsaale.min-saude.pt Unidade Local de Saúde do Alto Alentejo - Hospital Doutor José Maria Grande General Surgery Portalegre Portugal

Hugo Capote hugo.capote@ulsaale.min-saude.pt Unidade Local de Saúde do Alto Alentejo - Hospital Doutor José Maria Grande General Surgery Portalegre Portugal

Portugal

Oral or Poster

Although breast cancer is the most frequent cancer in women, occult breast cancer occurs in 0,3 – 1% of cases and with the improvement in breast screening methods, its incidence has been decreasing through the years. The treatment of N+ breast cancer has evolved in recent years, decreasing the number of patients undergoing axillary dissection and adjuvant treatment. However, in occult breast cancer with complete pathological response the adjuvant treatment is still unclear. This case illustrates a case of occult breast cancer and its treatment.

Case report and literature revision of occult breast cancer.

50-year-old female patient with no personal or family history of breast cancer, with a 3 cm, right axillary node. The patient underwent breast screening, that showed no breast lesions and multiple enlarged lymph nodes on the right axilla. The biggest node (3.5 cm) was biopsied and confirmed to be breast cancer metastasis HER-2 positive. She started neoadjuvant chemotherapy and immunotherapy with partial imaging response. After 6 cycles, the patient was submitted to right axillary lymph node dissection, showing complete pathological response. After surgery, she completed immunotherapy and underwent whole right breast + axillary radiotherapy, remaining free from disease up to now.

This case illustrates a rare case of a frequent cancer and the treatment followed. Although the morbidity associated the disease has decrease, it raises the question if some adjuvant treatments can be omitted after complete pathological response.