A CASE OF MIXED INFILTRATING (LOBULAR AND DUCTAL) BREAST CARCINOMA IN A PREVIOUSLY DIAGNOSED PATIENT OF UDH

Introduction: Breast carcinoma has a heterogenous clinical and pathological presentation. Here is a female of 41 years, with a clear-cut, painless mass of the left breast for three years. Her radiology consisted of an USG which had an evidence of heterogeneously hypoechoic space occupying lesion in left breast with evidence of few ipsilateral, subcentimetric, lymph nodes in left axilla (BIRADS ¾). Her tru-cut biopsy had earlier showed Usual Ductal Hyperplasia (UDH) but her excisional biopsy revealed 'Infiltrating Mixed (Lobular+Ductal) Carcinoma with Usual Ductal Hyperplasia'. Thus, a Modified Radical Mastectomy (MRM) was done under General Anesthesia and the specimen was sent to our histopathology laboratory which revealed Invasive Carcinoma with Mixed Lobular and Ductal features; Lymph nodes, left, axillary dissection: 17/17 positive. Nottingham Grade III (3+3+3=9). Discussion: Diagnosing cases of DCIS is not an issue but the problem arises in differentiating benign intraductal lesions from invasive carcinoma. Conclusion: To the best of our understanding, this is a rare presentation case where there is transformation from benign intraductal lesion into mixed invasive (ductal and lobular) carcinoma.