Invasive lobular carcinoma Quiz: Ace Your Exams
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A 48-year-old woman presents to the primary care office with fullness of the medial left breast for the past two months. The area is not tender and she cannot feel a specific lump in the breast, but she has noticed some lumps in her left armpit. She has been having abdominal pain and new back pain for the last three weeks as well. Past medical history is unremarkable and she does not take any daily medications. Temperature is 37.0°C (98.6°F), pulse is 92/min, respiratory rate is 18/min, and blood pressure is 122/82 mmHg. Chaperoned examination of the breasts reveals an area of fullness and firmness in the medial left breast with lymphadenopathy in the left axilla. No skin changes are present and there is no nipple discharge. The right breast is normal. Imaging and biopsy lead to a diagnosis of stage IV lobular carcinoma of the breast with metastasis to the bone and omentum. The cancer is ER- and PR-positive, HER2-negative. Which of the following is the most appropriate treatment at this time?
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