Work

Early Nodal Metastasis in an 81-Year-Old Woman With Subcentimeter Retroareolar Invasive Ductal Carcinoma: A Case That Defies Indolence Expectations

Year: 2026

Type: article

Abstract: Retroareolar invasive ductal carcinoma (IDC) represents an anatomically distinct subset of breast cancers that may evade early clinical detection. In elderly patients, small, estrogen receptor (ER)-positive tumors with low proliferative indices are often presumed to follow an indolent course. We report the case of an 81-year-old woman diagnosed with a 0.6-cm Grade II/III retroareolar IDC exhibiting strong ER expression, low Ki-67 (~6%), and human epidermal growth factor receptor 2 (HER2) negativity, yet with synchronous axillary lymph node metastasis confirmed at initial biopsy. This case underscores the limitations of relying on tumor size, age, and proliferation markers alone to estimate metastatic risk and highlights the importance of comprehensive axillary evaluation, even in clinically and biologically favorable presentations.

Source: Cureus

DOI: 10.7759/cureus.105719

Authors: Christopher M Ahmad, Rachana Tadakamalla, Rae-Anne Kastle, Andrea Weitoschova, Amer Abboud

Institution: Kansas City University

Language: English

Topic: Breast Lesions and Carcinomas

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7140093007