CASE REPORT
INVASIVE DUCTAL CARCINOMA IN AN ELDERLY PATIENT: HOW SOCIOECONOMIC BARRIERS INFLUENCE DIAGNOSTIC DELAY AND TREATMENT PATHWAYS

UDK: 618.19-006.6-091.8

Lukarov V.

1Institute of Radiology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
2Public Health Institution – General Hospital, Veles, Republic of North Macedonia

 

Abstract

Invasive breast carcinoma is the most common malignant breast tumor and remains a major global public health challenge, with high morbidity and mortality rates among women worldwide. Early diagnosis relies on clinical assessment, imaging, and histopathological evaluation, while treatment requires a multidisciplinary approach. Invasive ductal carcinoma (IDC) accounts for approximately 70–80% of invasive cases, most frequently metastasizing to regional lymph nodes and distant organs via lymphatic and hematogenous pathways.

We present a case of a 78-year-old female with a palpable retro areolar mass in the right breast, accompanied by nipple retraction, erythema, and peau d’orange appearance. Imaging, including mammography, CT, and ultrasound, demonstrated an irregular, multilobulated, hypoechoic lesion consistent with malignancy, while fine-needle aspiration biopsy confirmed invasive ductal carcinoma. Immunohistochemistry revealed strong estrogen receptor positivity (ER 90%) and weak progesterone receptor expression (PR 2%), suggesting a hormonally driven tumor subtype with therapeutic implications.

This case highlights the diagnostic value of multimodal imaging and histopathology in elderly patients, where delayed presentation, comorbidities, and low socioeconomic status may complicate both the diagnostic process and access to timely treatment. It underscores the importance of early detection, sustained clinical suspicion, and a coordinated multidisciplinary approach to optimize outcomes in invasive breast carcinoma.

 

Keywords: invasive ductal carcinoma; multimodal imaging; peau d’orange; ER positive breast cancer.

 

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