[A woman with a disappearing breast]

Area of Science:

• Oncology
• Radiology
• Clinical Medicine

Background:

• A 76-year-old woman with a history of breast-conserving therapy for breast cancer 26 years prior presented with dyspnea.
• The patient had undergone regular mammographic follow-up for over two decades.

Observation:

• Physical examination revealed skin redness on the left torso and neck.
• A notable observation was the disappearance of the left breast and a shifted left nipple.

Findings:

• These clinical signs indicated a metastatic recurrence of the breast cancer.
• The locally recurrent disease, manifesting as complete breast shrinkage, was missed by mammography alone.

Implications:

• This case highlights the critical importance of physical examination in breast cancer follow-up.
• Integrating physical exams with mammography can improve early detection of recurrent disease.