CASE REPORT

Diagnosis: Breast cancer ( Ductal carcinoma ) - SE

In early September 2003, a 44-year-old woman felt a swelling with no pain in her right breast. About ten days later, another, but this time painful, swelling occurred in her left breast, and she presented to a physician. Bilateral breast ultrasonography performed on 15 September 2003 demonstrated two 17x7.8 mm and 3x2.3 mm lesions in the left breast, and four 6.6x9.4 mm, 8.5x6 mm, 12x13 mm, and 7x3.5 mm lesions in the right breast ( Appendix SE1 ).

Biopsy was performed on 25 September 2003. Histopathological examination of the specimen resected from the tumor located nearby the axilla in the upper exterior quadrant of the right breast revealed the diagnosis as "invasive ductal carcinoma - grade 3" ( Appendix SE2 ). The patient was offered chemotherapy, but she declined.

She presented to Dr. Ozel on 9 October 2003. On physical examination gastrointestinal, respiratory, and cardiovascular systems were normal. Blood pressure was 140/80 mm Hg. There was a 3x3 cm not very hard mass, which was not adhering anywhere, underneath the surgery scar in the upper exterior quadrant of the right breast. Palpation revealed one 1x1 cm mass at the right site of the right areola, and a few 1.5x1.5 cm nodules in the left breast. Further, there were some 1.5x1.5 cm lymphadenopathies in both axillae. These were in accordance with the findings of the bilateral mammography and bilateral breast ultrasonography performed a few days later on 13 October 2003 ( Appendix SE3 ). 0.8 cc test dose of NOI caused her body temperature to rise to 37.6^o C. She was then placed on a regular daily regimen of 0.8 cc dose of NOI to be given six times per week. It was advised to adjust the dosage according to the maximum fever occurring after NOI injections.

A follow up bilateral mammography performed on 22 October 2003 revealed the following: - millimetric cyst in the right breast, - lesions in both breasts that had smooth contours and that held the contrast in a benign manner, - a solid mass in the lower middle section of the left breast that held the contrast substance in a plateau form. Biopsy was recommended ( Appendix SE4 ).

On 27 October 2003, the masses in the left breast were excised. Histopathological examination of them revealed the diagnosis as "fibroadenoma and fibrocystic changes" ( Appendix SE 5 ).

Remarkable regression of the right breast tumor occurred. Lumpectomy and right axillar dissection were performed on 7 November 2003 at the same medical facility where the first biopsy was done. Histopathological examination of the biopsy specimens revealed no malignant cells ( Appendix SE6 ).

The patient presented to Dr. Ozel on 10 December 2003 for follow up. She had no complaint whatsoever. She was experiencing no fever after NOI injections. She was then placed on a maintenance regimen with 0.8 cc dose of NOI to be given every other day. She continued the maintenance treatment for three months, and N.O. treatment ended.

As in December 2006, she has been in complete and sustained regression.