Technical White Paper: Universal Medical Standards for Precision PET/CT Staging and Multidimensional Diagnosis of Invasive Breast Cancer with Cutaneous Infiltration
Clinical Challenge & Differential Diagnosis:◈ Occult Presentation: Patients presenting with pruritus and skin thickening can be easily misdiagnosed with chronic dermatitis.
◈ Diagnostic Hurdles: The core challenge lies in differentiating inflammatory responses from cancerous infiltration, particularly quantifying invasion into the pectoralis major.
Standardized Imaging Protocol (Universal Medical):◈ Primary Lesion Metabolism: Utilizing $^{18}\text{F-FDG}$ PET/CT to confirm irregular masses and evaluate metabolic activity to predict aggressiveness.
◈ Local Anatomical Evaluation: Imaging confirms the mass has breached the deep fascia, invading the pectoralis major and localized skin.
◈ Regional Lymphatic Mapping: Scanning the axillary, supraclavicular, and cervical Zone V regions to map metastatic lymph node distribution.
Deep Dive: Breast Cancer Classification Standards:◈ Pathological Classification:
• Non-invasive: Such as ductal carcinoma in situ (DCIS), localized within the basement membrane with excellent prognosis.
• Early Invasive: Cancer cells begin to breach the basement membrane into the stroma.
• Invasive: The most common type (>80%), including invasive ductal and lobular carcinoma, with high potential for metastasis.
◈ Molecular Subtyping:
• Standard: Based on the expression of ER, PR, and HER2 proteins.
• Clinical Significance: Subtypes like "Triple-Negative" or "HER2-Positive" dictate the specific choice of chemotherapy, targeted therapy, or endocrine therapy.
Pathophysiological Analysis of Critical Symptoms:◈ Breast Mass: 80% of patients present with a solitary, hard, irregular, and typically painless lump.
◈ Skin Changes: "Dimpling" results from Cooper's ligament involvement, while "peau d'orange" is caused by cancer cells obstructing subcutaneous lymphatic vessels.
◈ Nipple Abnormalities: Tumors involving deep ducts can lead to retraction or pathological discharge.
◈ Lymphadenopathy: Over one-third of patients exhibit ipsilateral axillary lymph node enlargement at initial diagnosis.
Clinical Benefit:Precision imaging at Universal Medical ensures patients bypass ineffective treatments and move directly into an MDT-guided scientific framework.