Document Type
Article
Publication Title
Cureus
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.
DOI
10.7759/cureus.105719
Publication Date
3-23-2026
Keywords
axillary lymph node metastasis, breast cancer, core needle biopsy, elderly patient, geriatric oncology, invasive ductal carcinoma, luminal a subtype
ISSN
2168-8184
Recommended Citation
Ahmad CM, Tadakamalla R, Kastle R, Weitoschova A, Abboud A. Early Nodal Metastasis in an 81-Year-Old Woman With Subcentimeter Retroareolar Invasive Ductal Carcinoma: A Case That Defies Indolence Expectations. Cureus. 2026; 18(3). doi: 10.7759/cureus.105719.
