What happened, in summary

A 62-year-old woman presented in June 2022 with a small left breast mass. Biopsy showed high-grade invasive ductal carcinoma. Imaging also found several liver masses, creating concern that the breast cancer might have spread.

Because the liver disease appeared more aggressive, she underwent liver surgery first. Pathology showed that the liver tumors were not breast-cancer metastases but a separate mixed primary liver cancer containing hepatocellular and intrahepatic cholangiocarcinoma components.

Her breast cancer was then treated with 4 cycles of docetaxel, cyclophosphamide, and trastuzumab, with trastuzumab continued for a total of 1 year. In September 2022, she underwent left breast resection with sentinel lymph node biopsy. Postoperative pathology showed Stage I invasive ductal carcinoma with no involved sentinel lymph nodes. The breast tumor did not progress. The separate liver cancer required its own surgical management and follow-up.