CLINICAL AND HISTOPATHOLOGICAL CHARACTERISTICS AND SURGICAL MANAGEMENT OF BREAST CANCER: A CASE SERIES FROM A TERTIARY UNIVERSITY HOSPITAL IN SYRIA: CASE SERIES

Raja Ibrahim Almousa, Saja Ibrahim Almousa, *Marimar Ahd Kabalan

ABSTRACT

Breast cancer is a heterogeneous disease with substantial variation in clinical presentation, tumor biology, treatment response, and surgical management. This case series describes five female patients with histologically confirmed invasive breast carcinoma managed at Al-Bairouni University Hospital, Damascus, Syria, during 2026. Patients ranged from 28 to 68 years and presented with breast masses of variable size and extent. Histopathology demonstrated invasive ductal carcinoma, with heterogeneous immunohistochemical profiles, including hormone receptor-positive/HER2-positive, hormone receptor-positive/HER2-negative, triple-negative, and HER2-positive/hormone receptor-negative disease. Three patients received neoadjuvant systemic therapy before definitive surgery, including HER2-directed treatment in HER2-positive tumors. Three patients underwent mastectomy and two underwent breast-conserving surgery, with axillary surgery performed in all cases. One HER2-positive patient achieved pathological complete response, with no residual invasive carcinoma and 0/19 involved lymph nodes. The cases highlight the importance of individualized treatment based on tumor biology, disease extent, treatment response, and multidisciplinary assessment.

Keywords: Breast cancer is a heterogeneous disease with substantial variation in clinical presentation, tumor biology, treatment response, and surgical management. This case series describes five female patients with histologically confirmed invasive breast carcino