METAPLASTIC CARCINOMA OF BREAST : A CASE REPORT

Metaplastic breast cancer constitute nearly 1 % of all breast carcinoma cases. There is metaplasia of normal epithelial components of the breast into other types. They are highly aggressive with very poor prognosis. Here we present a case of 30 year old female who presented with a breast lump in her left breast associated with dull aching pain. It was 10 x 10 cm in size involving upper inner, upper outer, lower outer quadrants and retroareolar area of left breast. USG was suugestive of BIRADS VI lesion. Axillary lymph nodes were not found enlarged clinically or radiologically. Core biopsy report showed Phylloides tumor of breast. The patient underwent simple mastectomy of left breast and histopathology revealed spindle cell variant of metaplastic breast cancer. The cell blocks sent for immunohistochemistry were negative for estrogen, progesterone receptors and Her2neu receptor. The post surgical treatment of this type of breast cancer is still under study.

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Massive inflammatory reaction following the removal of a ruptured silicone implant masking the invasive breast cancer – case report and literature review

Polish Journal of Surgery ◽

10.1515/pjs-2016-0026 ◽

2016 ◽

Vol 88 (1) ◽

Author(s):

Piotr Nowaczyk ◽

Aleksandra Budnicka ◽

Mateusz Wichtowski ◽

Paweł Kurzawa ◽

Dawid Murawa

Keyword(s):

Breast Cancer ◽

Histopathological Examination ◽

Breast Implants ◽

Breast Cancer Case ◽

Left Breast ◽

Cancer Case ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Breast Cancers ◽

Inflammatory Infiltration

AbstractThis paper presents a case of a patient with invasive ductal breast cancer following breast augmentation. Following breast implants rupture in March 2013 the breast implants have been removed – histopathological examination revealed leaked silicone with inflammatory infiltration, without evidence of cancerous lesions. Diagnostic imaging revealed multiple encapsulated silicone particles and clusters of post-inflammatory macrocalcifications in both breasts. In January 2014 the patient presented with symptoms of massive inflammation of the left breast. Following surgical consultation the patient had undergone radical left-sided mastectomy with lymphadenectomy. Postoperative histopathological examination revealed a multifocal advanced invasive ductal cancer G3 pT3pN3a (vascular invasion, metastases in 11 of 12 examined axillary lymph nodes). Following surgery the patient was qualified for further treatment – chemotherapy, radiotherapy, hormone therapy. The discussion includes a review of literature on the risk evaluation of co-occurrence of breast cancers in women with silicone breast implants and presents diagnostic challenges of breast cancer in this patient group.

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Adjuvant chemotherapy with doxorubicin plus cyclophosphamide, methotrexate, and fluorouracil in the treatment of resectable breast cancer with more than three positive axillary nodes.

Journal of Clinical Oncology ◽

10.1200/jco.1991.9.12.2134 ◽

1991 ◽

Vol 9 (12) ◽

pp. 2134-2140 ◽

Cited By ~ 113

Author(s):

R Buzzoni ◽

G Bonadonna ◽

P Valagussa ◽

M Zambetti

Keyword(s):

Breast Cancer ◽

Left Breast ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Free Survival ◽

Postoperative Irradiation ◽

High Risk Breast Cancer ◽

High Risk Breast ◽

Risk Breast Cancer

To improve current adjuvant results in high-risk breast cancer, in February 1982 we activated a prospective randomized trial using both intravenous cyclophosphamide, methotrexate, and fluorouracil (CMF) and Adriamycin (doxorubicin; Farmitalia-Carlo Erba, Milan, Italy) involving patients with resectable mammary carcinoma and more than three positive axillary lymph nodes. The objective of the study was to assess the effectiveness of four courses of Adriamycin followed by eight courses of CMF versus two courses of CMF alternated with one course of Adriamycin for a total of 12 courses. All drug courses were recycled every 3 weeks. Rather than temporarily reducing doses in the event of myelosuppression on the planned day of treatment, drug administration was delayed for 1 to 2 weeks. At a median follow-up of 59 months, treatment outcome was significantly superior for patients who received Adriamycin followed by CMF (Adriamycin----CMF) than for those given alternating regimens (CMF/Adriamycin). The 5-year relapse-free survival was superior post-Adriamycin----CMF (61%) compared with post-CMF/Adriamycin administration (38%; P = .001). The corresponding figures for the 5-year total survival were 78% and 62%, respectively (P = .005). The benefit of Adriamycin----CMF was observed in all patient subsets. Treatment was fairly well tolerated, and we documented only one case of fatal congestive heart failure in a patient who received postoperative irradiation to the left breast in addition to Adriamycin. Present findings indicate that in women with extensive nodal involvement, Adriamycin----CMF yielded superior results compared with CMF/Adriamycin.

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p29 Protein in Breast Cancer: Relation between Estrogen and Progesterone Receptors

Tumori Journal ◽

10.1177/030089168907500207 ◽

1989 ◽

Vol 75 (2) ◽

pp. 113-116 ◽

Cited By ~ 1

Author(s):

Arturo Artero Morà ◽

Ana Lluch Hernandez ◽

Antonio Cano Sanchez ◽

Francisco Javier Bueno Cañigral ◽

Gregorio Martin Quetglas ◽

...

Keyword(s):

Breast Cancer ◽

Progesterone Receptors ◽

Premenopausal Women ◽

Mean Value ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Immunoradiometric Assay ◽

Estrogen And Progesterone Receptors ◽

Primary Tumors ◽

Er Status

An immunoradiometric assay was used to determine the presence of p29 protein in 68 breast cancer cytosols. The p29 values ranged from 0 to 1123 U/mg, with a mean value of 127+28.7 U/mg. Using a cutoff point of 20 U/mg the frequency of p29 positive tumors was about 55%. A quantitative and qualitative relation was found between p29 and estrogen receptor (ER), but not between p29 and progesterone receptor (PR). Discordance between p29 and ER status was found in 13 out of 68 tumors. Both the frequency of p29 positive tumors and the p29 values were significantly higher in postmenopausal than in premenopausal women, in a similar way to ER but different from PR. There was no difference in p29 content between primary tumor and metastasis. We did not find any relation among p29 primary tumors content and axillary lymph nodes involvement or tumor size.

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Case Report: Sarcoidosis in the lymph nodes of a breast cancer patient

F1000Research ◽

10.12688/f1000research.20825.1 ◽

2019 ◽

Vol 8 ◽

pp. 1853

Author(s):

Perwasha Kerio ◽

Zain Abid ◽

Masooma Abid ◽

Desaar Zehra ◽

Ghulam Haider

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Stage Iv ◽

Left Breast ◽

The Body ◽

Mediastinal Lymphadenopathy ◽

Axillary Lymph Nodes ◽

Simultaneous Occurrence ◽

Axillary Lymph ◽

Multiple Organs

Background: Sarcoidosis is an inflammatory disease that affects multiple organs in the body, especially the lungs and lymph nodes. The coexistence of sarcoidosis and breast cancer has been reported, but the coexistence of both diseases in the same patient often leads to misdiagnosis. Case: We report a case of a 36-year-old woman who presented with concerns of a lump in her left breast along with pain and discharge from the nipple. On examination a 3-cm hard and tender mass was noted in the upper medial quadrant of the left breast with no palpable axillary lymph nodes. The patient was diagnosed with an infiltrating ductal cell carcinoma of the left breast with T2N0M1 Stage IV disease, due to positive mediastinal lymphadenopathy on positron emission tomography scan. The biopsy of mediastinal lymph nodes allowed us to diagnose sarcoidosis and correctly stage her disease as T2N0M0 Stage IIA breast cancer. The patient underwent lumpectomy followed by adjuvant chemo radiotherapy and hormonal therapy - corticosteroids given for sarcoidosis up to 1 year. The patient is doing well 18 months later without recurrence of disease. Conclusion: The simultaneous occurrence of both diseases in the same patient is the risk for misdiagnosis and mismanagement, therefore it is of utmost importance to correctly stage the disease with appropriate investigations and histologic confirmation prior to initiate the treatment for breast cancer.

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Carcinoma en Cuirasse from Recurrent Breast Cancer seen on FDG-PET/CT

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.159456 ◽

2015 ◽

Vol 5 ◽

pp. 35 ◽

Cited By ~ 1

Author(s):

Aung Zaw Win ◽

Carina Mari Aparici

Keyword(s):

Breast Cancer ◽

Fdg Pet ◽

Ductal Carcinoma ◽

Recurrent Breast Cancer ◽

Left Breast ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Pet Ct ◽

Recurrent Breast ◽

Fdg Pet Ct

Our patient was a 36-year-old female diagnosed with Grade II ER+/PR−/Her-2 − ductal carcinoma in situ (DCIS) in the left breast. She underwent left lumpectomy and received treatment with tamoxifen and radiotherapy. Three years later, she presented with multiple diffused skin nodules on the chest and upper left arm. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) exam showed widespread metastasis in the chest, upper left arm, left axillary lymph nodes, and left suprascapular muscle. FDG-PET/CT imaging of breast carcinoma en cuirasse is very rare. FDG-PET/CT is useful in detecting recurrent breast cancer.

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Diagnostic Dilemma in Metaplastic Chondroid Breast Carcinoma

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v13i1.495 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Farina MY ◽

Shahrun Niza AS ◽

Saladina JJ ◽

Nani Harlina ML ◽

Zaireen MN ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Treatment Strategies ◽

Rare Condition ◽

Left Breast ◽

Lymph Node Biopsy ◽

Metaplastic Carcinoma ◽

Metaplastic Breast Cancer ◽

Diagnostic Dilemma ◽

Year 2000

Metaplastic breast cancer is a rare form of primary breast cancer. It contains a mixture of adenocarcinoma with metaplastic elements. It is important to differentiate with primary sarcoma of the breast which carries different treatment strategies and prognosis. A 55-year-old lady previously diagnosed to have a left breast cancer in the year 2000 and carcinoma of the endometrium in 2009, presented with a right breast lump. A trucut biopsy reported as an infiltrating ductal carcinoma with background of chondromyxoid and cartilagenous matrix, most probably metaplastic carcinoma. A wide local excision with sentinel lymph node biopsy was performed, and the final histology was consistent with metaplastic chondroid carcinoma of the breast with no evidence of metastsis. The surgery was followed by adjuvant radiotherapy and currently free from any recurrence. The diagnostic dilemma on this very rare condition is reviewed.

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Impact of size of the tumor, persistence of estrogen receptors, progesterone receptors, HER2neu receptors and Ki67 values on positivity of axillar lymph nodes at patients with early breast cancer with clinically negative axillar examination

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.213 ◽

2017 ◽

Vol 5 (7) ◽

pp. 825-830

Author(s):

Borislav Kondov ◽

Rosalinda Isijanovska ◽

Zvonko Milenkovikj ◽

Gordana Petrusevska ◽

Marija Jovanovski-Srceva ◽

...

Keyword(s):

Breast Cancer ◽

Regression Analysis ◽

Lymph Nodes ◽

Estrogen Receptors ◽

Early Breast Cancer ◽

Treated Patient ◽

Progesterone Receptors ◽

Microscopic Analysis ◽

Axillary Lymph Nodes ◽

Axillary Lymph

Aim: The aim of the study was to identify factors that influence the positivity on axillar status at patients with early breast cancer with clinical negative axilla, at which were done radical surgery to breast but also radical lymphadenectomy of axillar lymph nodes.Material and methods: In the study were included 81 surgically treated patients with early breast cancer during 08-2015 to 05-2017 year. All the cases have been analyzed by standard histological analysis including macroscopic and microscopic analysis on standard H&E staining. For determining of molecular receptors immunostaining by PT LINK immunoperoxidase has been done for HER2neu, ER, PR, p53 and Ki67. Results: Patients age ranged between 31-73 years, average of 56.86 years. The mean size of the primary tumor in the surgically treated patient was 20.33 + 6.0 mm. On dissection from the axilary pits there were taken out 5 to 32 lymph nodes, an average of 14. Metastases have been found in 1 to 7 lymph nodes, an average 0.7. In only 26 (32.1%) of the patients have been found metastases in the axillary lymph nodes. The univariant regression analysis showed that the size of tumor and presence of HER2 neu receptors on cancer cell influence on the positivity of the axillary lymph nodes. The presence of the estrogen receptors, progesterone receptors showed that they do not have influence on the positivity for metastatic deposits in axillary lymph nodes. Multivariant model and logistic regression analysis as independent significant factors or predictors of positivity of the axillary lymph nodes is influenced from the tumor size only.Conclusion: Our study showed that the involving of the axillary lymph nodes is mainly influenced from the size of the tumor and presence of HER2neu receptors in the univariant analysis points the important influence of positivity in the axillary lymph nodes but only size of the tumor in multivariate regressive analysis.

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Contralateral Axillary Lymph Node Enlargement in a Woman with Silent Silicone Breast Implant Rupture 30 Years After Breast Cancer Diagnosis: A Lesson to Be Learnt

Archives of Breast Cancer ◽

10.32768/abc.202183255-260 ◽

2021 ◽

pp. 255-260

Author(s):

Helen J Trihia ◽

Epthymia Souka ◽

Gabriela Stanc ◽

George Galanopoulos ◽

Eleftheria Ignatiadou ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Breast Implant ◽

Breast Cancer Diagnosis ◽

Left Breast ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Implant Rupture ◽

Breast Implant Rupture

Background: Silicone lymphadenopathy is a recognized complication of silicone implant rupture. It occurs when silicone droplets migrate from breast implants to lymph nodes, resulting in the formation of granulomas (known as siliconoma) and lymph node enlargement. The ipsilateral axillary lymph nodes are most commonly involved but it can also affect contralateral axillary, supraclavicular, internal mammary and mediastinal lymph nodes.Case presentation: A 60-year-old woman with a history of left breast cancer who had undergone modified radical mastectomy (MRM) followed by left breast reconstruction with implant (30 years ago) presented with right axillary lymph nodes enlargement. An excisional biopsy of the two larger lymph nodes was performed to rule out malignancy. Pathologic examination showed features of silicone lymphadenopathy. Further examination with Ultrasound and MRI confirmed breast implant rupture. Conclusion: Silicone lymphadenopathy following breast augmentation and reconstruction primarily affects the ipsilateral axillary nodes. Contralateral lymph node involvement is rare and may occur several years after breast cancer diagnosis and can be the first sign of breast implant rupture. Although, the need to exclude malignancy in such cases is of outmost importance, silicone lymphadenopathy should also be considered in the differential diagnosis.

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