Yang Si-Yuan, Li Yang, Nie Jian-Yun, Yang Shou-Tao, Yang Xiao-Juan, Wang Mao-Hua, Zhang Ji
Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming 650118, Yunnan Province, China.
Department of Digestive Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650118, Yunnan Province, China.
World J Clin Cases. 2022 May 26;10(15):5064-5071. doi: 10.12998/wjcc.v10.i15.5064.
Metaplastic breast carcinoma (MBC) is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells. Compared with other invasive breast cancers, MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern, which leads to a significant risk of recurrence and mortality.
In this study, we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass. The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy. Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma (luminal B) in the right breast. As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy, we administered six months of intensive capecitabine treatment. Then the patient was switched to continuous treatment with endocrine therapy using letrozole + goserelin, and the patient is currently in stable condition. However, as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation, our case is sporadic.
Given the variety of immunohistochemical types of bilateral breast cancer, achieving effective chemotherapy should be a key research focus.
化生性乳腺癌(MBC)是浸润性乳腺癌的一种罕见亚型,由恶性上皮细胞和间充质细胞组成。与其他浸润性乳腺癌相比,MBC不仅在组织学上具有明显的异质性,而且具有快速侵袭性的生长模式,这导致了显著的复发和死亡风险。
在本研究中,我们报告了一例患者,该患者左乳有一较大肿块,在对双侧乳房肿块进行术前粗针穿刺活检后,被诊断为双侧浸润性导管癌。患者接受了新辅助化疗,并接受了双侧乳房改良根治术。术后病理提示左乳为癌肉瘤,以软骨肉瘤为主,右乳为浸润性导管癌(luminal B型)。由于患者在六个周期的新辅助化疗后未达到完全病理缓解,我们给予了六个月的密集卡培他滨治疗。然后患者改用来曲唑+戈舍瑞林进行内分泌持续治疗,目前患者病情稳定。然而,由于该例乳腺MBC同时伴有软骨肉瘤分化,我们的病例为散发性。
鉴于双侧乳腺癌免疫组化类型多样,实现有效的化疗应是关键的研究重点。