Hoshina Hideko, Kubouchi Kouichi, Tsutsumi Yutaka, Takei Hiroyuki
Department of Breast Surgery and Oncology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan.
Department of Breast Surgery, Kikuna Memorial Hospital, 4-4-27 Kikuna, Kouhoku-Ku, Yokohama, Kanagawa, 222-0011, Japan.
Surg Case Rep. 2023 Mar 29;9(1):50. doi: 10.1186/s40792-023-01629-4.
Radiation-induced sarcoma (RIS) has a 10-year incidence of 0.2-0.27% and a poor prognosis, although the radiation should need for breast-conserving surgery. In particular, radiation-induced fibrosarcoma has been rarer, and its incidence is 2.6-3.7% of RIS.
A 43-year-old woman with pT1N1M0 breast cancer underwent breast-conserving surgery, chemotherapy, radiation therapy 8 years ago, and continued hormonal therapy. She complained of a hard unprotruded mass palpated in her right upper outer quadrant of breast. Although we suspected local recurrence, core needle biopsy revealed atypical spindled tumor cells without mammary or epithelial markers. A diagnosis of fibrosarcoma was made via tumorectomy. She underwent additional enlarged surgery.
We report a rare case of fibrosarcoma in breast after breast-conserving surgery and radiation therapy. Fibrosarcoma after radiation therapy for breast cancer has been reported in 30 cases, including the present case. The dead and alive cases were not significantly different in terms of age, primary breast cancer, radiation dose, and following months. Patients with breast masses after radiation therapy should be suspected local recurrence and RIS.
放射性肉瘤(RIS)的10年发病率为0.2 - 0.27%,预后较差,尽管保乳手术需要进行放疗。特别是,放射性纤维肉瘤更为罕见,其发病率占RIS的2.6 - 3.7%。
一名43岁pT1N1M0乳腺癌女性患者8年前接受了保乳手术、化疗、放疗,并继续接受激素治疗。她主诉右乳外上象限可触及一个质地硬且未突出的肿块。尽管我们怀疑是局部复发,但粗针活检显示为非典型梭形肿瘤细胞,无乳腺或上皮标记物。通过肿瘤切除术诊断为纤维肉瘤。她接受了扩大手术。
我们报告了一例保乳手术和放疗后发生在乳腺的罕见纤维肉瘤病例。包括本病例在内,已有30例报告了乳腺癌放疗后发生纤维肉瘤。死亡和存活病例在年龄、原发性乳腺癌、放疗剂量及随访月数方面无显著差异。放疗后出现乳腺肿块的患者应怀疑局部复发和RIS。