Sasamoto Mahato, Yamada Akimitsu, Oshi Masanori, Ota Ikuko, Yoshida Kenichi, Yakeishi Mayumi, Tsuura Yukio, Masui Hidenobu, Endo Itaru
Department of Breast Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.
Department of Breast Surgery, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.
Gland Surg. 2023 Jun 30;12(6):853-859. doi: 10.21037/gs-22-629. Epub 2023 Jun 13.
Spontaneous regression (SR) of cancer is a rare condition in which the cancer partially or completely disappears without treatment. We report a case of breast cancer with tumor regression and spontaneously induced T-cell-mediated immunological responses in a surgical specimen obtained after core needle biopsy (CNB).
A 52-year-old woman presented with a mass in the right breast. Mammography showed a high-density mass with fine serrated margins in the right lower outer quadrant. Breast ultrasonography showed an irregular hypoechoic mass with a maximum diameter of 22 mm. CNB was performed and revealed an invasive ductal carcinoma with negative estrogen receptors, positive progesterone receptors, and negative HER2 (1+). The Ki67 index was 70% to 80%. Luminal B cT2N1M0 stage IIB right breast cancer was diagnosed. Although preoperative chemotherapy was considered, surgery was selected because of her history of schizophrenia. She underwent right mastectomy and axillary lymph node dissection. A postoperative pathological analysis revealed a 20 mm × 10 mm × 10 mm mass. However, most areas of the mass regressed and appeared as necrotic tissue with no obvious invasive areas. Only intraductal extension was observed in one glandular duct. Axillary lymph node metastases were not observed. These results suggest that the tumor may have spontaneously regressed, possibly because of the CNB procedure. Follow-up without treatment was performed, and no recurrence occurred during 2 years after surgery.
Invasive ductal carcinoma may spontaneously regress after preoperative CNB.
癌症的自发消退（SR）是一种罕见的情况，即癌症在未经治疗的情况下部分或完全消失。我们报告了一例乳腺癌病例，在粗针活检（CNB）后获得的手术标本中出现肿瘤消退并自发诱导T细胞介导的免疫反应。
一名52岁女性因右乳肿块就诊。乳腺钼靶显示右下外象限有一个边缘呈细锯齿状的高密度肿块。乳腺超声显示一个最大直径为22mm的不规则低回声肿块。进行了CNB，结果显示为浸润性导管癌，雌激素受体阴性，孕激素受体阳性，HER2阴性（1+）。Ki67指数为70%至80%。诊断为luminal B型cT2N1M0期IIB级右乳腺癌。尽管考虑了术前化疗，但由于她有精神分裂症病史，所以选择了手术。她接受了右乳切除术和腋窝淋巴结清扫术。术后病理分析显示有一个20mm×10mm×10mm的肿块。然而，肿块的大部分区域消退，表现为坏死组织，无明显浸润区域。仅在一个腺管中观察到导管内扩展。未观察到腋窝淋巴结转移。这些结果表明肿瘤可能自发消退，可能是由于CNB操作所致。进行了无治疗的随访，术后2年内未发生复发。
浸润性导管癌在术前CNB后可能自发消退。
