BILATERAL BREAST SARCOMA IN WOMEN WITH MACROMASTIA
Bilateral breast sarcomas are rare malignancies of unknown etiology. Most common histological subtypes of breast sarcoma are angiosarcoma, ﬁbrosarcoma and malignant ﬁbrous histiocytoma. Phyllodes tumors have a predisposition to transform into sarcoma.
The present clinical case describes bilateral breast fibrosarcomas in a 39 years-old female with macromastia. This peculiarity gave possibilities to do wide local excision of both tumors within 3.0 cmresection margins and preserve both breasts. Histological and immunohistochemical (ERG, CK-AE1/AE3) examination confirmed fibrosarcomas in both breast (in right – stage IIB, in left – stage IIA). Patient carried on postoperative treatment with radiation therapy (36.1 Gy for both breasts) and four cycles of adjuvant chemotherapy (doxorubicin, cisplatin, cyclophosphamide).
For the first year patient had clinical and ultrasound examination every three months, then every 6 months. CT scan of chest and abdomen was every year. In seven post-op years there was no evidence of disease recurrence.
Thus, macromastia gives an exceptional chance to carry out organ-sparing radical surgery in women with advanced breast malignancies.
Adem, C., Reynolds, C., Ingle, J. N., Nascimento, A. G. (2004). Primary breast sarcoma: clinicopathologic series from the Mayo Clinic and review of the literature. British Journal of Cancer, 91, 237–241. doi: 10.1038/sj.bjc.6601920
Lim, S. Z., Ong, K. W., Tan, B. K. T., Selvarajan, S., Tan, P. H. (2016). Sarcoma of the breast: an update on a rare entity. Journal of Clinical Pathology, 69 (5), 373–381. doi: 10.1136/jclinpath-2015-203545
Pai, M., Upadhyaya, K., Naik, R., Malhotra, S. (2008). Bilateral angiosarcoma breast diagnosed by fine needle aspiration cytology. Indian Journal of Pathology and Microbiology, 51 (3), 421. doi: 10.4103/0377-4929.42549
De Bree, E., van Coevorden, F., Peterse, J. L., Russell, N. S., Rutgers, E. J. T. (2002). Bilateral angiosarcoma of the breast after conservative treatment of bilateral invasive carcinoma: genetic predisposition? European Journal of Surgical Oncology (EJSO), 28 (4), 392–395. doi: 10.1053/ejso.2001.1249
Zhou, S.-A., Wei, H., Ding, K. (2009). A Rare Case of Metachronous Bilateral Angiosarcoma of the Breast. Breast Care, 4 (6), 405–407. doi: 10.1159/000261506
Astudillo, L., Lacroix-Triki, M., Ferron, G., Rolland, F., Maisongrosse, V., Chevreau, C. (2005). Bilateral Breast Metastases From Ewing Sarcoma of the Femur. American Journal of Clinical Oncology, 28 (1), 102–103. doi: 10.1097/01.coc.0000149741.46332.17
Kwatra, K. S., Prabhakar, B. R., Arora, Y. (2004). Bilateral granulocytic sarcoma (chloroma) of the breast in CML in blast crisis: a case report. Indian Journal of Pathology & Microbiology, 47 (1), 66–68.
Grenier, J., Delbaldo, C., Zelek, L., Piedbois, P. (2010). Phyllodes Tumors and Breast Sarcomas: A Review. Bull Cancer, 97 (10), 1197–1207.
Warrier, S., Hwang, S. Y., Gibbings, K., Carmalt, H., O’Toole, S. (2015). Phyllodes tumour with heterologous sarcomatous differentiation: Case series with literature review. International Journal of Surgery Case Reports, 11, 91–94. doi: 10.1016/j.ijscr.2015.02.009
Jang, J. H., Choi, M.-Y., Lee, S. K., Kim, S., Kim, J., Lee, J. et. al. (2012). Clinicopathologic Risk Factors for the Local Recurrence of Phyllodes Tumors of the Breast. Annals of Surgical Oncology, 19 (8), 2612–2617. doi: 10.1245/s10434-012-2307-5
Shaaban, M., Barthelmes, L. (2017). Benign phyllodes tumours of the breast: (Over) treatment of margins – A literature review. European Journal of Surgical Oncology (EJSO), 43 (7), 1186–1190. doi: 10.1016/j.ejso.2016.10.019
Zhou, Z.-R., Wang, C.-C., Yang, Z.-Z., Yu, X.-L., Guo, X.-M. (2016). Phyllodes tumors of the breast: diagnosis, treatment and prognostic factors related to recurrence. Journal of Thoracic Disease, 8 (11), 3361–3368. doi: 10.21037/jtd.2016.11.03
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