CASE 684: PRIMARY BREAST SARCOMA, Dr PHAN THANH HẢI, Dr LÊ THÔNG LƯU, MEDIC MEDICAL CENTER, HCMC, VIETNAM

A 61 year-old female patient suffers from 2 tumors of her right breast which are abandoned for 2 years by a deadly illness of her husband.

Ultrasound and elastography technique represent two BI-RADS 4B tumors of her right breast which one has perivascular signals.

Mammography notes an asymetric sign in superiolateral region of the right breast.

MRI confirms the two BI-RADS 5 right malignant breast tumors: # 34x28 mm and # 21x 27 mm, with spiculated border, high signals on T2W2 and moderate signals on T1W1, captured contrast media type 3.

But the report of histoimmunology of the breast tumor is a breast sarcoma while axillary lymph nodes are not in malignancy.

Surgery is done in large field, no mastectomy nor lymph node curetage due to the sarcoma tumor characters.

As no clue of gene mutation, the patient goes through a planning of radiation therapy  for 3 months of 54 Gy dosages in 27 times.

DISCUSSIONS:

Breast sarcome is a rare mesenchymal breast tumor (<1% cancer breast tumor). MRI,  mammography and ultrasound could not differentiaze breast sarcoma from other breast cancer tumors.

Core biopsy and histoimmunologic exam are keys of diagnosis.

Surgery could save patient life that sarcoma invades in situ and rarely goes far via the blood stream. Chemotherapy and radiation may be managed in case of metastase and spreading exist. Liver, lung, bone marrow and recurrent breast tumor may happen in the first 2 years.  The 5-year survival rate reported in the literature ranges from 50% to 64% for the breast sarcoma.

The female patient remains well and in schedule of reexamination.

REFERENCES:

A rare case report of breast sarcoma - PMC-NCBI.

Primary breast sarcoma: case report-African Journal online.

Breast sarcoma: a case report and review of literature.