Primary osteosarcoma (breast)

Primary osteosarcoma of the breast is an uncommon breast malignancy and is a sub type extraskeletal osteosarcoma.

While it can present in a wide are group, the peak age at presentation is around the 6th decade 7.

The presence of bone in breast lesions is not diagnostic of osteosarcoma as osteoid tissue can be present in epithelial and mesenchymal neoplasms, both benign and malignant, such as fibroadenoma, phyllodes tumour 13, and metaplastic carcinomas. Therefore, a diagnosis of mammary osteosarcoma can only be established after a metaplastic carcinoma or biphasic tumour has been adequately excluded. Approximately 60% of tumours are grossly circumscribed 7.

Markers

Serum alkaline phosphate (ALP) levels are typically elevated.

Mammography

Mammographic appearances can be variable. Most of the tumours presented as large masses with relatively well-defined margins and lobulated borders, often containing calcifications. Calcifications tend to be usually coarse (cotton wool like), dense, and sometimes similar to fibroadenomas.

Mammary osteosarcomas are aggressive tumours with a propensity for blood-borne rather than lymphatic spread. A total excision without an  axillary dissection is usually part of standard treatment.


Breast imaging and pathology
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Article Information

rID: 15431
System: Breast
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Extra skeletal osteosarcoma of breast
  • Primary osteosarcoma of breast
  • Extra skeletal osteosarcoma of the breast
  • Osteosarcoma of breast
  • Primary breast osteosarcoma
  • Primary pure osteosarcoma of the breast

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