Breast sarcoma

Presentation

Palpable right big breast mass.

Patient Data

Age: 50 years
Gender: Female
Mammography

A. Mediolateral oblique mammogram of the right breast shows high-density mass with obscured margins and associated skin thickening, located in all the upper external quadrant.

B. Craniocaudal mammogram of the right breast shows a high-density mass with obscured margins and skin infiltration.

Ultrasound

A longitudinal gray-scale sonogram of the right breast shows a solid irregular heterogeneous mass with indistinct margins, anechoic areas, and internal vascularity.

Nuclear medicine

FDG PET-CT of the right breast and the axillary region shows focal hypermetabolism.

Ultrasound

A transverse gray-scale sonogram of the right breast shows a core biopsy of the solid irregular heterogeneous mass. 

Pathology report: 

Macroscopic description

A sample referred to as a biopsy of the right breast lesion in the upper external quadrant is received, there are 2 tubular fragments of approximately 1.2 cm in length each, they are included intact in 1 capsule.

Diagnosis:

BIOPSY OF RIGHT BREAST TUMOR IN UPPER EXTERNAL QUADRANT:

- SARCOMA OF HIGH-GRADE

Immunohistochemistry

  • CKAE/AE3: Negative
  • Actina: Negative
  • CD 34: Negative
  • CD 45: Negative
  • CD10:  Focal positive
  • Vimentina: Positive
  • HMB-45: Negative
  • S100-P: Negative

Case Discussion

The Breast sarcoma is a rare tumor of mesenchymal origin and represents <1% of the all-breast cancers. This cancer is very aggressive and affects women young. 

These tumors can be primary or secondary. The most common are the primary ones and those associated with Fraumeni syndrome and NF1 and environmental exposures and the second related to exposure to radiotherapy and lymphedema secondary to breast cancer. 

The most common subtype is Angiosarcoma of breast sarcoma, approximately 20-30% of primary breast sarcoma and 50-70% of secondary. 

A tumor that big size represents a high -grade and generally has a worse prognosis.

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