Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2022; 10(15): 5064-5071
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.5064
Metaplastic breast cancer with chondrosarcomatous differentiation combined with concurrent bilateral breast cancer: A case report
Si-Yuan Yang, Yang Li, Jian-Yun Nie, Shou-Tao Yang, Xiao-Juan Yang, Mao-Hua Wang, Ji Zhang
Si-Yuan Yang, Jian-Yun Nie, Shou-Tao Yang, Xiao-Juan Yang, Mao-Hua Wang, Ji Zhang, Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming 650118, Yunnan Province, China
Yang Li, Department of Digestive Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650118, Yunnan Province, China
Author contributions: Yang SY and Zhang J performed the conceptualization; Yang SY performed the resources; Yang SY and Li Y wrote the original draft preparation; Yang ST and Yang XJ wrote the review and editing; Wang MH performed the visualization; Li Y and Zhang J performed the supervision; all authors have read and agreed to the published version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ji Zhang, MBBS, Doctor, Department of Breast Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Kunming 650118, Yunnan Province, China. zhangji502@163.com
Received: December 6, 2021
Peer-review started: December 6, 2021
First decision: January 25, 2022
Revised: February 23, 2022
Accepted: March 27, 2022
Article in press: March 27, 2022
Published online: May 26, 2022
Processing time: 168 Days and 22.3 Hours
Abstract
BACKGROUND

Metaplastic breast carcinoma (MBC) is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells. Compared with other invasive breast cancers, MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern, which leads to a significant risk of recurrence and mortality.

CASE SUMMARY

In this study, we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass. The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy. Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma (luminal B) in the right breast. As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy, we administered six months of intensive capecitabine treatment. Then the patient was switched to continuous treatment with endocrine therapy using letrozole + goserelin, and the patient is currently in stable condition. However, as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation, our case is sporadic.

CONCLUSION

Given the variety of immunohistochemical types of bilateral breast cancer, achieving effective chemotherapy should be a key research focus.

Keywords: Metaplastic breast cancer; Invasive ductal carcinoma; Carcinosarcoma; Chondrosarcoma differentiation; Bilateral breast cancer; Case report

Core Tip: Metaplastic breast carcinoma (MBC) is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells, with low incidence. Our patient with a large left breast mass was diagnosed with carcinosarcoma with predominantly chondrosarcoma in the left breast, and postoperative pathology also suggested invasive ductal carcinoma in the right breast. The current knowledge of MBC is limited, particularly in patients with concurrent bilateral breast cancer. Clinicians should fully consider the situation of bilateral mammary glands and formulate a comprehensive treatment plan for such patients.