Wei L, Tian Z, Wang ZY, Liu WJ, Li HB, Zhang Y. Concurrent invasive ductal carcinoma and ductal carcinoma in situ arising inside and outside a breast hamartoma: A case report. World J Clin Cases 2025; 13(18): 101882 [DOI: 10.12998/wjcc.v13.i18.101882]
Corresponding Author of This Article
Zhi-Yong Wang, Associate Chief Physician, Associate Professor, Department of Surgery, Affiliated Hospital of Beihua University, No. 12 Jiefang Middle Road, Jilin 132011, Jilin Province, China. 2166715675@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Lai Wei, Zhe Tian, Zhi-Yong Wang, Wei-Jia Liu, Department of Surgery, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
Hong-Bo Li, Department of Breast and Thyroid Surgery, Jinhua People's Hospital, Jinhua 321000, Zhejiang Province, China
Ying Zhang, Department of Pathology, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
Co-first authors: Lai Wei and Zhe Tian.
Author contributions: Wei L drafted the manuscript; Wei L and Tian Z contributed equally to this study as co-first authors, both of two authors have made equally significant contributions to the work and share equal responsibility and accountability for it; Wei L, Tian Z and Wang ZY contributed to conception and design of the study; Tian Z and Li HB organized the database; Liu WJ and Zhang Y collected histopathological data; all authors contributed to manuscript revision, and have read and approved the submitted version.
Supported by Jilin City Science and Technology Innovation Development Plan Project, China, No. 20230406201; and Jilin Province Traditional Chinese Medicine Technology Project, China, No. 2024159.
Informed consent statement: The study participant’s legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflicts 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: Zhi-Yong Wang, Associate Chief Physician, Associate Professor, Department of Surgery, Affiliated Hospital of Beihua University, No. 12 Jiefang Middle Road, Jilin 132011, Jilin Province, China. 2166715675@qq.com
Received: September 29, 2024 Revised: January 28, 2025 Accepted: February 12, 2025 Published online: June 26, 2025 Processing time: 150 Days and 17.7 Hours
Abstract
BACKGROUND
Breast hamartomas are rare benign breast tumors, with an incidence rate of 0.8%-4.8%. Further, the coexistence of hamartomas and carcinoma is also uncommon. Our case report presents a unique instance where invasive ductal carcinoma (IDC) and ductal carcinoma in situ were found both inside and outside a breast hamartoma. This is the second case reported in the literature.
CASE SUMMARY
A 51-year-old woman presented with a 6.0 cm breast tumor on mammography and ultrasound, with suspicious areas indicative of malignant transformation. Biopsy of the suspicious area confirmed IDC with intraductal carcinoma. Breast magnetic resonance imaging showed typical hamartoma changes with irregular areas of abnormal enhancement both inside and outside. A breast-conserving surgery was performed, and postoperative pathology confirmed mammary hamartoma, concurrent with IDC and intraductal carcinoma occurring both inside and outside the hamartoma. Subsequently, appropriate adjuvant therapy was initiated. Currently, the patient is in good condition. Breast cancer may be located both inside and outside the ipsilateral mammary hamartoma, which is difficult to detect preoperatively, especially when there is a focus of intraductal carcinoma, requiring accurate assessment of the tumor extent by modern imaging techniques. Early detection of the coexistence of cancer is clinically important as it can alter patient management.
CONCLUSION
This case emphasizes the importance of modern imaging techniques in accurately evaluating mammary hamartomas associated with malignancies prior to surgery.
Core Tip: This case reports a rare instance of concurrent invasive ductal carcinoma and ductal carcinoma in situ inside and outside a breast hamartoma in a 51-year-old woman. Imaging suggested suspicious malignancy within the hamartoma, confirmed by postoperative pathology. It highlights the importance of modern imaging in preoperative evaluation of breast hamartomas associated with malignancies. Thorough assessment is crucial for determining safe margins in breast-conserving surgery and reducing postoperative recurrence risk.
