CARCINOSARCOMA OF THE BREAST - A VERY RARE CASE REPORT

Abstract

Abstract : Background - Carcinosarcoma
of the breast, often referred to as
Metaplastic carcinoma of the breast, is a
very rare malignancy with two distinct
cell lines - ductal with sarcoma-like component.
Clinically, Carcinosarcoma is an
aggressive breast cancer and its prognosis
is less favorable compared to the
commoner infiltrating ductal or lobular
carcinoma. We report, here, a patient
with Carcinosarcoma breast a very rare
and often a difficult diagnosis. Case
Presentation - A 60 years old postmenopausal
woman presented with a 6
month history of left breast swelling a
slow-growing mass associated with pain
lately. There was no discharge per nipple.
Physical examination revealed a
huge tender well defined mass in the left
breast, with consistency ranging from
firm to hard, along with areas of fluctuation.
The mass was mobile with the
breast tissue but not fixed to the pectorals.
The skin over the mass was reddish,
not pinchable and had a peau
dorange appearance
. The left axilla and supraclavicular fossa
were free. So clinically, the mass was initially
thought of as an Inflammatory Carcinoma
of the left breast.FNAC yielded only
a bloody aspirate, which was followed by
an incision biopsy and that clinched the diagnosis
of Metaplastic Carcinoma of the
breast CarcinoSarcoma. The patient had
Left Modified Radical Mastectomy, followed
by Adjuvant chemotherapy. Histopathological
examination confirmed the diagnosis.
The patient is now free from the disease for
more than a year post-operatively. Discussion
- Carcinosarcoma breast has been reported
to account for 0.080.2 of all breast
malignancies. The true definition of Metaplastic
carcinoma of the breast is a tumor
of malignant epithelial tissue (carcinoma)
mixed with malignant cells of mesenchymal
origin (sarcoma) with apparent histologic
and cytologic features present on light microscopy
and immunohistochemical testing.
The origin of these tumours is still being
debated and are probably derived of
myoepithelial cells. Generally the prognosis
of these tumours