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Category: Volume 08 Issue 08 August 2020
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Title: Carcinosarcoma of the Breast - A Rare Presentation

Authors: Aniruddha Mundhada, Lawrence DCruze, Sandhya Sundaram, D. Pratiba, Ramya Ramakrishnan, Bhawna Dev

 DOI: https://dx.doi.org/10.18535/jmscr/v8i8.43

Abstract

Metaplastic carcinoma of the breast with mesenchymal differentiation (MCMD), previously known as carcinosarcoma, has been recently designated as a subtype of metaplastic breast carcinoma. It is a very rare and aggressive tumor that accounts for 0.08%–0.2% of all breast cancers reported in the literature. Histologically, MCMD is characterized by a biphasic pattern of malignant epithelial and sarcomatous components without evidence of a transition zone between the two elements. We herein describe a unique case of metaplastic carcinoma of the breast in a young lady, which on core biopsy showed features of a poorly differentiated malignancy. The differential diagnosis was given as poorly differentiated carcinoma and high-grade lymphoma. IHC was suggested to confirm the lineage. The mass was large and rapidly growing and showing signs of impending rupture. Patient therefore underwent an elective modified radical mastectomy with a very close margin confirmed on frozen sections and final diagnosis after extensive sampling as triple negative MCMD. There was involvement of ipsilateral axillary nodes. These tumors present with distal metastases, and have earlier local recurrence and poor prognosis compared with classic invasive breast cancer. Because of the rarity of MBC, the optimal treatment has not been well defined. Surgery is the main curative treatment modality since MBC has shown a suboptimal response to standard chemotherapy. 

Keywords: metaplastic breast carcinoma, carcinosarcoma, differentiation, mesenchymal

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Corresponding Author

Sandhya Sundaram

Associate Professor, Department of Pathology, Sri Ramachandra Medical College and RI, Porur, Chennai, India-6001164