•  
  •  
 

Manipal Journal of Medical Sciences

Abstract

Background
Metaplastic breast carcinoma (MBC) is a rare and aggressive subtype of breast cancer, characterized by a heterogeneous combination of epithelial and mesenchymal components. It is often challenging to diagnose due to its distinct clinical and histological features, and it generally carries a poor prognosis due to its rapid progression and limited response to conventional therapies.

Case Presentation
We present the case of a 43-year-old female who presented with a rapidly enlarging right breast lump, which increased from 3 x 4 cm to 10 x 10 cm in 4 months. Clinical examination revealed a fixed, pigmented lump in the upper outer quadrant of the right breast, extending into the axilla, along with multiple palpable axillary lymph nodes. Imaging, including sonomammogram and Doppler ultrasound, suggested a malignant phyllodes tumor (BIRADS-4), which was confirmed by Tru-Cut biopsy. However, postoperative histopathological examination revealed a diagnosis of metaplastic breast carcinoma with stromal and epithelial features, including areas of necrosis, pleomorphism, and atypical mitosis. The tumor had infiltrated the pectoralis major and serratus anterior muscles. No metastatic involvement was found in 22 axillary lymph nodes. The patient underwent a modified radical mastectomy followed by adjuvant chemotherapy and radiotherapy. The postoperative course was uneventful.

Conclusion
Metaplastic breast carcinoma is a rare and aggressive form of breast cancer that requires a high index of suspicion for diagnosis. The case demonstrates the challenges in differentiating MBC from other tumors and emphasizes the importance of histopathological evaluation for an accurate diagnosis. Although treatment options remain limited, ongoing research into targeted therapies such as immunotherapy may improve the prognosis for patients with MBC.

Download

Included in

Surgery Commons

Share

COinS