Primary breast sarcoma: Case report and literature review

Abstract

Introduction

Primary breast sarcoma (PBS), excluding phyllodes tumors, is an extremely rare and heterogeneous group of cancers, accounting for <1 % of all breast cancers. PBS is typically diagnosed in the fifth or sixth decades of life. There are no pathognomonic clinical or radiological features. Diagnosis is generally established through a microbiopsy. For young women, the diagnosis can be confused with a benign pathology.

Clinical presentation

Our patient was 27 years old, with no family or personal history of breast cancer, which was initially brought to the emergency department with a breast abscess. The clinical diagnosis of abscessed mastitis was made. The patient underwent tissue excision with evacuation of blood clots and necrotic tissue. Histopathological examination revealed a primary breast sarcoma. An MRI showed locally advanced retro-glandular tumor. An abdominal and pelvic CT scan performed showed no evidence of secondary locations. Therefore, the patient was referred for neoadjuvant radiotherapy and chemotherapy. After the third course of chemotherapy, the patient died following cardiogenic shock.

Discussion

The PBS in younger women is extremely rare. The etiopathogenesis remains undetermined. The clinical and radiological characteristics of PBS mimic breast adenocarcinoma. Mastectomy is the treatment of choice but in the case of locally advanced tumor, the use of neoadjuvant chemotherapy can be indicated. PBS presents a significantly poorer prognosis.

Conclusion

Breast sarcomas are rare malignant tumors for which treatment protocols are not well-established. Further research efforts are needed to improve the understanding and treatment of PBS.

Highlights

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  Primary breast sarcoma is an extremely rare cancer, accounting <1 % of all breast cancers

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  Although the clinical characteristics and radiological images of primary breast sarcoma mimic, to some extent, mammary adenocarcinoma, it presents a high risk of recurrence and a significantly poorer prognosis

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  We present atypically case of primary breast sarcoma, with a young patient who was initially brought to the emergency department with a breast abscess.

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  Histological examination is crucial for a breast abscess, regardless of the patient's age.