Breast Disease

Cancer chemotherapy exerts deleterious effects in patients, causing structural and physiological changes to their vital organs. These drugs are capable of destroying bone marrow cells and may reduce lymphocyte count. This study was aimed to investigate the frequency of lymphocytopenia in cancer patients taking vinorelbine and its combination as part of cancer chemotherapy. A total 60 adult cancer patients were selected and divided into two groups; Group-1 patients were either on Vinorelbine alone treatment protocol, while group 2 patients were on either Vinorelbine/Cisplatin or Vinorelbine/Doxorubicin treatment protocol. The mean ± SEM lymphocyte counts ( × 10 3 ) per uL, pre and post chemotherapy were noted. The outcomes demonstrated no statistically important difference in the patients who were either on vinorelbine alone, vinorelbine plus cisplatin or vinorelbine plus doxorubicin combinations. On comparison of the lymphocytopenia over time for Group-I & II (P-values 0.064, 0.23), and at every week (P-value −0.063, 0.427), we observed the non significant statistical differences. However, comparison of mean values before with that of at week-1,2 and 3 showed significant (P-value³ 0.003, 0.003 and 0.055), and at week-4 no significant difference (P-value³ 0.727). Thus, the overall lymphocytopenic syndrome in both of the chemotherapy protocols allows the clinical oncologists and consultant physicians to select either of the chemotherapy protocol. Vinorelbine may be a choice of cancer chemotherapy, as they do not compromise immunity in cancer patients. Hence; therapeutic efficacy should constitute the intervening consideration in treating a particular neoplasm.

Epidermal, or inclusion, cysts are frequently seen benign lesions that are lined with stratified squamous epithelium. Malignant transformation of these is rare, occurring in 0.011% to 0.045% cases [1]. We herein report an unusual case of squamous cell carcinoma occurring in an epidermal cyst of the breast in a middle aged lady.

The genetic link between neurofibromatosis and breast cancer has recently intrigued the researchers and breast practitioners alike. While the association is well established in females, the same cannot be said for the male breast cancer due to paucity of cases. With only two cases reported previously, our knowledge is sparse. We hereby report two cases of male breast cancer with neurofibromatosis.

We are reporting a case of bilateral eosinophilic mastitis which is rare and hardly heard. It is a mimicker of carcinoma breast both clinically & radiologically. A 30 years old non diabetic female presented with bilateral breast lumps with history of rhinitis off & on and peripheral eosinophilia. Mammography was suspicious while ultrasonography was diagnostic of bilateral mastitis. Aspiration cytology exhibited inflammatory lesion rich in eosinophils. Histopathology revealed the diagnosis of eosinophilic mastitis. Eosinophilic infiltration of the breast is a rare manifestation of tissue involvement in peripheral eosinophilia and bilateralism is even rarer.

Skeletal muscle metastasis from breast cancer is a very rare clinical entity. We describe an extremely rare case of breast cancer metastasis to the rectus abdominis muscle. Our patient, who had undergone a left modified radical mastectomy for breast cancer four years ago, presented with a painful abdominal mass. Computed tomography scans showed a rim-enhancing mass with central hypoatennuation within the sheath of the rectus abdominis muscle. A Fine needle aspiration biopsy was initially performed and the findings were suggestive of malignancy. The muscle lesion was then resected and the histopathological analysis showed metastasis of breast cancer. Through our review of the literature, we found that only two cases of rectus abdominis muscle metastasis from breast cancer have been reported so far. This case highlights the need to rule out muscle metastatic lesions in patients with history of breast cancer presenting with these clinical and imaging characteristics. Differentiation from primary sarcoma is of paramount importance. Skeletal muscle metastases usually indicate an advanced disease associated with poor prognosis. Treatment should be individualized depending on the patient's clinical condition.

Breast carcinoma is a common condition worldwide but stromal sarcomas of breast are rarity in day to day surgical practice. Out of primary breast sarcomas, fibrosarcoma constitutes only 16% of cases. We report a primary fibrosarcoma of breast in a young female patient which presented as ulcerated growth and fixity to chest wall and multiple ipsilateral axillary lympadenopathy (Stage IIIb). After biopsy confirmation palliation mastectomy was done and patient was sent for chemoradiotherapy.

Actinomycosis of the breast is a rare disease which may mimic malignancy in presentation. Clinical presentation may make it difficult to distinguish primary actinomycosis from mastitis and inflammatory carcinoma. A 22-year-old lady presented with a 3-week history of right breast pain and greenish discharge through her nipple piercing. Physical examination revealed a palpable fluctuant lump in the upper inner quadrant of the right breast and a nipple jewelry in-situ in the upper inner quadrant of the right breast with an abscess at the edge of the areola. Needle aspiration was performed and microbiological examination of the aspirate isolated Actinomyces turicensis and Peptoniphilus harei. Actinomycosis of the breast is rare and the specie, Actinomyces turicensis, is even rarer especially in association with Peptoniphilus harei. Actinomyces is a difficult organism to treat due to its relative indolent course with potential scarring and disruption of local tissue. However, surgical intervention could be avoided with an intensive course of high-dose intravenous antibiotics and prolonged oral antibiotics afterwards.

Fibroadenomas with a predominant cystic change are called cystic fibroadenomas. These are extremely rare forms of fibroadenomas and only one case has been reported so far. They are classified under the category of complex fibroadenomas. Complex fibroadenomas are a rare variant of fibroadenomas occurring in elderly females. They are characterized by presence of one of the complex features along with the usual patterns of fibroadenoma such as cysts more than 3 mm, papillary apocrine metaplasia, or sclerosing adenosis. Patients with these lesions have higher chances of developing carcinoma of breast.

We present a case of 35 years old lady with a freely mobile mass in the left breast diagnosed as cystic fibroadenoma after thorough histopathological examination of the lesion.

Hamartoma of the breast is an uncommon, benign, slow-growing mass usually diagnosed in women in the fourth and fifth decade of life undergoing mammography (MX). Here we report two cases of hamartoma of the breast assessed by integrated MX, ultrasonography and magnetic resonance imaging (MRI) examination. Case 1 was an asymptomatic 47-year-old woman who had never been screened previously. A 90 mm mass was found in her left breast on MX. Case 2 was a 35-year-old woman with pain in her right breast where a 50 mm mass was found on MX. Both patients underwent MRI examination. Breast MRI is an adjunct to MX that can confirm hamartoma diagnosis and exclude rare malignant transformation.

Phyllodes tumor of the breast is a biphasic fibroepithelial neoplasm. 10 to 20% of phyllodes tumor show malignant transformation, often in the form of stroma, which usually shows fibrosarcomatous differentiation and rarely heterologous sarcomatous elements. Liposarcomatous differentiation is not common among phyllodes tumors. The correct diagnosis of heterologous liposarcomatous differentiation in a malignant PT requires identification of the biphasic component of the tumor. We reported a case of malignant phyllodes tumor which initially transformed into liposarcoma, in addition to a very rare intraductal hyperplasia and flat epithelial atypia. The patient was a 75-year-old woman, with a lump in the left breast without axillary lymphadenopathy. She also have a positive family history of breast carcinoma. She underwent surgery and still alive and disease free after one year.

Breast cancer, after malignant melanoma, is the most common cancer metastasizing to the gastrointestinal tract [1,4]. Isolated gastrointestinal metastasis from breast cancer is a quite rare finding. We describe a female patient with a gastric metastasis from an undiagnosed breast cancer who presented to gastroenterology department with a symptoms of abdominal pain.

Mondor's disease is a rare benign and self-limiting condition characterized by thrombophlebitis of the superficial veins of the anterolateral thoracoabdominal wall. We describe a case of Mondor's disease of the breast as a complication of an ultrasound-guided core needle biospy. The patient presented with a palpable cord-like structure in her left breast, associated with severe pain and tenderness. She was treated concervatively and complete resolution was observed after four weeks. We conclude that emergency clinicians and interventional breast radiologists should be aware of Mondor's disease as a potential complication of ultrasound-guided core needle biopsy of the breast.