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Synchronous presentation of breast carcinoma and non-Hodgkin lymphoma (NHL) is a rare occurrence (Bradford PT, Freedman DM, Goldstein AM, Tucker MA. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol 2010;146:265–72; Dutta Roy S, Stafford JA, Scally J, Selvachandran SN. A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma. World J Surg Oncol 2003;1:27; Suresh Attili VS, Dadhich HK, Rao CR, Bapsy PP, Batra U, Anupama G et al. A case of breast cancer coexisting with B-cell follicular lymphoma. Austral Asian J Cancer 2007;6:155–6). In particular, only two reported cases on synchronous presentation of invasive ductal carcinoma (IDC) and mantle cell lymphoma (MCL) exist in the English literature. Owing to the rarity, there is a lack of consensus about underlying mechanism as well as optimal treatment strategy, and diagnosing both malignancies together without a delay remains a complex clinical challenge. We report a case of synchronous presentation of IDC and MCL in a 67-year-old female patient whose MCL diagnosis was delayed due to a misinterpretation of her B symptoms as postmenopausal, with a review of the literature on concurrently occurring breast carcinoma and NHL.

Triple negative breast cancer (TNBC) comprises 17-20% of all breast cancers and is one of the most common breast cancers. The lack of therapy and failure of existing therapy has been a challenge for clinicians. Doxorubicin (DOX) is the first-line therapy, however, it has significant limitations. Rapid extensive recurrence with metastasis in any cancer has been a challenge for surgeons and medical oncologists. The challenge can be due to failure of therapy, drug resistance, or epigenetic changes. Here, we are discussing a stage I breast cancer patient, operated and treated with appropriate chemotherapy with complete response, which recurred in less than 8 months and metastasized to bone, liver and other organs. We are also presenting lab data of the IL-6 secretions on exposure to DOX in one of the most commonly used TNBC cell lines MDA-MB-231. Breast cancer cell line MDA-MB-231 upon exposure to DOX shows an increase in IL-6 levels more than the already elevated IL-6 levels. This might be a reason for early recurrence. We concluded that patients with TNBC might benefit from a standard DOX treatment regimen with an inflammation-blocking agent.

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In the United States, breast cancer is the most common cancer in women and the second most common cause of cancer death in women after lung cancer. 1 Breast cancer is associated with significant morbidity, mortality, and health care expenditure. When breast cancer is diagnosed in its earliest stages, it is a curable disease, with a 5-year survival of more than 90%. 1 Therefore, an annual screening mammogram in women, starting at 40 years of age in women with no family history and earlier in women with a family history of breast cancer, is the current standard-of-care recommendation by the National Cancer Institute.Mammography, the gold standard in breast cancer detection, results in up to 30% reduction in breast cancer mortality. 2 Mammography uses high-resolution radiography that evaluates breast anatomy to detect density, distortion, asymmetry, and calcifications. However, there are challenges in mammographic interpretation. One such challenge lies in eval-uation of dense breast tissue, because an increased density in the breast on mammography is a typical appearance of breast abnormality. Another challenge of mammographic evaluation is posed by overlapping breast tissue, causing summation of shadows that can mimic abnormal density or architectural distortion. These factors lower the sensitivity of mammography. Because mammography relies solely on the anatomic appearance of an abnormality, only 20% to 30% of biopsied suspicious mammographic lesions are found to be true breast malignancies. Mammography cannot definitively differentiate between benign and malignant lesions. Furthermore, 10% to 15% of breast cancers are mammographically undetectable.From 10% to 15% of breast cancers are mammographically undetectable, and only 20% to 30% of biopsied suspicious mammographic lesions are found to be true breast malignancies.Breast sonography, the second most commonly used technology for cancer detection, is considered a complement to the mammographic evaluation. Similar to mammography, sonography facilitates evaluation of the breast anatomy. Evolution of Breast-Specific Gamma ImagingScintimammography was incidentally discovered in 1992 during cardiac imaging with 99m technetium sestamibi in a patient with breast cancer. 4