Câncer de Mama Multifocal: Relato de Caso

Abstract

Introdução: O câncer de mama é a neoplasia que mais acomete o sexo feminino, sendo a primeira causa de morte por câncer em mulheres. O carcinoma mamário representa um grupo heterogêneo de doenças. Casos individuais diferem uns dos outros na morfologia, fenótipo e prognóstico. As patologias malignas das mamas podem se manifestar como tumores unifocais, multifocais e/ou multicêntricos. A incidência de tumores multifocais e multicêntricos no câncer de mama varia de 13% a 70%. Relato do caso: Paciente L.C., sexo feminino, 65 anos, com relato de nódulo palpável em mama direita em setembro de 2015. O estudo anatomopatológico do nódulo mostrou carcinoma intraductal. Realizada quadrantectomia, com anatomopatológico que identificou carcinoma papilífero bem diferenciado intracístico e invasivo da mama, associado a componente intraductal cribriforme e papilar, com margens e linfonodo sentinela livres e imuno-histoquímica compatível com perfil triplo-negativo. Em fevereiro de 2019, apresentou duas novas lesões em mama contralateral, identificadas como carcinoma ductal invasivo multifocal com papiloma intraductal associado, e carcinoma ductal invasivo associado a componente intraductal in situ dos tipos papilar, sólido e cribriforme, com imuno-histoquímica com perfis moleculares distintos entre si, sendo uma lesão do tipo luminal A e a outra, luminal híbrido. Conclusão: Este estudo relata um caso de uma paciente que apresentou lesões neoplásicas em ambas as mamas, em tempos distintos e com perfis histológicos e imuno-histoquímicos diferentes. Dessa forma, destacam-se a raridade do caso e a relevância da terapia dirigida a alvos específicos, uma vez que a paciente apresentava lesões com perfis moleculares distintos.

Atypical Presentation of Triple-Negative Breast Cancer

“…Only 10% of breast cancer cases have genetic background, being the majority, sporadic (90%) [5]. The definitive diagnostic is made by biopsy with positive results of malignancy classified by immunohistochemistry (IHC) depending by positivity of Estrogenic Receptors (ER), Progesterone Receptors (PR) and Epidermal growth factor receptor 2 (HER2) [4,6,7]. Immunohistochemistry classification is being classified by subtypes: Luminal A, Luminal B, HER2 positive and Triple-negative [7].…”

“…The Triple negative Breast Cancer (BCTN) it been defined as the absence of Estrogenic Receptors (ER), Progesterone Receptors (EP), Epidermal growth factor receptor 2 (HER2) [2,4,[8][9][10][11], and it conforms 10 to 20% of all cases of breast cancer [10,12,13]. It has been made a study by Acta Medica Grupo Angeles, in the Angeles Summary Introduction: Triple-Negative Breast Cancer (BCTN) has been defined as the absence of Estrogenic Receptors (ER), Progesterone Receptors (EP), Epidermal growth factor receptor 2 (HER2), and it conforms 10 to 20% of all cases of breast cancer.…”

“…Breast cancer ranks first in incidence and leading cause of death among women in the world [1][2][3][4][5][6]. In Pedregal Hospital in Mexico where it is observed during a period of 2009-2015 of 3,290 samples only 9.6% of the cases were BCTN cases [14].…”

“…A patient suffering breast cancer has about 77 years of life expectancy and being diagnosed with an average of years of 52.5-years-old, being the majority diagnosed after 50-years-old, a 23% are found in those under 45-years-old [5,6].Only 10% of breast cancer cases have genetic background, being the majority, sporadic (90%) [5]. The definitive diagnostic is made by biopsy with positive results of malignancy classified by immunohistochemistry (IHC) depending by positivity of Estrogenic Receptors (ER), Progesterone Receptors (PR) and Epidermal growth factor receptor 2 (HER2) [4,6,7]. Immunohistochemistry classification is being classified by subtypes: Luminal A, Luminal B, HER2 positive and Triple-negative [7].…”

“…Immunohistochemistry classification is being classified by subtypes: Luminal A, Luminal B, HER2 positive and Triple-negative [7]. In Mexico, the incidence according to the IHC is of hormone receptors 60%, HER-2 positive 20.4% and triple-negative 23.1% [8].The Triple negative Breast Cancer (BCTN) it been defined as the absence of Estrogenic Receptors (ER), Progesterone Receptors (EP), Epidermal growth factor receptor 2 (HER2) [2,4,[8][9][10][11], and it conforms 10 to 20% of all cases of breast cancer [10,12,13]. It has been made a study by Acta Medica Grupo Angeles, in the Angeles Summary Introduction: Triple-Negative Breast Cancer (BCTN) has been defined as the absence of Estrogenic Receptors (ER), Progesterone Receptors (EP), Epidermal growth factor receptor 2 (HER2), and it conforms 10 to 20% of all cases of breast cancer.Case report: A 42-years-old female, debuting with abdominal pain, a 44 pounds of weight loss on the last 2 months and abdominal mass presence.…”