Infiltrating duct cell carcinoma in lactating adenoma: A rare case in pair

Abstract

Lactating adenomas, though considered being benign, sometimes turn out to be malignant. We are hereby presenting two cases of lactating adenomas which turned out to be harboring infiltrating duct cell carcinoma (DCC). Two lactating women with mass in the breast were referred from surgery for fine-needle aspiration cytology and biopsy. On histopathology, it was found that both had infiltrating DCC (either as collision tumor or as a malignant transformation of lactating adenoma). These cases point toward some association between lactating adenoma and DCC, however, small it may be. Therefore, any mass lesion in the breast should be followed up under strict vigilance for an early diagnosis and management of this deadly disease. A large sample size and elaborate study are required to frame its prognostic relevance. Like estrogen receptor and progesterone receptor, prolactin and prolactin receptor expression can be exploited for developing newer receptor-targeted therapy.

Coexisting lactating adenoma and invasive breast carcinoma: A case report and review of literature

“…3 To the best of our knowledge, only 7 cases of concurrent lactating adenoma and invasive breast carcinoma have been reported in current English literature, with our case being the eighth. [4][5][6][7][8][9] The underlying pathogenesis for its coexistence remains unclear. The popular opinion is lactating adenomas are benign entities and their coexistence with invasive carcinoma is a mere collision tumor, however, few consider it to have malignant potential.…”

“…On microscopic examination, half the cases had distinct areas of malignant and benign lesions supporting the theory of collision, and one case showing intermingling of the two cell populations suggesting infiltration. However, Kumar et al 6 and Dakhure et al 7 reported carcinoma in situ admixed with LA, and Sharma et al 9 reported carcinoma in the center of LA suggesting a malignant potential of LA. The present case had IBC adjacent to LA, with a distinctly demarcated boundary separated by an area of fibrosis.…”

“…3 On doing a literature search through Google scholar and PUBMED, only 7 cases of concurrent lactating adenoma and invasive breast carcinoma have been reported in current English literature, with our case being the eighth. [4][5][6][7][8][9] The underlying pathogenesis behind its coexistence remains unclear, and the evaluation of such cases is needed to help determine whether it's a mere coincidence, a malignant transformation, or an increased association between the two.…”