Osteosarcoma of breast: A rare case of extraskeletal osteosarcoma

Abstract

Primary osteogenic sarcomas of the breast are exceptionally uncommon. We describe such a case occurring in a 50 year-old woman who presented with a large painful mass in her left breast. Simple mastectomy of the left breast was performed. Microscopical and immunohistochemical findings established the diagnosis of primary osteogenic sarcoma. Similar to extremity osteosarcoma, adjuvant adriamycin and cisplatin based chemotherapy and external beam radiotherapy was given to the present case. She remained well 57 months later, without tumor recurrence. The current article made a literature search proving the rarity of this lesion type and discusses in detail the diagnostic implications and the treatment of this rare site tumor entity.

Osteosarcoma

“…Most commonly they present in the extremities, but have been reported in the breast, heart, and colon amongst other visceral organs [10,[34][35][36]. There may be an association with prior radiation.…”

<p>Primary Osteosarcoma of the Breast with Extensive Chondroid Matrix in a Teenager Female Patient: The Paradoxical Diagnosis in Breast Mastopathy</p>

“…The argument of if adjuvant radiotherapy should be used remains unclear, albeit several studies reporting on a small number of patients suggest that adjuvant chemotherapy may be of value in patient management. 13…”

Primary Breast Osteosarcoma; a case report and review of the literature

“…Some consider it as a sarcoma and emphasized that the management of PBOS should be similar to that of other sarcomas (20,37) ; whereas, some others believe that it should be treated like triple-negative epithelial carcinomas (1) . The value and effectiveness of chemotherapy have been emphasized, particularly with the tumor size more than 5 cm (38,39,40) ; however, there are still some reports that they did not offer chemotherapy to/for their patients (22,31) even with the tumor size of 6 cm (41) . Although Axillary Lymph Node Dissection (ALND) or sentinel lymph node biopsy has been performed in some reports (18,22,23,40,42,43) in most of the reports ALND was not performed for the patients (2,3,4,24,44,45) .…”

“…Although Axillary Lymph Node Dissection (ALND) or sentinel lymph node biopsy has been performed in some reports (18,22,23,40,42,43) in most of the reports ALND was not performed for the patients (2,3,4,24,44,45) . Similar to chemotherapy, considering irradiation as a part of treatment is not widely accepted at least as far as the tumor size is not large enough and the margins are clear from tumoral deposits (4,31,38) ; however, chest wall irradiation has been suggested by some other authors to reduce the risk of local recurrence as a routine part of treatment (46) . It seems that achieving a negative margin either with wide local excision or simple mastectomy without ALND is widely accepted/adapted and offering chemotherapy and radiotherapy should be based on prognostic factors of each patient.…”