METAPLASTIC CARCINOMA OF THE BREAST: CARCINOSARCOMA CASE REPORT

Breast carcinosarcoma is malignant sarcomatoid metaplasia of epithelial carcinoma. It's thought that this tumor has a different natural history than carcinoma or sarcoma of the breast. A postmenopausal 52 year-old woman, first had a lumpectomy because of a mass in her left breast and then had a modified radical mastectomy due to inadequate surgical margin. As a result of the pathological examination her tumor was evaluated as pT2N1, ER (-) carcinosarcoma and no distant metastasis was found in the systemic survey, so the patient received 6 cycles of CMF chemotherapy. Four and a half years after the operation local recurrence occured and after the excision of the mass she received an adjuvant radiotherapy course of 5000 cGy TD to her left chest wall and total dose of 6000 cGy TD to the local recurrence region with a 1000 cGy boost. Four months after the completion of radiotherapy suspicious metastatic lesions were detected in the liver by abdominal CT scan and ultrasound. Since the patient did not accept the FNAB procedure offered, additional 7 cycles of chemotherapy (3 cycles of ADR, 4 cycles of DTIC+ifosfamide) were applied with a clinical decision of liver metastasis. The liver lesions were found stationary on USG and CT at the end of chemotherapy but were evaluated as completely regressed on CT and MRI 17 months after the completion of chemotherapy. The patient is under follow-up without any symptoms at 86 months from the time of diagnosis and 32 months after local recurrence. There's not adequate knowledge in the literature related with the prognosis and treatment of primary and recurrent breast carcinosarcoma. In this article the clinical and histological characteristics of a case were presented with the accompanying literature data.