Breast Sarcoma: A Case Report in Young Patient

INTRODUCTION: Sarcomas are defined as mesenchymal tumors are usually found in soft tissues and present as a large mass palpable. Metastatic lymph nodes are rare because the spread occurs most commonly by hematogenous, being the lung an important metastatic site. (Robbins, 2004). This condition is considered a rare cancer that affects mainly elderly women. Belong to this group of neoplasms filoides malignant tumors, a heterogeneous group of sarcomas, including liposarcomas, osteosarcoma, angiosarcomas, malignant histiocitofibroma, leiomiosarcomas, among others. (Gustalla, 1997). This condition has clinical aspect as breast mass palpable, painless, fast growing, leading to a diffuse increase of the breast. This study aims to discuss the clinical and histological sarcoma of the breast, from the case report, considered to be an uncommon clinical condition. CASE REPORT: LR, 41, white, married, teacher, born and raised in Lucena-PB, sought outpatient Mastology presenting breast enlargement 4 months ago. Gesta II to II, breastfeeding for 5 years. Lack of oral hormonal contraception and family history of breast cancer. There was no report of alcohol consumption or smoking. On physical examination, there was a bulky mass in the left breast, with areas of necrosis and increased vascularity of the skin. Palpable axillary lymph nodes in left axilla, measuring about 2 cm the largest one. It was performed a core needle biopsy that revealed mesenchymal neoplasm and after immunohistochemical evaluation it was confirmed the diagnosis of undifferentiated sarcoma of the breast. DISCUSSION: The breast sarcomas represent 1% of malignant breast diseases, making it a rare malignant neoplasm. It mainly affects women of advanced age, over 60 years, but it can also affect more rarely women in adolescence. The histopathological diagnosis of the lesion can be accomplished by core biopsy, a minimally invasive method, which has high sensitivity and specificity in the evaluation of mammary lesions. In order to ensure the accuracy diagnosis, immunohistochemistry is a valuable procedure to confirm the diagnosis (Cezar, 1995). Most publications do not define what is the best follow-up treatment in terms of surgery, chemotherapy and radiotherapy. However, it is common to consider total mastectomy without axillary dissection, in the absence of palpable lymph nodes. The role of wide excision and adjuvant therapy remain uncertain (Amaral 2008). The prognosis is difficult to define, although local invasion and the degree of cellular atypia appear to have some predictive value, while the tumor size and mitotic activity less correlated with the result. (Barnes, 1977).