Breast Carcinosarcoma:a Clinical Analysis Of2Cases And Review Of Literature

Breast carcinosarcoma is the metaplastic carcinoma which contains both carcinomatous and sarcomatous elements. Carcinosarcoma is rare breast malignancy with aggressive behaviour and poor prognosis. Very few cases of carcinosarcoma have been reported in the literature, and the lack of clinical characteristics and biological characteristics make it a challenge to diagnose. The diagnose of carcinosarcoma is depending on histopathology. The most efficient treatment strategie of breast carcinosarcoma is still unknown. In this paper, two cases will be reported. The woman who is26years old came to our hospital with a complaint of a lump in the left breast of2years duration. And2days before presenting to our hospital, diabrosis with exudation was observed on the surface of the mass. An irregularly shaped malleable mass measuring12×10cm was found in the inferior outer quadrant of the left breast with a2x2cm ulcer on the surface. Sonography detected an11×8cm isoechoic mass in the left breast with a4.7×1.1cm hypoechoic area within the mass. A lumpectomy was performed. Histological and immunohistochemical examinations confirmed the masses as breast carcinosarcoma. A nipple-sparing modified radical mastectomy was performed in the left breast. A51-year-old Mongolian female presented to the hospital with the complaint of lumbago that had persisted for two months. On physical examination, a0.5×0.5-cm mass was identified in the right breast near the areola. Sonography detected two masses near the areola of the right breast; one mass measured0.6×0.5cm and the second mass measured0.9×0.6cm and was proximal to the ectopectoralis. After completing of the examinations(including mammogram,breast MRI,PET and do on),the the primary was diagnosed as breast cancer with bone metastases.A lumpectomy biopsy and a biopsy of the fourth lumbar spinous process were performed to verify the diagnosis. One0.8×0.6-cm mass was identified in the upper inner quadrant of the right breast. Pathological results indicated intraductal carcinoma. The other mass (diameter,0.5cm) was excised from the upper outer quadrant of the right breast. Histological and immunohistochemical examinations determined a diagnosis of a malignant phyllodes tumor with invasive and poorly differentiated carcinoma. The final diagnosis was determined to be breast carcinosarcoma (pTINOMI, stage IV) One cycle of a chemotherapy regimen (lasting21days) comprising of cisplatin (40mg, days1-3), doxorubicin (70mg, day1) and cyclophosphamide (0.8g, day1) was administered. However, the patient can’t suffered the chemotherapy and succumbed after a month, then she chose to have the treatment of tamoxifen10mg bid. The paper want to make the clinical characteristics and biological characteristics of breast carcinosarcoma clear and find the proper treatment strategic of the disease through the learning of the2cases and analysis of literatures.