Primary squamous cell carcinoma of the breast is an extremely rare invasive breast carcinoma with rapid progression and worse prognosis. Careful assessment and diagnosis of the entity should also be considered in a rapidly progressing breast tumor.
Introduction and importance Metastatic ovarian cancer of breast carcinoma is rare and accounts for only 0.68%–2% of all ovarian tumors, the majority of which are diagnosed incidentally during follow-up or therapeutic oophorectomy. Risk-reducing salpingo-oophorectomy (RRSO) is a highly recommended prophylactic surgery associated with a significant decrease in ovarian cancer risk in both BRCA1 and BRCA2 mutation carriers, and in those with and without prior breast cancer. Case presentation We present two cases who presented with a lump in the right axilla and left breast respectively and were subsequently diagnosed as invasive mammary carcinoma but later, diagnosed with metastatic ovarian carcinoma with breast primary after RRSO. The patients were treated with cycles of chemo-radiation. Discussion Invasive lobular carcinoma, larger tumor size, advanced breast cancer increases the risk of developing ovarian metastases. Thorough macroscopic, microscopic, immunohistochemical, and molecular tests are considered the cornerstone in the diagnosis of metastatic breast cancer to the ovaries. Bilateral salpingo-oophorectomy, a risk-reducing surgery for the BRCA gene mutation, has been shown to reduce the risk of death from ovarian cancer. Conclusions Metastatic ovarian cancer in breast cancer is a rare possibility among patients undergoing RRSO for breast cancer. The importance of continued surveillance of ovaries rather than the delayed diagnosis of ovarian metastasis for patients with newly diagnosed breast cancer cannot be less emphasized.
Primary breast liposarcoma is an extraordinarily rare breast malignancy. Histological subtypes including dedifferentiated are confirmed after a thorough histopathological and immunohistochemistry analysis. Liposarcoma of the breast can mimic other breast lesions. Long‐term follow‐up is needed due to the risk of local recurrence and delayed dedifferentiation.
Background Invasive mammary Paget's disease (MPD) is an extremely rare eczematous eruption on the nipple and areola with an invasion of the dermis by Paget cells. This entity can often be misdiagnosed and overtreated for invasive carcinoma of the breast. Case A 34‐year woman presented with a 2‐year history of right nipple eczema and right axillary lump for a month. Breast ultrasound revealed dilated intra‐nipple lactiferous duct and an enlarged right axillary lymph node. Histopathology from biopsy revealed MPD with ductal carcinoma in situ (DCIS) whereas final histopathology after right modified radical mastectomy revealed Invasive MPD with DCIS and axillary metastasis. She underwent adjuvant chemotherapy and is under hormonal therapy with complete remission for 18 months. Conclusion Awareness of invasive MPD is important to avoid misdiagnosis and probable radical treatment. Close follow‐up is warranted due to limited knowledge regarding treatment and prognosis of invasive MPD.
Introduction Breast cancer is the most frequent cancer among women. In the last few decades, the outcome of breast cancer has improved significantly in terms of survivorship and quality of life. However, it is crucial that alongside managing the disease, breast cancer services address and manage associated or co-occurring psychiatric illnesses such as acute stress reactions, procedural anxieties, adjustment issues, depression, and fear of recurrence, which leads to an overall better experience of the patient. Objective There is a paucity of data on the patterns of psychiatric morbidity in patients with breast cancer who access psycho-oncology services in a naturalistic setup outside research studies from India. The current study focused on exploring this alongside reporting the common treatment methods adopted for this group of patients. Materials and Methods Real-life data from electronic patient records were retrospectively reviewed for all patients with breast cancer accessing integrated psycho-oncology services in a tertiary care hospital in India over three 3 years (2018–2020). The various psychiatric morbidities were reported, along with associated cancer demographic data, disease characteristics, and treatment details. Results Of all the breast cancer patients (n = 338) in the calendar years 2018 to 2020 reviewed by psycho-oncology services, the most common psychiatric diagnosis was depressive illness (n = 100, 29.6%), followed by adjustment disorders (n = 68, 20.1%) and anxiety (n = 66, 19.5%). There was a significant minority with serious enduring mental illnesses such as schizophrenia (n = 11, 3.3%) and bipolar disorders (n = 14, 4.1%). On the other hand, 14.2% (n = 48) of the patients with breast cancer who attended Psycho-oncology outpatient department did not have any psychiatric syndrome. Around 16.3% of patients could be managed without a prescription for any medications and almost half of the patients needed only one psychotropic medicine. Psychological interventions were used for 45.6% of patients. Conclusions Integrated psycho-oncology services in a cancer hospital catering to patients with breast cancer help in psychiatric assessment, diagnosis, and addressing the mental health needs of patients. The treatment offered needs to be nuanced and individualized and may require a combination of psychotropic medications and psychological techniques.
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