Metaplastic breast cancer is rare and aggressive, accounting for only 0.2% of all breast cancers with a survival ranging from 40-65%. A recent case from our institution posed many diagnostic and management challenges prompting a review of our local ten-year experience with this cancer and a review of the literature to compare the behaviour of this cancer in a developing country and considering guidelines for management.The incidence is higher with what appears to be a better prognosis in our patient population. Early diagnosis and treatment may be responsible for the apparent better outcome in our patient population. Successful treatment consists of surgery, radiotherapy and with comparable results from both breast conservation and modified radical mastectomy. Preoperative biopsy does not usually yield the correct diagnosis so most patients undergo axillary node dissection even though the mode of spread is supposed to be primarily hematogenous.
Dermatofibrosarcoma protuberans (DFSP) is an extremely rare cutaneous neoplasm of the dermal layer of the skin and is histologically classified as a sarcoma. DFSP itself has an incidence of 0.8 cases per million annually. It accounts for 1% of all soft tissue sarcomas and less than 0.1% of all malignancies. DFSP has a high rate of local recurrence especially if there are positive margins on excision, but only up to 4% develop metastasis. Most reported cases are located in the trunk, extremities and head especially scalp. However, DFSP of the breast is very rare with very few reported in the literature. We report a case of a 33-year-old woman who presented with a histological diagnosis of DFSP of the breast, based on incisional biopsy. We report this case which highlights the important aspects in evaluating DFSP in the breast as well as its treatment.
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