A case study from the Lynn Sage Comprehensive Cancer Center. Primary sarcoma of the breast: a diagnostic dilemma

Abstract

A 44-year-old premenopausal, nulliparous woman presented with a recently discovered 4 cm palpable mass in the upper outer quadrant of her right breast. She denied any skin changes, nipple discharge, or axillary adenopathy. She had no family history of breast cancer and has had no previous mammographic abnormalities or biopsies. On physical examination, the mass was palpable at the 10 o'clock position of the right breast. There were no nipple or skin changes, no cervical, supraclavicular, or axillary adenopathy, and no expressible nipple fluid. Diagnostic mammography was performed with radiopaque markers placed at the level of the palpable abnormality, located in the posterior aspect of the right upper outer quadrant and over the palpable mass. Her prior mammograms were performed at an outside institution and were unavailable for comparison. The film-screen mammographic views revealed a 4.0 ϫ 3.5 cm macrolobulated, hyperdense mass corresponding to the palpable area, a portion of which demonstrated ill-defined margins (Fig. 1). To further characterize the mass, sonography was performed and revealed a complex mass with a near-anechoic portion, suggesting a cystic or necrotic component. In addition, an eccentric 1.2 cm, more