Abstract:
Small-cell breast carcinoma (SCBC) is a very rare type of aggressive breast cancer constituting less than 1% of all breast cancers. The WHO classification categorizes this tumor as small-cell neuroendocrine carcinoma, and its prognosis is usually worse as compared to invasive breast cancers. We report a 64-year-old Caucasian female who presented with a large fungating left breast mass. Biopsy of the mass revealed small-cell carcinoma of the breast, negative for all 3 receptors (estrogen, progesterone, and Her2/neu). Imaging studies were negative for distant metastasis. She was subsequently treated after multidisciplinary discussion utilizing neoadjuvant chemotherapy with platinum agents and etoposide, modified radical mastectomy with axillary lymph node dissection, and adjuvant radiation therapy. Since she has triple-negative small-cell breast cancer, she will be followed with active surveillance without hormonal therapy. With less than 100 cases reported and in the absence of evidence-based standard treatment guidelines, we have reviewed various case series reported in the literature. We further discuss various chemotherapy regimens used previously, adverse prognostic factors of breast neuroendocrine tumors, common receptor status, and genetic mutations found in SCBC.
摘要:
小细胞乳腺癌(SCBC)是一种非常罕见的侵袭性乳腺癌,占所有乳腺癌的不到1%。WHO分类将这种肿瘤归类为小细胞神经内分泌癌,与浸润性乳腺癌相比,其预后通常更差。我们报告了一名64岁的白人女性,她表现出巨大的左乳肿块。活检显示乳腺小细胞癌,所有3种受体(雌激素,黄体酮,和Her2/neu)。影像学检查未发现远处转移。她随后在多学科讨论后使用铂类药物和依托泊苷的新辅助化疗进行治疗。改良根治术伴腋窝淋巴结清扫术,和辅助放射治疗。因为她得了三阴性小细胞乳腺癌,她将在没有激素治疗的情况下接受积极监测。报告的病例少于100例,并且缺乏循证标准治疗指南,我们回顾了文献中报道的各种病例系列.我们进一步讨论以前使用的各种化疗方案,乳腺神经内分泌肿瘤的不良预后因素,普通受体状态,和在SCBC中发现的基因突变。