To report a case of metaplastic breast carcinoma with osteosarcomatous differentiation and discuss its diagnostic and therapeutic challenges.
Approach:
Patient History: A 65-year-old female with a history of left breast invasive carcinoma underwent breast-conserving surgery and adjuvant therapy. She presented with a recurrent mass four years later.
Diagnostic Assessment: Imaging and core needle biopsy suggested metaplastic carcinoma. Immunohistochemistry indicated triple-negative features with specific markers.
Therapeutic Intervention: The patient received TP regimen plus immunotherapy for four cycles, followed by modified radical mastectomy and adjuvant AC chemotherapy combined with immunotherapy.
Key Findings:
Metaplastic breast carcinoma (MBC) is rare, accounting for less than 0.2-1% of breast cancers.
MBC with osteosarcomatous differentiation is extremely rare, comprising 0.003%-0.12% of cases.
The patient was diagnosed with triple-negative MBC with osteosarcomatous differentiation after initial treatment for invasive breast carcinoma, following a recurrence four years later.
Interpretation:
This case highlights the diagnostic and therapeutic challenges associated with MBC with osteosarcomatous differentiation.
Limitations:
The original histological slides from the initial diagnosis were not available for review.
The rarity of the condition limits the generalizability of findings, as well as the limited number of cases available for study.
Conclusion:
This case suggests that a multimodal treatment approach, including surgery, chemotherapy, and immunotherapy, may be necessary for optimal management of MBC with osteosarcomatous differentiation.
