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Spontaneous Complete Regression Of Breast Cancer: Two Case Report

Yilmaz, O. 2024Breast cancer

Yılmaz , O., Kesici, U., Duman, M. G., Yuzer, O., Erturk, A., & Nayir, P. O. (2024). Spontaneous Complete Regression of Breast Cancer: Two Case Report. Annali Italiani Di Chirurgia, 95(5), 767–771. https://doi.org/10.62713/aic.3461

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Abstract

Spontaneous regression (SR) is a tumor's partial or complete disappearance without any treatment. In the literature, it has been documented that SR is uncommon in breast cancer (BC) and other types of cancer. Multiple mechanisms are believed to contribute to the development of SR. However, its mechanism still needs to be clearly demonstrated. Although two SR patients were presented in our study, the evidence needed to be more sufficient to determine the mechanism. However, due to Programmed Death-Ligand 1 (PD-L1) negativity in both patients, the hypothesis in the literature that PD-L1 has strong antitumoral activity was not supported. In addition, it was determined that the patient in case 2 was the first Cerb B2 positive case reported in the literature and had the earliest SR period. Due to this, it has been disclosed that the SR mechanism of BC will be concluded within 21 days at the earliest. This situation suggests that breast surgeons, in particular, should conduct a thorough physical examination and, if necessary, re-radiological examination before surgery on patients for whom surgery is decided after diagnosis. Being careful in this regard may increase the number of SR in BC cases and allow molecular investigations on living tissue samples to reveal the underlying mechanism.

Case Details

Disease Location

Right breast

Personal Characteristics

65-year-old female, history of hypertension and appendectomy

Clinical Characteristics

Complained of a palpable mass in the right breast. Physical examination: a 2×3 cm, irregularly circumscribed, painless, mobile mass was palpated in the 11 o’clock position of the patient’s right breast. The patient’s mammogram revealed a 2.5×2.5 cm birads - v lesion with irregular borders in the upper outer quadrant of the right breast. Benign axillary lymphadenopathy was present, with nipple retraction and increased skin thickness prominent in the periareolar region. She was scheduled for surgery 46 days afterthe date of the biopsy. Palliative radiotherapy wasapplied in the postoperative period after remission

Remission Characteristics

The mass was not palpable during the preoperative physical exam. Since no mass could be detected sonographically, the patient underwent quadrenectomy and sentinel lymph node biopsy (slnb), including uoq. The axillary lymph node was reported to be reactive. No cancer was detected in the breast pathology sample. There were reports of focal periductal chronic inflammation, focal fat necrosis, fibrocystic changes, and columnar cell changes.

Treatment & Mechanisms

Proposed Remission Mechanisms

Related to trauma of biopsy

Clinical Treatment

Biopsy quadrenectomy (after remission) palliative radiotherapy (after remission)

Non-Clinical Treatment

None reported