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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

57-year-old female, history of diabetes (metformin), hypertension

Clinical Characteristics

Complained about a mass in her right breast. Physical examination, a 2.5×3 cm, irregularly circumscribed, painless, mobile mass was found in the 10 o’clock position of the right breast. The patient’s breast us examination revealed a 20×10mm mass with irregular contours and spicular extension at 10 o’clock on the right breast, a 23×16 mm hypoechoic lesion with irregular borders in the deep plane of this lesion, and a 13×7 mm mass with irregular borders at 12 o’clock (satellite lesion). It was designated birads 4c a core biopsy was performed on a 2.5×3 cm malignant breast mass on the right side. Medullary pattern invasive carcinoma was reported. Tumor-infiltrating lymphocyte (til) was 80%, er was 5% positive, pr was negative, cerbb2 was positive, ki 67 was 80%, p63 staining was present in a limited number of tumor cells, and gata-3 was positive

Remission Characteristics

The patient underwent a mastectomy and axillary lymph node dissection at another center. According to the patient’s surgical pathology report, no metastatic lymph nodes in the axilla and no tumor cells could be detected in the mastectomy specimen.

Treatment & Mechanisms

Proposed Remission Mechanisms

Related to trauma of biopsy

Clinical Treatment

Biopsy mastectomy

Non-Clinical Treatment

None reported