Spontaneous Regression Of Breast Cancer With Immune Response: A Case Report
Ohara, M., Koi, Y., Sasada, T., Kajitani, K., Mizuno, S., Takata, A., Okamoto, A., Nagata, I., Sumita, M., Imachi, K., Watanabe, M., Daimaru, Y., & Kawamura, S. (2021). Spontaneous regression of breast cancer with immune response: a case report. Surgical case reports, 7(1), 10. https://doi.org/10.1186/s40792-020-01103-5
View Original Source →Abstract
BACKGROUND: Spontaneous regression (SR) is a rare phenomenon in which a cancer disappears or remits without treatment. We report a case of breast cancer that showed spontaneous tumor regression in the surgical specimen after core needle biopsy. CASE PRESENTATION: A 59-year-old woman came to our hospital complaining of a painful lump in the right breast. In the upper-outer quadrant of the right breast, a tumor with an unclear boundary, 30 mm in diameter, was palpable. In pathological findings from needle biopsy, the tumor was diagnosed as solid-type invasive ductal breast carcinoma. Partial coagulation necrosis was generated in estrogen receptor-negative, HER2-negative, and AE1/AE3-positive ductal carcinoma without infiltration of lymphocytes. Surgery for right breast cancer was then performed. Histological examination of the surgical specimen revealed the tumor was invasive ductal carcinoma with lymphocyte infiltration, coagulation necrosis, and fibrous tissue with hemosiderin. The tumor formed a solid nest, 3 mm in diameter, suggesting the possibility of SR. CONCLUSIONS: Immune responses, infection, hormones, surgical stress, and ischemia have been reported as mechanisms of SR. The findings in this case strongly suggest that SR of breast cancer is associated with anti-tumor immune responses.
Case Details
Disease Location
Breast
Personal Characteristics
59-year-old woman. Type 2 diabetes, hypertension, and hyperlipidemia. She was treated with metformin, olmesartan medoxomil/ azelnidipine, and pravastatin for less than 5 years. Total hysterectomy at age of 47 for a uterine leiomyoma
Clinical Characteristics
Chief complaint of a painful lump in the right breast. A tumor with an unclear boundary was palpable in the upper-outer region of the right breast, about 30 mm in diameter along the major axis. Mammography revealed a mass with a clear boundary, 19×18 mm in size, in the middle outer portion of the right breast. Ultrasonography revealed a smooth, round mass measuring 20×18×18 mm in size, in the upper-outer quadrant of the right breast. Subcutaneous fat tissue around the tumor appeared as a highly echogenic, edematous region. Needle biopsy diagnosed the tumor as a solid-type invasive ductal breast carcinoma. Adjuvant radiation therapy (50 gy in 25 fractions) to the whole breast was performed after surgery
Remission Characteristics
Thirteen days after core needle biopsy ultrasonography showed that the tumor size had decreased to 12×10×11 mm, and the edema around the tumor had disappeared. Right partial breast resection and sentinel lymph node biopsy was performed 53 days after core needle biopsy. Histological examination showed lymphocyte infiltration, coagulation necrosis, and fibrous tissue spread with hemosiderin deposition
Treatment & Mechanisms
Proposed Remission Mechanisms
Unknown immunogenic cell death (icd)-derived anti-tumor immunity
Clinical Treatment
Biopsy, right partial brest resection and sentinel lymph node biopsy
Non-Clinical Treatment
None reported