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What Can Trigger Spontaneous Regression Of Breast Cancer?

D'Alessandris, N. 2023Breast cancer

D'Alessandris, N., Santoro, A., Arciuolo, D., Angelico, G., Valente, M., Scaglione, G., Sfregola, S., Carlino, A., Navarra, E., Mulè, A., & Zannoni, G. F. (2023). What Can Trigger Spontaneous Regression of Breast Cancer?. Diagnostics (Basel, Switzerland), 13(7), 1224. https://doi.org/10.3390/diagnostics13071224

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Abstract

BACKGROUND: Spontaneous regression of tumors is a rare phenomenon in which cancer volume is reduced or, alternatively, a tumor completely disappears in the absence of any pharmacological treatment. This phenomenon has previously been described in several tumors, such as neuroblastomas, testicular malignancies, renal cell carcinomas, melanomas, and lymphomas. Spontaneous remission has also been documented in breast cancer; however, it represents an extremely rare and poorly understood phenomenon, with only a few reported cases in the literature. METHODS: We herein report two cases of breast cancer that showed spontaneous tumor regression in the surgical specimen after a pathologically confirmed diagnosis of invasive breast cancer in core needle biopsy samples. RESULTS: Macroscopically, both the surgical samples revealed a whitish, fibrous area with a rubbery consistency. On histological examination, diffuse fibrous tissue, hemosiderin deposition, and chronic inflammation were observed. The first case showed the complete disappearance of the tumor, whereas the second case showed just a small (3 mm), residual nest of neoplastic cells. CONCLUSIONS: Although spontaneous regression of breast cancer is a rare event, it is important to know that it might happen. It is also of great importance to try to better explain, over time, its underlying mechanism. This knowledge could help us to further develop cancer prevention methods and predict the clinical course of these kinds of neoplasms.

Case Details

Disease Location

Breast

Personal Characteristics

76-year-old woman

Clinical Characteristics

Referred for a palpable lump in her left breast. Mammographic examination demonstrated a well-defined mass, 3 cm in diameter at its longest, without lymph node involvement. Fine-needle aspiration revealed numerous atypical epithelial clusters with hyperchromatic nuclei. A diagnosis of high-grade breast cancer was made.

Remission Characteristics

Lumpectomy and sentinel node biopsy were performed. Histological examination revealed diffuse fibrosis without residual neoplastic cells. Immunohistochemistry showed that the majority of inflammatory cells were represented by t lymphocytes.

Treatment & Mechanisms

Proposed Remission Mechanisms

Local trauma induced by fine-needle aspiration may have triggered the immune response following the possible release of a segregated tumor antigen.

Clinical Treatment

Fine-needle aspiration lumpectomy and sentinel node biopsy

Non-Clinical Treatment

None reported