The Phenomenon Of Spontaneous Tumor Regression In Breast Cancer
Qureshi, A., Gollamudi, S., Qureshi, S., Sondhi, N., Nabi, S., Genato, R., Xiao, P., & Asarian, A. (2023). The phenomenon of spontaneous tumor regression in breast cancer. Journal of surgical case reports, 2023(12), rjad651. https://doi.org/10.1093/jscr/rjad651
View Original Source →Abstract
Spontaneous tumor regression is an increasingly prevalent phenomenon of partial or complete disappearance of primary tumor tissue or associated metastases in the absence of therapeutic intervention. Cases of spontaneous regression have been established in malignant tumors, such as testicular germ cell tumor, renal cell cancer, melanoma, basal cell carcinoma, neuroblastoma, colon cancer, breast cancer, as well as metastases. Breast cancer has increasingly been reported to have a higher rate of spontaneous regression than previously thought. Immunologic response is cited as the forefront of spontaneous regression phenomenon, with the focus on immunologic cell death. This report brings awareness to a case of spontaneous regression observed in invasive ductal carcinoma of the breast and how disruption of the tumor microenvironment can take a variable course even in malignant disease.
Case Details
Disease Location
Breast
Personal Characteristics
84-year-old female, history of hypertension, diabetes mellitus, and stroke.
Clinical Characteristics
Presented for biopsy-proven malignant 2-cm palpable mass on physical examination in the right retroareolar region. She had a diagnostic bilateral mammogram and sonogram, along with a biopsy of the site in question, consistent with invasive ductal carcinoma with perineural invasion. Indeterminate linear microcalcifications were visualized in the central right breast 3 cm posterior to the mass, and also in the central far posterior lower right breast. Repeat diagnostic mammogram and sonogram showed the biopsy-proven malignant 1.2-cm mass in the right retroareolar region. Additional suspicious microcalcifications 3-cm and 7-cm posterior to the mass were noted, classified as birads 4. She underwent a stereotactic biopsy. Pathology for the retroareolar mass was positive for moderately differentiated invasive ductal carcinoma with perineural invasion, and pathology for calcifications was positive for ductal carcinoma in situ. The patient underwent a right simple mastectomy without reconstruction with right axillary sentinel node biopsy.
Remission Characteristics
Surgical pathology did not find evidence of active malignancy in any of the previously biopsied areas. Evidence of nodular necrosis of tumor cells was noted, consistent with an inflammatory reaction and fibrocystic changes.
Treatment & Mechanisms
Proposed Remission Mechanisms
It is possible the biopsies disrupted the tumor microenvironment and alerted the immune response to impede further tumor progression as well as kill cancer cells.
Clinical Treatment
Biopsy, stereotactic biopsy, simple mastectomy, right axillary sentinel node biopsy
Non-Clinical Treatment
None reported