Breast Carcinoma With Spontaneous Regression After Needle Biopsy: A Case Report And Literature Review
Sasamoto, M., Yamada, A., Oshi, M., Ota, I., Yoshida, K., Yakeishi, M., Tsuura, Y., Masui, H., & Endo, I. (2023). Breast carcinoma with spontaneous regression after needle biopsy: a case report and literature review. Gland surgery, 12(6), 853–859. https://doi.org/10.21037/gs-22-629
View Original Source →Abstract
BACKGROUND: Spontaneous regression (SR) of cancer is a rare condition in which the cancer partially or completely disappears without treatment. We report a case of breast cancer with tumor regression and spontaneously induced T-cell-mediated immunological responses in a surgical specimen obtained after core needle biopsy (CNB). CASE DESCRIPTION: A 52-year-old woman presented with a mass in the right breast. Mammography showed a high-density mass with fine serrated margins in the right lower outer quadrant. Breast ultrasonography showed an irregular hypoechoic mass with a maximum diameter of 22 mm. CNB was performed and revealed an invasive ductal carcinoma with negative estrogen receptors, positive progesterone receptors, and negative HER2 (1+). The Ki67 index was 70% to 80%. Luminal B cT2N1M0 stage IIB right breast cancer was diagnosed. Although preoperative chemotherapy was considered, surgery was selected because of her history of schizophrenia. She underwent right mastectomy and axillary lymph node dissection. A postoperative pathological analysis revealed a 20 mm × 10 mm × 10 mm mass. However, most areas of the mass regressed and appeared as necrotic tissue with no obvious invasive areas. Only intraductal extension was observed in one glandular duct. Axillary lymph node metastases were not observed. These results suggest that the tumor may have spontaneously regressed, possibly because of the CNB procedure. Follow-up without treatment was performed, and no recurrence occurred during 2 years after surgery. CONCLUSIONS: Invasive ductal carcinoma may spontaneously regress after preoperative CNB.
Case Details
Disease Location
Breast, axillary lymph node
Personal Characteristics
52-year-old woman, history of schizophrenia and diabetes mellitus, hysterectomy for uterine cancer at age 51 years. She was using several medications, including ezetimibe, sitagliptin phosphate hydrate, metformin hydrochloride, glimepiride, perospirone hydrochloride, biperiden hydrochloride, mecobalamin, sultopride hydrochloride, and calcium sennoside a and b.
Clinical Characteristics
Ultrasonography of the breast showed an irregular hypoechoic mass in the right breast, which was suspected to be breast cancer. Physical examination revealed an elastic hard mass in the lower outer quadrant of the right breast without dimpling. Core needle biopsy (cnb) showed invasive ductal carcinoma of no special type that was grade 3, estrogen receptor (er)-negative, progesterone receptor (pgr)-positive, and human epidermal growth factor receptor 2 (her2)- negative. Computed tomography was performed 13 days after cnb and showed an enhanced 22-mm mass in the right breast and an enlarged and enhanced lymph node in the right axilla. Stage iib breast cancer (ct2n1m0) was diagnosed. She underwent a right mastectomy and axillary lymph node dissection 48 days after cnb
Remission Characteristics
Postoperative histopathology revealed that ae1/ae3-positive tumor cells were not observed in the region presumed to be the original tumor location. Tumor cells were replaced with necrotic tissue, and lymphocyte infiltration was observed in the surrounding area. Tumor cells in the cnb specimen were not present in the postoperative specimen
Treatment & Mechanisms
Proposed Remission Mechanisms
Stimulation of core needle biopsy caused the spontaneous remission in this case
Clinical Treatment
Biopsy, right mastectomy and axillary lymph node dissection
Non-Clinical Treatment
None reported