Spindle Cell Metaplastic Breast Carcinoma

Area of Science:

• Oncology
• Pathology

Background:

• Metaplastic breast carcinoma is a rare malignancy (<5% of breast cancers) with subtypes including spindle cell carcinoma (<0.3% of invasive breast cancers).
• Spindle cell carcinoma is typically triple-negative, presenting distinct pathological features but often inconclusive imaging findings.

Observation:

• A case of an elderly woman with a painful, enlarging left breast lump over one year is presented.
• Mammography and ultrasound revealed a high-density lesion with indistinct margins and heterogeneous solid-cystic areas.

Findings:

• Histopathology confirmed atypical spindle-shaped cells, positive for cytokeratins and negative for hormone and growth factor receptors.
• The diagnosis was consistent with metaplastic spindle cell carcinoma, necessitating mastectomy and axillary dissection.

Implications:

• Spindle cell carcinoma of the breast is aggressive and may exhibit benign imaging features.
• Accurate tissue diagnosis and multidisciplinary team discussion are essential for effective management and improved patient outcomes.