Breast Amyloidosis: A Case Report and Literature Review

Area of Science:

• Oncology
• Rheumatology
• Pathology

Background:

• Amyloidosis is an uncommon condition involving the extracellular deposition of misfolded proteins.
• Localized breast amyloidosis is a rare manifestation, often presenting subtly on imaging.
• Systemic lupus erythematosus (SLE) is an autoimmune disease that can be associated with various systemic complications.

Purpose of the Study:

• To report a unique case of localized breast amyloidosis in an asymptomatic patient with SLE.
• To highlight the mammographic findings and diagnostic approach for this rare condition.
• To discuss the recommended management and prognosis of localized breast amyloidosis.

Main Methods:

• Case presentation of a 56-year-old woman with asymptomatic localized breast amyloidosis.
• Mammographic evaluation revealing suspicious microcalcifications without a discernible mass.
• Confirmation of amyloidosis through vacuum biopsy with Congo-red staining and polarized light microscopy.

Main Results:

• The case demonstrated localized breast amyloidosis presenting as mammographic microcalcifications.
• Congo-red staining showed characteristic apple-green birefringence under polarized light, confirming amyloid deposition.
• The patient was asymptomatic, and no mass was detected on initial mammography.

Conclusions:

• Localized breast amyloidosis can present as suspicious microcalcifications, mimicking other breast pathologies.
• Vacuum biopsy is crucial for diagnosis, and polarized light microscopy is essential for characteristic findings.
• Further workup to rule out systemic amyloidosis or hematologic malignancy is recommended; prognosis is favorable if negative.