The Challenges of Approaching a Giant Breast Mass: A Case Report With Literature Review

The classical clinical approach to any breast lesion is through the triple assessment: clinical, radiological, and pathological. However, with giant breast masses, the classical assessment might have limitations in revealing the diagnosis. We report a case of a rapidly growing left breast mass in a 60-year-old woman. In a short period of time, the lesion reached a giant size of 48 cm x 43 cm with mixed constructure and skin changes. The lesion was considered malignant by triple assessment, but the core needle biopsy could not reach a single pathological diagnosis. Giant breast masses are a rare entity of breast lesions that include different benign and malignant diseases. These diseases include malignant forms of breast sarcomas, phyllodes, and leiomyosarcomas, which are aggressive diseases requiring combative management. Diagnosing a giant breast tumor is challenging and demands a high level of suspicion. The classical approach may fail, raising the need for a special approach for such lesions. The adjusted guidelines may involve early multidisciplinary team involvement, advanced imaging, precise biopsy techniques, and earlier neoadjuvant therapy planning.