[Pleomorphic Invasive Lobular Carcinoma Developed after Surgery for Simultaneous Ipsilateral Multiple Cancers]

Area of Science:

• Oncology
• Pathology

Background:

• A 54-year-old woman presented with a right breast lesion.
• Initial biopsy revealed invasive ductal carcinoma.

Purpose of the Study:

• To report a case of pleomorphic invasive lobular carcinoma (ILC) arising after treatment for multiple ipsilateral breast cancers.
• To discuss the diagnostic and therapeutic challenges posed by this rare presentation.

Main Methods:

• Initial diagnosis via needle biopsy.
• Surgical management including mastectomy and axillary lymph node dissection.
• Histopathological examination of resected tumors.
• Postoperative adjuvant therapies (chemotherapy, radiation, endocrine therapy).
• Subsequent diagnosis and surgical management of recurrent pleomorphic ILC.

Main Results:

• Initial presentation: Invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC).
• Post-treatment recurrence: Pleomorphic ILC with multiple daughter nodules.
• Tumor characteristics: Both initial and recurrent tumors were ER/PgR negative and HER2 negative, with varying Ki-67 indices.
• Recurrent tumor: Pleomorphic ILC, 22 mm, ER negative, PgR positive, HER2 negative, Ki-67 25%.

Conclusions:

• Pleomorphic ILC can develop after treatment for other breast cancer types.
• The prognosis and optimal treatment strategy for pleomorphic ILC remain unclear, necessitating cautious management.
• This case underscores the importance of vigilant follow-up for patients with a history of multiple breast cancers.