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Journal of IMAB
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue2
Subject Area: Medicine
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DOI: 10.5272/jimab.2024302.5455
Published online: 01 April 2024

Case report
J of IMAB. 2024 Apr-Jun;30(2):5455-5459
CHALLENGES IN THE MANAGEMENT OF METAPLASTIC SQUAMOUS CELL BREAST CARCINOMA
Tsvetan Popov^{1, 2}, Angel Arabadzhiev^{1, 2}, Vasil Pavlov^{1, 2}, Manol Sokolov^{1, 2}, Svilen Maslyankov^{1, 2},
1) Clinic of Surgery, University Hospital “Alexandrovska”,Sofia, Bulgaria.
2) Department of Surgery, Faculty of Medicine, Medical University - Sofia, Bulgaria.

ABSTRACT:
Purpose: To present a clinical case of metaplastic squamous cell sarcomatoid breast carcinoma – a rare entity within the spectrum of breast cancer, comprising up to 1% of all cases.
Material/Methods: We report the clinical course of a 68-year-old woman who sought medical attention regarding a locally advanced breast cancer characterized by exophytic growth.
Results: Despite initial systemic treatment, the tumor displayed rapid progression and extensive ulceration with spontaneous bleeding, prompting additional cycles of systemic and radiotherapy. Subsequently, the patient experienced life-threatening acute breast bleeding and hemorrhagic shock, leading to an admission to the Intensive care unit, followed by an emergent modified radical mastectomy. Histological examination of the specimen revealed a high-grade sarcomatoid variant of squamous cell metaplastic breast carcinoma (MBCa) without lymph node (LN) metastasis. Adjuvant radiation therapy was performed, yet a local recurrence was diagnosed, necessitating a second surgical intervention. Despite also receiving adjuvant systemic therapy, the patient presented with a second recurrence with distant metastases in the lungs. A transcatheter arterial embolization (TAE) of the tumor-supplying artery was performed, aiming to impede the tumor vasculature, thus reducing the risk of recurrent life-threatening hemorrhage. However, only a short-term effect was observed, and the patient experienced an unfavorable outcome.
Conclusions: This case underscores the challenges in managing advanced MBCa, its aggressive clinical course, and the struggles of achieving a favorable prognosis.

Keywords: metaplastic breast cancer, squamous cell, treatment, management, diagnosis,

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Please cite this article as: Popov T, Arabadzhiev A, Pavlov V, Sokolov M, Maslyankov S. Challenges in the Management of Metaplastic Squamous Cell Breast Carcinoma. J of IMAB. 2024 Apr-Jun;30(2):5455-5459. [Crossref - 10.5272/jimab.2024302.5455]

Correspondence to: Tsvetan Popov MD, Clinic of Surgery, University Hospital “Alexandrovska”, Sofia, Bulgaria, Department of Surgery, Faculty of Medicine, Medical University - Sofia; 1, St. Georgi Sofiyski Str., 1431 Sofia, Bulgaria; E-mail: ts.popov@medfac.mu-sofia.bg

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Received: 30 January 2024
Published online: 01 April 2024

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