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Rare case of primary leiomyosarcoma of the breast treated with wide local excision and planned cosmetic breast reduction surgery
  1. Luke Horton1,
  2. Madeline Wohlfeil1,
  3. Nabil Al-Kourainy2 and
  4. Lydia Choi1,3
  1. 1The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
  2. 2Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA
  3. 3Department of Surgery, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
  1. Correspondence to Luke Horton; luke.horton2{at}med.wayne.edu

Abstract

Primary leiomyosarcoma of the breast is an extremely rare neoplasm accounting for less than 0.0006% of all breast malignancies, with fewer than 80 cases reported in the literature to date. Here, we present a case of leiomyosarcoma of the breast in a 61-year-old woman without traditional risk factors. This case was treated with lumpectomy requiring wide margins due to the high rate of local recurrence. A planned breast reduction surgery was deemed adequate postlumpectomy therapy to prevent cancer recurrence, negating the need for chemotherapy or radiation therapy. To our knowledge, this is the first case in which cosmetic breast reduction surgery will be used as postlumpectomy cancer recurrence risk mitigation for primary leiomyosarcoma of the breast. Patients with this malignancy have a relatively poor prognosis compared with other breast cancer types, with a 5-year disease-free survival of 33%–52%. As such, frequent follow-up and monitoring for postresection recurrence is essential.

  • cancer intervention
  • breast cancer
  • pathology
  • breast surgery
  • surgical oncology

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Footnotes

  • Contributors LH drafted the manuscript. LH, MW, NA-K and LC edited the manuscript providing significant insights and expertise. LC played vital roles in the diagnosis and care of this patient, interpreting results and determining and carrying out the treatment plan. All authors reviewed and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.