Abstract
A 63-year-old woman was referred to our hospital complaining of huge left axillary lymph nodes and left nipple erosion. Core needle biopsy diagnosis identified the breast lesion as ductal carcinoma in situ (DCIS), whereas the axillary lymph nodes showed anaplastic carcinoma. General survey showed no definitive primary site for the axillary anaplastic carcinoma. We diagnosed coexisting DCIS of the breast and axillary anaplastic carcinoma from an unknown primary site. After chemotherapy (CDDP + CPT-11), axillary lymph nodes shrank markedly. Left muscle-preserving mastectomy and axillary and subclavian lymphadenectomy were performed subsequently.
Postoperative radiotherapy of the supraclavicular, subclavian and axillary nodal areas was performed. Two years and six months after surgery, the patient is healthy with no recurrence. This rare case suggests that axillary lymph node biopsy is mandatory if any clinical discrepancy is seen between breast cancer and axillary lymph nodes.
