Abstract
An 82-year-old woman underwent a radical mastectomy for right breast cancer at the age of 38 years. She also had a postoperative oophorectomy and radiation therapy of the chest wall. The patient was now being evaluated for a chief complaint of right anterior chest pain. Thoracic CT showed a 33 mm × 28 mm solid lesion with an irregular margin in the right 6th anterior intercostal space. The pain was severe, but there was no evidence of other distant metastases.
The chest wall tumor was resected, followed by chest wall and diaphragm reconstruction. Histopathology showed moderate to poorly differentiated adenocarcinoma. The tumor was ER, PgR, and HER-2 negative, and the Ki-67 index was 50%. Immunostaining was positive for CK7, negative for CK20, and negative for TTF-1. Based on these results and the clinical findings, the patient was diagnosed with a late recurrence of breast cancer.
Blood tests 4 months after surgery showed that the tumor markers were again elevated. FDG-PET showed abnormal uptake in lymph nodes inferior to the tracheal bifurcation. The patient was diagnosed with a metastatic recurrence and is now being treated. Although late recurrence of breast cancer is common, we now report this rare, very late recurrence of breast cancer more than 40 years after initial surgery.
