Abstract
A 37-year-old woman with Down's syndrome diagnosed at birth was evaluated at our hospital for an enlarging mass in the right breast that her mother had first noticed year 6 months previously. On palpation, there was a 10-cm, hard mass in the right CD area, and ultrasound showed a round, well-circumscribed, heterogeneous, hypoechoic lesion at the same site. On aspiration, there was bloody fluid, and since both cytology and histology showed no evidence of malignancy, the patient was followed up.
However, 3 months later, the mass continued to enlarge, and because a malignancy could not be ruled out, surgery was scheduled for diagnosis and treatment. Because of obesity, macroglossia, and atlantoaxial subluxation, the Department of Anesthesia decided that general anesthesia would require awake intubation in this patient. However, due to lack of her understanding, a decision was made to perform a lumpectomy under local anesthesia rather than under general anesthesia.
Histopathology showed a mucinous carcinoma with a luminal A subtype. Radiotherapy to the residual breast was judged not possible, so the patient is currently on hormone therapy alone. The case of this patient with Down's syndrome who had breast cancer presenting as a breast hematoma and underwent surgical resection under local anesthesia is described.
