A Case of Breast Cancer with Infarct Necrosis and a Cutaneous Fistula

Abstract

Here, together with a literature review, we report on a case of breast cancer with extensive infarct necrosis and fistula formation, which was difficult to diagnose and treat preoperatively. A 42-year-old woman visited our hospital complaining of a painful, rapidly enlarging growth in her left breast. During the examination, a 10 × 15 cm mass in her left breast and left axillary lymph node were palpated, and a fistula was detected at the 12 o'clock position. Breast ultrasonography and contrast-enhanced MRI revealed an approximately 10 cm mass with a mixture of liquid and solid components in the left breast and an abnormal communication to the skin. The pathological findings of the initial needle biopsy led to a diagnosis of ductal hyperplasia. However, on re-examination, an invasive ductal carcinoma was identified. As T4 breast cancer with axillary lymph node metastasis was considered, she underwent a total left mastectomy, axillary lymph node dissection, and full-thickness skin grafting. Postoperative histopathological examination yielded a diagnosis of encapsulated papillary carcinoma with invasive components (mucinous). Extensive infarct necrotic tissue was observed in the encapsulated papillary carcinoma without tumor invasion in the skin surrounding the fistula.