Korean J Radiol.  2007 Jun;8(3):254-257. 10.3348/kjr.2007.8.3.254.

Breast Cancer from the Excisional Scar of a Benign Mass

• Kim MJ
• Kim EK
• Lee JY
• Youk JH
• Park BW
• Kim H
• Oh KK

• KMID: 1779444
• DOI: http://doi.org/10.3348/kjr.2007.8.3.254

Abstract

Breast cancer developing from a surgical scar is rare; this type of malignancy has been reported in only 12 cases to date. Herein, we report on a 52-year-old female who developed infiltrating ductal carcinoma in a surgical scar following excision of a benign mass. Two years previously, the patient underwent surgery and radiotherapy for invasive ductal carcinoma of the contralateral breast. The initial appearance of the scar was similar to fat necrosis; it was observed to be progressively shrinking on follow-up sonography. On the two year follow-up ultrasound, the appearance changed, an angular margin and vascularity at the periphery of the scar were noted. A biopsy and subsequent excision of the scar were performed; the diagnosis of infiltrating ductal carcinoma of the scar was confirmed.

Keyword

Breast neoplasm; Breast, biopsy; Breast, surgery; Breast, US; Breast radiography

MeSH Terms

Breast Neoplasms/*etiology/pathology/surgery
Carcinoma, Ductal, Breast/*etiology
Cicatrix/*complications
Female
Foreign-Body Reaction/pathology
Giant Cells/pathology
Humans
Middle Aged
Papilloma, Intraductal/pathology/surgery

Figure

• 

  Fig. 1 A. Sonography from June 2003 shows a 12 mm irregular mass (calipers) at the medial portion of the left breast. B. The histopathologic findings from the left breast surgical specimen shows an intraductal papilloma (Hematoxylin & Eosin staining, ×100). C. Follow-up sonography, from March 2004, shows an irregular mass with internal heterogeneous hyperechogenicity. An anechoic portion (thick arrow), suggestive of fat necrosis, was noted, and the mass abutted the thickened skin (thin arrow) from the previous excision. D. The third follow-up sonogram from March 2005, demonstrates that the irregular mass decreased in size, from 15 mm to 10 mm. E. The fourth follow-up sonography from September 2005, showing that the mass had developed a new angular margin (arrows) in one portion (right split-screen image: transverse view, left split-screen image: longitudinal view). F. On Doppler ultrasound, penetrating vascularity (arrow) was detected. G. On compression mammography of the craniocaudal view, a 4 mm mass (arrow) is seen just beneath the skin scar. H. On tissue confirmation, the surgical specimen demonstrates a 4 mm infiltrating ductal carcinoma (arrows) in the peripheral portion of the excised specimen with marked fibrosis and foreign body reaction in the majority of the specimen (Hematoxylin & Eosin staining, ×100).

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