A 21-Year-Old Female with Invasive Breast Cancer within a Benign Phyllodes Tumor

TL;DR

A 21-year-old woman was diagnosed with invasive breast cancer within a benign phyllodes tumor, a rare condition difficult to detect preoperatively.

Contribution

This case report highlights the rare occurrence of breast cancer within a phyllodes tumor in a very young patient.

Findings

A 21-year-old female was diagnosed with invasive ductal carcinoma within a benign phyllodes tumor.

Preoperative imaging and biopsy could not reliably predict the presence of cancer due to the patient's age and lesion characteristics.

The case underscores the importance of thorough pathological examination in complex breast masses.

Abstract

Although breast cancer occurring within a phyllodes tumor (PT) has been reported, it is extremely rare in young patients. Herein, we describe a case of breast cancer complicated by a PT in a 21-year-old female.

A 21-year-old female was referred to our hospital with a rapidly growing breast mass and suspected PT. Mammography revealed a well-defined, high-density mass. Ultrasonography revealed a blood-flow-rich hypoechoic mass with multiple slit structures, and MRI revealed a heterogeneous high signal on T2 weighted image with some diffusion restriction. A core needle biopsy revealed fibroepithelial lesions, and the lack of stromal changes suggested a high possibility of fibroadenoma. Based on the clinical and imaging findings, we considered the possibility of the PT being more than borderline malignant and planned tumor resection with a safety margin. The postoperative pathology revealed a benign PT complicated by invasive ductal carcinoma, with a predominance of intraductal carcinoma.

We report the case of a 21-year-old female with breast cancer occurring within a PT. The presence of cancer was difficult to predict preoperatively based on the patient’s young age and imaging findings.

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