Small cell breast carcinoma. Case report

Abstract

Introduction: Primary small cell breast carcinomais a highly malignant, uncommon cancer, whichaccounts for less than 1% of all breast cancers. It isusually found in women over 60 years of age as apalpable tumour of the breast or armpit. Due to thesmall number of relevant case reports, this type ofcancer presents a diagnostic and therapeuticchallenge.Case presentation: A 85-year-old woman showedup at the Oncology Clinic with a palpable node in theleft breast. On physical examination, the patient wasin general good condition, ECOG performancestatus of 1. In deviations from the norm, there was apalpable tumour with a diameter of ca. 4cm in thelower outer quadrant, 4 o'clock position of the leftbreast; and an enlarged, movable left axillary lymphnode, with a diameter of about 3 cm. The diagnosis,strongly influenced by the abovementioned tests,was small cell breast cancer TNBC-cT2N1M0. Asagreed at the case conference meeting, the patientwas qualified for neoadjuvant chemotherapyaccording to the 4-EP scheme, followed bymastectomy with lymphadenectomy of the leftarmpit and complementary radiotherapy. The patientreceived four courses of chemotherapy from 28March to 30 May 2023. The visible tumourregression in physical examination revealed goodtreatment tolerance – a reduction of tumour size onpalpation by half. The patient is undergoing followup checks after chemotherapy and awaits ascheduled surgery.Conclusions: Literature on primary small cell breastcarcinoma is still limited . Diagnostics of SCNCBinclude positron emission tomography (PET) and CTscans to rule out metastases from another primarylocation. Clinical treatment of SCNCB is stillunderdeveloped. A particularly important prognosticfactor is the size of tumour at the time of treatment.Early detection and interdisciplinary therapies maybe relevant for improving prognosis. Research on thediagnosis, treatment and prognosis of SCNCB is stillongoing.