Triple-Negative Metaplastic Breast Cancer Treated With Chemotherapy, Oncoplastic Surgery, and Radiation

What happened, in summary

A 46-year-old woman presented in September 2020 with a left breast lump measuring about 5 to 6 cm and enlarged left axillary lymph nodes. Biopsy showed invasive breast cancer that was negative for estrogen receptor, progesterone receptor, and HER2. Initial assessment showed a large breast tumor with involved axillary lymph nodes and no abnormalities on chest X-ray or abdominal ultrasound.

She received 6 cycles of docetaxel, doxorubicin, and cyclophosphamide before surgery. Imaging after chemotherapy showed that the breast mass had enlarged despite treatment. Wanting to preserve the breast if possible, she underwent an extreme oncoplastic operation that removed the tumor and axillary tissue, with reconstruction using a latissimus dorsi flap. Final pathology identified high-grade metaplastic breast carcinoma with adenosquamous features. The removed axillary nodes were negative.

She then completed adjuvant radiotherapy in June 2021. Over the next 2 years, regular breast and axillary imaging, chest CT, and clinical examinations showed no residual or recurrent disease. She also reported restoration of her pre-illness quality of life without major treatment-related complications.