Synchronous breast carcinoma and peritoneal mesothelioma

Our plain-English summary of Synchronous breast carcinoma and peritoneal mesothelioma, by S. Prathibha, H. Beckwith, R.A. Kratzke, et al (The Breast Journal, 2021).

The study

• Authors: S. Prathibha, H. Beckwith, R.A. Kratzke, M. Klein, A. Kne, T.M. Tuttle
• Journal: The Breast Journal
• Published: 2021;27(6):550-552
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Breast cancer may be associated with other primary cancers via germline mutations; however, sporadic occurrences of other malignancies are rare. With increased use of advanced breast cancer imaging, including MRI and PET/CT, other incidental synchronous cancers are increasingly identified. Such cases can represent unique diagnostic and treatment challenges. Here, we present a case of a young woman diagnosed with primary breast cancer who underwent imaging studies identifying an incidental primary peritoneal mesothelioma.

© 2021 Wiley Periodicals LLC.

In plain English

This case report described one 36-year-old woman, with no significant past medical or family history, who was found to have breast cancer and a malignant peritoneal mesothelioma (a cancer of the lining of the abdomen) at the same time. She came in with a left breast lump, which biopsy showed was invasive ductal carcinoma. Breast MRI showed fluid around the right lung. A PET/CT scan done to check that fluid found masses in the left breast, the pelvis, and between the right kidney and liver, and no fluid around the lung. Biopsies of the abdominal masses showed epithelioid mesothelioma. Genetic testing found only a variant of unknown significance in the BRIP1 gene. Treatment included surgery to remove the abdominal tumors and right ovary, heated chemotherapy (mitomycin C) given into the abdomen, partial mastectomy, and then chemotherapy and breast radiation. The authors called it a challenging case. They said only one earlier case of both cancers had been reported, in a male patient. The article does not mention asbestos or any other exposure, and it does not say how the patient did afterward.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of a single patient
• Who was studied: One 36-year-old woman with no significant past medical or family history who presented with a left breast lump. The article gives no location or dates for her care.
• Exposure: Not reported: the article does not mention asbestos or any other exposure
• Main results:
  • PET/CT, done to evaluate a right pleural effusion seen on breast MRI, showed hypermetabolic masses in the left breast, the pelvis, and between the right kidney and liver, with no pleural effusion
  • Core biopsy of the peritoneal mass showed low-grade, epithelioid type malignant peritoneal mesothelioma
  • Diagnostic laparoscopy found multiple peritoneal implants, and biopsies were consistent with malignant peritoneal mesothelioma
  • Germline genetic testing found only a variant of unknown significance, p.D1112Y, in BRIP1
  • Cytoreductive surgery removed all tumor nodules and the right ovary, which had a 12-cm cystic mass. HIPEC with mitomycin C was given, and partial mastectomy and sentinel node biopsy were done during the perfusion.
  • Pathology of the peritoneal and ovarian tissue showed epithelioid malignant peritoneal mesothelioma
  • The breast tumor was a 2.3-cm, grade 3, ER-positive, PR-positive, HER2-negative invasive ductal carcinoma with negative sentinel nodes and margins (it had measured 2.8 cm on ultrasound)
  • After surgery she received adjuvant chemotherapy with taxol, adriamycin and cyclophosphamide, followed by whole-breast irradiation
• The authors' conclusion: The authors described the patient as a challenging case of synchronous primary breast cancer and incidental malignant peritoneal mesothelioma. They stated that the combination is very rare, with only one previously reported case, in a male patient.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Carcinoma, Peritoneal Mesothelioma, Germline Mutation.

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• Diagnostic utility of immunohistochemistry in distinguishing between epithelioid pleural mesotheliomas and breast carcinomas: a comparative study — N.G. Ordóñez, A.A. Sahin (2014)
• Expression of calretinin by breast carcinoma and the potential for misdiagnosis of mesothelioma — G. Powell, H. Roche, et al. (2011)
• Evaluation of androgen receptor and GATA binding protein 3 as immunohistochemical markers in the diagnosis of metastatic breast carcinoma to the lung — Y. Hattori, A. Yoshida, et al. (2015)

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