Hematology, Transfusion and Cell Therapy (Oct 2023)
A RARE INTERSECTİON: COEXİSTENCE OF BREAST CANCER AND SİCKLE CELL DİSEASE İN A 40- YEAR-OLD FEMALE - A CASE REPORT
Abstract
Background: Breast cancer, a prevalent malignancy in women, and sickle cell disease (SCD), a genetic disorder affecting red blood cells, are both well-understood individually. However, their coexistence is rare and presents unique challenges in diagnosis, treatment, and management. The complex interplay between these two conditions necessitates a tailored approach to care. The report focuses on a case of coexistence of breast cancer and sickle cell disease in a 40 - year-old female. Case Presentation: A 40-year-old female patient, diagnosed with SCD and managed with 20 mg/kg hydroxyurea, experiencing 1-2 mild painful crises annually and requiring 1-2 units of transfusion yearly, presented with swelling in the right breast in October 2022.Initial MRI revealed widespread edematous changes in the right breast parenchyma and multiple lymph nodes in the right axilla. Follow-up ultrasound in December 2022 detected an ill-defined hypoechoic area in the right breast and lymphadenopathies. A tru-cut biopsy confirmed invasive ductal carcinoma. PET scan showed no metastatic focus, but cranial imaging revealed an aneurysmatic dilation in the left ICA cavernous segment. The patient's biopsy material was re-examined, showing 90% positive estrogen receptor, 60% positive progesterone receptor, Cerb2:1 positive, E-cadherin positive, and a Ki-67 proliferation index of 10%. The patient underwent neoadjuvant chemotherapy followed by modified radical mastectomy surgery, and adjuvant RT was planned with radiation oncology. Comments: The coexistence of breast cancer and SCD in this case underscores the importance of an integrated approach to diagnosis and treatment. The rarity of this coexistence in the literature highlights the need for further research to understand the specific interactions between these diseases. The case also emphasizes the necessity of collaboration between oncology, hematology, and other specialties to develop effective therapeutic strategies tailored to the unique needs of patients affected by both conditions.
