J Breast Cancer.  2011 Dec;14(4):337-339. 10.4048/jbc.2011.14.4.337.

Clinically Positive Axillary Lymphadenopathy May Lead to False Diagnosis of Overstaged Breast Cancer in Patients with Sjogren's Syndrome: A Case Report

• Cipe G
• Genc V
• Genc A
• Ozben V
• Basceken S
• Dusunceli

• KMID: 2175737
• DOI: http://doi.org/10.4048/jbc.2011.14.4.337

Abstract

Sjogren's syndrome (SS) is an autoimmune disease that chronic inflammation and lymph node proliferation. Patients with SS carry a greater risk of developing lymphoproliferative malignancy. In addition to other organ cancers, breast cancer may also occur in these patients. Considering these, breast cancer in patients with SS can be misdiagnosed as being in an advanced stage particularly in the presence of axillary lymphadenopathy. Here, we report a rare case of a 45-year-old woman with SS who presented with a breast mass. Radiology showed a 4 cm solid lesion and conglomerates of axillary lymphadonepathy. A breast biopsy revealed ductal carcinoma in situ. A modified radical mastectomy was performed; however, no axillary metastases were detected. Clinicians should remain vigilant to the possibility that a false clinical impression of axillary metastasis may occur in such patients with breast cancer. Therefore, axillary node status should be verified first.

Keyword

Breast neoplasms; Lymphatic diseases; Overstaging; Sjogren's syndrome

MeSH Terms

Autoimmune Diseases
Biopsy
Breast
Breast Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Female
Humans
Inflammation
Lymph Nodes
Lymphatic Diseases
Mastectomy, Modified Radical
Middle Aged
Neoplasm Metastasis
Sjogren's Syndrome

Figure

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  Figure 1 Ultrasonographic appearance of the breast mass. The mass is a hypoechogenic lesion with irregular margins measuring 4 cm in diameter.

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  Figure 2 Mammography of the right breast (mediolateral oblique view). Mammographic sensitivity decreased due to the increased density of the fibroglandular breast tissue.

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  Figure 3 Histopathological appearance of high-grade ductal carcinoma in situ (H&E stain, × 200).

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