title: Sudden hemorrhage without skin invasion in a patient with breast cancer: a case report and literature review.
abstract: We report a rare case of sudden hemorrhage caused by breast cancer. A 70-year-old Japanese woman noted fresh bleeding from her left breast. On physical examination, continuous hemorrhage accompanied by an open cavity was observed in the left breast. Mammography and ultrasonography revealed a well-circumscribed mass, with solid and cystic components, that was highly suggestive of intracystic breast carcinoma with direct skin invasion. Computed tomography and bone scintigraphy showed no distant metastasis. Aspiration biopsy of the lesion showed several clusters of adenocarcinoma cells. Modified radical mastectomy was performed with a presumptive diagnosis of stage III B left breast cancer. Invasive ductal carcinoma without skin invasion was diagnosed histologically. To the best of our knowledge, only 6 other cases of sudden hemorrhage caused by breast cancer without skin invasion have been reported in Japan. We review the literature and discuss the clinical characteristics of this unusual phenomenon.
authors.affiliation: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan. ykijima@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.affiliation: Department of Tumor Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Umekita
authors.affiliation: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Ehi
authors.affiliation: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Heiji
authors.initials: H
authors.lastname: Yoshinaka
authors.affiliation: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Yawara
authors.initials: Y
authors.lastname: Funasako
authors.affiliation: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.affiliation: Department of Tumor Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Aikou
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D009361:Neoplasm Invasiveness / Q000473:pathology*; D012867:Skin / Q000473:pathology*; D014057:Tomography, X-Ray Computed