title: Breast cancer presenting in the midline without a lesion in the breast: a therapeutic dilemma.
abstract: Breast cancer presenting in the midline of the chest and without a primary focus in the breast is extremely rare. A 48 year old post-menopausal lady presented with a rapidly enlarging lump over the middle of her chest along with bilateral axillary lymph nodes. Clinical and imaging tests failed to demonstrate a focus of cancer in either of the breasts. Incisional biopsy of the lesion revealed it to be an infiltrating ductal carcinoma. As no guidelines exist to manage such patients, she was started on neo-adjuvant chemotherapy. Following a good response to chemotherapy, she underwent wide local excision of the lesion with bilateral axillary lymphadenopathy. She subsequently received adjuvant chemotherapy, radiotherapy and hormonal therapy.
authors.affiliation: Department of Oncoplastic Breast Surgery, Shaw Mazumdar Cancer Center, Narayana Hrudayalaya Health City, Bangalore, India.
authors.forename: Rohan
authors.initials: R
authors.lastname: Khandelwal
authors.forename: C U
authors.initials: CU
authors.lastname: Poovamma
authors.forename: Chauhan
authors.initials: C
authors.lastname: Shilpy
authors.forename: M
authors.initials: M
authors.lastname: Prema
authors.forename: Pais
authors.initials: P
authors.lastname: Anthony
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D006801:Humans; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D035441:Thoracic Wall / Q000473:pathology*
keywords: Breast cancer; midline; sarcoma