Localized primary amyloidosis of the breast: a case report and review of the literature.
BACKGROUND
Primary amyloidosis of the breast is an unusual benign disease that mostly occurs in postmenopausal elderly women. Amyloidosis is the deposition of amorphous protein within tissues. Breast biopsy is necessary to make a definite diagnosis in order to avoid unnecessary surgical methods. Localized primary amyloidosis of the breast has a good prognosis. However, secondary amyloidosis is a systemic disease and has a poor prognosis.


METHODS
We report the case of a 77-year-old female with primary amyloidosis of the breast. She noticed a lump in her left breast. Mammographic and ultrasonographic examinations indicated breast cancer. However, core needle biopsy showed amyloidosis, not cancer of the breast. For further examinations, the patient visited the outpatient clinics of the hematology, dermatology, and gastroenterology departments. She underwent bone marrow aspiration, computed tomography, cardiac ultrasonography, random skin biopsy, gastrofiberscopy, and colonofiberscopy. Plasma cell myeloma and systemic amyloidosis were ruled out, and localized breast amyloidosis was highly suspected. Lumpectomy was performed to make a definite diagnosis, and histological evaluations revealed that this patient had localized amyloidosis of the breast, and the deposited amyloid protein was of the amyloid light chain kappa type.


CONCLUSIONS
Breast biopsy is necessary in order to avoid unnecessary surgical technique. A diagnosis should be achieved only through a histological evaluation. The main treatment of localized primary amyloidosis of the breast is surgical removal.
Department of Breast Surgery, Shiga Medical Center for Adults, Shiga, Japan. w-sato@kuhp.kyoto-u.ac.jp.
Wakako
http://orcid.org/0000-0003-1167-3780
W
Tsuji
Department of Pathology, Moriguchi Keijinkai Hospital, Osaka, Japan.
Eiji
E
Takeuchi
Department of Hematology and Oncology, Shiga Medical Center for Adults, Shiga, Japan.
Satoshi
S
Oka
Diagnosis Unit for Amyloidosis, Department of Neurology, Kumamoto University Hospital, Kumamoto, Japan.
Taro
T
Yamashita
Department of Breast Surgery, Shiga Medical Center for Adults, Shiga, Japan.
Fumiaki
F
Yotsumoto
D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis* / Q000601:surgery; D001706:Biopsy; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D000075363:Immunoglobulin Light-chain Amyloidosis; D008327:Mammography; D015412:Mastectomy, Segmental
ALk; Amyloid; Breast cancer; Congo red; Primary amyloidosis of the breast