title: The First Case of HER2+ Invasive Ductal Carcinoma Arising From a Breast Hamartoma and Literature Review.
abstract: Carcinomas arising from breast hamartomas are exceedingly rare. We present the first reported case of an African-American female presenting with a right breast lump and a subsequent mammogram suggestive of a hamartoma. She later underwent lumpectomy and was found to have HER2+ invasive ductal carcinoma (IDC) arising from a hamartoma. She was amenable to HER2-targeted trastuzumab, hormone therapy and adjuvant radiation but declined chemotherapy. In a review of the literature, IDC is the predominant neoplastic type found in hamartomas. The average hamartoma size at time of neoplasm diagnosis is 6.0 cm. Patients with hamartomas greater than 6.0 cm, with changes in calcification pattern; new nodules or asymmetry should be considered for additional evaluation with ultrasound, MRI and/or biopsy. HER2 status is under-reported among cases and should be evaluated in any malignancy found within hamartomas as HER-2 therapy has improved overall survival and recurrence free survival in HER2+breast cancer patients.
authors.affiliation: Department of Hematology and Oncology, Stony Brook University Hospital, NY, USA. Electronic address: lea.baer@stonybrookmedicine.edu.
authors.forename: Lea
authors.initials: L
authors.lastname: Baer
authors.affiliation: Department of Internal Medicine, Stony Brook University Hospital, NY, USA.
authors.forename: Sherise Chantell
authors.initials: SC
authors.lastname: Rogers
authors.affiliation: Division of Breast and Oncologic Surgery, Stony Brook University Hospital, NY, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Farrelly
authors.affiliation: Department of Pathology, Stony Brook University Hospital, NY, USA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Tornos
authors.affiliation: Department of Pathology, Stony Brook University Hospital, NY, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Sweeney
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging; D001941:Breast Diseases / Q000175:diagnosis / Q000378:metabolism; D001943:Breast Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D005260:Female; D006222:Hamartoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D057285:Precision Medicine / Q000379:methods; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis / Q000037:antagonists & inhibitors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Breast cancer; Hamartoma; Her2