Multimodal Imaging and Histopathological Correlation in Right Breast Carcinoma Associated with Malignant Phyllodes Tumor: A Case Report with Review of Literature

Abstract

Breast cancer remains the most frequently diagnosed malignancy among women worldwide and is a major cause of cancer-related morbidity and mortality. Early detection and accurate pathological characterization are essential for appropriate therapeutic planning and improved patient outcomes. This report describes a case of right breast carcinoma evaluated through multimodal imaging and detailed histopathological assessment. A 62-year-old female presented with a progressively enlarging palpable mass in the right breast associated with visible asymmetry. Diagnostic evaluation included mammography, ultrasonography, and contrast-enhanced computed tomography. Imaging studies revealed a large irregular high-density mass with lobulated margins and internal calcifications highly suspicious for malignancy (BI-RADS 5), accompanied by axillary lymphadenopathy. Core needle biopsy followed by histopathological examination demonstrated invasive ductal carcinoma. Immunohistochemical analysis showed strong estrogen receptor and progesterone receptor expression, absence of HER2 overexpression, and a low Ki-67 proliferation index consistent with the Luminal A molecular subtype. The patient subsequently underwent a modified radical mastectomy with immediate reconstruction by tissue expander. Pathological examination revealed a malignant phyllodes tumor with an associated invasive ductal carcinoma component. This case highlights the importance of integrating clinical findings, radiological imaging, histopathology, and immunohistochemistry in the accurate diagnosis and biological characterization of complex breast tumours.