A Rare Case of Myelodysplastic Syndrome Presenting Synchronously with Invasive Ductal Carcinoma of the Breast

Abstract

The presence of cytopenias in a breast cancer patient usually signify bone marrow carcinomatosis instead of an underlying myeloid neoplasm. We hereby describe a rare case of breast cancer coexisting synchronously with Myelodysplastic syndrome.

A 67 years old female presented with exertional dyspnea, pallor and breast lump.  Workup revealed Stage IIIB Invasive Ductal Carcinoma Breast, estrogen and progesterone receptor positive and human epidermal growth factor receptor 2 negative. A bone marrow biopsy performed to investigate for bicytopenia showed Myelodysplastic syndrome-Increased Blasts I. The patient was treated with upfront breast surgery followed by radiation and hormonal therapy. Venetoclax was given to treat Myelodysplastic syndrome. One year post treatment patient had no evidence of breast disease and stable marrow disease.

Myeloid neoplasms rarely present synchronously with solid tumors. The management of synchronous malignancies is a challenge for treating oncologist and needs to be tailored on a case to case basis.