A 63-year-old woman with a sister who died at age 50 due to uterine leiomyocorma, a maternal aunt who died of breast cancer.
She denied using hormone therapy, menarche at age 14, postmenopausal.
It begins with self-detection of a nodule in the right breast of six months of evolution.
Physical examination showed a 3.5 x 3.5 cm tumor in the upper inner quadrant of the radius from 1 to 3 to 1 cm of the nipple, without affecting deep planes or skin, negative axilla.
The contralateral breast and armpit were negative.
Mammography was performed with report of hyperdense nodule with well-defined irregular edges, which is associated with mild retraction of the adjacent tissue [BIRADS 4 (Breast Imaging Reporting and Ultrasound System) greater than 15.9.
Chest radiography and abdominal ultrasound were negative.
Triple biopsy was performed with histopathological report of high grade sarcoma, with areas of production of osteoid material and giant cells, compatible with osteosarcoma originating in osteocutdes tumor.
The immunohistochemical study yielded the following results: estrogen receptor negative [RE (-)], progesterone receptor negative [RP (-)], human epidermal growth factor receptor-15% negative [HER2 marker].
Wide local excision was performed with definitive histopathological report compatible with giant cell osteosarcoma with osteoclastic component, originated in nodular lesions, tumor size x 2.8 x 2.5 cm, with negative margins.
The macroscopic cut showed an ovoid, poorly defined, pearly white lesion with areas of myxoid, nodular, granular appearance and focal central hemorrhage.
Adjuvant treatment was indicated with external beam radiotherapy 50 Gy in 25 cases, currently with more than 10 months of disease-free period.
