Bilateral synchronous low-grade adenosquamous carcinoma of the breast: A Case report with review of the current literature
Bibliographic record
Abstract
INTRODUCTION: Low-grade adenosquamous carcinoma (LGASC) is a rare, unique variant of metaplastic breast carcinoma, characterized by clinical indolence and low-grade cytomorphology. Being clinically asymptomatic with indefinite imaging characteristics, diagnosis is solely dependent on histopathology. PRESENTATION OF CASE: A 68-year-old woman presented to the Breast Health Center with mammogram-detected left-sided retroareolar calcifications. She had a three-year history of non-progressive bilateral nipple inversion, and was otherwise asymptomatic. Left breast biopsy revealed atypical metaplastic squamous epithelial cells. Subsequently a wire-guided lumpectomy diagnosed a syringomatous adenoma of the nipple. A surveillance MRI identified a contralateral breast lesion, which on core biopsy showed an atypical adenosquamous lesion. Bilateral central mastectomies with bilateral sentinel node biopsies were undertaken. Histopathological review of both breast specimens confirmed the unique features of adenosquamous carcinoma identified by an infiltrative pattern of small rounded compressed angulated glands with squamous differentiation and low-grade cytomorphology. The tumors were triple negative [ER, PR, HER2]. The sentinel lymph nodes were negative. CONCLUSION: Bilateral synchronous LGASC of the breasts is exceedingly uncommon and remains a diagnostic and therapeutic challenge. Despite being triple negative, due to its indolent behavior, recognition of this unusual primary breast malignancy is important as it has a more favorable prognosis. Yet, due to its rarity, there are no guidelines for best practice management regarding the role of adjuvant therapy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".