Rare presentation of breast carcinoma in an old burn scar

Malignancies from old burn scars (BSs) have been documented in literature but are rarely encountered in our day-to-day practice. Adenocarcinoma is an extremely uncommon while squamous cell carcinoma is the most common malignant entity seen as BS neoplasm. Breast cancer arising from an old BS is rarely reported in literature. Till now, to the best of our knowledge, only four cases have been reported in literature. Here, we are reporting an interesting case of 38-year-old female with a history of burn injury on her chest wall including left breast and axilla 20 years back which was left to heal secondarily, i.e., without any active intervention. Later, she developed an ulceroproliferative growth over her left breast for which she consulted a local physician. A diagnosis of infiltrating ductal carcinoma breast of the left side was made after biopsy and was referred to our hospital. Metastatic workup was negative, i.e., chest X-ray posteroanterior view, ultrasound sonography abdomen and pelvis with blood investigations were found to be normal. Right side breast, axilla, and supraclavicular region along with abdomen were found to be normal. Clinically, she was staged as T_4b, N₀, M₀, Stage III B carcinoma breast left side. She was managed with upfront surgery, i.e., a simple mastectomy followed by adjuvant chemotherapy and radical radiotherapy. After completing the radical treatment, she was kept on tamoxifen 20 mg once daily for 5 years. At present, the patient is doing well with locoregional complete response after 6 years of regular follow-up.