Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Metaplastic Breast Carcinoma: a Heterogeneous Disease

  • Gultekin, Melis (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Eren, Gulnihan (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Babacan, Taner (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Yildiz, Ferah (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Altundag, Kadri (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Guler, Nilufer (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Ozisik, Yavuz (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Yazici, Gozde (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Hurmuz, Pervin (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University) ;
  • Gurkaynak, Murat (Department of Radiation Oncology, Faculty of Medicine, Hacettepe University)
  • Published : 2014.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.

Keywords

References

  1. Al Sayed AD, El Weshi AN, Tulbah AM, et al (2006). Metaplastic carcinoma of the breast clinical presentation, treatment results and prognostic factors. Acta Oncol, 45, 188-95. https://doi.org/10.1080/02841860500513235
  2. Bae SY, Lee SK, Koo MY, et al (2011). The prognoses of metaplastic breast cancer patients compared to those of triple negative breast cancer patients. Breast Cancer Res Treat, 126, 471-8. https://doi.org/10.1007/s10549-011-1359-8
  3. Brenner RJ, Turner RR, Schiller V, et al (1998). Metaplasic carcinoma of the breast: report of three cases. Cancer, 82, 1082-7. https://doi.org/10.1002/(SICI)1097-0142(19980315)82:6<1082::AID-CNCR11>3.0.CO;2-2
  4. Carey LA, Dees EC, Sawyer L, et al (2007). The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res, 13, 2329-34. https://doi.org/10.1158/1078-0432.CCR-06-1109
  5. Carlson RW, Allred DC, Anderson BO, et al (2009). NCCN breast cancer clinical practice guidelines panel. J Natl Compr Cancer Netw, 7, 122-92.
  6. Chao TC, Wang CS, Chen SC, et al (1999). Metaplastic carcinomas of the breast. J Surg Oncol, 71, 220-5. https://doi.org/10.1002/(SICI)1096-9098(199908)71:4<220::AID-JSO3>3.0.CO;2-L
  7. Chuthapisith S, Warnnissorn M, Amornpinyokiat N, et al (2013). Metaplastic carcinoma of the breast with transformation from adenosquamous carcinoma to osteosarcomatoid and spindle cell morphology. Oncol Lett, 6, 728-32.
  8. Dave G, Cosmatos H, Do T, et al (2006). Metaplastic carcinoma of the breast: a retrospective review. Int J Radiat Oncol Biol Phys, 64, 771-5. https://doi.org/10.1016/j.ijrobp.2005.08.024
  9. Ellis IO, Cornelisse CJ, Schnitt SJ, et al (2003). Tumors of the breast. Invasive breast carcinoma. In: Tavassoli FA, Devilee P, editors. Pathology and genetics of tumors of the breast and female genital organs. Lyon: IARC Press, p. 37-41.
  10. Esbah O, Turkoz FP, Turker I, et al (2012). Metaplastic breast carcinoma: Case series and review of the literature. Asian Pac J Cancer Prev, 13, 4645-9. https://doi.org/10.7314/APJCP.2012.13.9.4645
  11. Fulford LG, Reis-Filho JS, Ryder K, et al (2007). Basal-like grade III invasive ductal carcinoma of the breast: patterns of metastasis and long-term survival. Breast Cancer Res, 9, 4.
  12. Gutman H, Pollock RE, Janjan NA, et al (1995). Biologic distinctions and therapeutic implications of sarcomatoid metaplasia of epithelial carcinoma of the breast. J Am Coll Surg, 180, 193-9.
  13. Hennessy BT, Giordano S, Broglio K, et al (2006). Biphasic metaplastic sarcomatoid carcinoma of the breast. Ann Oncol, 17, 605-13. https://doi.org/10.1093/annonc/mdl006
  14. Hu Q, Chen WX, Zhong SL, et al (2013). Current progress in the treatment of metaplastic breast carcinoma. Asian Pac J Cancer Prev, 14, 6221-5. https://doi.org/10.7314/APJCP.2013.14.11.6221
  15. Kurian KM, Al-Nafussi A (2002). Sarcomatoid/metaplastic carcinoma of the breast: aclinicopathological study of 12 cases. Histopathology, 40, 58-64. https://doi.org/10.1046/j.1365-2559.2002.01319.x
  16. Lai HW, Tseng LM, Chang TW, et al (2013). The prognostic significance of metaplastic carcinoma of the breast (MCB)- -a case controlled comparison study with infiltrating ductal carcinoma. Breast, 22, 968-73. https://doi.org/10.1016/j.breast.2013.05.010
  17. Luini A, Aguilar M, Gatti G, et al (2007). Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European institute of oncology and review of the literature. Breast Cancer Res Treat, 101, 349-53. https://doi.org/10.1007/s10549-006-9301-1
  18. Pezzi CM, Patel-Parekh L, Cole K, et al (2007). Characteristics and treatment of metaplastic breast cancer: analysis of 892 cases from the National Cancer Data Base. Ann Surg Oncol, 14, 166-73.
  19. Pitts WC, Rojas VA, Gaffey MJ, et al (1991). Carcinomas with metaplasia and sarcomas of the breast. Am J Clin Pathol, 95, 623-32.
  20. Poggi MM, Danforth DN, Sciuto LC, et al (2003). Eighteenyear results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute randomized trial. Cancer, 98, 697-702. https://doi.org/10.1002/cncr.11580
  21. Rosen PP, Ernsberger D (1987). Low grade adenosquamous carcinoma. A variant of metaplastic mammary carcinoma. Am J Surg Pathol, 115, 351-8.
  22. Rayson D, Adjei AA, Suman VJ, et al (1999). Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol, 10, 413-9. https://doi.org/10.1023/A:1008329910362
  23. Song Y, Liu X, Zhang G, et al (2013). Unique clinicopathological features of metaplastic breast carcinoma compared with invasive ductal carcinoma and poor prognostic indicators. World J Surg Oncol, 11, 129. https://doi.org/10.1186/1477-7819-11-129
  24. Sorlie T (2004). Molecular portraits of breast cancer: tumour subtypes as distinct disease entities. Eur J Cancer, 40, 2667-75. https://doi.org/10.1016/j.ejca.2004.08.021
  25. Tan PH, Ellis IO (2013). Myoepithelial and epithelialmyoepithelial, mesenchymal and fibroepithelial breast lesions: updates from the WHO classification of tumours of the breast 2012. J Clin Pathol, 66, 465-70. https://doi.org/10.1136/jclinpath-2012-201078
  26. Tavassoli FA (1992). Classification of metaplastic carcinomas of the breast. Pathol Annu, 27, 89-119.
  27. Tavassoli FA, Devilee P (2003). The WHO Classification of Tumors. Pathology and Genetics of Tumours of the Breast and Female Genital Organs. Lyon: IARC press.
  28. Toumi Z, Bullen C, Tang AC, et al (2011). Metaplastic breast carcinoma: a case report and systematic review of the literature. Pathol Int, 61, 582-8. https://doi.org/10.1111/j.1440-1827.2011.02698.x
  29. Tseng WH, Martinez SR (2011). Metaplastic breast cancer:to radiate or not to radiate? Ann Surg Oncol, 18, 94-103. https://doi.org/10.1245/s10434-010-1198-6
  30. Wargotz ES, Norris HJ (1989). Metaplastic carcinomas of the breast. III. Carcinosarcoma. Cancer, 64, 1490-9. https://doi.org/10.1002/1097-0142(19891001)64:7<1490::AID-CNCR2820640722>3.0.CO;2-L
  31. Wargotz ES, Deos PH, Norris HJ (1989). Metaplastic carcinomas of the breast. II. Spindle cell carcinoma. Hum Pathol, 20, 732-40. https://doi.org/10.1016/0046-8177(89)90065-8
  32. Wargotz ES, Norris HJ (1989). Metaplastic carcinomas of the breast. I. Matrix-producing carcinoma. Hum Pathol, 20, 628-35. https://doi.org/10.1016/0046-8177(89)90149-4
  33. Wargotz ES, Norris HJ (1989). Metaplastic carcinomas of the breast III: Carcinosarcoma. Cancer, 64, 1490-9. https://doi.org/10.1002/1097-0142(19891001)64:7<1490::AID-CNCR2820640722>3.0.CO;2-L
  34. Wargotz ES, Norris HJ (1990). Metaplastic carcinomas of the breast: V. Metaplastic carcinoma with osteoclastic giant cells. Hum Pathol, 21, 1142-50. https://doi.org/10.1016/0046-8177(90)90151-T
  35. Wargotz ES, Norris HJ (1990). Metaplastic carcinomas of the breast. IV. Squamous cell carcinoma of ductal origin. Cancer, 65, 272-6. https://doi.org/10.1002/1097-0142(19900115)65:2<272::AID-CNCR2820650215>3.0.CO;2-6

Cited by

  1. Axillary Metaplastic Breast Carcinoma with Ipsilateral Pectoral Invasive Ductal Carcinoma: An Unusual Presentation vol.2014, pp.2090-6714, 2014, https://doi.org/10.1155/2014/938509
  2. Clinicopathological Features and Prognosis of Metaplastic Breast Carcinoma: Experience of a Major Chinese Cancer Center vol.10, pp.6, 2015, https://doi.org/10.1371/journal.pone.0131409
  3. Metaplastic Breast Cancer: Clinical Overview and Molecular Aberrations for Potential Targeted Therapy vol.17, pp.3, 2015, https://doi.org/10.1007/s11912-014-0431-z