Imaging Findings of Metaplastic Carcinoma of the Breast with Pathologic Correlation

Abstract

Objectives:To review the imaging findings of a series of cases of metaplastic carcinoma of the breast, a rare and aggressive form of breast cancer with variable imaging features.Materials and methods:Retrospective review of multimodality imaging features of eleven cases of metaplastic carcinoma of the breast retrieved from a single hospital institution database. Clinical and pathologic data were also documented.Results:The median age of presentation was 65 years. Four cases had axillary lymphadenopathies, and two had distant metastases. An oval mass was the most common sonographic finding (7/11; 64%). Lesions displayed circumscribed/partially circumscribed margins (6/11; 55%) or non-circumscribed margins (5/11; 45%). Most lesions had a heterogeneous echo structure (9/11; 82%) and posterior acoustic enhancement (6/11; 55%). In nine patients, mammographies were available. An oval dense mass was the most common mammographic finding (5/9; 56%). The majority of cases had non-circumscribed margins (6/9; 67%), and nearly half displayed calcifications (4/9; 44%).Conclusions:Mammographic findings were not different from the usual features of more prevalent types of breast cancer, though the majority of metaplastic carcinoma of the breast showed possible distinctive sonographic features, such as circumscribed margins or complex echogenicity, reflecting the histologic background.

A Retrospective Study of the Imaging and Pathological Features of Metaplastic Breast Carcinoma and Review of the Literature

“…In the present study, six patients with MBC (54.5%) had tumors with an oval shape on imaging, and four patients with MBC (36.4%) had tumors with ill-defined margins on imaging, which is similar to a previously published study [15]. Donato et al reported that in MBC, an oval dense mass with a non-circumscribed margin was most common on imaging [14]. Petterson et al reported the imaging findings on mammography in nine patients and showed that cases of MBC that had an irregular or spiculated margin had an IDC component of metaplastic carcinoma [4].…”

“…Pezzi et al compared the biological behavior of 892 patients with MBC with 255,164 patients with invasive ductal carcinoma (IDC) and reported that 5.5% of patients with MBC had a tumor size of less than 10 mm, compared with 26.9% of patients IDC [13]. Donato et al reported that the median tumor size in cases of IDC was 27 mm [14]. In the present study, the mean diameter of the tumor was 3.43 cm on mammography, which is similar to the findings in previous studies.…”

“…Park et al [5] and Donato et al [14] studied the ultrasound characteristics of 11 patients with MBC and reported the most common finding were an oval shape with a circumscribed margin and posterior enhancement. Choi et al studied the ultrasound characteristics of 33 patients with MBC and reported the most common finding was an indistinct tumor margin [15].…”

Clinicopathologic Characteristics and Outcome Descriptors of Metaplastic Breast Carcinoma

“…Indeed, several other studies on MBC have reported similar age incidences, because these women tend to be older than 50 years. 2,14,20,21 An intriguing finding from our study was the fact that these tumors can indeed grow to be very large, confirming prior observations that they tend to grow larger than ductal carcinomas. 14,16,22 We observed a maximum tumor size of 21.5 cm from our cohort of patients.…”

When Something Seems Amiss: Radiology-Pathology Correlation of Metaplastic Breast Cancer

“…Early diagnosis presents a challenge, as the radiologic phenotypes of MBC are diverse and may mimic benign lesions or other invasive breast carcinomas. There is no mammographic or sonographic appearance that reliably predicts the presence of MBC [3][4]. High signal intensity on T2-weighted magnetic resonance imaging (MRI) related to the necrotic component of the 1 2 3 1 4 tumor, however, may be a useful imaging marker [5].…”