Metaplastic carcinoma of the breast: analysis of 38 cases from a single institute

Abstract

Objective: To evaluate the pathological and radiological features, hormone profiles, surgery and treatment methods of metaplastic breast carcinoma cases diagnosed at our center in the light of current literature. Material and Method: A total of 38 metaplastic breast cancer cases diagnosed between 2006-2018 at our center were included in the study. The patients were evaluated in terms of age, tumor size, localization, histological grade, hormone profiles (ER, PR, Her2-neu), American Joint Committee on Cancer (AJCC) Tumor, Lymph node status, Metastases (TNM) stage, progression, survival, radiological features, types of surgery and therapy modalities (chemotherapy and / or radiotherapy). Results: The age of the patients ranged between 32 and 95 years. Pathological evaluation of cases showed that 14 were pure epithelial (IC-NST + squamous cell carcinoma) and 24 were metaplastic carcinomas with mesenchymal differentiation. Ductal carcinoma in situ (DCIS) was accompanying an invasive component in twenty cases. Seventeen patients had lymph node metastasis. Twelve patients developed distant metastasis. Thirty patients were triple negative for hormone receptors. The mean follow-up period of the patients was 34 months. The estimated life expectancy was 116 months. All of the patients received chemotherapy and 28 patients received adjuvant radiotherapy. There was no correlation between tumor size and lymph node or distant metastasis in our series. Our findings are consistent with the literature. Conclusion: Metaplastic breast carcinoma is a rare entity among breast carcinomas. Metaplastic carcinomas of the breast draw attention with the differences in their clinical course and the radiological and pathological heterogeneity.

Unique clinicopathological characteristic and survival rate of metaplastic breast cancer;a special subtype of breast cancer a 5 year cohort study in single referral centre in North Borneo

“…The current study reported 64.3% of the patients were high grade. This corresponds to the findings of previous studies, which documented significantly higher histological grading of MBC (75–100%) [ 2 , 5 , 6 , 8 , 11 ]. When compared with invasive ductal carcinoma, MBC also showed preponderance towards high histological grading (68.4% vs 34.5%, p=<0.001) [ 4 ].…”

“…This classification has been widely adopted in multiple studies in the past, including our current study. Our case series reported that squamous cell carcinoma is the most common histological subtype (42.9%), which corresponds to the findings of several studies, with documented incidence ranging between 26 and 48% [ [5] , [6] , [7] , [8] ]. Schroeder et al which included a total of 1516 cases of MBC in the United States, documented the most common histological type was metaplastic carcinoma of no specific type (81.9%) [ 4 ].…”

“…MBC is commonly presented with large sized breast lesions, previously reported an average largest tumor diameter of 30–57.5 mm [ 3 , [6] , [7] , [8] , 12 ]. Our study revealed a slightly higher average largest tumor diameter, 69.23 mm.…”

Metaplastic breast carcinoma with extensive osseous differentiation

“…1,4 Inadequate sampling can lead to misdiagnosis on core needle biopsy and fine-needle aspiration cytology. 7 The sarcomatous component of MBCs can resemble other spindle cell neoplasms like malignant phyllodes, fibrosarcoma, myoepithelial carcinoma, malignant fibrous histiocytoma, etc. Adequate sampling also helps find the DCIS component which, is strongly supportive of metaplastic carcinoma, thus, avoiding misinterpretation.…”

“…Adequate sampling also helps find the DCIS component which, is strongly supportive of metaplastic carcinoma, thus, avoiding misinterpretation. 7 Definitive diagnosis of MBC can appropriately be made on excisional biopsy specimens. 1 Immunohistochemical confirmation of tumor epithelial component is necessary for the diagnosis of metaplastic carcinoma.…”