Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 4, April, p. 509–513

doi: 10.17219/acem/68293

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Clinicopathological features of metaplastic breast carcinoma

Oğuz Ahmet Hasdemir1,A,B,C,D,E,F, Serhat Tokgöz1,B,C,D,F, Fulya Köybaşıoğlu2,B,C,E, Harun Karabacak1,C,D, Cüneyt Yücesoy3,B,F, Gökşen İnanç İmamoğlu4,B,F

1 Department of General Surgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

2 Department of Pathology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

3 Department of Radiology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

4 Department of Medical Oncology, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

Abstract

Background. Metaplastic carcinoma of the breast (MpBC) is defined as a group of heterogeneous malignant neoplasms that contain glandular and non-glandular components with mixed epithelial and mesenchymal differentiations.
Objectives. The aim of this study was to research the clinical and pathological characteristics of MpBC determining its rank among all breast cancers.
Material and Methods. Metaplastic carcinoma of the breast was found in 7 out of 1,164 patients who had been diagnosed with breast cancer within the period of 12 years in our hospital. Demographic and clinical characteristics of the patients were retrieved from the patient files, and their final status was verified by a phone call. Diagnoses of the patients were confirmed by examining hematohylen and eosin (H&E) preparations. They were stained immunohistochemically for estrogen receptor (ER), progesterone receptor (PR), C-erbB-2, CK5/6 (Sitokeratin5/6), and EGFR (epidermal growth factor receptor), and the subgroups were determined according to the WHO classification.
Results. All patients were female with a median age of 61 years (41–87 years). Three of them were diagnosed with stage IIB, 2 with IIIB and 1 with IV. Four patients had squamous type of metaplastic cell differentiation, 1 spindle, 1 adenosquamous, and 1 osteosarcomatous. In 6 out of 7 patients, ER, PR and C-erbB-2 expressions were negative immunohistochemically. In the case of squamous metaplasia, estrogen receptor was 10% and progesterone receptor was 5% positive. CK5/6 was positive in 5 cases. Epidermal growth factor was positive in all cases.
Conclusion. Metaplastic carcinoma of the breast is relatively rare and, in our series, its incidence was 0.6%. According to its immunohistochemical characteristics, MpBC can be interpreted as a subgroup of triplenegative breast cancers (TNBC). Five of the presented patients resembled the subgroup of TNBC with a basaloid phenotype. The chemotherapy regimens suggested in the treatment of MpBC are platin in the epithelial subgroup and high-dose anthracycline in the mesenchymal subgroup. There is a need of new studies that evaluate different choices of treatment as MpBC has a bad prognosis and an aggressive nature.

Key words

metaplastic breast cancer, breast cancer, triple-negative breast cancer

References (21)

  1. Hu Q, Chen WX, Zhong SL, et al. Current progress in the treatment of metaplastic breast carcinoma. Asian Pac J Cancer Prev. 2013;14:6221–6225.
  2. Abouharb S, Moulder S. Metaplastic breast cancer: Clinical overview and molecular aberrations for potential targeted therapy. Curr Oncol Rep. 2015;17(3):431.
  3. Nelson RA, Guye ML, Luu T, Lai LL. Survival outcomes of metaplastic breast cancer patients: Results from a US population-based analysis. Ann Surg Oncol. 2015;22(1):24–31.
  4. Reis-Filho JS, Lakhani SR, Gobbi H, Sneige N. Metaplastic carcinoma. In: Lakhani SR, Schnitt SJ, Tan PH, Vijner MJ, eds. WHO Classification of Tumours of the Breast. Lyon, France: IARC Pres: 2012;48–52.
  5. Bae SY, Lee SK, Koo MY, et al. The prognoses of metaplastic breast cancer patients compared to those of triple-negative breast cancer patients. Breast Cancer Res Treat. 2011;126:471–478.
  6. Rosai J. Surgical Pathology. 10th ed. St. Louis, MO: Mosby Elsevier; 2011:1659–1770.
  7. Sørlie T, Perou CM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2011;98:10869–10874.
  8. Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: A population-based study from the California Cancer Registry. Cancer. 2007;109:1721–1728.
  9. Rakha EA, El-Sayed ME, Green AR, Lee AH, Robertson JF, Ellis IO. Prognostic markers in triple-negative breast cancer. Cancer. 2007;109:25–32.
  10. Tischkowitz M, Brunet JS, Bégin LR, et al. Use of immunohistochemical markers can refine prognosis in triple-negative breast cancer. BMC Cancer. 2007;7:134.
  11. Nielsen TO, Hsu FD, Jensen K, et al. Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res. 2004;10:5367–5374.
  12. Lai HW, Tseng LM, Chang TW, et al. The prognostic significance of metaplastic carcinoma of the breast (MpBC): A case controlled comparison study with infiltrating ductal carcinoma. Breast. 2013;22:968–973.
  13. Choi BB, Shu KS. Metaplastic carcinoma of the breast: Multimodality imaging and histopathologic assessment. Acta Radiol. 2012;53:5–11.
  14. Chao TC, Wang CS, Chen SC, Chen MF. Metaplastic carcinomas of the breast. J Surg Oncol. 1999;71:220–225.
  15. Beatty JD, Atwood M, Tickman R, Reiner M. Metaplastic breast cancer: Clinical significance. Am J Surg. 2006;191:657–664.
  16. Song Y, Liu X, Zhang G, et al. Unique clinicopathological features of metaplastic breast carcinoma compared with invasive ductal carcinoma and poor prognostic indicators. World J Surg Oncol. 2013;11:129.
  17. Rakha EA, Tan PH, Varga Z, et al. Prognostic factors in metaplastic carcinoma of the breast: A multi-institutional study. Br J Cancer. 2015;112(2):283–289.
  18. Günhan-Bilgen I, Memiş A, Ustün EE, Zekioglu O, Ozdemir N. Metaplastic carcinoma of the breast: Clinical, mammographic, and sonographic findings with histopathologic correlation. AJR Am J Roentgenol. 2002;178:1421–1425.
  19. Greenberg D, McIntyre H, Bierre T. Metaplastic breast cancer. Australas Radiol. 2004;48:243–247.
  20. Dave G, Cosmatos H, Do T, Lodin K. Varshney D. Metaplastic carcinoma of the breast: A retrospective review. Int J Radiat Oncol Biol Phys. 2006;64:771–775.
  21. Al Sayed AD, El Weshi AN, Tulbah AM, Rahal MM, Ezzat AA. Metaplastic carcinoma of the breast clinical presentation, treatment results and prognostic factors. Acta Oncol. 2006;45:188–195.
© Wroclaw Medical University