Metaplastic breast cancer: clinical significance
- 1 May 2006
- journal article
- research article
- Published by Elsevier BV in The American Journal of Surgery
- Vol. 191 (5), 657-664
- https://doi.org/10.1016/j.amjsurg.2006.01.038
Abstract
Metaplastic breast carcinoma (MBC) is a rare poorly differentiated breast cancer characterized by coexistence of ductal carcinoma with areas of matrix producing, spindle-cell, sarcomatous, or squamous differentiation; ER/PR/HER2 negativity; and a reputation for poor outcome. The Swedish Cancer Institute prospective breast cancer database (> 6500 patients; 1990-2005) has 24 MBC cases that were compared with typical breast cancer cases matched for age, date of diagnosis, stage, and ER/PR/HER2 status. The mean metaplastic primary tumor diameter was 2.5 cm. The histological/nuclear grade was high in 21 of 24 cases. No patient had distant metastasis. ER and/or PR receptor status was negative in all cases. HER2 was negative in 10 of 11 cases tested. EGFR (HER1) was positive in 7 of 7 cases tested. All patients had sentinel and/or axillary lymph node dissection and surgical resection; 18 received chemotherapy and 22 had radiation therapy. Four patients had distant recurrences 5 to 88 months from diagnosis. Five-year survival was 83% (95% confidence interval, 66-100%). Comparison with matched typical breast cancer cases revealed no major significant difference in multidisciplinary treatment patterns, recurrence, or survival. MBC is associated with poor prognostic indicators, but outcomes comparable with matched typical breast cancer cases can be achieved with routine aggressive multidisciplinary care. Increased, expression of EGFR (HER1) provides an opportunity for targeted tumor therapy.Keywords
This publication has 38 references indexed in Scilit:
- Benign and malignant spindle cell lesions of the breastSeminars in Diagnostic Pathology, 2004
- An immunohistochemical study of metaplastic spindle cell carcinoma, phyllodes tumor and fibromatosis of the breastHuman Pathology, 2003
- Metaplastic Spindle Cell Breast Tumors Arising within Papillomas, Complex Sclerosing Lesions, and Nipple AdenomasLaboratory Investigation, 2003
- Benign Myoepithelial Tumors of the Breast Have Immunophenotypic Characteristics Similar to Metaplastic Matrix-Producing and Spindle Cell CarcinomasAmerican Journal of Clinical Pathology, 2003
- Novel and Classic Myoepithelial/Stem Cell Markers in Metaplastic Carcinomas of the BreastApplied Immunohistochemistry & Molecular Morphology, 2003
- Metastatic metaplastic carcinoma of the breast (MCB): an uncharacteristic pattern of presentation with clinicopathologic correlation.Diagnostic Cytopathology, 2001
- Low-Grade (Fibromatosis-Like) Spindle Cell Carcinoma of the BreastThe American Journal of Surgical Pathology, 2001
- Metaplastic carcinoma of the breast arising within complex sclerosing lesion: a report of five casesHistopathology, 2000
- Spindle cell tumours of the breast: practical approach to diagnosisHistopathology, 1999
- Myofibroblastoma of the BreastThe American Journal of Surgical Pathology, 1987