Carcinoma of the breast with pseudosarcomatous metaplasia

Abstract

Twenty‐six cases of breast carcinoma demonstrating pseudosarcomatous metaplasia are described, and their clinical and pathologic aspects are correlated. The metaplastic elements include mature and immature bone, cartilage, myxoid stroma, loose fibromyxoid and dense spindle‐cell stroma, and anaplastic stroma with giant cell features. Light and electron microscopic examination demonstrated an orderly sequence of transformation and dedifferentiation of epithelial cells to become undifferentiated mesenchymal cells. These tumors are more aggressive than purely epithelial carcinomas. The overall survival rate was 44%. Five‐year survival figures for TNM Stages I, II, and III lesions were 56%, 26%, and 18%, respectively. The incidence of lymph node metastasis was 25% despite the large size of many of these tumors. Systemic metastases replicated the range of metaplastic elements seen in the primary site. Patients with tumors composed predominantly of pseudosarcomatous elements had worse prognoses than those with predominantly epithelial components (28% versus 62%, 5‐year survival).

Metaplastic Breast Carcinoma: Case Series and Review of the Literature

“…Although the median age of MpBC patients was over 50 years of age in the literature (Kaufman et al, 1984;Oberman et al,1987;Rayson et al, 1999), the median age of our series was found to be about 5 years younger (45.5 years). Female preponderance is obvious but rarely male MpBC patients were reported in case series (Kuo et al, 2000).…”

“…MpBC has a lesser tendency to involve axillary lymph nodes compared to adenocarcinoma and reported to be in the range of 0-53% in some series (Gersell et al, 1981;Bauer et al, 1984;Kaufman et al, 1984;Chao et al, 1999;Rayson et al, 1999;Al Sayed et al, 2006;Bae et al, 2011). Although lower incidence of axillary lymph node involvement, classical surgery techniques such as radical mastectomy and modified radical mastectomy including axillary dissection were the preferred surgery choices in the literature (Pitts et al, 1991;Gutman et al, 1995;Rayson et al, 1999) except for one study (Caceres et al, 2002).…”

Metaplastic Carcinoma of the Breast: p53 Analysis Identified the Same Point Mutation in the Three Histologic Components

“…Metaplastic carcinoma of the breast is rare and it has been classified into two groups: squamous metaplasia (3.7% of all breast cancers) (1) and heterologous metaplasia (0.2%) (2). The exact histogenesis whether they are from a single progenitor cell or not is an issue to be solved.…”

Metaplastic carcinoma breast (IDC and chondrosarcoma): a rare entity

“…It has been reported that these tumors are more likely to occur in women over 50 years of age. 5,6 The patients usually describe a rapid growth with a short period of diagnosis. The tumors tend to have a circumscribed contour radiologically.…”