Clinicopathologic study of 53 metaplastic breast carcinomas: their elements and prognostic implications

Yamaguchi, Rin; Horii, Rie; Maeda, Ichiro; Suga, Shin Ichi; Makita, Masujiro; Iwase, Takuji; Oguchi, Masahiko; Ito, Yoshiaki; Akiyama, Futoshi

doi:10.1016/j.humpath.2009.10.009

Cited by 69 publications

(49 citation statements)

References 15 publications

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“…[1][2][3][4][5] Metaplastic carcinoma of the breast typically presents at a more-advanced stage than either invasive ductal or lobular adenocarcinoma cases and, in general, has a worse prognosis. 6,7 On routine biomarker testing for estrogen receptor (ER) and/or progesterone receptor (PR) status, most MPBCs are negative.…”

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confidence: 99%

Genomic Profiling of Advanced-Stage, Metaplastic Breast Carcinoma by Next-Generation Sequencing Reveals Frequent, Targetable Genomic Abnormalities and Potential New Treatment Options

Ross

Badve

Wang

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Metastatic metaplastic breast carcinoma (MPBC) is an uncommon, but aggressive, tumor resistant to conventional chemotherapy.Objective.-To learn whether next-generation sequencing could identify potential targets of therapy for patients with relapsed and metastatic MPBC.Design.-Hybridization capture of 3769 exons from 236 cancer-related genes and 47 introns of 19 genes commonly rearranged in cancer was applied to a minimum of 50 ng of DNA extracted from 20 MPBC formalin-fixed, paraffinembedded specimens and sequenced to high uniform coverage.Results.-The 20 patients with MPBC had a median age of 62 years (range, 42-86 years). There were 9 squamous (45%), 9 chondroid (45%), and 2 spindle cell (10%) MPBCs, all of which were high grade. Ninety-three genomic alterations were identified, (range, 1-11) with 19 of the 20 cases (95%) harboring an alteration that could potentially lead to a targeted treatment option. The mostcommon alterations were in TP53 (n ¼ 69; 75%), PIK3CA (n ¼ 37; 40%), MYC (n ¼ 28; 30%), MLL2 (n ¼ 28; 30%), PTEN (n ¼ 23; 25%), CDKN2A/B (n ¼ 19; 20%), CCND3 (n ¼ 14; 15%), CCNE1 (n ¼ 9; 10%), EGFR (n ¼ 9; 10%), and KDM6A (n ¼ 9; 10%); AKT3, CCND1, CCND2, CDK4, FBXW7, FGFR1, HRAS, NF1, PIK3R1, and SRC were each altered in a single case. All 16 MPBCs (100%) that were negative for ERBB2 (HER2) overexpression by immunohistochemistry and/or ERBB2 (HER2) amplification by fluorescence in situ hybridization were also uniformly (100%) negative for ERBB2 amplification by next-generation sequencing-based copy-number assessment.Conclusions.-Our results indicate that genomic profiling using next-generation sequencing can identify clinically meaningful alterations that have the potential to guide targeted treatment decisions in most patients with metastatic MPBC.

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confidence: 99%

Genomic Profiling of Advanced-Stage, Metaplastic Breast Carcinoma by Next-Generation Sequencing Reveals Frequent, Targetable Genomic Abnormalities and Potential New Treatment Options

Ross

Badve

Wang

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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“…Sin embargo, el único factor que ha demostrado claramente ser útil como indicador pronóstico es el tamaño tumoral, observándose que por encima de 5 cm el pronóstico empeora. El valor que tiene en el pronóstico el tipo de componente mesenquimal no está claradamente definido (1,3,6,9,11,12).…”

Section: Discussionunclassified

Carcinoma Sarcomatoide Monofásico De Mama: Caso Clínico

Buján

et al. 2011

Rev. chil. obstet. ginecol.

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RESUMENEl carcinoma sarcomatoide de mama es una variante histológica del carcinoma metaplásico, compuesto predominantemente por células fusiformes. Presentamos el caso de un tumor en mujer de 54 años, en que las características clínicas y de imagen sugerían un tumor maligno, y finalmente la histología y la inmunohistoquímica confirmaron el diagnóstico de carcinoma sarcomatoide monofásico. En esta variante no es posible identificar un componente epitelial claro, por lo que plantea problemas de diagnóstico diferencial con sarcomas y otras lesiones mesenquimatosas. La demostración mediante inmunohistoquímica de la naturaleza epitelial de las células fusiformes, resultó fundamental para establecer el diagnóstico.PALABRAS CLAVE: Mama, carcinoma metaplásico, carcinoma sarcomatoide SUMMARY Sarcomatoid carcinoma of the breast is a histological variant of metaplastic carcinoma, composed predominantly of spindle cells. We report a case of a tumor in a woman of 54 years old, which suggested a clinical and radiological malignant tumor. Finally the histology and immunohistochemistry confirmed the diagnostic of monophasic sarcomatoid carcinoma. In this variant of sarcomatoid carcinoma, is not possible to identify a clear epithelial component, creating problems of differential diagnosis between sarcomas and other mesenchymal damages. The immunohistochemical demonstration of epithelial nature of the spindle cells was essential for the diagnosis.KEY WORDS: Breast, metaplastic carcinoma, sarcomatoid carcinoma INTRODUCCIÓNEl carcinoma metaplásico de mama es una neoplasia maligna muy poco frecuente, representa menos del 1% de todos los cánceres invasivos de mama (1-3). Engloba a un grupo heterogéneo de tumores que se caracterizan por presentar un doble componente, epitelial y mesenquimal. El componente epitelial suele ser un carcinoma de alto grado. El componente mesenquimal puede adoptar distintos fenotipos (condroide, óseo, fusiforme, escamoso, etc.) de variables grados citológicos (1-5).El carcinoma sarcomatoide es una variedad de carcinoma metaplásico donde el componente mesenquimal está formado exclusivamente por célu-las fusiformes (6-8).

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“…Yamagachi et al indicate that the presence of high-grade spindle cells in PPSCC was at least one important prognostic factor [19]. The 5-year disease-free survival for this tumor has been reported to be 63% [20] and 52% [21].…”

Section: Discussionmentioning

confidence: 99%

Pure Primary Squamous Cell Carcinomas of the Breast: A Report of Eight Cases

Znati

2010

J Med Cases

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Pure primary squamous cell carcinoma (PPSCC) of the breast is a rare neoplasm included in World Health Organization Classification of tumors (2003) in metaplastic breast cancer. It accounts for less than 0.1% of all breast carcinomas. We performed a retrospective review of all women diagnosed or treated as PPSCC, from January 2004 to June 2009 to assess clinical presentation, surgical and pathological findings, treatment and outcome. Eight patients were identified. The median age was 48.2 (range: 40 -57) years. The average tumor size was 7.3 cm, with a range of 3.5 to 18 cm. There were one well differentiated, three moderately differentiated and four poorly differentiated PPSCC. Two cases were stage IIA, two cases stage IIIA and three cases stage IIIB. Primary treatment was mastectomy in six patients and large local excision in one patient. There was lymph node (LN) involvement in one patient. Estrogen and progesterone receptors status and over expression of HER 2 were assessed and none tumors was positive. Cytokeratin 5/6 and/ or Cytokeratin 14 were positive in all tumors. All patients were treated by radiotherapy and chemotherapy. Though PPSCC of the breast is a very rare and aggressive disease, in our experience it's relatively frequent. Strict histologic criteria should be used to diagnose PPSCC, because they have significantly lower axillary lymph node metastasis, lower estrogen and PR positivity, and they are often treatment-refractory. The role of different new chemotherapy regimens needs to be explored.

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Clinicopathologic study of 53 metaplastic breast carcinomas: their elements and prognostic implications

Cited by 69 publications

References 15 publications

Genomic Profiling of Advanced-Stage, Metaplastic Breast Carcinoma by Next-Generation Sequencing Reveals Frequent, Targetable Genomic Abnormalities and Potential New Treatment Options

Genomic Profiling of Advanced-Stage, Metaplastic Breast Carcinoma by Next-Generation Sequencing Reveals Frequent, Targetable Genomic Abnormalities and Potential New Treatment Options

Carcinoma Sarcomatoide Monofásico De Mama: Caso Clínico

Pure Primary Squamous Cell Carcinomas of the Breast: A Report of Eight Cases

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