Clinicopathological Features and Prognosis of Metaplastic Breast Carcinoma: Experience of a Major Chinese Cancer Center

Abstract

Metaplastic breast carcinoma (MBC) is a rare heterogeneous group of primary breast malignancies, with low hormone receptor expression and poor outcomes. To date, no prognostic markers for this tumor have been validated. The current study was undertaken to evaluate the clinicopathologic characteristics, the response to various therapeutic regimens and the prognosis of MBCs in a large cohort of patients from Tianjin Medical University Cancer Hospital in China. Ninety cases of MBCs diagnosed in our hospital between January 2000 and September 2014 were retrieved from the archives. In general, MBCs presented with larger size, a lower rate of lymph node metastasis, and demonstrated more frequent local recurrence/distant metastasis than 1,090 stage-matched cases of invasive carcinoma of no specific type (IDC-NST), independent of the status of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 expressions. The five-year disease-free survival (DFS) of MBC was significantly worse than IDC-NST. Using univariate analysis, lymph node metastasis, advanced clinical stage at diagnosis, high tumor proliferation rate assessed by Ki-67 labeling, and epidermal growth factor receptor (EGFR) overexpression/gene amplification were associated significantly with reduced DFS, while decreased OS was associated significantly with lymph node metastasis and EGFR overexpression/gene amplification. With multivariate analysis, lymph node status was an independent predictor for DFS, and lymph node status and EGFR overexpression/gene amplification were independent predictors for OS. Histologic subtyping and molecular subgrouping of MBCs were not significant factors in prognosis. We also found that MBCs were insensitive to neoadjuvant chemotherapy, routine chemotherapy, and radiation therapy. This study indicates that MBC is an aggressive type of breast cancer with poor prognosis, and that identification and optimization of an effective comprehensive therapeutic regimen is needed.

Metaplastic Carcinoma of the Breast Is More Aggressive Than Triple-negative Breast Cancer: A Study From a Single Institution and Review of Literature

“…There was inconsistency in data handling and analysis. While some authors performed matching (4,8–13,15), some did not match instead they compared with either all TNBC (14) or with BC regardless of tumor molecular subtype (5). There was also inconsistency in the chosen variables for matching, ranging from only one variable such as Nottingham grade (4), or stage (12), to a more comprehensive matching including age, stage, and therapy modality (11 and current study).…”

Comparative Study of Metaplastic Breast Carcinoma (Mbc) and Idc-Nos: A 7 Years Retrospective Analysis in a Tertiary Care Centre of Western Odisha

“…Mitotic activity is usually moderate to high and areas of necrosis may be present. 17 In a major Chinese cancer centre study by yiqian Zhang et al 18 they got spindle cell carcinoma as the most common variant, G M Tse et al 19 found in their study metaplastic carcinoma with sarcomatoid component was the most common type of MBC (70.58%) but in our study, (Table.IV), we got metaplastic squamous cell carcinoma as the most common type of MBC. we had small number of case study in 7 years period in our population group.…”

Carcinoma metaplásico de mama com diferenciação osteossarcomatosa: um relato de caso

“…Isso poderia explicar a menor taxa de sobrevida 10 . Esses tumores geralmente são receptores hormonais negativos e não respondem ao tratamento clínico 11 . Contudo, apesar do grande tamanho, têm pouco envolvimento linfonodal.…”

“…Um estudo com 90 pacientes mostrou menor acometimento dos linfonodos axilares (20,8%) em relação aos carcinomas não metaplásicos, ainda que esse acometimento seja maior em relação aos sarcomas mamários. Todavia, estes tumores possuem alta probabilidade de metástase, mesmo com pouco acometimento linfonodal 11 . O estudo imunoistoquímico é fundamental para o estabelecimento do diagnóstico.…”