Metaplastic Breast Cancer: Current Understanding and Future Directions

Thomas, Alexandra; Douglas, Emily M.; Reis‐Filho, Jorge S.; Gürcan, Metin N.; Wen, Hannah Y.

doi:10.1016/j.clbc.2023.04.004

Cited by 6 publications

(4 citation statements)

References 67 publications

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“…Metaplastic cancer, on the other hand, is a heterogenous group of cancers that were also associated with unfavourable pathological features. Unlike invasive micropapillary cancers that are more commonly associated with hormonal receptor and HER2 positivity, metaplastic cancers tend to be associated with triple-negative phenotypes, with the majority having an inferior outcome [ 15 ]. In our study, however, the histological subtype was not one of the statistically significant factors for predicting systemic metastasis at staging.…”

Section: Discussionmentioning

confidence: 99%

Is Metastatic Staging Needed for All Patients with Synchronous Bilateral Breast Cancers?

Lim,

Hoo,

Shin

et al. 2023

Cancers

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Background: Patients with bilateral breast cancers are uncommon and are associated with a poorer prognosis. While metastatic staging guidelines in patients with unilateral cancer were established, the indication of metastatic staging in patients with bilateral breast cancers is unclear. We aimed to determine which patients with synchronous bilateral breast cancers require metastatic staging at diagnosis. This is the first such reported study, to the best of our knowledge. Methods: A retrospective review of newly diagnosed synchronous bilateral invasive breast cancer patients at our institution was performed. We excluded patients with malignant phyllodes or no metastatic staging. Patients’ demographics and pathological and staging results were analysed to determine the group of bilateral breast cancer patients who required metastatic staging. Results: A total of 92 patients with synchronous bilateral invasive cancers were included. The mean age was 58 years old, and 64.1% had bilateral invasive ductal carcinoma. 23.9% had systemic metastasis. Nodal status was statistically significant for systemic metastasis on staging (p = 0.0081), with only three patients (3.3%) having negative nodal status and positive metastatic staging. These three patients, however, showed symptoms of distant metastasis. 92.3% of patients with negative nodes also had negative metastatic staging. Using negative nodal status as a guide avoided metastatic staging in 40.4% of all patients. Conclusions: Negative nodal status was the most predictive factor for no systemic metastasis on staging in patients with synchronous bilateral invasive breast cancers. Hence, metastatic staging could be reserved for patients with symptoms of systemic metastasis and/or metastatic nodes. This finding could be validated in larger studies.

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Section: Discussionmentioning

confidence: 99%

Is Metastatic Staging Needed for All Patients with Synchronous Bilateral Breast Cancers?

Lim,

Hoo,

Shin

et al. 2023

Cancers

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“…20 However, the molecular heterogeneity of MBC is strong, and its molecular expression is unique. 18,21,22 Positive expressions of phosphatidylinositol 3-kinase (PI3K), mammalian target of rapamycin (mTOR), TP53, and epidermal growth factor receptor (EGFR) in certain cases can be observed. 21 Patients with variations in the PI3K/AKT/mTOR pathway can receive targeted treatment with everolimus.…”

Section: Discussionmentioning

confidence: 99%

Immunotherapy Combined with Chemotherapy in Relapse Metaplastic Breast Cancer

Chen,

Meng,

Zhou

et al. 2023

OTT

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Metaplastic breast cancer (MBC) is a rare disease, and there was rarely reported the treatment after recurrence and metastasis. Here, we report the treatment of an adult patient who suffered from MBC with lung, lymph nodes and left pleura metastasis after radical surgery. The next-generation sequencing result demonstrated that it had tumor mutational burden (TMB) of 12.0 Muts/Mb and microsatellite stability. The patient received sintilimab, an immune checkpoint inhibitor, plus chemotherapy and achieved partial response (PR). This is a report of a good outcome of metastatic MBC achieving 24 months of progression-free survival (PFS) and 39 months of overall survival (OS) with a combination therapy of immune checkpoint inhibitor and chemotherapy. Immunochemotherapy may have antitumor activity for relapse MBC. TMB may serve as a potential predictor associated with PD-1 inhibitors in MBC and help clinicians make an optimum treatment strategy.

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“…A prolonged disease control in metastatic disease and pCR have been found in many studies evaluating different types of agent classes and determining the effect of these agents in MpBCs histological variants [124][125][126][127][128][129][130]. Thomas et al summarize these some "exceptional" responses in patients with MpBC using immunotherapy and immunotherapy combinations, PARP Inhibition with deleterious germline BRCA mutations, anti-angiogenesis, pathway Inhibition, and BRAF inhibition/MEK inhibition combination [131].…”

Section: Treatment and Prognosismentioning

confidence: 99%

Translational Aspects in Metaplastic Breast Carcinoma

Barrientos-Toro,

Ding,

Raso

2024

Cancers

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Breast cancer is the most common cancer among women. Metaplastic breast carcinoma (MpBC) is a rare, heterogeneous group of invasive breast carcinomas, which are classified as predominantly triple-negative breast carcinomas (TNBCs; HR-negative/HER2-negative). Histologically, MpBC is classified into six subtypes. Two of these are considered low-grade and the others are high-grade. MpBCs seem to be more aggressive, less responsive to neoadjuvant chemotherapy, and have higher rates of chemoresistance than other TNBCs. MpBCs have a lower survival rate than expected for TNBCs. MpBC treatment represents a challenge, leading to a thorough exploration of the tumor immune microenvironment, which has recently opened the possibility of new therapeutic strategies. The epithelial–mesenchymal transition in MpBC is characterized by the loss of intercellular adhesion, downregulation of epithelial markers, underexpression of genes with biological epithelial functions, upregulation of mesenchymal markers, overexpression of genes with biological mesenchymal functions, acquisition of fibroblast-like (spindle) morphology, cytoskeleton reorganization, increased motility, invasiveness, and metastatic capabilities. This article reviews and summarizes the current knowledge and translational aspects of MpBC.

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Metaplastic Breast Cancer: Current Understanding and Future Directions

Cited by 6 publications

References 67 publications

Is Metastatic Staging Needed for All Patients with Synchronous Bilateral Breast Cancers?

Is Metastatic Staging Needed for All Patients with Synchronous Bilateral Breast Cancers?

Immunotherapy Combined with Chemotherapy in Relapse Metaplastic Breast Cancer

Translational Aspects in Metaplastic Breast Carcinoma

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