Metaplastic Breast Carcinoma: Clinicopathological Parameters and Prognostic Profile

Haroon, Saroona; Zia, Shamail; Shirazi, Umme Aiman; Ahmed, Omer; Asghar, Ishaq Azeem; Diwan, Muhammad Asad; Afzal, Anoshia; Irfan, Muhammad; Ali, Syed Jawwad; Hashmi, Atif Ali

doi:10.7759/cureus.14347

Cited by 5 publications

(7 citation statements)

References 21 publications

(28 reference statements)

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“…Breast cancer was divided into luminal A (ER/PR positive, Her-2 negative with low Ki-67 index) disease, luminal B (ER/PR positive, Her-2 negative with high Ki-67 index, or ER/PR positive and Her-2 positive) disease, Her-2 positive (ER and PR negative and Her-2 positive) disease, and triple-negative (ER, PR, and Her-2 negative) disease according to molecular subtyping. MBC: metaplastic breast carcinoma; NSIBC: nonspecific invasive breast carcinoma; ER: estrogen receptor; PR: progesterone receptor; Her-2: human epidermal growth factor receptor 2. e Breast Journal 3 is poorly differentiated and greatly aggressive [10]. Previous studies showed that MBC mainly metastasized via the lymphatics and blood, and early hematogenous metastasis often involved the lung and the bone, especially in metaplastic carcinoma with mesenchymal differentiation [11].…”

Section: Discussionmentioning

confidence: 99%

“…In our study, a total of 34 patients with MBC were able to obtain complete pathological diagnoses, including 17 cases (50.00%) of squamous cell carcinoma, 1 case (2.94%) of spindle cell carcinoma, 11 cases (32.35%) of carcinoma with mesenchymal differentiation, 4 cases (11.76%) of mixed metaplastic carcinoma, and 1 case (2.94%) of fibromatosis-like metaplastic carcinoma. As for biological behavior, MBC is poorly differentiated and greatly aggressive [ 10 ]. Previous studies showed that MBC mainly metastasized via the lymphatics and blood, and early hematogenous metastasis often involved the lung and the bone, especially in metaplastic carcinoma with mesenchymal differentiation [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Differences of Clinicopathological Features between Metaplastic Breast Carcinoma and Nonspecific Invasive Breast Carcinoma and Prognostic Profile of Metaplastic Breast Carcinoma

Qiu

Chen

et al. 2022

The Breast Journal

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Introduction. Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological features of metaplastic breast carcinoma compared with nonspecific invasive breast carcinoma and study the prognosis of metaplastic breast carcinoma. Methods. We reviewed metaplastic breast carcinoma cases (n = 37) from January 2000 to December 2021 and nonspecific invasive breast carcinoma cases (n = 433) from January 2019 to December 2020 extracted from our institution retrospectively. The following variables were recorded, including the patients’ general information, complications, T stage, expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular subtyping, lymph node status, skin or chest wall involvement, vessel carcinoma embolus, therapy modality (surgical treatments, chemotherapy, and radiotherapy), and survival. Results. Patients with metaplastic breast carcinoma had more advanced disease than patients with nonspecific invasive breast carcinoma (T stage: P = 0.0011 ). A greater proportion of metaplastic breast carcinoma presented with triple-negative breast cancer than nonspecific invasive breast carcinoma (79.41% vs. 12.47%, P ≤ 0.001 ). Our study showed that the skin or chest wall invasion was more frequent in metaplastic breast carcinoma patients (11.76% vs. 1.62%, P = 0.005 ). The 5-year survival rate for metaplastic breast carcinoma patients was 57.66% (95% CI: 0.3195∼0.7667). No local recurrence was observed while distant metastasis occurred in 33.33% of patients with metaplastic breast carcinoma. Death due to disease occurred in 24.24% of patients with metaplastic breast carcinoma. Conclusion. The majority of metaplastic breast carcinoma patients had more advanced disease and triple-negative disease than nonspecific invasive breast carcinoma patients. Also, metaplastic breast carcinoma patients had frequent skin or chest wall invasion and a high rate of distant metastasis and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Differences of Clinicopathological Features between Metaplastic Breast Carcinoma and Nonspecific Invasive Breast Carcinoma and Prognostic Profile of Metaplastic Breast Carcinoma

Qiu

Chen

et al. 2022

The Breast Journal

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“…5,7) Most tumors are triple negative (85%), and the most common age group is between 36 and 50 years. 7,8) They tend to be large in size, and most cases are grade 3. 8) One-third of patients have metastatic disease at initial presentation.…”

Section: T He Diagnosis Of St Elevation Myocardial Infarction (Stemi)...mentioning

confidence: 99%

ST Segment Elevation in a Young Woman with Metaplastic Breast Carcinoma

2023

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The 12-lead electrocardiogram (ECG) remains a key tool to diagnose ST elevation myocardial infarction (STEMI). However, a variety of other conditions aside from obstructive coronary disease, including hyperkalemia, myocarditis, pericarditis, and Takotsubo and Brugada syndrome, may also cause ST segment elevation, with an incidence rate of 3%-15% and mean age of 45 ± 14 years. A combination of a detailed past medical history, thorough physical examination, and additional imaging tests may allow physicians to make the correct diagnosis.In this report, we present a case of a 39-year-old woman with metaplastic breast cancer in the process of combined oncological treatment admitted to the emergency department because of general body weakness, chest pain, and accompanying hypotonia with an initial diagnosis of acute coronary syndrome.The ECG at presentation showed ST segment elevation, but owing to the observed neoplastic cachexia and frailty, she was medically managed and the diagnostics were extended to include transthoracic echocardiogram and computed tomography scan. The patient was found to have an external mass that infiltrated into the thoracic wall, pericardium, right ventricle, interventricular septum, and coronary arteries.In cancer patients with chest pain and ST segment elevation, STEMI should not be the only diagnosis taken into account. In our report, using a combination of available cardiac imaging methods, we were able to evaluate the stage of the lesion and coronary involvement.

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“…Metaplastic breast carcinoma (MBC) is one of the rare special subtypes of breast carcinoma associated with poor prognostic features compared with invasive breast ductal carcinoma [ 1 , 2 ]. These tumors tend to have a large tumor size at the time of presentation, and, therefore, require neoadjuvant chemotherapy [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Triple-Negative Metaplastic Breast Carcinoma: Association of Epidermal Growth Factor Receptor Expression With Prognostic Parameters and Clinical Outcome

Munawar¹,

Haider²,

Ali³

et al. 2021

Cureus

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IntroductionMetaplastic breast carcinoma (MBC) is one of the rare special subtypes of breast carcinoma associated with poor prognostic features compared with invasive ductal carcinoma. Moreover, therapeutic options are limited in MBC owing to frequent triple-negative profiles of these tumors. Epidermal growth factor receptor (EGFR) is a proto-oncogene that is overexpressed in many human cancers, and is a potential therapeutic target. Therefore, in this study, we evaluated the expression of EGFR in MBC by immunohistochemistry, and its association with clinicopathological and prognostic parameters. MethodsWe conducted a retrospective observational study in the Department of Histopathology at Liaquat National Hospital and Medical College, Pakistan, over a period of seven years. A total of 61 cases with a histopathological diagnosis of MBC were included in the study. All slides were reviewed by histopathologists for diagnostic confirmation. Histopathological parameters, such as tumor size, grade, and nodal metastasis, were recorded. The representative tissue blocks were also retrieved and immunohistochemical studies were performed for cytokeratin 5/6 (CK5/6), Ki67, and EGFR. ResultsThe mean age of the patients was 44.48 ± 13.01 years. The mean tumor size was 5.72 ± 2.72 cm, with most of the cases belonging to tumor (T)-stage T3. Axillary metastasis was present in 57.4% cases, and the perinodal extension was present in 11.5% cases. Most tumors were grade III (85.2%), with a mean Ki67 index of 39.67% ± 20.38%. Most of the cases were nonbasal (83.6%), owing to the absent CK5/6 expression. Tumor recurrence was noted in 14.8% cases, with a median follow-up of 43 (13-83) months and median disease-free survival of 36 (12-60) months. Positive EGFR expression was noted in 52.5% cases. A significant association of EGFR expression was noted with tumor grade, mean Ki67 index, axillary metastasis, and nodal (N)-stage. Cases with positive EGFR expression were found to have higher grade (grade III), with higher Ki67 index, higher frequency of axillary metastasis, and higher N-stage. Moreover, cases with positive EGFR expression had lower disease-free survival compared to cases with negative EGFR expression. ConclusionWe found that a significant proportion of triple-negative MBC expressed EGFR. Moreover, EGFR overexpression was associated with poor pathological parameters and lower disease-free survival. Therefore, EGFR can be considered a potential prognostic biomarker and therapeutic target in triple-negative MBC; however, the correlation between gene amplification and protein overexpression is required to better uncover the role of EGFR as a therapeutic target.

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Metaplastic Breast Carcinoma: Clinicopathological Parameters and Prognostic Profile

Cited by 5 publications

References 21 publications

Differences of Clinicopathological Features between Metaplastic Breast Carcinoma and Nonspecific Invasive Breast Carcinoma and Prognostic Profile of Metaplastic Breast Carcinoma

Differences of Clinicopathological Features between Metaplastic Breast Carcinoma and Nonspecific Invasive Breast Carcinoma and Prognostic Profile of Metaplastic Breast Carcinoma

ST Segment Elevation in a Young Woman with Metaplastic Breast Carcinoma

Triple-Negative Metaplastic Breast Carcinoma: Association of Epidermal Growth Factor Receptor Expression With Prognostic Parameters and Clinical Outcome

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