Metaplastic breast carcinoma: A case report and systematic review of the literature

• Published in: Pathology international Vol. 61; no. 10; pp. 582 - 588
• Main Authors: Toumi, Zaher, Bullen, Caroline, Tang, Albert C. S., Dalal, Neha, Ellenbogen, Simon
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.10.2011
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - metabolism; breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - surgery; case report; Female; Humans; matrix producing breast cancer; Metaplasia; metaplastic breast cancer; Mixed Tumor, Malignant - drug therapy; Mixed Tumor, Malignant - pathology; Mixed Tumor, Malignant - surgery; Nitriles - therapeutic use; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; systematic review; Triazoles - therapeutic use
• DOI: 10.1111/j.1440-1827.2011.02698.x
• ISSN: 1320-5463

A 78‐year‐old retired woman was diagnosed with metaplastic breast carcinoma (MBC), a rare tumor, in our hospital. We reviewed 15 articles with a total of 1328 patients to determine the epidemiology, clinical features, biomarkers, histology, management and outcome of patients with this tumor. The mean age at presentation is 58.5 years (range 32–83). Eighty‐one percent of patients presented either with a breast mass or abnormal mammographic finding. Twenty‐three percent of patients had a family history of breast cancer. Estrogen receptors were only found in 12%, progesterone receptors in 10% and HER2 in 6% of patients. The main method of treatment was mastectomy (66.9%) in combination with chemotherapy (57%) and radiotherapy (47%). Five‐year disease‐free survival ranged between 40% and 84% and 5‐year overall survival ranged between 64 and 83%. We have further reviewed the nature of this disease in the light of advancement in genetics, such as microarray gene expression profiling. The relationship of MBC with triple‐negative tumor and basal‐like tumor is discussed. It is hoped that advances in genetics and biomarkers will bring forward the era of personalized medicine in the treatment of breast carcinoma.