E-poster Presentation 2014 World Cancer Congress

Metaplastic Carcinoma of Breast: The Basilisk among Breast Cancer (#742)

SHRAVAN S NADKARNI 1 , Vivekanand Sharma 1 , Pinakin Patel 1 , Savita Soni 2 , Suresh Singh 1 , Raj Govind Sharma 1
  1. SAWAI MANSINGH MEDICAL COLLEGE & HOSPITALS, JAIPUR, Rajasthan, India, JAIPUR, RAJAS, India
  2. Department of Pathology, Bhagwan Mahaveer Cancer Hospital & Research Centre, Jaipur, Rajasthan, India

Background:Metaplastic carcinoma breast (MBC) is a rare & aggressive tumour, accounting for <1% of all breast cancers. 5-yr survival rate is 65% vs. 89% for conventional Invasive ductal cancer. Treatment paradigm is based on that of conventional IDC since available evidence is largely institutional case series-based. We aspire to add to the existing literature and study the clinico-epidemiologic and pathologic features in cases we came across

Aim: To evaluate & study the clinico-epidemiologic parameters, tumour characteristics, hormone receptor status, & marker positivity of metaplastic carcinoma breast.

Methods:Patients of breast lump presenting during the study period of 2009 – 2014, proven to have metaplastic carcinoma on histopathology were included in the study. Clinical presentation (age, menopausal status), tumour characteristics (size, grade, stage, margins, nodes, marker positivity) were studied.

Results:We encountered 33 cases during the study. Of the total, 1 patient was male. The mean age was 48.55 yrs ranging from 23-88 yrs. Cases were clustered in the 4th-5th decade of life. Based on conclusive oncological diagnosis, 23 patients underwent Modified Radical Mastectomy (MRM). Resected tumour was more commonly a pT3 disease. Of the 4 patients with nodal disease 1 had N3, 1 had N2 and 2 had N1 disease. 19 cases were triple negative tumours (ER, PR, Her2neu) & most were positive for epithelial markers and sarcomatous markers. 1 case had lymphovascular invasion and none had perineural invasion.

Conclusions:Metaplastic carcinoma at present, is at best a large pool of case series. With increasing recognition of its histopathological characteristics, known poor prognoses & a lack of uniform guidelines, it is pertinent that this entity is studied in its entirety.Increased awareness of its occurrence with subsequent data collection & analysis shall be the key in highlighting the natural history of the disease subset. This would further be instrumental in formulating management protocols. 

  1. 1. Kuo S H, Chen C L, Huang C S. et al Metaplastic carcinoma of the breast: analysis of eight Asian patients with special emphasis on two unusual cases presenting with inflammatory‐type breast cancer. Anticancer Res 2000. 202219–2222.2222
  2. 2. Adem C, Reynolds C, Adlakha H. et al Wide spectrum screening keratin as a marker of metaplastic spindle cell carcinoma of the breast: an immunohistochemical study of 24 patients. Histopathology 2002. 40556–562.562
  3. 3. Kurian K M, Al‐Nafussi A. Sarcomatoid/metaplastic carcinoma of the breast: a clinicopathological study of 12 cases. Histopathology 2002. 4058–64.64