Published articles, Case Studies and Media regarding
Metaplastic Breast Cancer
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The articles are listed below by the date they became available online.
8/26/2023 Unraveling Stigmas of Male Breast Carcinoma: A Singular Case of Advanced Metaplastic Breast Carcinoma in a Young Male
Abstract: Breast carcinoma in males is a rare and unique condition that differs from breast cancer in females and is typically diagnosed at an advanced stage in older male patients. Late diagnosis is often due to the rarity of male breast carcinoma. Among the various types of breast carcinomas, metaplastic breast carcinoma is one of the rarest kind of breast malignancy and is associated with poorer outcomes. This case report presents a singular case of a young male in his early thirties who presented with a breast lump and was diagnosed with metaplastic breast carcinoma. Breast cancer in males is a topic that is often overlooked and lacks extensive research. However, with an increasing incidence of breast carcinoma in males, including even the rarest forms, such as metaplastic carcinoma, and its occurrence in young patients as highlighted in this case report, it is crucial to initiate more discussions, enhance education, and promote further research in male breast carcinoma. In addition, the psychosocial impacts of the disease should be carefully considered, as men with breast cancer face unique emotional challenges that require attention and support.
To read more click here
8/16/2023 The First Metaplastic Breast Cancer Global Alliance Webinar
8/9/2023 Dr Batra-Sharma on Conducting a Clinicopathologic Investigation Into Metaplastic Breast Cancer
Hemali Batra-Sharma, MD, fellow, Hematology/Oncology, University of California San Diego (UCSD) Medical Center, UCSD Health, discusses a single-institution, retrospective clinicopathologic analysis of patients with metaplastic breast cancer, findings from which were presented at the 2023 ASCO Annual Meeting.
To read more and see the video click here
8/5/2023 An Update on the Molecular Pathology of Metaplastic Breast Cancer
Abstract: Abstract: Metaplastic breast cancer (MpBC) is a fascinating morphologic sub-type of breast cancer, characterised by intra-tumoural heterogeneity. By definition, these tumors show regions of metaplasia that can present as spindle, squamous, chondroid or even osseous differentiation. MpBC are typically triple-negative, and are therefore not targetable with hormone therapy or anti-HER2 therapies, leaving only chemotherapeutics for management.
MpBC are known for their aggressive course and poor response to chemotherapy. We review herein the pathology and molecular landscape of MpBC and discuss opportunities for targetted therapies as well as immunotherapies.To read more click here
4/19/2023 Metaplastic Breast Cancer: Current Understanding and Future Directions
Abstract: Metaplastic breast cancers (MBC) encompass a group of highly heterogeneous tumors which share the ability to differentiate into squamous, mesenchymal or neuroectodermal components. While often termed rare breast tumors, given the relatively high prevalence of breast cancer, they are seen with some frequency. Depending upon the definition applied, MBC represents 0.2% to 1% of breast cancers diagnosed in the United States. Less is known about the epidemiology of MBC globally, though a growing number of reports are providing information on this. These tumors are often more advanced at presentation relative to breast cancer broadly. While more indolent subtypes exist, the majority of MBC subtypes are associated with inferior survival. MBC is most commonly of triple-negative phenotype. In less common hormone receptor positive MBCs, hormone receptor status appears not to be prognostic. In contrast, relatively rare HER2-positive MBCs are associated with superior outcomes. Multiple potentially targetable molecular features are overrepresented in MBC including DNA repair deficiency signatures and PIK3/AKT/mTOR and WNT pathways alterations. Data on the prevalence of targets for novel antibody-drug conjugates is also emerging. While chemotherapy appears to be less active in MBC than in other breast cancer subtypes, efficacy is seen in some MBCs. Disease-specific trials, as well as reports of exceptional responses, may provide clues for novel approaches to this often hard-to-treat breast cancer. Strategies which harness newer research tools, such as large data and artificial intelligence hold the promise of overcoming historic barriers to the study of uncommon tumors and could markedly advance disease-specific understanding in MBC
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4/2023 A molecular reappraisal of matrix-producing breast metaplastic carcinoma highlighted by PLAG1 and MYC rearrangements
Background: Very little is currently known about molecular alteration of matrix-producing carcinoma of the breast. However, the morphological similarity with other neoplasm with a myxo-chondroid component is remarkable. In this pilot study we evaluated the molecular alterations involving PLAG1 and MYC genes in 12 cases of matrix producing carcinoma.
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1/27/2023 Transcriptomic alterations underlying metaplasia into specific metaplastic components in metaplastic breast carcinoma
Background: Metaplastic breast carcinoma (MpBC) typically consists of carcinoma of no special type (NST) with various metaplastic components. Although previous transcriptomic and proteomic studies have reported subtype-related heterogeneity, the intracase transcriptomic alterations between metaplastic components and paired NST components, which are critical for understanding the pathogenesis underlying the metaplastic processes, remain unclear.
Methods: Fifty-nine NST components and paired metaplastic components (spindle carcinomatous [SPS], matrix-producing, rhabdoid [RHA], and squamous carcinomatous [SQC] components) were microdissected from specimens obtained from 27 patients with MpBC for gene expression profiling using the NanoString Breast Cancer 360 Panel on a NanoString nCounter FLEX platform. BC360-defined signatures were scored using nSolver software.
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1/22/2023 Metaplastic breast cancer: A review
Abstract: Metaplastic breast cancer (MpBC) is an uncommon aggressive malignancy that is associated with a poor prognosis. Due to its rarity, the relationships between the clinical and pathological features of MpBC, treatment approach, and clinical outcomes remain underexplored. In the following review article, we synthesize the existing data on the clinical, pathological and genomic features, management, and outcomes of MpBC. We also identify potential targets for future clinical trials.
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8/19/2022 Disease Behavior and Treatment Response of Special Histological Types of Triple-Negative Breast Cancer
Abstract:
Background : Special histological types (SHT) of triple-negative breast cancer (TNBC) are a heterogeneous group of rare poorly understood diseases. We aimed to evaluate the clinical features, treatment, and outcomes of patients with SHT of TNBC.
Methods : We evaluated patients with a SHT of TNBC treated in a cancer center between 2009 and 2020. The endpoints were characterization of clinical and pathological features, pathologic complete response (PCR) rate after neoadjuvant chemotherapy, disease-free survival (DFS), progression-free survival, and overall survival (OS).To read more click here
8/29/2022 Metaplastic Breast Cancer: Characteristics and Survival Outcomes
Summary:
Objectives:Metaplastic breast cancer (MBC) is a rare neoplasm accounting for <1% of all breast cancer. We evaluated the clinical characteristics and survival outcomes of MBC.
Methods: Patients diagnosed with pathologically proven MBC were reviewed from the institutional breast cancer database from 2000 to 2017.
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8/31/2022 Expertise To Treat Metaplastic Breast Cancer From MSK’s Rare Breast Cancer Program
Summary: This article covers surgery for rare breast cancers, like Metaplastic, nipple-sparing mastectomy after rare breast cancer diagnosis, using chemotherapy and immunotherapy to treat rare breast cancers and supportive care for all people with breast cancer.
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9/2021 Metaplastic Breast Cancer – Mayo Clinic Proceedings
Path to Patient Image Quiz
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7/22/2021 Poor response to neoadjuvant chemotherapy in metaplastic breast carcinoma
Abstract: Metaplastic breast carcinoma (MpBC) is a rare special histologic subtype of breast carcinoma characterized by the presence of squamous and/or mesenchymal differentiation. Most MpBCs are of triple-negative phenotype and neoadjuvant chemotherapy (NAC) is frequently utilized in patients with MpBC. The aim of this study was to evaluate response to NAC in a retrospective cohort of MpBCs. We identified 44 patients with MpBC treated with NAC at our center between 2002 and 2018. Median age was 48 years, 86% were clinical stage II–III, and 36% were clinically node-positive. Most (80%) MpBCs were triple-negative or low (1–10%) hormonal receptor positive and HER2 negative on pre-NAC biopsy. While on NAC, 49% showed no clinical response or clinico-radiological progression. Matrix-producing subtype was associated with clinico-radiological response (p = 0.0036). Post NAC, two patients initially ineligible for breast-conserving surgery (BCS) were downstaged to be eligible for BCS, whereas three patients potentially eligible for BCS before treatment became ineligible due to disease progression. Only one (2%) patient had a pathologic complete response (pCR). Among the 16 patients presenting with biopsy-proven clinical node-positive disease, 3 (19%) had nodal pCR. Axillary lymph node dissection was avoided in 3 (19%) patients who had successful axillary downstaging. Residual cancer burden (RCB) was assessed in 22 patients and was significantly associated with disease-free survival and overall survival. We observed a poor response or even disease progression on NAC among patients with MpBC, suggesting that NAC should be reserved for patients with inoperable MpBC.
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6/8/2021 A Case Series of Metastatic Metaplastic Breast Carcinoma Treated With Anti-PD-1 Therapy
Abstract: Metaplastic breast cancer is a rare and often chemo-refractory subtype of breast cancer with poor prognosis and limited treatment options. Recent studies have reported overexpression of programmed death ligand 1 (PD-L1) in metaplastic breast cancers, and there are several reports of anti-PD-1/L1 being potentially active in this disease. In this case series, we present 5 patients with metastatic metaplastic breast cancer treated with anti-PD-1-based therapy at a single center, with 3 of 5 cases demonstrating a response to therapy, and one of the responding cases being a metaplastic lobular carcinoma with low-level hormone receptor expression. Cases were evaluated for PD-L1 expression, tumor infiltrating lymphocytes (TILs), DNA mutations, RNA sequencing, and T-cell receptor sequencing. Duration of the response in these cases was limited, in contrast to the more durable responses noted in other recently published reports.
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5/2021 Metaplastic breast cancer: Treatment and prognosis by molecular subtype
Abstract: Background: Metaplastic breast cancer (MBC) is a rare and aggressive subtype of breast. However, the effect of molecular subtype on treatment and prognosis of MBC remains unclear.
Patients and Methods: The Surveillance, Epidemiology, and End Results database was used to analyze patients with MBC between 2010 and 2016. Molecular subtype was stratified to TN group (ER and PR-/HER2-), HER2 group (ER and PR-/HER2+, ER/PR+ and HER2+), and HR group (ER/PR+ and HER2-). The breast cancer-specific survival (BCSS) differences were estimated using multivariate Cox regression model and Kaplan-Meier curves.
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4/8/2021 Breast- Metaplastic carcinoma – Metaplastic
Summary:Textbook style presentation of facts, diagrams, and links of pathology facts regarding metaplastic breast cancer.
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3/19/2021 Survival Rates Similar Among Patients With Metaplastic or Ductal Triple-Negative Breast Cancer
Summary: Similar rates of disease-free and overall survival were seen in a study of women with metaplastic and ductal triple-negative breast cancer (TNBC), according to an Italian study presented at the 17th St. Gallen International Breast Cancer Conference.
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1/2021 Metaplastic breast cancer: Prognostic and therapeutic considerations
Abstract: Introduction: Metaplastic breast cancer (MBC) is a rare condition of breast tumor with different subtypes, considered a disease with worse prognosis; treatments and survival are often unclear and conflicting.
Methods: We consecutively collected 153 primary MBCs of different subtypes. Breast surgery, neoadjuvant or adjuvant treatment, clinic-pathological factors, number and type of events during follow-up were considered to evaluate overall survival (OS) and invasive disease-free survival (IDF
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11/04/2020 A comprehensive overview of metaplastic breast cancer: clinical features and molecular aberrations
Abstract: Metaplastic breast cancer (MpBC) is an exceedingly rare breast cancer variant that is therapeutically challenging and aggressive. MpBC is defined by the histological presence of at least two cellular types, typically epithelial and mesenchymal components. This variant harbors a triple-negative breast cancer (TNBC) phenotype, yet has a worse prognosis and decreased survival compared to TNBC. There are currently no standardized treatment guidelines specifically for MpBC. However, prior studies have found that MpBC typically has molecular alterations in epithelial-to-mesenchymal transition, amplification of epidermal growth factor receptor, PI3K/Akt signaling, nitric oxide signaling, Wnt/β-catenin signaling, altered immune response, and cell cycle dysregulation. Some of these molecular alterations have been studied as therapeutic targets, in both the preclinical and clinical setting. This current review discusses the histological organization and cellular origins of MpBC, molecular alterations, the role of radiation therapy, and current clinical trials for MpBC.
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05/25/2020 Metaplastic breast cancer: A retrospective analysis over 14 years
Background: Metaplastic breast carcinoma (MBC), a rare entity, is known to be an aggressive form of breast cancer. With few published reports and scant literature, there are no current guidelines for this type of cancer. The aim of the study is to describe the patient characteristics, pathologic features, treatment and clinical outcomes of the patients with MBC at our institution. Methods: A retrospective analysis of patient charts with histologically confirmed MBC from 2001 to 2014 was done. Clinical information was abstracted from the medical records. Medical records were reviewed for patient age, tumor size, nodal status, tumor grade, hormone receptor status, treatment, recurrence rates and survival characteristics. Results: Twenty-three patients were identified with a median age at diagnosis of 59 years (range 42-91 years). The median tumor size was 2.1 cm (range 0.4-4.5 cm). Most tumors were grade 3 (73.9 %). None of the patients had metastatic disease at presentation. 17 patients were node negative (74%). 13 patients (56.5 %) were triple negative. 6 patients (26 %) underwent mastectomy and 17 underwent lumpectomy. 16 out of 23 patients underwent post-operative radiation therapy. The 5-year disease free survival was 73.9 % and 5-year overall survival was 82.6%. The tumor size was more than or equal to 2.4 cm in all the patients with recurrence. 60 % of the patients with recurrence were triple negative and 20% were Her2 neu positive. 33.33 % patients were poorly differentiated on histology. Conclusions: Based on our analysis and review of literature, MBC has higher tumor grade, hormone receptor negativity and lesser nodal involvement on presentation. Various studies have shown that tumor size is often large on presentation. In our study, tumor size was modest on presentation. Hence, our survival rates are better than seen with other studies. As per our analysis and as demonstrated by other studies, tumor size is an independent risk factor for recurrence. Other ominous factors for recurrence are triple negative hormone status and poorly differentiated tumor as seen in our case. Further studies and clinical trials comparing with infiltrating ductal carcinoma are needed to understand this rare breast cancer.
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04/16/2020 Novel Protein Landscape Identified for Metaplastic Breast Cancer
Summary: A new study has attempted to identify several biomarkers associated with metaplastic breast carcinoma (MBC), a highly aggressive form of triple-negative breast cancer (TNBC).
“Clinically, MBCs are more metastatic and chemoresistant than nonmetaplastic TNBC, with the spindle subtype reported to have the worst prognosis,” the researchers wrote. “This significant clinical challenge highlights the need to distinguish MBC tumors for diagnostic and precision treatment purposes.”
In order to explore this further, researchers used multiplex quantitative tandem mass tag-based proteomics and quantified 5798 proteins from 27 patients. Of these, 15 samples were from patients with MBC (6 spindle, 4 squamous, and 5 sarcomatoid subtypes); 6 were for nonmetaplastic TNBCs; and 6 were from normal adjacent breast tissues. (read 2 of 5 articles)
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04/07/2020 Quantitative proteomic landscape of metaplastic breast carcinoma pathological subtypes and their relationship to triple-negative tumors.
Abstract: Metaplastic breast carcinoma (MBC) is a highly aggressive form of triple-negative cancer (TNBC), defined by the presence of metaplastic components of spindle, squamous, or sarcomatoid histology. The protein profiles underpinning the pathological subtypes and metastatic behavior of MBC are unknown. Using multiplex quantitative tandem mass tag-based proteomics we quantify 5798 proteins in MBC, TNBC, and normal breast from 27 patients. Comparing MBC and TNBC protein profiles we show MBC-specific increases related to epithelial-to-mesenchymal transition and extracellular matrix, and reduced metabolic pathways. MBC subtypes exhibit distinct upregulated profiles, including translation and ribosomal events in spindle, inflammation- and apical junction-related proteins in squamous, and extracellular matrix proteins in sarcomatoid subtypes. Comparison of the proteomes of human spindle MBC with mouse spindle (CCN6 knockout) MBC tumors reveals a shared spindle-specific signature of 17 upregulated proteins involved in translation and 19 downregulated proteins with roles in cell metabolism. These data identify potential subtype specific MBC biomarkers and therapeutic targets.
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01/01/2020 Outcomes after Treatment of Metaplastic Versus Other Breast Cancer Subtypes
Purpose: Metaplastic breast cancer (BC) is an uncommon yet aggressive histologic subtype of BC. We sought to identify factors associated with its diagnosis and compare the management and outcomes of metaplastic BC with those of other BCs and triple negative invasive ductal carcinoma in particular given how often it has a triple negative phenotype.
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11/06/2019 Complete Response of Chemo-Refractory Metastatic Metaplastic Breast Cancer to Paclitaxel-Immunotherapy Combination
Case Study- Conclusion of note: This is the first report on a case of durvalumab and paclitaxel combination for the treatment of metastatic TNBC in general, and MPBC in specific. The limited therapeutic options available for MPBC support further clinical trials with chemo-immunotherapy for this type of highly refractory breast cancer.
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09/23/2019 The role of radiotherapy in metaplastic breast cancer: a propensity score-matched analysis of the SEER database
Background: Only few studies, with small patient cohorts, have evaluated the effect of radiotherapy (RT) for metaplastic breast cancer (MBC). Hence, it is important to investigate the role of RT in MBC survival using a large population-database.
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9/18/2019 Case Reports on Metaplastic Squamous Cell Carcinoma of the Breast and Treatment Dilemma
Abstract: Metaplastic squamous cell carcinoma of the breast is a very rare form of breast cancer that consists of both glandular and nonglandular components mixed with epithelial and mesenchymal tissues. Worldwide, the incidence of this tumor is between 0.1 and 2%. Because of the rarity of this tumor and heterogeneous behavior of the tumor cells, it is difficult to establish the standard therapeutic approach. We report 2 cases of metaplastic squamous cell carcinoma of the breast in young patients with different responses to treatment strategies. The first case is a premenopausal female with metaplastic squamous cell carcinoma treated with surgery, chemotherapy, and radiotherapy, and the second case is perimenopausal metaplastic squamous cell carcinoma with sarcomatoid subtype and osteoid matrix production which progressed on chemotherapy and was treated with surgery and radiation.
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9/5/2019 Pathway activity profiling of growth factor receptor network and stemness pathways differentiates metaplastic breast cancer histological subtypes
Background: Gene expression profiling of rare cancers has proven challenging due to limited access to patient materials and requirement of intact, non-degraded RNA for next-generation sequencing. We customized a gene expression panel compatible with degraded RNA from formalin-fixed, paraffin-embedded (FFPE) patient cancer samples and investigated its utility in pathway activity profiling in patients with metaplastic breast cancer (MpBC).
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5/22/2019 Metaplastic breast cancer has a poor response to neoadjuvant systemic therapy.
Objective: Metaplastic breast cancer (MetaBC) is a rare breast cancer subtype poorly responsive to systemic therapy in the metastatic setting with high recurrence rates in the adjuvant setting. However, limited data exist regarding response to neoadjuvant chemotherapy (NAC). We performed a single institutional study to assess the clinical and pathological complete response rates (pCR) of MetaBC to NAC.
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05/17/2019 A Molecular and Morphological Deep-Dive Into Metaplastic Breast Cancers
Abstract: Metaplastic breast cancers (MBC) are relatively rare but account for significant global breast cancer mortality. Typically presenting without oestrogen and progesterone receptors or HER2 expression, these triple negative breast cancers are the archetypal ‘stem cell-like’ tumours that show a variety of metaplastic elements, including squamous, spindle, and chondroid. Given the vast heterogeneity in MBC by definition, large cohort studies are needed to draw conclusions. Together with our consortium colleagues, a cohort of 347 MBC was established, and a detailed morphological assessment made in an effort to understand the clinical relevance of the current diagnostic guidelines. Biomarker expression was investigated, and whole exome sequencing was performed. Herein, we provide an overview and contextualisation of the study.
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04/2019 Metaplastic breast cancers: Genomic profiling, mutational burden and tumor-infiltrating lymphocytes
Abstract: Metaplastic breast cancer (MPBC) is a rare subtype that accounts for <1% of all breast cancers. Although these are typically “triple negative,” they are relatively chemotherapy-refractory compared to conventional triple negative invasive breast cancers with more aggressive features and an overall poor prognosis. MPBC is a heterogeneous group of tumors that are enriched for TP53 and PIK3CA mutations, and have been found to have high PD-L1 expression though the mechanisms underlying its immunogenicity remain unclear. We perform comprehensive genomic profiling in the largest MPBC dataset (n = 192) to date and assess for other potential biomarkers of immune response.
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03/29/2019 Metaplastic carcinoma of the breast: Prognosis and response to systemic treatment in metastatic disease
Background: Metaplastic breast carcinomas (MpBCs) are rare, aggressive breast cancers. Due to the scant literature of this disease most guidelines do not give recommendation for this entity. The aim of the study was to review the clinicopathologic features, treatment, and outcomes of the patients with MpBC treated at our institution.
Materials & Methods: We searched databases for patients with histologically confirmed MpBC from 2002 to 2016.
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01/08/2019 A Retrospective Study of the Imaging and Pathological Features of Metaplastic Breast Carcinoma and Review of the Literature
Background: Metaplastic breast cancer (MBC) is a rare type of breast cancer, characterized histologically by the presence of two or more malignant cell types (epithelial and mesenchymal). This retrospective study aimed to review the imaging and histological features of MBC, with a review of the literature.
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10/23/2018 Impact of clinical, morphologic and molecular characteristics on response to neoadjuvant systemic therapy (NAST) in metaplastic breast cancer (MpBC)
Background: MpBCs are morphologically heterogeneous, frequently triple-negative and resistant to chemotherapy. To better understand why MpBCs are resistant to chemotherapy, we investigated associations between response to NAST and clinical, morphologic, as well as molecular characteristics in a cohort of MpBC patients (pts).
Methods: 19 MpBC pts were identified from a prospective cohort of 242 triple-negative breast cancer (TNBC) pts treated with anthracycline-based NAST. Histologic subtype of MpBC was determined by light microscopy. TNBC subtypes were determined using the Vanderbilt gene expression signatures (GES). Residual cancer burden (RCB) was assessed after surgery.
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10/19/2018 Prognosis in different subtypes of metaplastic breast cancer: a population-based analysis.
Background: Metaplastic breast cancer (MpBC) is a rare histological subtype of breast cancer recognized as a unique pathologic entity in 2000. However, the pathogenesis, optimal therapy, and prognosis of MpBC and the potential effect of systemic treatments on different subtypes of MpBC are not well defined.
Methods: A retrospective population-based study was performed to identify breast cancer patients with MpBC and other triple-negative breast cancers (TNBC) between 2010 and 2014 using the surveillance, Epidemiology, and End Results (SEER) database.
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10/02/2018 Metaplastic Breast Cancer Presenting as a Breast Abscess
Abstract: Metaplastic breast cancer is a rare subtype of invasive breast cancer that tends to have an aggressive clinical presentation as well as a variety of distinct histologic designations. Few systemic treatment options are available for MBC, as it has consistently shown a suboptimal response to standard chemotherapy regimens. These characteristics result in a worse overall prognosis for patients with Metaplastic breast cancer compared to those with standard invasive breast cancer. Due to its rarity, data focusing on Metaplastic breast cancer is limited. This review will discuss the clinical presentation, breast imaging findings, histologic and molecular characteristics of MBC as well as potential future research directions.
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10/2018 Better diagnosis to improve breast cancer treatment
Breast cancer patients will soon have a better chance of fighting the disease thanks to new pathology guidelines created by University of Queensland researchers.
The guidelines allow pathologists to identify which patients have more aggressive forms of breast cancer, which means they can be classified appropriately and their treatment can be tailored.
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9/15/2018 Ccn6/Wisp3 Regulates the IGF2BP2/HMGA2 Signaling Axis in Metaplastic Carcinomas of the Breast
AbstractMetaplastic breast carcinomas (MBC) are an aggressive subtype of triple negative breast carcinomas (TNBC) in which part or all of the adenocarcinoma transforms into a non-glandular component (e.g. spindled, squamous, or sarcomatous). We discovered that mammary-specific Ccn6/Wisp3 knockout mice develop MBC with spindle and squamous differentiation that share upregulation of the oncofetal proteins IGF2BP2 (IMP2) and HMGA2 with human MBC. Here, we tested the expression of IGF2BP2 and HMGA2 proteins as biomarkers of MBC, and investigated their contribution to MBC.
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8/2018 Challenges in Managing Metaplastic Breast Cancer-Referencing an Indexed Case and a Ten-Year Experience in a Developing Country
Abstract: Metaplastic breast cancer is rare and aggressive, accounting for only 0.2% of all breast cancers with a survival ranging from 40-65%. A recent case from our institution posed many diagnostic and management challenges prompting a review of our local ten-year experience with this cancer and a review of the literature to compare the behaviour of this cancer in a developing country and considering guidelines for management.
To read more click HERE
8/2018 Comparative Effectiveness of an mTOR-Based Systemic Therapy Regimen in Advanced, Metaplastic and Nonmetaplastic Triple-Negative Breast Cancer.
Background: Triple-negative breast cancer (TNBC) is a heterogeneous disease with subtypes having different “targetable” molecular aberrations. Metaplastic breast cancers (MpBCs) are typically TNBCs and commonly have alterations in the PI3K/Akt/mTOR pathway. We previously reported efficacy for an mTOR-based chemotherapy regimen in MpBC. To determine if tumor subtype influences prognosis, we compared treatment outcomes of patients with MpBC with those of patients with nonmetaplastic TNBC receiving an mTOR-based systemic therapy regimen.
To read more click HERE
06/01/2018 Survival of metastatic metaplastic breast cancer patients receiving chemotherapy.
Background: Metaplastic breast cancer (MBC) is a rare, aggressive variant of breast cancer, usually triple negative disease and chemotherapy refractory. Despite this, the standard of care remains the same as invasive breast cancer. We sought to analyze outcomes of chemotherapy in patients with metastatic MBC.
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06/2018 Genomic profiling of metaplastic breast carcinomas reveals genetic heterogeneity and relationship to ductal carcinoma.
Excerpt of Abstract: Metaplastic breast carcinomas comprise a histologically heterogenous group of tumors. Although most are triple (estrogen/progesterone receptor, HER2) negative, these rare tumors are clinicopathologically distinct from other triple negative carcinomas and may be aggressive with worse chemotherapy responses. On the other hand, metaplastic carcinomas are histologically diverse, which is reflected in gene expression differences among subtypes. Whether metaplastic carcinomas are genetically distinct from other triple negative cancers and whether genetic differences underlie histologic subtypes remains poorly understood.
To read more click HERE
06/2018 Impact of metaplastic histology (MpBC) in triple-negative breast cancer (TNBC) patients (pts) receiving neoadjuvant systemic therapy (NAST).
Background: Abstract excerpt: MpBCs are aggressive cancers, often TNBC, and considered chemo-resistant, such that some providers avoid NAST. Using data from an IRB approved prospective trial, we compared characteristics and outcomes between MpBC and non-metaplastic (non-MpBC) TNBC pts receiving NAST.
To read more about this poster presentation at the 2018 ASCO Annual Meeting click here
To view the poster from the presentation click here
05/20/2018 Impact of metaplastic histology (MpBC) in triple-negative breast cancer (TNBC) patients (pts) receiving neoadjuvant systemic therapy (NAST).
Background: MpBCs are aggressive cancers, often TNBC, and considered chemo-resistant, such that some providers avoid NAST. Using data from an IRB approved prospective trial, we compared characteristics and outcomes between MpBC and non-metaplastic (non-MpBC) TNBC pts receiving NAST.
To read more click here
05/2018 Metaplastic Breast Cancer Masquerading as Liposarcoma of the Breast: A Case Report following Oncoplastic Treatment
Abstract: Mammary liposarcoma is among the rarest of breast tumours. Here we report the presentation, macroscopic, microscopic, and immunohistochemical features of an extremely rare case of metaplastic carcinoma with extensive pleomorphic liposarcomatous differentiation. A 47-year-old woman presented with bilateral grade III breast ptosis and a 3 × 4 cm mass in the lower outer quadrant of the left breast. Mammography and ultrasound confirmed a well-defined mass. A core biopsy performed was diagnosed as pleomorphic liposarcoma. Microscopically, this was a well-defined, lobulated tumour comprising solid sheets of large pleomorphic and spindle cells with bizarre forms, vacuolated cytoplasm, and ample mitoses. Atypical lipoblasts were easily identifiable. Due to the strong, though patchy, cytokeratin expression, the diagnosis of metaplastic carcinoma with pleomorphic liposarcomatous differentiation was made. Extensive sampling, careful search for a biphasic pattern, ductal carcinoma in situ, and/or epithelial differentiation, and a panel of broad-spectrum cytokeratins are essential to establish the diagnosis. here
04/2018 Metaplastic Breast Cancer: Practice Patterns, Outcomes, and the Role of Radiotherapy
Purpose: Metaplastic breast cancer (MBC) is a rare, aggressive form of breast cancer with limited data to guide management. This study of a large, contemporary US database described national practice patterns and addressed the impact of radiotherapy (RT) on survival.
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04/2018 Chemotherapy in metaplastic breast cancer; a single centre experience
Background: Less than 1% of all breast cancers are of the metaplastic subtype, which are often poorly responsive to chemotherapy. We observed one patient with a complete response to single agent carboplatin for biopsy-retrospective analysis to determine whether carboplatin should be further investigated in this subtype.
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4/2018 CDKN2A loss and PIK3CA mutation in myoepithelial‐like metaplastic breast cancer
Abstract excerpt: Metaplastic breast carcinoma comprises a heterogeneous group of tumours with poorly understood pathogenesis. A subset of metaplastic breast cancers show myoepithelial differentiation and constitute a morphological spectrum with ill‐defined borders from fibromatosis‐like spindle cell carcinoma to myoepithelial carcinoma. In a series of 34 metaplastic breast cancers with spindle cell and myoepithelial differentiation, we found recurrent genetic aberrations, which set them apart from other metaplastic breast cancers and suggest a unique pathogenesis.
To read this study in its entirety click here
4/2018 Clinical Next-Generation Sequencing for Precision Oncology in Rare Cancers
Background: The European Society for Medical Oncology defines rare cancers as 5 or fewer cases per 100,000 persons/year. For many rare cancers, no standard of care exists, and treatment is often extrapolated. Identifying potentially targetable genomic alterations is a rational approach to improving treatment options. We sought to catalog these mutations in rare tumors and assess their clinical utility.
To read this study in its entirety click here
4/2018 Metaplastic breast carcinoma composed of epithelial–myoepithelial carcinoma and squamous cell carcinoma
Rationale: Metaplastic breast carcinomas are a group of breast malignancies with varying histomorphological characteristics and prognoses. The tumor composed of epithelial -myoepithelial carcinoma and squamous cell carcinoma was not reported previously.
To read this study in its entirety click here
3/2018 Clinicopathological features of metaplastic breast carcinoma.
Background: Metaplastic carcinoma of the breast (MpBC) is defined as a group of heterogeneous malignant neoplasms that contain glandular and non-glandular components with mixed epithelial and mesenchymal differentiations.
To read this study in its entirety click here
3/2018 Rare case of metaplastic breast cancer in a man.
Abstract: Metaplastic breast cancer (MBC) in men is an extremely rare entity. MBC is typically very aggressive with a poor prognosis. In men, it has only been reported three times in the literature. We report a 47-year-old man who presented with right-sided breast erythema and nipple inversion. Mammogram revealed a 2.4 cm spiculated mass. Initial pathology was inconclusive; however, right-sided simple mastectomy showed invasive metaplastic carcinoma with adenosquamous histology. He received adjuvant chemotherapy with 4 cycles of dose dense Adriamycin and cyclophosphamide followed by 12 weeks of paclitaxel and chest wall radiation. Although oestrogen receptor status was 1%, tamoxifen was not given due to recent diagnosis of pulmonary embolism. Two years after treatment, he is currently living with no signs of recurrence. This case will serve as a useful addition to the current literature discussing successful diagnosis, treatment and prognosis of a man with MBC.
To read this study in its entirety click here
2/18/2018 Multimodality Imaging Findings of Metaplastic Breast Carcinomas
Abstract: Metaplastic carcinoma is a rare subtype of breast cancer that comprises histologically diverse malignancies. Metaplastic carcinoma tends to have an aggressive clinical presentation, high metastatic potential, and more chances of local recurrence, as compared with intraductal carcinoma. Although many clinical and pathologic finding have been reported, to our knowledge, there are few reports of imaging findings for this type of tumor.
In this study, we reviewed data of 5 patients with histopathologically proven metaplastic breast carcinoma. Multimodality imaging findings including those from mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography–computed tomography were recorded.
The results indicated that metaplastic carcinomas tend to show more benign imaging features such as round or oval shape with circumscribed margins and less axillary lymph node metastasis compared with invasive ductal carcinoma. High signal intensity on T2-weighted magnetic resonance imaging due to its cystic or necrotic component may be useful for diagnosis of metaplastic carcinoma.
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2/2018 Metaplastic breast cancers: Genomic profile, mutational burden and TILs
Background: Metaplastic breast cancers (MPBC) are rare, typically triple negative aggressive tumors composed of both, adenocarcinoma and metaplastic elements. Recent evidence that TNBC and MPBC can respond vigorously to immune checkpoint inhibitor therapy (Adams et al, ASCO 2017 and npj Breast Cancer 2017) has prompted the following comprehensive genomic profiling (CGP) and histopathologic assessment of tumor infiltrating lymphocytes (TIL) designed to uncover potential biomarkers of immunotherapy response for MPBC, including mutational burden, Microsatellite Instability (MSI) status and gene amplification of 9p21.4 (or CD274, which includes the PD-L1 locus).
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2/2018 Multimodality Imaging Findings of Metaplastic Breast Carcinomas
Metaplastic carcinoma is a rare subtype of breast cancer that comprises histologically diverse malignancies. Metaplastic carcinoma tends to have an aggressive clinical presentation, high metastatic potential, and more chances of local recurrence, as compared with intraductal carcinoma. Although many clinical and pathologic finding have been reported, to our knowledge, there are few reports of imaging findings for this type of tumor.
In this study, we reviewed data of 5 patients with histopathologically proven metaplastic breast carcinoma. Multimodality imaging findings including those from mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography–computed tomography were recorded.
The results indicated that metaplastic carcinomas tend to show more benign imaging features such as round or oval shape with circumscribed margins and less axillary lymph node metastasis compared with invasive ductal carcinoma. High signal intensity on T2-weighted magnetic resonance imaging due to its cystic or necrotic component may be useful for diagnosis of metaplastic carcinoma.
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01/12/2018 Early and Locally Advanced Metaplastic Breast Cancer: Presentation and Survival by Receptor Status in Surveillance, Epidemiology, and End Results (SEER) 2010–2014
Background: Metaplastic breast cancer (MBC) is a rare disease subtype characterized by an aggressive clinical course. MBC is commonly triple negative (TN), although hormone receptor (HR) positive and human epidermal growth receptor 2 (HER2) positive cases do occur. Previous studies have reported similar outcomes for MBC with regard to HR status. Less is known about outcomes for HER2 positive MBC.
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12/13/2017 Natural history of metaplastic squamous cell breast cancer: a case report and literature review on surgical management
Abstract: Metaplastic squamous cell breast cancer is an extremely rare subtype, accounting for less than 1% of all invasive breast cancers. As a result, there is sparse data in literature relating to its presentation and management. We report the first known case of metaplastic squamous cell breast cancer which was detected on screening mammogram and followed up as the patient delayed her treatment. This case highlights the aggressive natural behaviour of this subtype and importance of early treatment. The surgical management of this rare entity was reviewed.
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11/7/2017 MMTV-cre;Ccn6 knockout mice develop tumors recapitulating human metaplastic breast carcinomas
AbstractMetaplastic breast carcinoma is an aggressive form of invasive breast cancer with histological evidence of epithelial to mesenchymal transition (EMT). However, the defining molecular events are unknown. Here we show that CCN6 (WISP3), a secreted matricellular protein of the CCN (CYR61/CTGF/NOV) family, is significantly down regulated in clinical samples of human spindle cell metaplastic breast carcinoma. We generated a mouse model of mammary epithelial-specific Ccn6 deletion by developing a floxed Ccn6 mouse which was bred with an MMTV-Cre mouse. Ccn6fl/fl; MMTV-Cre mice displayed severe defects in ductal branching and abnormal age-related involution compared to littermate controls. Ccn6fl/fl ;MMTV-Cre mice developed invasive high grade mammary carcinomas with bona fide EMT, histologically similar to human metaplastic breast carcinomas. Global gene expression profiling of Ccn6fl/fl mammary carcinomas and comparison of orthologous genes with a human metaplastic carcinoma signature revealed a significant overlap of 87 genes (p=5×10−11). Among the shared deregulated genes between mouse and human are important regulators of epithelial morphogenesis including Cdh1, Ck19, Cldn3 and 4, Ddr1, and Wnt10a. These results document a causal role for Ccn6 deletion in the pathogenesis of metaplastic carcinomas with histological and molecular similarities with human disease. We provide a platform to study new targets in the diagnosis and treatment of human metaplastic carcinomas, and a new disease relevant model in which to test new treatment strategies.
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10/2017 The Importance of Treatment and Timing in Metaplastic Breast Cancer
Purpose: Metaplastic breast cancer (MBC) is a rare variant of breast cancer with high rates of locoregional recurrence and limited data available regarding patterns of care and treatment outcomes. We queried the National Cancer Data Base (NCDB) to examine the impact of clinical and treatment factors on overall survival (OS) in patients with metaplastic breast cancer.
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9/2017 Metaplastic breast carcinoma: Analysis of 31 cases from a single institute
Purpose: Metaplastic carcinoma of the breast (MBC) accounts for less than 1% of all mammary tumors. This study aimed at revision of the clinico-pathological features, treatment strategy and outcome for MBC patients presented to the Kuwait Cancer Control Center to define the clinical behavior and prognostic factors of these neoplasms in our population.
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8/2017 Metaplastic Carcinoma Breast: A Clinical Analysis of Nine Cases
Abstract: Metaplastic Breast Carcinoma (MBC) is a rare heterogeneous group of primary breast malignancies with different subgroups; exhibits a variety of histopathologic patterns and appears to be both epithelial and mesenchymal in origin. The ideal treatment for MBC remains unknown, due to its low incidence and pathological variability. Owing to its rarity, MBC has been treated as a variant of Invasive Duct Carcinoma (IDC). But it has poorer prognosis as compared to IDC. This is a case series to evaluate clinicopathologic characteristics and the multi-disciplinary treatment of nine MBC patients treated in a single institute.
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7/31/2017 Clinicopathologic features of invasive metaplastic and micropapillary breast carcinoma: comparison with invasive ductal carcinoma of breast
Objectives: The aim of this study was to determine the frequency of metaplastic breast carcinoma and invasive micropapillary carcinoma in our population and also to compare the clinico-pathologic features of metaplastic breast carcinoma and invasive micropapillary carcinoma with invasive ductal carcinoma, not otherwise specified (IDC, NOS).
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7/2017 The Landscape of Somatic Genetic Alterations in Metaplastic Breast Carcinomas
Background : Metaplastic breast cancer is one of the most therapeutically challenging forms of breast cancer because of its highly heterogeneous and chemoresistant nature. We have previously demonstrated that ribosomal protein L39 (RPL39) and its gain-of-function mutation A14V have oncogenic activity in triple-negative breast cancer and this activity may be mediated through inducible nitric oxide synthase (iNOS). The function of RPL39 and A14V in other breast cancer subtypes is currently unknown. The objective of this study was to determine the role and mechanism of action of RPL39 in metaplastic breast cancer.
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6/2017 Role of RPL39 in Metaplastic Breast Cancer
Purpose: Metaplastic breast carcinoma (MBC) is a rare and aggressive histologic type of breast cancer, predominantly of triple-negative phenotype, and characterized by the presence of malignant cells showing squamous and/or mesenchymal differentiation. We sought to define the repertoire of somatic genetic alterations and the mutational signatures of MBCs.
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5/2017 The epidemiology of metaplastic breast cancer: A review of 2,500 cases from the national cancer database.
Background: Metaplastic breast cancer (MBC) is a rare, aggressive, sarcomatoid breast cancer that was first described in 1973 but only became recognized as a histologically distinct entity in 2000. Given the paucity of data on the epidemiology of MBC, we performed a population-based analysis to delineate sociodemographic and clinicopathological characteristics associated with increased likelihood of MBC diagnosis.
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5/2017 Metaplastic breast carcinoma with chondroid differentiation: a rare variant of infiltrative carcinoma in a 38-year-old woman (Case Report)
Summary: Metaplastic breast carcinoma (MBC) is a rare type of invasive breast carcinoma, and chondroid differentiation is even rarer. Here we report a case of MBC with extensive chondroid differentiation in a 38-year-old woman who presented with a lump in her left breast. Ultrasound findings were most compatible with those of giant fibroadenoma. A histopathological examination revealed a malignant lesion comprising neoplastic epithelial cells arranged in solid nests, with large areas of chondroid differentiation. Neoplastic chondroid cells exhibited a positive reaction for S-100, patchy positive reaction for pan-cytokeratin (AE1/AE3) and negative reaction for epithelial membrane antigen. Both carcinomatous and chondroid cells exhibited p53 overexpression. Sentinel lymph node biopsy revealed no tumorous involvement.
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04/26/2017 Metaplastic Carcinoma of the Breast is More Aggressive than Triple-Negative Breast Cancer: A study from a Single Institution and Review of Literature
Abstract: We aimed to describe our experience with metaplastic breast carcinoma (MBC), evaluate its clinical outcome compared with triple negative breast cancer (TNBC), and provide a through and comprehensive review of the literature to date.
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4/17/2017 Whole exome sequencing of metaplastic breast carcinoma indicates monoclonality with associated ductal carcinoma component
Purpose: Although most human cancers display a single histology, there are unusual cases where two or more distinct tissue types present within a primary tumor. One such example is metaplastic breast carcinoma, a rare but aggressive cancer with a heterogenous histology, including squamous, chondroid, and spindle cells. Metaplastic carcinomas often contain an admixed conventional ductal invasive or in situ mammary carcinoma component, and are typically triple-negative for estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER-2) amplification/overexpression. An unanswered question is the origin of metaplastic breast cancers. While they may arise independently from their ductal components, their close juxtaposition favors a model that postulates a shared origin, either as two derivatives from the same primary cancer, or one histology as an outgrowth of the other. Understanding the mechanism of development of these tumors may inform clinical decisions.
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4/2017 Targeting the PI3K/AKT/mTOR Pathway for the Treatment of Mesenchymal Triple-Negative Breast Cancer: Evidence From a Phase 1 Trial of mTOR Inhibition in Combination With Liposomal Doxorubicin and Bevacizumab.
Abstract Importance: Triple-negative breast cancer (TNBC) classified by transcriptional profiling as the mesenchymal subtype frequently harbors aberrations in the phosphoinositide 3-kinase (PI3K) pathway, raising the possibility of targeting this pathway to enhance chemotherapy response. Up to 30% of mesenchymal TNBC can be classified histologically as metaplastic breast cancer, a chemorefractory group of tumors with a mixture of epithelial and mesenchymal components identifiable by light microscopy. While assays to identify mesenchymal TNBC are under development, metaplastic breast cancer serves as a clinically identifiable surrogate to evaluate potential regimens for mesenchymal TNBC.
To read this study in its entirety click here.
02/2017 Carcinosarcoma of the Breast: An Aggressive Subtype of Metaplastic Cancer. Report of a Rare Case in a Young BRCA-1 Mutated Woman
Introduction: According to literature, the majority of BRCA-1 associated breast cancers are triple-negative and display a basal-like (BL) phenotype. Metaplastic breast cancers (MBCs) are part of the spectrum of BL and among them, breast carcinosarcoma (BCS) is a rare, aggressive subtype.
We report a case of BCS in a 35-year-old female who was subsequently found to be BRCA-1 mutated. To the best of our knowledge, this is one of the few carcinosarcomas reported in a woman with the BRCA mutation. We also present a review of the literature.
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2/2017 Metaplastic Breast Cancer: Molecular Typing and Identification of Potential Targeted Therapies at a Single Institution
Background: Metaplastic breast carcinoma (MBC) is a rare and aggressive histologic subtype of breast cancer comprising approximately 0.5% to 5.0% of all invasive breast cancers with a poor prognosis and limited therapeutic options. We investigated MBC at our institution to evaluate outcomes and investigate the molecular profile of our cohort to determine the presence of mutations for which there are targeted therapies.
To read this study in its entirety click here.
12/2016 Metaplastic carcinoma of the breast: A case series and review of the literature
Purpose: Metaplastic breast carcinoma (MBC) is a rare aggressive type of breast cancer, which accounts
for less than 1% of breast tumors. Since its recognition as a distinct pathological entity in 2000, number of
MBC patients has been increasing over years. We aimed to report a series of 7 cases of MBC treated in our
clinicsTo read this study in its entirety click here.
6/2016 Management and Outcomes in Metaplastic Breast Cancer.
Background: Metaplastic breast cancer (MBC) constitutes a rare clinical entity with special clinicopathologic, immunohistochemical, and molecular features. Resistance to systemic therapies, whether chemotherapy or hormonal therapy, is among its main characteristics, which in turn explains the poor prognosis and renders its management a challenge. Thus, the scope of the present review is to discuss the current therapeutic strategies for MBC in clinical practice and the corresponding outcomes and to suggest possible directions for future research. Potential novel targeted therapies could provide a hope for better outcomes but limited data are available owing to the rarity of MBC. As knowledge accumulates on the pathogenesis and genetic characteristics of MBC, emphasis should be given to the implementation of more targeted treatments, which will allow more efficient and individualized management of the disease.
To read this study in its entirety click here.
12/2015 Comprehensive Profiling of Metaplastic Breast Carcinoma Reveals Frequent Over-Expression of PD-L1
Background : Metaplastic breast carcinoma (MBC) is a rare subtype of breast carcinoma less responsive to conventional chemotherapy relative to usual breast carcinomas such as ductal and lobular subtype. In molecular terms, MBC usually clusters with triple negative breast cancers (TNBC), but MBCs portray a worse prognosis in comparison with TNBC. Published studies investigating MBCs for specific biomarkers of therapy response are rare and limited by the methodological approaches.
12/2015 Metaplastic Breast Carcinoma Versus Triple-Negative Breast Cancer
Abstract: Metaplastic breast carcinoma (MBC) differs from classic invasive ductal carcinomas regarding incidence, pathogenesis, and prognosis. The purpose of this study was to compare patients with MBC with clinicopathologic and treatment-matched patients with triple-negative breast carcinoma (TNBC) in terms of response to treatment, progression, and survival.
To read this study in its entirety click here.
9/2015 Comparing 126 TNBC MpBC tumors at Caris Life Sciences
Researcher Rebecca Feldman discusses a research project done in 2014 for Caris Life Sciences. 126 Metaplastic tumors that were profiled at Caris were analyzed for similarities and potential drug targets.
7/2015 Inhibition of the phosphoinositide 3-kinase pathway for the treatment of patients with metastatic metaplastic breast cancer.
Background: Mesenchymal/metaplastic breast cancers (MpBCs) are often triple-negative (TNBC), and chemo-refractory, and can harbor phosphoinositide 3-kinase (PI3kinase) alterations; thus, therapy with mTor inhibitors may demonstrate activity.
To read this study in its entirety click here.
06/2015 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.
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2/2015 Metaplastic Breast Cancer: Clinical Overview and Molecular Aberrations for Potential Targeted Therapy
Abstract: Metaplastic breast cancer is a rare subtype of invasive mammary carcinoma, with an aggressive behavior and usually poor outcome. Responses to systemic chemotherapy are suboptimal compared to patients with standard invasive ductal carcinoma. Limited data are available in regards to best treatment modalities, including chemotherapy. This review gives an overview of metaplastic breast cancer and its clinical and pathologic characteristics, in addition to treatment strategies, clinical trials, and future directions.
To read this study in its entirety click here.
10/2014 Carcinosarcoma Masquerading as Giant Cystic Hematomasurekha
Abstract: Carcinoarcoma of breast is rare tumor with aggressive behaviour and poor prognosis. Histologically it is biphasic tumor with epithelial and mesenchymal component. Very few cases of carcinosarcoma, its presentation and behaviour have been reported in the literature, and due to its bizarre behaviour it is a diagnostic challenge to pathologist and clinicians. Here we present a rare case of carcinosarcoma breast in a 55-year-old female who initially presented with cystic mass( lump) in right breast which was reported as organised hematoma on FNAC, on frozen divtion it was diagnosed as malignant cystic tumour. This was followed by mastectomy. Histopathology with immune markers, the case was diagnosed as metaplastic carcinoma with biphasic type called carcinosarcoma. The case merits presentation because of its rare presentation as cystic lesion and difficult to diagnose mainly due to sarcomatous elements. An accurate diagnosis of this aggressive tumour is essential in order to optimally tailor adjuvant therapy.
To read this study in its entirety click here.
9/2014 Metaplastic Breast Cancer: Pathological Subtypes, Clinical Presentation, Imaging Characteristics, Immunohistochemistry, Treatment and Prognosis.
Abstract: Metaplastic breast cancer is a rare subtype of breast cancer that is histologically heterogeneous, being composed of both sarcomatous and epithelial components. It presents as rapidly growing palpable masses. Incidence of nodal metastasis is low, as compared to intraductal carcinoma, but it has a high metastatic potential and more chances of local recurrence. Many different pathological classifications are available, the most popular being “Wargotz and Norris classification”. Imaging features mimic those of intraductal carcinoma. Immunohistochemically, these tumors show a basal/myoepithelial phenotype with positivity for cytokeratins, AE1/AE3, smooth muscle actin, p63, alpha B-crystallin, etc. These tumors show no or very low positivity for hormone receptors or HER-2 over expression. Therefore, they are often called triple negative carcinomas. They are aggressive tumors with suboptimal response to standard chemotherapy regimens. Overall prognosis of the patients with metaplastic breast cancer is worse than the patients with intraductal breast carcinoma. Further research is needed for formulating targeted therapies for this aggressive tumor.
To read this study in its entirety click here.
11/2013 Metaplastic breast cancer: histologic characteristics, prognostic factors and systemic treatment strategies
Abstract: Metaplastic breast cancer (MBC) is a rare subtype of invasive breast cancer that tends to have an aggressive clinical presentation as well as a variety of distinct histologic designations. Few systemic treatment options are available for MBC, as it has consistently shown a suboptimal response to standard chemotherapy regimens. These characteristics result in a worse overall prognosis for patients with MBC compared to those with standard invasive breast cancer. Due to its rarity, data focusing on MBC is limited. This review will discuss the clinical presentation, breast imaging findings, histologic and molecular characteristics of MBC as well as potential future research directions.
To read this study in its entirety click here.
5/2013 Triple-Negative Phenotype of Poorly-differentiated Metaplastic Breast Carcinoma in a Male: An Oncological Rarity
Abstract: Metaplastic breast carcinoma (MBC) is an extremely rare breast malignancy having highly aggressive clinicopathological behaviour and dismal prognosis. A 75 years old man presented with a painless lump on right side of his chest along with two additional lumps in the ipsilateral axillary and inguinal areas. Microscopic evaluation and immunohistochemistry of trucut tissue biopsies of the lumps and that of mastectomy specimen revealed a triple-negative phenotype of poorlydifferentiated metaplastic breast carcinoma with metastatic deposits to the axillary and inguinal lymph nodes. Exhaustive internet research has revealed only a few case reports of MBC in the men; thus highlighting its absolute oncological rarity.
To read this study in its entirety click here.
4/2013 Metaplastic Breast Carcinoma in the Lungs: A Case Report
Abstract: Metaplastic carcinoma of the breast is a rare, aggressive form of cancer occurring in less than 1% of all breast cancers. Spindle cell carcinoma is a rare variant of the metaplastic carcinoma seen in less than 10% of such cases. The prognosis of spindle cell breast cancers is poor, hence aggressive treatment with surgery, chemotherapy and/or radiation is required. Here we report a case of a 62-year-old female with metastatic metaplastic breast cancer to the lungs.
To read this study in its entirety click here.
6/2012 Treatment Options for Metaplastic Breast Cancer
Abstract: Metaplastic breast cancer (MBC) is a malignancy characterized by the histologic presence of two or more cellular types, commonly a mixture of epithelial and mesenchymal components. MBC is rare relative to invasive ductal carcinoma (IDC), representing less than 1% of all breast cancers. Other than a lower rate of lymph node metastases, MBC tumors display poorer prognostic features relative to IDC. Due to its low incidence and pathological variability, the ideal treatment paradigm for MBC is unknown. Because of its rarity, MBC has been treated as a variant of IDC. Despite similar treatment regimens, however, patients with MBC have worse outcomes. Recent research is focused on biological differences between MBC and IDC and potential novel targets for chemotherapeutic agents. This paper serves as a summation of current literature on approaches to the multidisciplinary treatment of patients with MBC.
To read this study in its entirety click here.
11/2011 A Phase I Trial of Liposomal Doxorubicin, Bevacizumab and Temsirolimus in Patients with Advanced Gynecologic and Breast Malignancies
Purpose: Liposomal doxorubicin (D) and bevacizumab (A) are active single agents in gynecologic and breast malignancies which share a resistance mechanism: up-regulation of hypoxia inducible factor (HIF-1α). We therefore added temsirolimus (T), which inhibits HIF-1α, to D and A (DAT). Trial objectives were assessment of safety, preliminary efficacy and identification of biologic response correlates.
To read this study in its entirety click here.
7/2011 Responses to Liposomal Doxorubicin, Bevacizumab, and Temsirolimus in Metaplastic Carcinoma of the Breast: Biologic Rationale and Implications for Stem-Cell Research in Breast Cancer
Summary: MpBCs seem to represent a subset of tumors enriched in epithelial to mesenchymal transition and cancer stem-cell (CSC) characteristics, which may account for their resistance to therapy and propensity to metastasize.9 Like tumors that arise from CSCs, MpBCs display high activation of phosphoinositide 3-kinase (PI3K) pathway components and commonly carry mutations in PI3K or loss of phosphatase and tensin homolog (PTEN).9 MpBCs also show strong correlation with a CSC-derived genomic profile that is heavily weighted for PI3K activity.9,15 Like CSC-derived tumors, most MpBCs also display high levels of angiogenesis and commonly express VEGF and HIF-1α.16–18 On the basis of these features, we treated five patients with metastatic MpBC on a phase I clinical trial of liposomal doxorubicin, bevacizumab, and temsirolimus (DAT).
To read this study in its entirety click here.
Spring/2011 Triplet Targeting mTOR and Angiogenesis Sends Aggressive Metaplastic Breast Cancer into Complete Remission
Excerpt: Laurie Dragon had to make a second home in Houston for eight months when her oncologist in Georgia discovered that her rare form of breast cancer—a high-grade, triple negative, metastatic, sarcomatous type of metaplastic breast cancer—had returned after 15 months in remission. But she looks forward to her semi-annual return visits to MD Anderson’s
Clinical Center for Targeted Therapy (CCTT) now that she has had a lasting complete response to a Phase I clinical trial of the triple drug combination DAT.To read this article in its entirety click here. (page3)
12/2007 Imaging Differences in Metaplastic and Invasive Ductal Carcinomas of the Breast
Objective. The purpose of this study was to compare the imaging features of metaplastic breast carcinoma with those of invasive ductal carcinoma.
Materials and Methods. Women diagnosed on preoperative mammography or sonography with metaplastic breast carcinoma and T-stage matched invasive ductal carcinoma of the breast from a single pathology database were included in the study. Clinical and pathologic information on all metaplastic cancers was documented. Mammography and sonography variables were recorded using the BI-RADS lexicon. Groups were compared using Fisher’s exact test, the chi-square test, or Wilcoxon’s rank sum test, as appropriate.To read this study in its entirety click here.
2/2006 Biphasic metaplastic sarcomatoid carcinoma of the breast
Background: Breast biphasic metaplastic sarcomatoid carcinoma (MSC) is rare and aggressive. We analyzed 100 patients treated at M. D. Anderson Cancer Center (MDACC) with 213 MSC and 98 carcinosarcoma patients identified through the Surveillance, Epidemiology and End-Results (SEER) database to describe clinical and pathologic characteristics.
To read this study in its entirety click here.