CLINICOPATHOLOGIC FEATURES OF METAPLASTIC BREAST CARCINOMA: EXPERIENCE FROM A TERTIARY CANCER CENTER OF NORTH INDIA.

Keywords: Modified radical mastectomy, squamous cell carcinoma, hormone receptors, breast cancer, triple negative breast carcinoma.

Introduction: Metaplastic breast cancer (MBC) is a rare malignancy that accounts for < 1% of all breast cancers. The aim of this study is to evaluate the clinicopathologic characteristics of MBC patients treated at a tertiary cancer center [1,2].

Materials and methods: In this study, the authors retrospectively analyzed the prospectively maintained data of MBC patients treated at a tertiary cancer care center in North India between a period of 3 years.

Results: A total of 28 MBCs were identified. The median age of presentation was 47 years (range 27-81 years). Seventeen patients (60.7%) presented with clinical T3/T4 disease, and axillary nodal involvement was detected in 11 patients (39.3%) at presentation. Two patients had metastatic disease at presentation. A preoperative diagnosis of MBC on core biopsy was attained in five patients (17.9%), and the most common histologic subtype was sarcomatoid carcinoma. Triple-negative receptor status was observed in 15 patients (53.6%). Six patients (21.4%) underwent upfront breast conservation surgery and another six (21.4%) upfront mastectomy. Thirteen patients (46.4%) underwent mastectomy following neoadjuvant therapy. Definitive axillary nodal metastasis was found in eight patients (32%). Following neoadjuvant chemotherapy, five patients (35.7%) had stable disease, disease progression was evident in five patients (35.7%), partial response in four patients (28.6%), and no patient evinced complete response. Adjuvant postoperative radiation therapy was administered in 16 patients (57.1%). At a median follow-up of 13.2 months (range 4-26 months), 16 patients (57.1%) were alive with no evidence of disease, one patient (3.6%) was alive with disease, nine patients (32.1%) died of disease, and two patients (7.2%) died of other causes. One patient suffered from locoregional recurrence and nine patients developed distant metastasis.

Conclusion: MBC is an infrequent entity among breast carcinomas in India, which is similar to the reports of MBC worldwide. The diagnosis of MBC is difficult and requires the use of immunohistochemistry. Most of the cases in our study presented with a larger tumor size; however, they displayed a relatively lower incidence of nodal involvement as well as hormone receptor negativity. Being a rare and heterogeneous disease, large-scale studies are essential for better understanding and management of these tumors.

1. Pezzi CM, Patel-Parekh L, Cole K, Franko J, Klimberg VS, Bland K: Characteristics and treatment of metaplastic breast cancer: analysis of 892 cases from the National Cancer Data Base. Ann Surg Oncol. 2007, 14:166-73.
2. Hasdemir OA, Tokgöz S, Köybaşıoğlu F, Karabacak H, Yücesoy C, İmamoğlu Gİ: Clinicopathological features of metaplastic breast carcinoma. Adv Clin Exp Med. 2018, 27:509-13.

Biography: I, Dr. Silky Rai have completed my M.D. from Era Medical college, Lucknow, U.P. India. I am working as senior resident in the Department of Oncopathology at Mahamana Pandit Madan Mohan Malviya Cancer Centre & Homi Bhabha Cancer Hospital (Tata Memorial Hospital), Varanasi, India. I have around 10 publications in different journals.

Presenting author details :
Full Name: Dr. Silky Rai
Category: Oral Paper Presentation
Track name: 4-Breast Pathology
Research interest: Oncopathology, Surgical Pathology, Breast Pathology, Digital Pathology

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