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Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Clinicopathological and Imaging Features Predictive of Clinical Outcome in Metaplastic Breast Cancer

Author(s): Ga Young Yoon, Joo Hee Cha*, Hak Hee Kim, Hee Jung Shin, Eun Young Chae, Woo Jung Choi and Ha-Yeun Oh

Volume 16 , Issue 6 , 2020

Page: [729 - 738] Pages: 10

DOI: 10.2174/1573405615666190219105810

Price: $65


Background: Metaplastic breast cancer (MC) is a rare disease, thus it is difficult to study its clinical outcomes.

Objectives: To investigate whether any clinicopathological or imaging features were associated with clinical outcome in MC.

Methods: We retrospectively evaluated the clinicopathological and imaging findings, and the clinical outcomes of seventy-two pathologically confirmed MCs. We then compared these parameters between triple-negative (TNMC) and non-TNMCs (NTNMC).

Results: Oval or round shape, and not-circumscribed margin were the most common findings on mammography, ultrasound (US), and magnetic resonance imaging (MRI). It was mostly a mass without calcification on mammography, and revealed complex or hypoechoic echotexture, and posterior acoustic enhancement on US, and rim enhancement, wash-out kinetics, peritumoral edema, and intratumoral necrosis on MRI. Of all 72, 64 were TNMCs, and eight were NTNMCs. Clinicopathological and imaging findings were similar between the two groups, except that MRI showed peritumoral edema more frequently in TNMCs than NTNMCs (p=0.045). There were 21 recurrences and 13 deaths. Multivariable analysis showed that larger tumor size and co-existing DCIS were significantly predictive of Disease free survival (DFS), and larger tumor size and neoadjuvant chemotherapy were significantly predictive of overall survival (OS).

Conclusion: MC showed characteristic imaging findings, and some variables associated with survival outcome may help to predict prognosis.

Keywords: Breast neoplasms, triple-negative breast cancer, mammography, ultrasonography, magnetic resonance imaging, survival analysis.

Graphical Abstract
Tavassoli FA. Classification of metaplastic carcinomas of the breast. Pathol Annu 1992; 27(Pt 2): 89-119.
[PMID: 1584629]
Esbah O, Turkoz FP, Turker I, et al. Metaplastic breast carcinoma: case series and review of the literature. Asian Pac J Cancer Prev 2012; 13(9): 4645-9.
[] [PMID: 23167395]
Song Y, Liu X, Zhang G, et al. Unique clinicopathological features of metaplastic breast carcinoma compared with invasive ductal carcinoma and poor prognostic indicators. World J Surg Oncol 2013; 11: 129.
[] [PMID: 23738706]
Choi BB, Shu KS. Metaplastic carcinoma of the breast: multimodality imaging and histopathologic assessment. Acta Radiol 2012; 53(1): 5-11.
[] [PMID: 22090465]
Gutman H, Pollock RE, Janjan NA, Johnston DA. Biologic distinctions and therapeutic implications of sarcomatoid metaplasia of epithelial carcinoma of the breast. J Am Coll Surg 1995; 180(2): 193-9.
[PMID: 7850054]
Lim KH, Oh DY, Chie EK, et al. Metaplastic breast carcinoma: clinicopathologic features and prognostic value of triple negativity. Jpn J Clin Oncol 2010; 40(2): 112-8.
[] [PMID: 19887523]
Rakha EA, Tan PH, Varga Z, et al. Prognostic factors in metaplastic carcinoma of the breast: a multi-institutional study. Br J Cancer 2015; 112(2): 283-9.
[] [PMID: 25422911]
Hudis CA, Barlow WE, Costantino JP, et al. Proposal for standardized definitions for efficacy end points in adjuvant breast cancer trials: the STEEP system. J Clin Oncol 2007; 25(15): 2127-32.
[] [PMID: 17513820]
BI-RADS Committee ACR BI-RADS® Atlas, Breast imaging reporting and data system. 5th ed. Reston, VA: American College of Radiology 2013.
Reis-Filho JS, Lakhani SR, Gobbi H, Sneige N. Metaplastic carcinoma.Lakhani SR, International Agency for Research on Cancer, Organització Mundial de la Salut.In: WHO Classification of Tumours of the Breast. 4th ed. Lyon: IARC press 2012.
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(1): 166-73.
[] [PMID: 17066230]
Lee H, Jung SY, Ro JY, et al. Metaplastic breast cancer: clinicopathological features and its prognosis. J Clin Pathol 2012; 65(5): 441-6.
[] [PMID: 22412048]
Günhan-Bilgen I, Memiş A, Ustün EE, Zekioglu O, Ozdemir N. Metaplastic carcinoma of the breast: clinical, mammographic, and sonographic findings with histopathologic correlation. AJR Am J Roentgenol 2002; 178(6): 1421-5.
[] [PMID: 12034610]
Luini A, Aguilar M, Gatti G, et al. Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat 2007; 101(3): 349-53.
[] [PMID: 17009109]
Bian T, Lin Q, Wu Z, et al. Metaplastic carcinoma of the breast: Imaging and pathological features. Oncol Lett 2016; 12(5): 3975-80.
[] [PMID: 27895758]
Oberman HA. Metaplastic carcinoma of the breast. A clinicopathologic study of 29 patients. Am J Surg Pathol 1987; 11(12): 918-29.
[] [PMID: 2825549]
Yang WT, Hennessy B, Broglio K, et al. Imaging differences in metaplastic and invasive ductal carcinomas of the breast. AJR Am J Roentgenol 2007; 189(6): 1288-93.
[] [PMID: 18029860]
Shin HJ, Kim HH, Kim SM, et al. Imaging features of metaplastic carcinoma with chondroid differentiation of the breast. AJR Am J Roentgenol 2007; 188(3): 691-6.
[] [PMID: 17312055]
Park JM, Han BK, Moon WK, Choe YH, Ahn SH, Gong G. Metaplastic carcinoma of the breast: mammographic and sonographic findings. J Clin Ultrasound 2000; 28(4): 179-86.
[<179:AID-JCU5>3.0.CO;2-Y] [PMID: 10751739]
Velasco M, Santamaría G, Ganau S, et al. MRI of metaplastic carcinoma of the breast. AJR Am J Roentgenol 2005; 184(4): 1274-8.
[] [PMID: 15788609]
Bae MS, Shin SU, Ryu HS, et al. Pretreatment MR imaging features of triple-negative breast cancer: association with response to neoadjuvant chemotherapy and recurrence-free survival. Radiology 2016; 281(2): 392-400.
[] [PMID: 27195438]
de Ruijter TC, Veeck J, de Hoon JP, van Engeland M, Tjan-Heijnen VC. Characteristics of triple-negative breast cancer. J Cancer Res Clin Oncol 2011; 137(2): 183-92.
[] [PMID: 21069385]
Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 2007; 13(15 Pt 1): 4429-34.
[] [PMID: 17671126]
Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer 1989; 63(1): 181-7.
[<181::AID-CNCR2820630129>3.0.CO;2-H] [PMID: 2910416]
Alrahbi S, Chan PM, Ho BC, Seah MD, Chen JJ, Tan EY. Extent of margin involvement, lymphovascular invasion, and extensive intraductal component predict for residual disease after wide local excision for breast cancer. Clin Breast Cancer 2015; 15(3): 219-26.
[] [PMID: 25576998]

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