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The Breast Journal 2022Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological... (Review)
Review
Differences of Clinicopathological Features between Metaplastic Breast Carcinoma and Nonspecific Invasive Breast Carcinoma and Prognostic Profile of Metaplastic Breast Carcinoma.
INTRODUCTION
Metaplastic breast carcinoma is a rare special type of breast cancer, which has distinguished clinical characteristics. We aimed to evaluate the clinicopathological features of metaplastic breast carcinoma compared with nonspecific invasive breast carcinoma and study the prognosis of metaplastic breast carcinoma.
METHODS
We reviewed metaplastic breast carcinoma cases ( = 37) from January 2000 to December 2021 and nonspecific invasive breast carcinoma cases ( = 433) from January 2019 to December 2020 extracted from our institution retrospectively. The following variables were recorded, including the patients' general information, complications, T stage, expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, Ki-67, molecular subtyping, lymph node status, skin or chest wall involvement, vessel carcinoma embolus, therapy modality (surgical treatments, chemotherapy, and radiotherapy), and survival.
RESULTS
Patients with metaplastic breast carcinoma had more advanced disease than patients with nonspecific invasive breast carcinoma (T stage: =0.0011). A greater proportion of metaplastic breast carcinoma presented with triple-negative breast cancer than nonspecific invasive breast carcinoma (79.41% vs. 12.47%, ≤ 0.001). Our study showed that the skin or chest wall invasion was more frequent in metaplastic breast carcinoma patients (11.76% vs. 1.62%, =0.005). The 5-year survival rate for metaplastic breast carcinoma patients was 57.66% (95% CI: 0.3195∼0.7667). No local recurrence was observed while distant metastasis occurred in 33.33% of patients with metaplastic breast carcinoma. Death due to disease occurred in 24.24% of patients with metaplastic breast carcinoma.
CONCLUSION
The majority of metaplastic breast carcinoma patients had more advanced disease and triple-negative disease than nonspecific invasive breast carcinoma patients. Also, metaplastic breast carcinoma patients had frequent skin or chest wall invasion and a high rate of distant metastasis and mortality.
Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Ductal, Breast; Female; Humans; Metaplasia; Prognosis; Receptor, ErbB-2; Retrospective Studies; Triple Negative Breast Neoplasms
PubMed: 36051469
DOI: 10.1155/2022/2500594 -
Case Reports in Oncology 2023Metaplastic breast cancer (MpBC) is a rare form of breast malignancy with a poor prognosis and limited treatment guidance. Here, we report on a case of triple-negative...
Metaplastic breast cancer (MpBC) is a rare form of breast malignancy with a poor prognosis and limited treatment guidance. Here, we report on a case of triple-negative MpBC that was successfully treated following the Keynote-522 clinical algorithm using pembrolizumab, paclitaxel, carboplatin, adriamycin, and cyclophosphamide in a neo-adjuvant fashion. The radiographic and histologic findings of the tumor are reviewed here along with the treatment regimen and response. No major toxicities associated with pembrolizumab were observed in this case. This case report serves as an example of complete pathological response of triple-negative MpBC with pembrolizumab plus chemotherapy and demonstrates the need for further research on chemoimmunotherapy for MpBC.
PubMed: 37900847
DOI: 10.1159/000534146 -
Tumori Apr 2023Very little is currently known about molecular alteration of matrix-producing carcinoma of the breast. However, the morphological similarity with other neoplasm with a...
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 and genes in 12 cases of matrix producing carcinoma.
METHODS
We evaluated rearrangements as Break-Apart and Gene Copy Gain, and as amplification and polysomy in 12 cases of matrix producing carcinoma using a FISH method.
RESULTS
Among the 12 cases of matrix producing carcinomas we found that the three cases harboring amplification were all negative for break-apart; four cases with polysomy were associated to break-apart and high Gene Copy Number; among four cases wild type for , three showed a - break-apart signal and of them two died with disease. One of the deceased patients showed an amplification of with - wild-type and the other showed a break-apart (6%) and a wild-type.
CONCLUSION
This is the first report to the best of our knowledge that shows a possible correlation between a matrix producing carcinoma with and involvement in the development and progression of this kind of tumor. We can suppose that MYC amplification behaves in an aggressive way together with PLAG1- break-apart in the cases of matrix producing carcinoma presented here. The gene copy gain is a useful diagnostic tool in the case of difficult diagnosis because an increase was observed in more than 50% of cases.
Topics: Humans; Adenoma, Pleomorphic; Carcinoma; DNA-Binding Proteins; Immunohistochemistry; Pilot Projects; Salivary Gland Neoplasms; Transcription Factors; Proto-Oncogene Proteins c-myc
PubMed: 35361013
DOI: 10.1177/03008916221080190 -
Cureus Jul 2023Nephrogenic adenoma (NA) is a rare metaplastic entity commonly associated with a prior urothelial injury. Most are seen in the urinary bladder and a minority involve...
Nephrogenic adenoma (NA) is a rare metaplastic entity commonly associated with a prior urothelial injury. Most are seen in the urinary bladder and a minority involve the urethra. In this study, we evaluated the expression of p16 as a surrogate marker of this entity and correlated it with clinical pathological parameters. A total of 17 cases of NA were retrospectively studied to assess the immunohistochemical expression of p16 and its value for the diagnosis of this entity.
PubMed: 37533615
DOI: 10.7759/cureus.41285 -
World Journal of Surgical Oncology Nov 2023Metaplastic breast cancer(MBC) is a specific pathological type of invasive breast cancer. There are few studies related to MBC due to its rarity. This study aimed to...
BACKGROUND
Metaplastic breast cancer(MBC) is a specific pathological type of invasive breast cancer. There are few studies related to MBC due to its rarity. This study aimed to analyse the differences in clinicopathological characteristics and prognosis between Metaplastic breast cancer and triple-negative invasive ductal carcinoma (TN-IDC).
METHODS
We retrospectively compared the clinicopathological characteristics of patients diagnosed with MBC and TN-IDC at the Fourth Hospital of Hebei Medical University between 2011 and 2020 in a 1:2 ratio. The log-rank test was used to compare the two groups' disease-free survival (DFS) and overall survival (OS). For MBCs, we performed univariate and multivariate analyses using the Cox proportional hazards model to determine the characteristics that impacted OS and DFS.
RESULTS
A total of 81 patients with MBC and 162 patients with TN-IDC were included in this study. At initial diagnosis, MBC patients had larger tumour diameters(P = 0.03) and fewer positive lymph nodes (P = 0.04). Patients with MBC were more likely to have organ metastases after surgery (P = 0.03). Despite receiving the same treatment, MBC patients had worse DFS (HR = 1.66, 95%CI 0.90-3.08, P = 0.11) and OS (HR = 1.98, 95% CI 1.03-3.81, P = 0.04), and OS was statistically significant. Positive lymph nodes at initial diagnosis were associated with worse DFS (HR = 3.98, 95%CI 1.05-15.12, P = 0.04) and OS (HR = 3.70, 95%CI 1.03-13.34, P = 0.04) for patients with MBC. The efficacy of platinum-based agents is insensitive for MBC patients receiving chemotherapy. In addition, patients treated with preoperative chemotherapy had worse DFS compared to patients treated with postoperative chemotherapy (HR = 3.51, 95%CI 1.05-11.75, P = 0.04).
CONCLUSIONS
The clinicopathological characteristics and prognosis of MBC and TN-IDC differ in many ways. Further studies are required to determine suitable treatment guidelines for patients with MBC.
Topics: Humans; Female; Breast Neoplasms; Retrospective Studies; Carcinoma, Ductal, Breast; Prognosis; Disease-Free Survival
PubMed: 37996840
DOI: 10.1186/s12957-023-03261-w -
Journal of Clinical Medicine Mar 2022Distal gastrectomy for benign gastroduodenal peptic disease has become rare, but it still represents a widely adopted procedure for advanced and, in some countries, even... (Review)
Review
Distal gastrectomy for benign gastroduodenal peptic disease has become rare, but it still represents a widely adopted procedure for advanced and, in some countries, even for early distal gastric cancer. Survival rates following surgery for gastric malignancy are constantly improving, hence the residual mucosa of the gastric stump is exposed for a prolonged period to biliopancreatic reflux and, possibly, to Helicobacter pylori (HP) infection. Biliopancreatic reflux and HP infection are considered responsible for gastritis and metachronous carcinoma in the gastric stump after oncologic surgery. For gastrectomy patients, in addition to eradication treatment for cases that are already HP positive, endoscopic surveillance should also be recommended, for prompt surveillance and detection in the residual mucosa of any metaplastic-atrophic-dysplastic features following surgery.
PubMed: 35329824
DOI: 10.3390/jcm11061498 -
Diagnostic Pathology Mar 2020We report an unusual case of low-grade fibromatosis-like metaplastic carcinoma (LG-FLMC) of the breast. This exceedingly rare epithelial breast malignancy has been... (Review)
Review
BACKGROUND
We report an unusual case of low-grade fibromatosis-like metaplastic carcinoma (LG-FLMC) of the breast. This exceedingly rare epithelial breast malignancy has been reported only 68 times in the past 20 years, and is classified as a subtype of metaplastic breast carcinoma (MBC). It is a locally aggressive tumor with a low potential for lymph node and distant metastases, but with a tendency to recur after excision. Here we describe a less common presentation of LG-FLMC, provide its molecular characterization, discuss the major differential diagnosis and bring a short review of the literature.
CASE PRESENTATION
A 65-year-old woman presented with a self-palpated breast lump that had discordant radio-pathological features. While imaging results were compatible with an infiltrative malignancy, on core needle biopsy (CNB) a sharply delineated lesion composed by a bland-looking population of spindle cells was observed; excision was recommended for final diagnosis. Histology of the resection specimen showed small areas of epithelial differentiation and foci of peripheral invasion. Immunohistochemical analysis revealed a co-immunoreactivity for epithelial and myoepithelial markers in the spindle cell component. Mutation analysis with a capture-based next generation sequencing method revealed pathogenic mutations in GNAS, TERT-promotor and PIK3R1 genes. A diagnosis of LG-FLMC was rendered.
CONCLUSION
This case highlights the importance of a broad differential diagnosis, exhaustive sampling and the use of a broad immunohistochemical panel whenever dealing with a low-grade spindle cell lesion in the breast, and provides further insights into the molecular background of LG-FLMC.
Topics: Aged; Biomarkers, Tumor; Breast Neoplasms; Carcinoma; Female; Fibroma; Humans; Metaplasia; Neoplasm Recurrence, Local
PubMed: 32127014
DOI: 10.1186/s13000-020-00943-x -
Journal of Cell Communication and... Mar 2018Located at 6q22-23, Ccn6 (WISP3) encodes for a matrix-associated protein of the CCN family, characterized by regulatory, rather than structural, roles in development and... (Review)
Review
Located at 6q22-23, Ccn6 (WISP3) encodes for a matrix-associated protein of the CCN family, characterized by regulatory, rather than structural, roles in development and cancer. CCN6, the least studied member of the CCN family, shares the conserved multimodular structure of CCN proteins, as well as their tissue and cell-type specific functions. In the breast, CCN6 is a critical regulator of epithelial-to-mesenchymal transitions (EMT) and tumor initiating cells. Studies using human breast cancer tissue samples demonstrated that CCN6 messenger RNA and protein are expressed in normal breast epithelia but reduced or lost in aggressive breast cancer phenotypes, especially inflammatory breast cancer and metaplastic carcinomas. Metaplastic carcinomas are mesenchymal-like triple negative breast carcinomas, enriched for markers of EMT and stemness. RNAseq analyses of the TCGA Breast Cancer cohort show reduced CCN6 expression in approximately 50% of metaplastic carcinomas compared to normal breast. Our group identified frameshift mutations of Ccn6 in a subset of human metaplastic breast carcinoma. Importantly, conditional, mammary epithelial-cell specific ccn6 (wisp3) knockout mice develop invasive high-grade mammary carcinomas that recapitulate human spindle cell metaplastic carcinomas, demonstrating a tumor suppressor function for ccn6. Our studies on CCN6 functions in metaplastic carcinoma highlight the potential of CCN6 as a novel therapeutic approach for this specific type of breast cancer.
PubMed: 29357008
DOI: 10.1007/s12079-018-0451-9 -
Asian Pacific Journal of Cancer... Nov 2021Metaplastic breast carcinoma (MBC) is a heterogeneous group of invasive carcinomas with squamous and/or mesenchymal differentiation. Because of their rare occurrence,... (Observational Study)
Observational Study
OBJECTIVE
Metaplastic breast carcinoma (MBC) is a heterogeneous group of invasive carcinomas with squamous and/or mesenchymal differentiation. Because of their rare occurrence, the information regarding the clinical behaviour of metaplastic carcinomas is limited. The purpose of our study was to delineate the clinicopathological and radiological features, treatment outcomes, prognostic factors, and survival of patients with MBC.
METHODS
Ambispective observational study with prospective recruitment was done from 1st January 2019 to 31st August 2020. Retrospective data included between 1st January 2009 and 31st December 2018. In the retrospective group surgical database of our department was searched and those with MBC diagnosis on post-operative histopathology recruited. In prospective group patients with MBC on core biopsy were followed and those operated were included. The patients followed up at our breast cancer clinic (BCC) and their demographic, clinical, pathological radiological and treatment details noted.
RESULTS
Forty patients formed the study population. The mean age of the patents was 42 years. Ipsilateral axillary lymph node metastasis was present in 22.5%. The pathological median tumor size was 5.4 (range 2.1 to 22 cm). The most common differentiation was cartilaginous (35%) followed by squamous (32.5%). The most common mammographic grading was BIRADS 4 (Breast Imaging Reporting and Data system). Magnetic resonance imaging was T2 hyperintense with peripheral rim enhancement and restriction on DWI. The median overall (OS) and disease-free survival (DFS) was 42 and 40 months, respectively. Fifteen patients (37.5%) had disease related mortality. A subgroup analysis revealed that, type of differentiation, histopathology and tumor size > 5cm affected both OS and DFS significantly.
CONCLUSION
Metaplastic breast cancer in our setup presents in young patients with aggressive large tumors at a higher stage and diverse histopathology and with comparable overall and disease-free survival. The histological subtype, tumor differentiation and tumor size are prognostic factors.
Topics: Adult; Biomarkers, Tumor; Breast Neoplasms; Disease-Free Survival; Female; Follow-Up Studies; Humans; India; Lymphatic Metastasis; Magnetic Resonance Imaging; Mammography; Middle Aged; Neoplasm Grading; Neoplasm Staging; Prognosis; Prospective Studies; Retrospective Studies; Treatment Outcome
PubMed: 34837903
DOI: 10.31557/APJCP.2021.22.11.3483 -
BioRxiv : the Preprint Server For... Apr 2024Pancreatic ductal adenocarcinoma (PDA) is partly initiated through the transdifferentiation of acinar cells to metaplastic ducts that act as precursors of neoplasia and...
Pancreatic ductal adenocarcinoma (PDA) is partly initiated through the transdifferentiation of acinar cells to metaplastic ducts that act as precursors of neoplasia and cancer. Tuft cells are solitary chemosensory cells not found in the normal pancreas but arise in metaplasia and neoplasia, diminishing as neoplastic lesions progress to carcinoma. Metaplastic tuft cells (mTCs) function to suppress tumor progression through communication with the tumor microenvironment, but their fate during progression is unknown. To determine the fate of mTCs during PDA progression, we have created a lineage tracing model that uses a tamoxifen-inducible tuft-cell specific Pou2f3 driver to induce transgene expression, including the lineage tracer tdTomato or the oncogene . mTC lineage trace models of pancreatic neoplasia and carcinoma were used to follow mTC fate. We found that mTCs, in the carcinoma model, transdifferentiate into neural-like progenitor cells (NRPs), a cell type associated with poor survival in PDA patients. Using conditional knock-out and overexpression systems, we found that activity in mTCs is necessary and sufficient to induce this Tuft-to-Neuroendocrine-Transition (TNT).
PubMed: 38405804
DOI: 10.1101/2024.02.12.579982