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[Clinicopathological characteristics and immune microenvironment of breast squamous cell carcinoma].Zhonghua Bing Li Xue Za Zhi = Chinese... Apr 2024To investigate the clinicopathological characteristics of breast squamous cell carcinoma and to analyze the relationship between its immune microenvironment tumor...
To investigate the clinicopathological characteristics of breast squamous cell carcinoma and to analyze the relationship between its immune microenvironment tumor infiltrating lymphocytes (TILs) and prognosis. Forty-four cases of primary squamous cell carcinoma of the breast diagnosed and treated in the First Affiliated Hospital of Air Force Medical University, Xi'an, China from January 2006 to July 2022 were selected. Their clinicopathological characteristics were analyzed. The cell composition of TILs was evaluated using immunohistochemistry (Mainly markers of B lymphocytes, T lymphocytes and plasma cells). The relationship between TILs and prognosis was also analyzed. The 44 patients of breast squamous cell carcinoma were all female and all were invasive carcinoma. Eight cases (8/44, 18.2%) were squamous cell carcinoma, while 36 cases (36/44, 81.8%) were mixed squamous cell carcinoma. The mixed components included non-specific carcinoma and spindle cell metaplastic carcinoma (17 cases each). One case contained ductal carcinoma in situ of the breast and 1 case contained tubular carcinoma. The proportion of squamous cell carcinoma was 10% to 90%. The cases with pure squamous cell carcinoma often had a large cystic cavity, which was lined by atypical squamous epithelium, while infiltrating squamous cell carcinoma nests were seen in the breast tissue around the cystic cavity. Immunohistochemical staining showed that p63 and CK5/6 were expressed in the squamous cell carcinoma component, but ER, PR and HER2 were not, except for one case of HER2 1+. The positive rates of TRPS1 and PDL-1 were 76% and less than 1%, respectively. Fifteen cases were in the high TILs group (TILs≥30%) and 29 cases were in the low TILs group (TILs<30%). Twenty-three patients were followed up for 5 to 118 months. Among them, 12 died within 3 years and 9 were alive at the end of the follow up. There was no significant difference in TNM stage, TILs and prognosis between simple squamous cell carcinoma and mixed squamous cell carcinoma. Breast squamous cell carcinoma can be divided into simple squamous cell carcinoma and mixed squamous cell carcinoma. There are differences in gross findings and histology between the simple and mixed squamous cell carcinoma of the breast. Sufficient samples should be taken to avoid missing the diagnosis of a minor squamous component. The prognosis of patients with high TILs is significantly better than that of patients with low TILs. The expression rate of TRPS1 in primary squamous cell carcinoma of breast is high and helpful to the differential diagnosis from metastatic squamous cell carcinoma.
Topics: Humans; Female; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Squamous Cell; Prognosis; Lymphocytes, Tumor-Infiltrating; Tumor Microenvironment; Repressor Proteins
PubMed: 38556816
DOI: 10.3760/cma.j.cn112151-20231023-00293 -
Oncology Letters May 2024Metaplastic breast cancer (BC-Mp), which includes a range of epithelial and mixed epithelial-mesenchymal tumours, are rare malignancies with an unfavourable prognosis....
Metaplastic breast cancer (BC-Mp), which includes a range of epithelial and mixed epithelial-mesenchymal tumours, are rare malignancies with an unfavourable prognosis. The limited literature on BC-Mp focuses mainly on retrospective data for radically treated patients. Notably absent are studies dedicated to the palliative treatment of BC-Mp with distant metastases. The present retrospective study investigated treatment modalities and prognosis in a multi-centre cohort of 31 female participants diagnosed with distant metastatic BC-Mp, including 7 patients with metastatic disease. The median age of the patients was 61 years (range, 33-87 years), with 38.7% presenting local lymph node involvement. Lungs were the most common site for the metastatic disease (61.3%). Median Ki-67 index was 50% (range, 35-70%), and 80.7% of cases were classified as grade 3. Human epidermal growth factor receptor 2 (HER2) and estrogen receptor were detected in 12.9 and 6.5% of cases, respectively. A total of 62.4% of patients received first-line palliative systemic treatment. The 1- and 2-year overall survival (OS) were 38.5 and 19.2%, respectively. Receiving ≥1 line of palliative treatment was significantly associated with improved OS (P<0.001). Factors such as age, Ki-67 index, HER2 or hormonal status, presence of specific epithelial or mesenchymal components, location of metastases or chemotherapy regimen type did not influence OS. The present study provided insights into the clinicopathological profile, systemic treatment experience, prognostic factors and OS data of BC-Mp with distant metastases, emphasizing the imperative for clinical trials in this population.
PubMed: 38516685
DOI: 10.3892/ol.2024.14331 -
Medical Archives (Sarajevo, Bosnia and... 2024Metaplastic breast cancer is a clinically rare subtype of breast carcinomas, accounting for less than 1% of all breast neoplasms, and was not officially recognized till... (Review)
Review
BACKGROUND
Metaplastic breast cancer is a clinically rare subtype of breast carcinomas, accounting for less than 1% of all breast neoplasms, and was not officially recognized till the end of the 20th century as an independent pathological diagnosis.
OBJECTIVE
In this paper, we report a case of metaplastic breast cancer with squamous differentiation in a 51-year-old female, with a succinct review of the literature.
CASE REPORT
The patient presented to our outpatient department with a complaint of left breast mass for 2 months duration with a diagnostic workup found to be grade three metaplastic carcinoma with squamous differentiation. The management decision was to proceed with neoadjuvant chemotherapy, followed by surgical intervention based on the tumor cell response to neoadjuvant therapy.
CONCLUSION
Metaplastic breast cancer represents a rare clinical entity, encountered in a minority of patients. The clinical presentation of metaplastic carcinomas in general is similar to other breast cancers, however, metaplastic breast cancer tend to present in later stages as a rapidly growing mass with poor prognosis. The recognized poor prognosis along with rarity necessities having a high index of suspicion for early detection and appropriate management of metaplastic breast cancer.
Topics: Female; Humans; Middle Aged; Breast Neoplasms; Metaplasia; Neoadjuvant Therapy; Carcinoma, Squamous Cell
PubMed: 38481595
DOI: 10.5455/medarh.2024.78.75-77 -
Frontiers in Pharmacology 2024Breast squamous cell carcinoma (SCC) is an uncommon and highly aggressive variant of metaplastic breast cancer. Despite its rarity, there is currently no consensus on...
Breast squamous cell carcinoma (SCC) is an uncommon and highly aggressive variant of metaplastic breast cancer. Despite its rarity, there is currently no consensus on treatment guidelines for this specific subtype. Previous studies have demonstrated that chemotherapy alone has limited efficacy in treating breast SCC. However, the potential for targeted therapy in combination with chemotherapy holds promise for future treatment options. In this case report, we present a patient with advanced HER2-positive breast SCC, exhibiting a prominent breast mass, localized ulcers, and metastases in the lungs and brain. Our treatment approach involved the administration of HER2-targeted drugs in conjunction with paclitaxel, resulting in a sustained control of tumor growth. This case represents a rare occurrence of HER2-positive breast SCC, with limited available data on the efficacy of previous HER2-targeted drugs in treating such patients. Our study presents the first application of HER2-targeted drugs in this particular case, offering novel therapeutic insights for future considerations. Additionally, it is imperative to conduct further investigations to assess the feasibility of treatment options in a larger cohort of patients.
PubMed: 38455963
DOI: 10.3389/fphar.2024.1332574 -
The Ocular Surface Jul 2024Chronic inflammation is a predisposing factor for metaplastic changes and ultimately dysplasia. We describe cases of OSSN occurring in the setting of chronic ocular...
PURPOSE
Chronic inflammation is a predisposing factor for metaplastic changes and ultimately dysplasia. We describe cases of OSSN occurring in the setting of chronic ocular surface inflammation.
METHODS
Sixteen eyes from 14 individuals were included from one ocular oncology clinic between 2010 and 2023. Patients presented with ocular surface squamous neoplasia (OSSN) in the setting of chronic inflammation. The diagnosis of OSSN was made using anterior segment high-resolution optical coherence tomography (HR-OCT) and confirmed by histopathological analysis in all cases.
RESULTS
Median age on presentation was 61 [IQR 47.5-69.2] years. Eleven (86%) individuals were male and five (36%) identified as White Hispanic. Ten eyes were referred with ocular surface diagnoses including pannus (n = 4), scarring (n = 3), pterygium (n = 2), and herpetic keratitis (n = 1). Only six eyes were referred as possible neoplasia. All individuals had a history of ocular surface inflammation. The most common inflammatory conditions were ocular rosacea (seven individuals) and atopic keratoconjunctivitis (AKC) (five individuals). Two individuals were found to have bilateral OSSN, one in the setting of ocular rosacea and the other in the setting of AKC. All 16 eyes from 14 individuals were suspected to have OSSN based on HR-OCT findings which guided the location of the incisional biopsies that subsequently confirmed histopathological diagnosis in all cases.
CONCLUSION
OSSN may arise in the setting of chronic inflammation on the ocular surface. Identification of the tumor can be challenging in these cases, and HR-OCT can be a key diagnostic tool in detecting OSSN.
Topics: Humans; Male; Middle Aged; Female; Aged; Risk Factors; Tomography, Optical Coherence; Chronic Disease; Retrospective Studies; Carcinoma, Squamous Cell; Eye Neoplasms; Inflammation; Conjunctival Neoplasms; Corneal Diseases
PubMed: 38432640
DOI: 10.1016/j.jtos.2024.02.006 -
Cancer Reports (Hoboken, N.J.) Mar 2024Metaplastic Breast Cancer (MpBC) is an exceedingly rare entity, accounting for less than 1% of all malignant breast tumours. Predominantly triple-negative, they are...
BACKGROUND
Metaplastic Breast Cancer (MpBC) is an exceedingly rare entity, accounting for less than 1% of all malignant breast tumours. Predominantly triple-negative, they are notorious for their chemoresistance, high rates of recurrence and decreased disease-free survival (DFS). All this contributes significantly to BC mortality and results in poor prognostic implications. Limited evidence has led to a lacuna of specific treatment guidelines for this entity and hence remains an uncharted territory for clinicians.
CASE
We report a case of a 46 year old premenopausal female with left-sided metaplastic triple negative T3N2aM0 BC with mesenchymal differentiation (high grade) whom we treated with neoadjuvant chemotherapy, primary surgery in the form of extreme oncoplasty and adjuvant radiotherapy by Telecobalt machine. Contrary to the expected aggressive course of the disease and poor prognosis of treatment, the patient is presently in remission without progression for over 2 years of follow up.
CONCLUSION
Limited experience in management of this pathological entity warrants the need for more research on it, with a special focus on targeted therapy. Discussing possibilities of a tailored approach, rather than a one-size-fits-all approach may aid in paving the path for the future of MpBC treatment.
Topics: Female; Humans; Middle Aged; Precision Medicine; Breast Neoplasms; Prognosis; Carcinoma, Squamous Cell; Disease-Free Survival
PubMed: 38421154
DOI: 10.1002/cnr2.1997 -
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 -
International Journal of Surgery Case... Mar 2024Mucin hypersecretion promoted by intestinal metaplasia can lead to gallstone formation. The presence of large amounts of mucin induced by a change in biliary epithelium...
INTRODUCTION
Mucin hypersecretion promoted by intestinal metaplasia can lead to gallstone formation. The presence of large amounts of mucin induced by a change in biliary epithelium structure is called a mucocele, a usually benign condition studied among animals but rarely described in humans. This entity must be distinguished from hydrops, a condition secondary to an impacted gallstone in the cystic duct leading to an outlet obstruction and distension of the gallbladder.
PRESENTATION OF CASE
We report a case of a 51-year-old female with lithiasic cholecystitis showing areas of intestinal metaplasia associated with a mucocele. Laparoscopic cholecystectomy was performed with an uneventful postoperative course. Macroscopic findings revealed a dilated gallbladder filled with mucoid fluid. Signs of chronic and focally acute cholecystitis with areas of intestinal metaplasia were observed microscopically.
DISCUSSION
Lithiasic gallbladders can bear a gene that is found in goblet cells of intestinal metaplasia, leading to mucin hypersecretion. Metaplasia - a benign lesion often encountered on cholecystectomy specimens - can be the precursor of carcinoma. Mucin-producing gallbladder carcinoma is a very aggressive tumor that can appear as a mucocele. Consequently, preoperative computed tomography or magnetic resonance cholangiopancreatography should be performed in the presence of an unusual aspect on sonography.
CONCLUSION
Metaplastic changes in gallbladder epithelium associated with an overproduction of mucin and lithiasic cholecystitis reported in this case is a rarity. Malignancy is an alternative diagnosis of gallbladder mucocele that must be suspected whenever preoperative imaging of the gallbladder is atypical.
PubMed: 38402642
DOI: 10.1016/j.ijscr.2024.109405 -
Asian Journal of Surgery Jun 2024
Topics: Humans; Breast Neoplasms; Female; Middle Aged
PubMed: 38388266
DOI: 10.1016/j.asjsur.2024.02.022 -
Asian Journal of Surgery May 2024
Topics: Humans; Female; Carcinoma, Squamous Cell; Breast Neoplasms; Receptor, ErbB-2; Middle Aged; Metaplasia
PubMed: 38388262
DOI: 10.1016/j.asjsur.2024.02.061