Metaplastic Breast Carcinoma: A Clinico-Pathological and Immunohistochemical Study
Fadwa J Altaf, Eman AS Emam, Ghadeer A Mokhtar, Rana Y Bokhary, Samia M Al Amoudi, Lamya A Baharith, Hiba H Ali. King Abdulaziz University, Jeddah, Western, Saudi Arabia
Background: Metaplastic breast carcinoma (MBC) is characterized by the expression of epithelial and or mesenchymal tissue morphologically or genotypically within the same tumor. There is little information in the literature about clinically relevant pathologic and immunohistochemical features that can affect tumor prognosis and treatment modalities. The aim of the present study is to evaluate the clinicopathological features of metaplastic breast carcinoma seen at King Abdulaziz University Hospital and to investigate the value of immunohistochemical study in diagnosis, classification and treatment of such cases.
Design: Seven cases of MBC were evaluated for Clinical, radiological and pathological features as well as treatment and follow up data were tabulated. Routine& immunohistochemistry for ER, PR, and HER-2. CK Pan, HCG, PLAP,Vimentin and other stains were evaluated whenever needed and their interpretation were discussed.
Results: The mean age of the patients was 36 years with range of (23-69 years). All cases presented with breast mass and large tumor size range (5-13cm). Histological examination revealed that three out of seven cases (43%) were composed of squamous cell carcinoma, four cases showed mixture of malignant epithelial and mesenchymal components: three cases (43%) showed infiltration by giant syncitiotrophoblastic cells proved to be positive to HCG and PLAP antibodies. Four patients (50%) had axillary lymph node metastasis. Local recurrence was seen in 50 % of the patients, and distant metastasis was present in 25%. Immunohistochemical staining revealed negative imumnoreactivity of the cases to estrogen receptors, progesterone receptors and HER-2 neu.
Conclusions: MBC in our population is an aggressive disease. Our patients are younger than other studies. They are presented with large tumor size and more advanced stage. All cases are shown immunohistochemically to be contained in the triple negative category of breast cancer and so may follow similar treatment modalities. Majority of them developed local recurrence and distant metastasis in a relatively short period of time.The relationship between the presence of syncitial cells histologically and pregnancy clinically, that is associated with advance stage at presentation, and very aggressive behavior require further investigation.
Wednesday, March 6, 2013 1:00 PM
Poster Session VI # 4, Wednesday Afternoon