Metaplastic Breast Cancer: Clinical Features and Outcomes

2005 ◽  
Vol 71 (9) ◽  
pp. 725-730 ◽  
Author(s):  
Glen R. Gibson ◽  
Dajun Qian ◽  
Joseph K. Ku ◽  
Lily L. Lai
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Menopausal Status ◽  
Axillary Node ◽  
Metaplastic Carcinoma ◽  
Metaplastic Breast Cancer ◽  
Histologic Subtype ◽  
Hormone Receptor Positive ◽  
Node Involvement

Metaplastic carcinoma of the breast, a neoplasm with both epithelial and mesenchymal elements, represents less than 1 per cent of all breast cancer. We reviewed the records of all patients diagnosed with localized metaplastic breast cancer from 1991 to 2003 at our institution. We identified 21 patients. Mean primary tumor size was 4.62 cm. Eight patients (38%) had axillary node involvement at presentation. All the tumors were high grade. Only two (10%) of the tumors were hormone receptor positive. Seventeen (81%) of the patients received adjuvant chemotherapy, and 12 (57%) of the patients received radiation. Ten (29%) patients suffered a local recurrence. With a mean follow-up of 46 months, the 5-year disease-free and overall survival was 42 per cent (95% CI: 20% to 65%) and 71 per cent (95% CI: 46% to 96%), respectively. Stage-specific overall survival was 100 per cent, 83 per cent, and 53 per cent for stages I, II, and III, respectively. By multivariate analysis, there was no impact on recurrence or survival with regard to size, age, menopausal status, nodal status, histologic subtype, adjuvant therapy, or extent of surgery. Metaplastic breast cancer is a unique neoplasm that tends to present at an advanced stage and has a propensity for local recurrence. When stratified by stage, however, survival appears similar to that of adenocarcinoma of the breast, and these tumors should be treated as such.

Estrogen and Progesterone Receptors as Prognostic Factors in Breast Cancer

1988 ◽  
Vol 74 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Branko Brdar ◽  
Dubravka Graf ◽  
Radovan Padovan ◽  
Petar Nola ◽  
Nikola Rudan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Menopausal Status ◽  
Age Groups ◽  
Progesterone Receptors ◽  
Tumor Grade ◽  
Axillary Node ◽  
Er Positive ◽  
Node Involvement ◽  
Receptor Phenotype

The relation between estrogen receptors (ER) and/or progesterone receptors (PgR) and some clinical factors such as tumor size, axillary node involvement, histological tumor grade, and disease-free interval (DFI) in 500 patients with operable (TNM stage I-III) breast cancer was studied. ER-positive (ER+) tumors were commoner in older patients, whereas PgR-positive (PgR+) tumors were similarly distributed within the age groups. The concentration of ER+ protein also increased with age in contrast to PgR+ protein concentration. However, receptor status was not associated with menopausal status independently of age. Axillary node involvement influenced neither ER nor PgR status, but there was a statistically significant relation between tumor size and positivity of ER or PgR. There was no association between histologic tumor grade and either steroid receptor phenotype. DFI was longer in patients with ER+ than those with ER− tumors, independently of axillary nodal status. The positivity of PgR in patients with ER+ tumors contributed to an even longer DFI, suggesting that the combination of ER/PgR is a better indicator of DFI than ER or PgR alone.

scholarly journals Combined chemotherapy and radiotherapy for patients with breast cancer and extensive nodal involvement.

1995 ◽  
Vol 13 (2) ◽  
pp. 435-443 ◽  
Author(s):  
O Ung ◽  
A O Langlands ◽  
B Barraclough ◽  
J Boyages
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Menopausal Status ◽  
Dose Intensity ◽  
High Dose ◽  
Combined Chemotherapy ◽  
Nodal Involvement ◽  
Standard Dosage ◽  
Distant Relapse

PURPOSE This retrospective review examines local control, freedom from distant failure, and survival for patients with nonmetastatic breast cancer with extensive nodal disease (> 10 nodes, 45 patients; or > or = 70% involved nodes, if < 10 nodes found, 19 patients). All patients received chemotherapy and radiotherapy following mastectomy. PATIENTS AND METHODS Sixty-four patients were treated between January 1980 and December 1988 at Westmead Hospital, Westmead, NSW Australia. The median follow-up duration for surviving patients was 91.5 months (range, 56 to 121). The median age was 51 years, and the median number of positive nodes was 11. Four successive protocols evolved, each with three phases, as follows: induction chemotherapy (doxorubicin or mitoxantrone, plus cyclophosphamide; three cycles), radiotherapy (50 Gy in 25 fractions to chest wall and regional nodes), then chemotherapy (cyclophosphamide, methotrexate, and fluorouracil [CMF]) of progressively shorter duration. Radiotherapy and chemotherapy were concurrent in the fourth regimen. RESULTS One patient (1.5%) developed local recurrence before distant relapse, and seven patients (11%) developed local and/or regional recurrence simultaneously or after distant relapse. The 5-year actuarial freedom from distant relapse and overall survival rates were 45% and 65%, respectively. Overall survival did not vary significantly by menopausal status, nodal subgroup, or dose-intensity. There were no treatment-related deaths. CONCLUSION Combined chemotherapy and radiotherapy in standard dosage is an acceptable approach following mastectomy for patients with extensive nodal involvement at high risk for local recurrence and distant relapse. This approach should be considered standard best therapy for any randomized trials that examine high-dose chemotherapy or bone marrow transplantation for this subgroup of patients.

scholarly journals Top 3 abstracts concerning hormone-receptor-positive early breast cancer

2021 ◽  
Author(s):  
Simon Peter Gampenrieder ◽  
Gabriel Rinnerthaler ◽  
Richard Greil
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Endocrine Therapy ◽  
Early Breast Cancer ◽  
Hormone Receptor ◽  
Menopausal Status ◽  
Pathologic Complete Response ◽  
Oncotype Dx ◽  
Hormone Receptor Positive ◽  
Her2 Breast Cancer

SummaryThe three top abstracts at the 2020 virtual San Antonio Breast Cancer Symposium regarding hormone-receptor-positive early breast cancer, from our point of view, were the long-awaited results from PenelopeB and RxPONDER as well as the data from the ADAPT trial of the West German Study Group. PenelopeB failed to show any benefit by adjuvant palbociclib when added to standard endocrine therapy in patients without pathologic complete response after neoadjuvant chemotherapy. RxPONDER demonstrated that postmenopausal patients with early hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2−) breast cancer, 1–3 positive lymph nodes and an Oncotype DX Recurrence Score of less than 26 can safely be treated with endocrine therapy alone. In contrast, in premenopausal women with positive nodes, adjuvant chemotherapy plays still a role even in case of low genomic risk. Whether the benefit by chemotherapy is mainly an indirect endocrine effect and if ovarian function suppression would be similarly effective, is still a matter of debate. The HR+/HER2− part of the ADAPT umbrella trial investigated the role of a Ki-67 response to a short endocrine therapy before surgery in addition to Oncotype DX—performed on the pretreatment biopsy—to identify low-risk patients who can safely forgo adjuvant chemotherapy irrespective of menopausal status.

scholarly journals Right Breast Metaplastic Carcinoma with Chondroid Diff erentiation (Chondrosarcoma)

2018 ◽  
Vol 22 (4) ◽  
pp. 45-51
Author(s):  
Alya S. Binmahfouz
Keyword(s):  
Breast Cancer ◽  
Metaplastic Carcinoma ◽  
Adjuvant Radiation ◽  
Resonance Imaging ◽  
Metaplastic Breast Cancer ◽  
Diagnostic Features ◽  
Palpable Mass ◽  
Adjuvant Radiation Therapy ◽  
The Right ◽  
Metaplastic Breast Carcinoma

Metaplastic breast cancer is rare, representing < 5% of breast cancer (only eight cases have been reported so far). We present here a 42-year-old female complaining of a painless lump in the right breast for the previous two months. Physical examination revealed a palpable mass. Lumpectomy was performed and histopathologic examination revealed metaplastic breast carcinoma with foci of chondrosarcoma. The patient received adjuvant radiation therapy and chemotherapy and is currently following up as an outpatient. We also discuss diff erentimaging diagnostic features of this specifi c type of breast cancer using mammography, ultrasonography, and magnetic resonance imaging.

Correlation between Changes in Prolactin and Melatonin Serum Levels after Radical Mastectomy

1987 ◽  
Vol 73 (3) ◽  
pp. 263-267 ◽  
Author(s):  
Paolo Lissoni ◽  
Franco Paolorossi ◽  
Sandro Barni ◽  
Gabriele Tancini ◽  
Sergio Crispino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Radical Mastectomy ◽  
Serum Levels ◽  
Axillary Node ◽  
Neoplastic Disease ◽  
Before And After ◽  
Node Involvement ◽  
Breast Cancer Growth ◽  
The Relationship

Both prolactin (PRL) and melatonin (MLT) (the most important pineal hormone) have been shown to play a role in regulating breast cancer growth. The present study was carried out to investigate the relationship between PRL and MLT secretions in human breast cancer. Twenty-four women with breast cancer, at clinical stage T1-2 N0-2 M0, were evaluated before and after radical mastectomy. As controls, 14 women who underwent surgery for reasons other than neoplastic disease were included in the study. PRL and MLT serum levels were measured by RIA before and 15 days after surgery. There were no significant differences in mean PRL serum levels between patients and controls; mean MLT serum values were significantly higher in patients than in controls. In no control subject was PRL affected by surgery. In contrast, 13/24 breast cancer women showed high PRL levels after mastectomy; the PRL rise induced by surgery was significantly higher in patients without axillary node involvement. MLT was not affected by mastectomy in 13 patients, whereas it was enhanced in 5 women and decreased in the last 6 cases. No significant correlation was seen between PRL and MLT changes induced by mastectomy. The present study shows that radical mastectomy influences PRL and MLT secretions, however, its clinical significance remains to be established.

Relapse of breast cancer after adjuvant treatment in premenopausal and perimenopausal women: patterns and prognoses.

1988 ◽  
Vol 6 (1) ◽  
pp. 89-97 ◽  
Author(s):  
A Goldhirsch ◽  
R D Gelber ◽  
M Castiglione
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Clinical Importance ◽  
Axillary Node ◽  
Contralateral Breast ◽  
Endocrine Treatment ◽  
Breast Cancer Patients ◽  
Regional Metastases ◽  
First Relapse ◽  
Isolated Local Recurrence

Eight hundred eighteen premenopausal or perimenopausal breast cancer patients with axillary node metastases were treated with adjuvant chemotherapy (CMF) with or without endocrine treatment (prednisone, oophorectomy) in two concurrent prospective trials. Three hundred fifty-two (43%) had recurrent disease at a median follow-up time of 6 years. The 2-year survival percentages from time of first relapse were 16% for patients with initial metastases in visceral or multiple sites (including bone and soft tissue), 41% for those with regional metastases or skeletal relapse alone and 70% for patients with isolated local recurrence or contralateral breast cancer. The features that most influenced prognosis within the categories defined by site of first relapse were disease-free interval (less than 24 months v greater than or equal to 24 months), and estrogen receptor content in the primary tumor. These features had clinical importance (identifying patients with at least a 50% 2-year survival percentage) only in those patients with local, contralateral breast, regional, or bony disease alone. The treatment of individual patients after relapse must be directed toward optimized palliation. The results of this study are important for defining groups of patients who relapse after CMF for whom the subsequent therapeutic approach might be differentiated (eg, experimental treatments for dire prognosis, accent on minimal side effect treatment for intermediate prognosis, and investigation of adjuvant systemic therapy for isolated local recurrence).

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