Department of Surgery, University Hospital of Basel, Basel, Switzerland.
Eur Rev Med Pharmacol Sci. 2017 Sep;21(18):4137-4140.
Metaplastic breast carcinomas represent a rare subtype of breast cancer exhibiting aggressive clinical features. They appear as highly chemoresistant tumors, therefore showing poor outcome and high rates of local recurrence or distant metastasis.
A 37-year-old greek man was referred to our hospital for evaluation of a locally advanced, ulcerated, fixed, irregular and hard in consistency mass covering his left breast and chest wall. Further work out with CT and biopsy of the tumor revealed a triple negative metaplastic breast cancer classified as cT4cN3cM1. The patient received first line chemotherapy and afterward a palliative resection of the tumor. The histology revealed the presence of a combined triple negative adenocarcinoma with a predominant metaplastic squamous carcinoma and a spindle cell (sarcomatoid) carcinoma of the breast. In the tissue sample stem cell markers, nestin and CD146 (MCAM) were expressed, enhancing the theory that cancer cells of this tumor could possibly harbor stem cell properties. The patient received several chemotherapy regimens but died 6 months after the initiation of treatment.
Metaplastic breast cancer consists of cells with stem cell properties. New targeted therapies are warranted in the view of the tumor's high resistance to conventional chemotherapy. Targeting nestin and CD146 might be a promising therapy as they seem to be implicated in the EMT pathway.
化生性乳腺癌是一种罕见的乳腺癌亚型，具有侵袭性的临床特征。它们表现为高度耐药的肿瘤，因此预后较差，局部复发或远处转移的发生率较高。
一名 37 岁的希腊男性因左乳房和胸壁出现一处局部进展、溃疡、固定、不规则且质地坚硬的肿块而被转诊至我院。进一步的 CT 检查和肿瘤活检显示为三阴性化生性乳腺癌，分类为 cT4cN3cM1。患者接受了一线化疗，随后进行了肿瘤的姑息性切除术。组织学显示存在一种混合的三阴性腺癌，主要为化生性鳞状细胞癌和乳腺梭形细胞（肉瘤样）癌。在组织样本中，干细胞标志物巢蛋白和 CD146（MCAM）表达，增强了该肿瘤的癌细胞可能具有干细胞特性的理论。患者接受了几种化疗方案，但在开始治疗后 6 个月死亡。
化生性乳腺癌由具有干细胞特性的细胞组成。鉴于肿瘤对常规化疗的高度耐药性，需要新的靶向治疗方法。针对巢蛋白和 CD146 可能是一种有前途的治疗方法，因为它们似乎与 EMT 途径有关。
