Niver Harper E, Foxhall Edward, Lahiry Anup
Northeast Georgia Medical Center and Health System, Gainesville, GA, United States.
Rare Tumors. 2023 Mar 15;15:20363613231163730. doi: 10.1177/20363613231163730. eCollection 2023.
Metaplastic Breast Cancer (MBC) is a rare group of tumors often presenting as triple-negative. MBC accounts for less than 1% of all breast cancers with the spindle cell variant comprising less than 0.5%. While rare, spindle cell carcinoma is the commonest subtype in the western world. It has a more aggressive biological behavior with increased risk of recurrence and death due to disease compared to triple negative breast cancers. There is no treatment guideline for management of MBC due to the rarity of the disease. Instead, treatment is theorized based off success with other types of aggressive breast and metaplastic cancers of different tissue. We present the first known case report of male spindle cell carcinoma of the breast treated with KEYNOTE-522 regimen. Therapy included a first phase with pembrolizumab (dose of 200 mg) every 3 weeks plus paclitaxel and carboplatin and second phase, with four cycles of pembrolizumab with doxorubicin-cyclophosphamide.
化生性乳腺癌（MBC）是一组罕见的肿瘤，通常表现为三阴性。MBC占所有乳腺癌的比例不到1%，其中梭形细胞变体占比不到0.5%。梭形细胞癌虽然罕见，但在西方世界是最常见的亚型。与三阴性乳腺癌相比，它具有更具侵袭性的生物学行为，疾病复发和死亡风险增加。由于该疾病罕见，目前尚无MBC的治疗指南。相反，治疗是基于其他类型侵袭性乳腺癌和不同组织化生性癌症的成功治疗经验进行理论推导的。我们报告了首例使用KEYNOTE-522方案治疗的男性乳腺梭形细胞癌病例。治疗包括第一阶段，每3周使用帕博利珠单抗（剂量为200毫克）加紫杉醇和卡铂，第二阶段，使用四个周期的帕博利珠单抗联合多柔比星-环磷酰胺。
