Turhan Nihan, Memişoğlu Ecem, Kökten Şermin Çoban, Güzel Nalan Turan, Zarbaliyev Elbrus
General Surgery, Martyr Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Istanbul, TUR.
General Surgery, Kartal Dr. Lutfi Kırdar City Hospital, Istanbul, TUR.
Cureus. 2024 Jun 2;16(6):e61517. doi: 10.7759/cureus.61517. eCollection 2024 Jun.
Metaplastic breast cancer (MBC) is a rare type of breast carcinoma with clinicopathological differences. The prognosis and treatment strategies for MBC are usually conflicting. In this study, we aim to present the clinicopathologic features, treatment strategies, and prognosis of our MBC patients.
In our retrospective study, 18 metaplastic breast cancer patients treated in our institution between January 2005 and December 2022 were evaluated. Demographic and clinicopathological characteristics, surgical and systemic treatment options, locoregional recurrences, distant metastases, and overall survival (OS) of the MBC patients were retrieved from the patient files.
All patients were female; the median age was 54.42 ± 12.37 years. Most of the patients (n = 15, 83.33%) presented with palpable masses. Tumors were mostly triple-negative, with a high grade and a high Ki‑67 proliferation index. Spindle cell carcinoma and MBC with mesenchymal differentiation were the most common subtypes. Most of the patients underwent mastectomy (n = 11, 61.11%); breast-conserving surgery (BCS) was performed on seven (38,88%) patients. Lymph node positivity was detected in six of 18 patients (33.33%). Fewer patients (n = 4, 22.22%) received neoadjuvant chemotherapy. While local recurrence developed in two out of seven patients (28.57%) who underwent BCS, there was no local recurrence in patients who had mastectomy. The OS time varied according to tumor size and the presence of lymph node metastases (p <0.001; p = 0.005).
Metaplastic breast cancer is genetically heterogeneous and resistant to conventional treatment strategies. Mastectomy is still the surgical treatment method that is performed more frequently and provides better local control for patients with metaplastic breast cancer.
化生性乳腺癌（MBC）是一种罕见的乳腺癌类型，具有临床病理差异。MBC的预后和治疗策略通常存在冲突。在本研究中，我们旨在呈现我们的MBC患者的临床病理特征、治疗策略和预后。
在我们的回顾性研究中，对2005年1月至2022年12月期间在我院接受治疗的18例化生性乳腺癌患者进行了评估。从患者病历中检索了MBC患者的人口统计学和临床病理特征、手术和全身治疗选择、局部区域复发、远处转移和总生存期（OS）。
所有患者均为女性；中位年龄为54.42±12.37岁。大多数患者（n = 15，83.33%）表现为可触及的肿块。肿瘤大多为三阴性，分级高，Ki-67增殖指数高。梭形细胞癌和具有间叶分化的MBC是最常见的亚型。大多数患者接受了乳房切除术（n = 11，61.11%）；7例（38.88%）患者接受了保乳手术（BCS）。18例患者中有6例（33.33%）检测到淋巴结阳性。较少患者（n = 4，22.22%）接受了新辅助化疗。接受BCS的7例患者中有2例（28.57%）发生了局部复发，而接受乳房切除术的患者未发生局部复发。OS时间根据肿瘤大小和淋巴结转移情况而有所不同（p <0.001；p = 0.005）。
化生性乳腺癌在基因上具有异质性，对传统治疗策略耐药。乳房切除术仍然是化生性乳腺癌患者更常采用的手术治疗方法，并且能提供更好的局部控制。
