Johnson T L, Kini S R
Department of Pathology, Henry Ford Hospital, Detroit, MI 48202, USA.
Diagn Cytopathol. 1996 May;14(3):226-32. doi: 10.1002/(SICI)1097-0339(199604)14:3<226::AID-DC6>3.0.CO;2-F.
Metaplastic breast carcinomas (MBC) account for < 5% of breast malignancies and have an uncertain prognostic significance. The tumors tend to grow rapidly, and most are negative for hormone receptors. Adenosquamous carcinomas and various types of carcinosarcomas may be classified as MBC. We evaluated the cytologic, histologic, and clinical parameters of 10 MBC to determine important diagnostic features of these tumors. A cytologic diagnosis of MBC, based on the identification of two distinct malignant components, was made preoperatively in five of 10 (50%) cases, and retrospectively in two additional cases; two specimens were inadequately cellular. Poorly-differentiated adenocarcinoma was the most frequently encountered component of MBC. It is recommended that malignant breast aspirates be carefully scrutinized for multiple neoplastic components. Our series of MBC differs from previous reports in that two cases presented as inflammatory breast cancer, one case was pregnancy-associated, and there was a higher incidence of estrogen and progesterone receptor positivity. No cancer-related deaths occurred during a mean follow-up period of over 6 yr.
化生性乳腺癌（MBC）占乳腺恶性肿瘤的比例不到5%，其预后意义尚不明确。这些肿瘤往往生长迅速，大多数激素受体呈阴性。腺鳞癌和各种类型的癌肉瘤可归类为MBC。我们评估了10例MBC的细胞学、组织学和临床参数，以确定这些肿瘤的重要诊断特征。10例中有5例（50%）在术前基于识别出两种不同的恶性成分做出了MBC的细胞学诊断，另有2例为回顾性诊断；2份标本细胞数量不足。低分化腺癌是MBC最常见的成分。建议仔细检查恶性乳腺抽吸物中是否存在多种肿瘤成分。我们的MBC系列与以往报道不同之处在于，有2例表现为炎性乳腺癌，1例与妊娠相关，且雌激素和孕激素受体阳性率较高。在平均超过6年的随访期内未发生与癌症相关的死亡。
