title: Metaplastic breast carcinoma: a case report and systematic review of the literature.
abstract: A 78-year-old retired woman was diagnosed with metaplastic breast carcinoma (MBC), a rare tumor, in our hospital. We reviewed 15 articles with a total of 1328 patients to determine the epidemiology, clinical features, biomarkers, histology, management and outcome of patients with this tumor. The mean age at presentation is 58.5 years (range 32-83). Eighty-one percent of patients presented either with a breast mass or abnormal mammographic finding. Twenty-three percent of patients had a family history of breast cancer. Estrogen receptors were only found in 12%, progesterone receptors in 10% and HER2 in 6% of patients. The main method of treatment was mastectomy (66.9%) in combination with chemotherapy (57%) and radiotherapy (47%). Five-year disease-free survival ranged between 40% and 84% and 5-year overall survival ranged between 64 and 83%. We have further reviewed the nature of this disease in the light of advancement in genetics, such as microarray gene expression profiling. The relationship of MBC with triple-negative tumor and basal-like tumor is discussed. It is hoped that advances in genetics and biomarkers will bring forward the era of personalized medicine in the treatment of breast carcinoma.
authors.affiliation: Department of General Surgery Pathology, Tameside General Hospital, Ashton-under-Lyne The University of Manchester, Manchester, UK. zahertoumi@btinternet.com
authors.forename: Zaher
authors.initials: Z
authors.lastname: Toumi
authors.forename: Caroline
authors.initials: C
authors.lastname: Bullen
authors.forename: Albert C S
authors.initials: AC
authors.lastname: Tang
authors.forename: Neha
authors.initials: N
authors.lastname: Dalal
authors.forename: Simon
authors.initials: S
authors.lastname: Ellenbogen
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D000077289:Letrozole; D008679:Metaplasia; D018198:Mixed Tumor, Malignant / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D009570:Nitriles / Q000627:therapeutic use; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D014230:Triazoles / Q000627:therapeutic use
chemical_list: D014408:Biomarkers, Tumor; D000077289:Letrozole; D009570:Nitriles; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014230:Triazoles; C508053:ERBB2 protein, human