Metaplastic breast carcinoma with chondrosarcomatous differentiation: an unusual disease with a worse prognosis
DOI:
https://doi.org/10.18203/2349-2902.isj20201000Keywords:
Chondrosarcoma, Carcinosarcoma, Metaplastic, MesenchymalAbstract
Metaplastic breast carcinoma (MBC) has an incidence of <1% of all breast cancers and MBC with chondrosarcomatous differentiation is even more rare, <0.1% of all cases. The World Health Organization have classified MBC into pure epithelial-type and mixed epithelial and mesenchymal type. The epithelial-type MBC is sub-classified into squamous cell carcinoma, adenosquamous carcinoma and adenocarcinoma with spindle cell differentiation; mixed type MBC is sub-classified into carcinosarcoma and carcinoma with osseous and chondroid metaplasia. Metaplastic carcinomas of the breast are characterized by large tumour size and rapid growth, and they are usually estrogen receptor, progesterone receptor, and HER2/neu negative and tend to have a worse prognosis than other triple negative breast cancers. There is a noteworthy increased risk of tumour recurrence and a worse prognosis with MBC compared with invasive lobular carcinoma and infiltrating duct carcinoma. We report a case of metaplastic carcinoma with extensive chondroid differentiation that is chondrosarcoma and chondroid metaplasia along with classic infiltrating duct carcinoma with involvement of ipsilateral axillary lymph nodes.
References
Tavassoli FA. Classification of metaplastic carcinomas of the breast. Pathol Annu. 1992;27:89-119.
Kurian KM, Nafussi A. Sarcomatoid/metaplastic carcinoma of the breast: a clinicopathological study of 12 cases. Histopathol. 2002;40:58-64.
Bocker W. WHO classification of breast tumors and tumors of the female genital organs: patholog and genetics. Verh Dtsch Ges Pathol. 2002;86:116-9.
Luini A, Aguilar M, Gatti G. Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat. 2007;101(3):349-53.
Fenyvesi A. A case of carcinoma of the breast with metaplasia to chondrosarcoma: light microscopic and immunohistochemical features. Arch Oncol. 2003;11:273-6.
Shah DR, Tseng WH, Martinez SR. Treatment options for metaplastic breast cancer. ISRN Oncol. 2012;70:61-2.
Lai HW, Tseng LM, Chang TW. The prognostic significance of metaplastic carcinoma of the breast (MCB) a case controlled comparison study with infiltrating ductal carcinoma. Breast. 2013;22(5):968-73.
Weigelt B, Eberle C, Cowell CF, Ng CK, Filho JS. Metaplastic breast carcinoma: more than a special type. Nat Rev Cancer. 2014;14:147-8.