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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2018; 39(03): 400-404
DOI: 10.4103/ijmpo.ijmpo_27_17
Case Report

Carcinosarcoma (Metaplastic Carcinoma) Breast: A Rare and Aggressive Primary – Report of Two Cases with Review of Literature

Gunjesh Kumar Singh
Department of Radiotherapy, VMMC and Safdarjung Hospital, New Delhi, India
,
Pragya Singh
Department of Pathology, VMMC and Safdarjung Hospital, New Delhi, India
,
KT Bhowmik
Department of Radiotherapy, VMMC and Safdarjung Hospital, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Carcinosarcoma (CS) also known as metaplastic carcinoma of the breast is a rare and aggressive type of malignancy with controversial origin. Currently, there are no standard treatment guidelines outlined, owing to the rarity of the disease, but according to the available literature, surgery followed by adjuvant radiation therapy has the greatest benefit. We are presenting two cases of CS of breast developing metastasis. One of the cases presented with lung metastasis during the course of follow-up and responded significantly to chemotherapy, and the other is currently receiving chemotherapy. The cases are being presented here along with the literature review enlightening the current knowledge and available treatment options.

Keywords

Carcinosarcoma breast - chemotherapy - metaplastic carcinoma


Publication History

Article published online:
17 June 2021

© 2018. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Srinivas V, Harjai MM, Subramanya H, Rajaram T, Rai R. Carcinosarcoma of the breast with an unusual secretory carcinoma as the carcinomatous component. Med J Armed Forces India 2004; 60: 410-2
    CrossrefPubMedGoogle Scholar
  • 2 Accurso A, Ciancia G, Della Corte GA, Reale P, Accardo G, Salerno C. et al. A rare case of true carcinosarcoma of the breast. Int J Surg Case Rep 2016; 21: 125-8
    CrossrefPubMedGoogle Scholar
  • 3 Ilhan E, Vardar E, Ozkok G, Sezgin A, Sahin S, Teker K. et al. A rare tumour of the breast: Carcinosarcoma. J Clin Med Res 2016; 2: 96-8
    Google Scholar
  • 4 Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M. et al. incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136: E359-86
    CrossrefPubMedGoogle Scholar
  • 5 Kim SH, Chung HC, Jeong J, Kim JH, Rha SY, Ahn JB. et al. A locally advanced breast cancer with difficult differential diagnosis of carcinosarcoma and atypical medullary carcinoma, which had poor response to adriamycin- and taxane-based neoadjuvant chemotherapy: A case report. Cancer Res Treat 2007; 39: 134-7
    CrossrefPubMedGoogle Scholar
  • 6 Huvos AG, Lucas JCJr, Foote FWJr. Metaplastic breast carcinoma. Rare form of mammary cancer. N Y State J Med 1973; 73: 1078-82
    PubMedGoogle Scholar
  • 7 Beatty JD, Atwood M, Tickman R, Reiner M. Metaplastic breast cancer: Clinical significance. Am J Surg 2006; 191: 657-64
    CrossrefPubMedGoogle Scholar
  • 8 Shin HJ, Kim HH, Kim SM, Kim DB, Kim MJ, Gong G. et al. Imaging features of metaplastic carcinoma with chondroid differentiation of the breast. AJR Am J Roentgenol 2007; 188: 691-6
    CrossrefPubMedGoogle Scholar
  • 9 Luini A, Aguilar M, Gatti G, Fasani R, Botteri E, Brito JA. et al. 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: 349-53
    CrossrefPubMedGoogle Scholar
  • 10 McKinnon E, Xiao P. Metaplastic carcinoma of the breast. Arch Pathol Lab Med 2015; 139: 819-22
    CrossrefPubMedGoogle Scholar
  • 11 Cil T, Altintas A, Pasa S, Buyukbayram H, Isikdogan A. Primary spindle cell sarcoma of the breast. Breast Care (Basel) 2008; 3: 197-9
    CrossrefPubMedGoogle Scholar
  • 12 Abbasi MA, Mahmood H, Faheem M, Khan KA, Irfan J. Carcinosarcoma of the breast. J Coll Physicians Surg Pak 2012; 22: 333-4
    PubMedGoogle Scholar
  • 13 Wargotz ES, Norris HJ. Metaplastic carcinomas of the breast III Carcinosarcoma. Cancer 1989; 64: 1490-9
    CrossrefPubMedGoogle Scholar
  • 14 Sørlie T. Molecular portraits of breast cancer: Tumour subtypes as distinct disease entities. Eur J Cancer 2004; 40: 2667-75
    CrossrefPubMedGoogle Scholar
  • 15 Esses KM, Hagmaier RM, Blanchard SA, Lazarchick JJ, Riker AI. Carcinosarcoma of the breast: Two case reports and review of the literature. Cases J 2009; 2: 15
    CrossrefPubMedGoogle Scholar
  • 16 Hennessy BT, Gonzalez-Angulo AM, Stemke-Hale K, Gilcrease MZ, Krishnamurthy S, Lee JS. et al. Characterization of a naturally occurring breast cancer subset enriched in epithelial-to-mesenchymal transition and stem cell characteristics. Cancer Res 2009; 69: 4116-24
    CrossrefPubMedGoogle Scholar
  • 17 Reis-Filho JS, Pinheiro C, Lambros MB, Milanezi F, Carvalho S, Savage K. et al. EGFR amplification and lack of activating mutations in metaplastic breast carcinomas. J Pathol 2006; 209: 445-53
    CrossrefPubMedGoogle Scholar
  • 18 Gurleyik E, Yildirim U, Gunal O, Pehlivan M. Malignant mesenchymal tumor of the breast: Primary chondrosarcoma. Breast Care (Basel) 2009; 4: 101-3
    CrossrefPubMedGoogle Scholar
  • 19 Pope TLJr, Fechner RE, Brenbridge AN. Carcinosarcoma of the breast: Radiologic, ultrasonographic, and pathologic correlation. Can Assoc Radiol J 1987; 38: 50-1
    PubMedGoogle Scholar
  • 20 Shah DR, Tseng WH, Martinez SR. Treatment options for metaplastic breast cancer. ISRN Oncol 2012; 2012: 706162
    PubMedGoogle Scholar
  • 21 Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ. et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: The national cancer institute randomized trial. Cancer 2003; 98: 697-702
    CrossrefPubMedGoogle Scholar
  • 22 Lai WH, Tseng LM, Chang TW, Kuo YL, Hsieh CM, Chen ST. et al. The prognostic significance of metaplastic carcinoma of the breast (MCB) – A case controlled comparison study with infiltrating ductal carcinoma. Breast 2013; 22: 968-73
    CrossrefPubMedGoogle Scholar
  • 23 Dave G, Cosmatos H, Do T, Lodin K, Varshney D. Metaplastic carcinoma of the breast: A retrospective review. Int J Radiat Oncol Biol Phys 2006; 64: 771-5
    CrossrefPubMedGoogle Scholar
  • 24 Buzdar AU, Valero V, Theriault RL, Frye D, Green M, Booser D. et al. Pathological complete response to chemotherapy is related to hormone receptor status [abstract]. Breast Cancer Res Treat 2003; 85: 2
    Google Scholar
  • 25 Hennessy BT, Giordano S, Broglio K, Duan Z, Trent J, Buchholz TA. et al. Biphasic metaplastic sarcomatoid carcinoma of the breast. Ann Oncol 2006; 17: 605-13
    CrossrefPubMedGoogle Scholar
  • 26 Bae SY, Lee SK, Koo MY, Hur SM, Choi MY, Cho DH. et al. The prognoses of metaplastic breast cancer patients compared to those of triple-negative breast cancer patients. Breast Cancer Res Treat 2011; 126: 471-8
    CrossrefPubMedGoogle Scholar
  • 27 Okubo S, Kurebayashi J, Otsuki T, Yamamoto Y, Tanaka K, Sonoo H. et al. Additive antitumour effect of the epidermal growth factor receptor tyrosine kinase inhibitor gefitinib (Iressa, ZD1839) and the antioestrogen fulvestrant (Faslodex, ICI 182,780) in breast cancer cells. Br J Cancer 2004; 90: 236-44
    CrossrefPubMedGoogle Scholar
  • 28 Leibl S, Moinfar F. Metaplastic breast carcinomas are negative for her-2 but frequently express EGFR (Her-1): Potential relevance to adjuvant treatment with EGFR tyrosine kinase inhibitors?. J Clin Pathol 2005; 58: 700-4
    CrossrefPubMedGoogle Scholar
  • 29 Weigelt B, Eberle C, Cowell CF, Ng CK, Reis-Filho JS. Metaplastic breast carcinoma: More than a special type. Nat Rev Cancer 2014; 14: 147-8
    CrossrefPubMedGoogle Scholar