Clinical Diagnosis And Therapy For Metaplastic Carcinoma Of Breast (Two Cases Reported And Literature Review)

Objective To discuss the clinical diagnosis and therapy for metaplastic carcinoma of breast in China. Method Two cases were selected from the surgical files of the Department of Oncology,Medical College of Zhejiang University between 2001 to 2006.And others had been diagnosised and reported in China from 1979 to 2006 in Chinese literature.All were analyzed retrospectively. Results In China 23 cases reported ,all were female,the mean age of the patients was 52.6 years old.The mean size of the tumor was 44.5mm(range 12-100mm) ,which was larger than non-metaplastic carcinoma of breast. None of the patients had distant metastasis at presentation and 4 of 16 patients(25%) had local lymph node metastasis.Three of twelve patients(25%) were positive for ER or PR. Based on pathological classification (Wargotz reported in 1990), of all the 23 cases:Type I , 3 cases; Type II, 9 cases; Type III, 5 cases; Type IV, 2 cases; Type V, 4 cases. Type II,the spindle cells type were the most,and in Type III, 3 of 5 patients of carcinosarcoma had local lymph node metastasis,which predicted bad prognosis. Conclusion Most metaplastic carcinoma had no special clinical feature, were pathologically proved finally.The best therapeutic method was operation. The metaplastic carcinoma of all cases must be extensively resected including surrounding tissues and lymphnodes. It may be less sensitive to endocrine therapy because of low expression of ER or PR.Histological type was the important determinants of prognosis.There were not much differences between Chinese people and foreigners in metaplastic carcinoma of breast.