The Clinical Feature And Therapy For Metaplastic Carcinoma Of Breast (Three Cases Repot And Literature Review)

Objective:To discuss the clinical feature and therapy for metaplastic carcinoma of breast in China.Method:Three cases were reported from the Department of Breast Surgery of School of Medicine Zhejiang University affiliated Women's hospital in 2010. And other cases had been diagnosised and reported in China from 1980 to 2010 in Chinese literatures.All were analyzed retrospectively.Results:123 cases were reported in china between 1980 and 2010,all of them were females except one male,the age was from 25 to 88 years old,the mean age of the patients was 54.23 years old.The mean size of the tumor was 50.06mm(range 12-180mm),which was larger than non- metaplastic carcinoma of breast.28 of 109 patients(25.68%) had local lymph node metastasis.7 of 56 patients(12.5%) had tumor recurrence,18 of 56 (32.14%) had lung or other organs metastasis.7 of 80 patients(8.75%) were positive for ER or PR,and 1 of 80 (1.25%) was positive for HER-2. Based on pathological classification (Wargotz reported in 1990), of all the 123 cases:Type I,3 cases; TypeⅡ,55 cases;TypeⅢ,23 cases; TypeⅣ,22 cases:TypeⅤ, 6 case,9 cases could not be classified.so TypeⅡ,the spindle cell type were the most, classification based on WHO 2003 edition of breast cancer, the pure epithelial metaplastic carcinoma,78 cases; epithelial/mesenchymal metaplastic carcinoma,45 cases.Concluion:Most metaplastic carcinoma is a rare mammary malignant tumor,it has no special clinical and iconography features, the diagnosis dependes on pathology and immunohistochemistry, the origin and classification of the organization are still in disputed. The best therapeutic method is operation. Radiotherapy brings benefits of the prognosis, but the benefit of chemotherapy is not clear. It may be lass sensitive to endocrine therapy because of low expression of ER or PR.Histological type,size of tumor, lymph node metastasis or not and the TNM stage were the important determinants of prognosis.There were not much differences between Chinese people and foreigners in metaplastic carcinoma of breast.