Metaplastic mammary carcinoma with discrepant hormone receptor results by IHC and RT-PCR

This is a young premenopausal woman with a T1cN0 metaplastic breast cancer that is ER/PR Allred score 3, but negative by mRNA. Our recommendations are: adjuvant chemotherapy with TAC x 6 or dose-dense doxorubicin and cyclophosphamide followed by paclitaxel (ddAC-T). Whole-breast radiation therapy would follow. The patient could try tamoxifen, although the likelihood of benefit is very small.