Metaplastic Breast Carcinoma: Clinicopathological Characteristics, Treatment Patterns, and Outcomes

Area of Science:

• Oncology
• Pathology
• Medical Research

Background:

• Metaplastic breast carcinoma (MBC) is a rare (<1%) aggressive breast cancer subtype.
• Characterized by epithelial-mesenchymal transition, most MBCs are triple-negative (ER-, PR-, HER2-), limiting treatment options.
• MBC exhibits significant histopathological heterogeneity and chemoresistance.

Purpose of the Study:

• To retrospectively analyze the clinicopathological features, treatment, and outcomes of metaplastic breast carcinoma patients in India.
• To understand the presentation and challenges associated with MBC in a tertiary care setting.

Main Methods:

• Retrospective study of 15 histopathologically confirmed triple-negative MBC cases.
• Data collected on demographics, clinical presentation, histopathology, treatment modalities (surgery, chemotherapy, radiotherapy), and patient outcomes.
• Analysis of metaplastic differentiation patterns (spindle cell, squamous, mixed).

Main Results:

• Median age at diagnosis was 52 years, with predominantly advanced-stage disease (Stage II: 60%, Stage III: 40%).
• Spindle cell features were most common (40%), followed by squamous (33.3%) and mixed (26.7%). Most tumors were in the right breast (73.3%).
• Neoadjuvant chemotherapy (NAC) in 40% yielded a 33.3% pathological complete response (pCR). Overall survival data showed 40% disease-free survival at follow-up.

Conclusions:

• MBC in this Indian cohort presented with aggressive features and advanced stage.
• Findings underscore the need for enhanced breast cancer awareness and early diagnosis.
• Individualized treatment strategies are essential, particularly in resource-limited settings.