Current Progress in the Treatment of Metaplastic Breast Carcinoma

  • Hu, Qing (Department of General Surgery, Xuzhou Medical College) ;
  • Chen, Wei-Xian (Department of General Surgery, Jiangsu Cancer Hospital) ;
  • Zhong, Shan-Liang (Clinical Laboratory Center, Jiangsu Cancer Hospital) ;
  • Li, Jian (Department of General Surgery, Jiangsu Cancer Hospital) ;
  • Luo, Zhou (Department of General Surgery, Jiangsu Cancer Hospital) ;
  • Tang, Jin-Hai (Department of General Surgery, Jiangsu Cancer Hospital) ;
  • Zhao, Jian-Hua (Clinical Laboratory Center, Jiangsu Cancer Hospital)
  • Published : 2013.11.30


Metaplastic breast cancer (MBC) is a rare type of breast carcinoma, characterized by various combinations of mesenchymal, adenocarcinoma and other epithelial components. MBC often manifests as a large mass, with low axillary lymph node involvement and poor prognosis. Knowledge and treatment patterns about MBC demographics, presentation and tumor characteristics are very limited. In clinical practice, MBC is usually treated based on the guidelines developed for infiltrating ductal carcinoma (IDC). The ideal treatment paradigm for MBC is unknown due to its low incidence and pathological variability, so potential predictors of treatment efficacy need to be explored. This review summarizes the current models and strategies for MBC according to the published literature.


Metaplastic breast cancer;therapy;systematic review


  1. Al Sayed AD, El Weshi AN, Tulbah AM, et al (2006). Metaplastic carcinoma of the breast clinical presentation, treatment results and prognostic factors. Acta Oncol, 45, 188-95.
  2. Bae SY, Lee SK, Koo MY, et al (2011). The prognoses of metaplastic breast cancer patients compared to those of triple-negative breast cancer patients. Breast Cancer Res Treat, 126, 471-8.
  3. Banerjee S, Reis-Filho JS, Ashley S, et al (2006). Basal-like breast carcinomas: clinical outcome and response to chemotherapy. J Clin Pathol, 59, 729-35.
  4. Barnes PJ, Boutilier R, Chiasson D, et al (2005). Metaplastic breast carcinoma: clinical-pathologic characteristics and HER2/neu expression. Breast Cancer Res Treat, 91, 173-8.
  5. Bauer TW, Rostock RA, Eggleston JC, et al (1984). Spindle cell carcinoma of the breast: four cases and review of the literature. Hum Pathol, 15, 147-52.
  6. Carey L, Winer E, Viale G, et al (2010). Triple-negative breast cancer: disease entity or title of convenience? Nat Rev Clin Oncol, 7, 683-92.
  7. Chao TC, Wang CS, Chen SC, et al (1999). Metaplastic carcinomas of the breast. J Surg Oncol, 71, 220-5.<220::AID-JSO3>3.0.CO;2-L
  8. Chen IC, Lin CH, Huang CS, et al (2011). Lack of efficacy to systemic chemotherapy for treatment of metaplastic carcinoma of the breast in the modern era. Breast Cancer Res Treat, 130, 345-51.
  9. Clarke M, Collins R, Darby S, et al (2005). Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet, 366, 2087-106.
  10. Dancey JE, Freidlin B (2003). Targeting epidermal growth factor receptor--are we missing the mark? Lancet, 362, 62-4.
  11. Dave G, Cosmatos H, Do T, et al (2006). Metaplastic carcinoma of the breast: a retrospective review. Int J Radiat Oncol Biol Phys, 64, 771-5.
  12. Ellis LM, Hoff PM (2004). Targeting the epidermal growth factor receptor: an important incremental step in the battle against colorectal cancer. J Clin Oncol, 22, 1177-9.
  13. Fowble B, Gray R, Gilchrist K, et al (1988). Identification of a subgroup of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from postoperative radiotherapy. J Clin Oncol, 6, 1107-17.
  14. Giaccone G , Herbst RS, Manegold C, et al (2004). Gefitinib in combination with gemcitabine and cisplatin in advanced non-small-cell lung cancer: a phase III trial--INTACT 1. J Clin Oncol, 22, 777-84.
  15. Gutman H, Pollock RE, Janjan NA,et al (1995). Biologic distinctions and therapeutic implications of sarcomatoid metaplasia of epithelial carcinoma of the breast. J Am Coll Surg, 180, 193-9.
  16. Hayes MJ, Thomas D, Emmons A, et al (2008). Genetic changes of Wnt pathway genes are common events in metaplastic carcinomas of the breast. Clin Cancer Res, 14, 4038-44.
  17. Hennessy BT, Giordano S, Broglio K,et al (2006). Biphasic metaplastic sarcomatoid carcinoma of the breast. Ann Oncol, 17, 605-13.
  18. Herbst RS, Giaccone G, Schiller JH, et al (2004). Gefitinib in combination with paclitaxel and carboplatin in advanced non-small-cell lung cancer: a phase III trial--INTACT 2. J Clin Oncol, 22, 785-94.
  19. Hiller DJ, Chu QD (2012). Current Status of Poly(ADP-ribose) Polymerase Inhibitors as Novel Therapeutic Agents for Triple-Negative Breast Cancer. Int J Breast Cancer, 2012, 829315.
  20. Leibl S, Moinfar F (2005). 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, 58, 700-4.
  21. Moulder S, Moroney J, Helgason T, et al (2011). Responses to liposomal Doxorubicin, bevacizumab, and temsirolimus in metaplastic carcinoma of the breast: biologic rationale and implications for stem-cell research in breast cancer. J Clin Oncol, 29, 572-5.
  22. Nonnis R, Paliogiannis P, Giangrande D, et al (2012). Low-grade fibromatosis-like spindle cell metaplastic carcinoma of the breast: a case report and literature review. Clin Breast Cancer, 12, 147-50.
  23. Oberman HA (1987). Metaplastic carcinoma of the breast. A clinicopathologic study of 29 patients. Am J Surg Pathol, 11, 918-29.
  24. Overgaard M, Hansen PS, Overgaard J, et al (1997). Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N Engl J Med, 337, 949-55.
  25. Pezzi CM, Patel-Parekh L, Cole K, et al (2007). Characteristics and treatment of metaplastic breast cancer: analysis of 892 cases from the National Cancer Data Base. Ann Surg Oncol, 14, 166-73.
  26. Pitts WC, Rojas VA, Gaffey MJ, et al (1991). Carcinomas with metaplasia and sarcomas of the breast. Am J Clin Pathol, 95, 623-32.
  27. Ragaz J, Jackson SM, Le N, et al (1997). Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med, 337, 956-62.
  28. Rauf F, Kiyani N, Bhurgri Y (2006). Metaplastic carcinoma of the breast, an intriguing rarity. Asian Pac J Cancer Prev, 7, 667-71.
  29. Rayson D, Adjei AA, Suman VJ, et al (1999). Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol, 10, 413-9.
  30. Rosen PP, Ernsberger D (1987). Low-grade adenosquamous carcinoma. A variant of metaplastic mammary carcinoma. Am J Surg Pathol, 11, 351-8.
  31. Rouzier R, Perou CM, Symmans WF, et al (2005). Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res, 11, 5678-85.
  32. Sneige N, Yaziji H, Mandavilli SR, et al (2001). Low-grade (fibromatosis-like) spindle cell carcinoma of the breast. Am J Surg Pathol, 25, 1009-16.
  33. Takuwa H, Ueno T, Ishiguro H, et al (2011). A case of metaplastic breast cancer that showed a good response to platinum-based preoperative chemotherapy. Breast Cancer. [Epub ahead of print]
  34. Tseng WH, Martinez SR (2011). Metaplastic breast cancer: to radiate or not to radiate? Ann Surg Oncol, 18, 94-103.
  35. Wargotz ES, Norris HJ (1989). Metaplastic carcinomas of the breast. III. Carcinosarcoma. Cancer, 64, 1490-9.<1490::AID-CNCR2820640722>3.0.CO;2-L
  36. Zhang Y, Toy KA, Kleer CG (2012). Metaplastic breast carcinomas are enriched in markers of tumor-initiating cells and epithelial to mesenchymal transition. Mod Pathol, 25, 178-84.

Cited by

  1. Lack of Prognostic Value of Blood Parameters in Patients Receiving Adjuvant Radiotherapy for Breast Cancer vol.15, pp.10, 2014,
  2. Functional Roles of Long Non-coding RNA in Human Breast Cancer vol.15, pp.15, 2014,
  3. Metaplastic Breast Carcinoma: a Heterogeneous Disease vol.15, pp.6, 2014,
  4. Clinicopathological Features and Prognosis of Metaplastic Breast Carcinoma: Experience of a Major Chinese Cancer Center vol.10, pp.6, 2015,
  5. Metaplastic Breast Cancer: Clinical Overview and Molecular Aberrations for Potential Targeted Therapy vol.17, pp.3, 2015,
  6. Clinicopathological characteristics and prognosis of metaplastic carcinoma of the breast vol.14, pp.2, 2017,
  7. Metastatic and triple-negative breast cancer: challenges and treatment options vol.8, pp.5, 2018,