Metaplastic breast carcinoma represents a group of rare diseases deviating from each other not only in their morphological appearance, but also in their prognosis. In addition to the routine histological analysis, immunohistochemistry plays a crucial role in delineating these tumors from usual breast carcinomas and sarcomas, in subtyping of these tumors into different prognostic categories and in the prediction of their response to individual therapy. Despite the wide variety of microscopic morphology of the lesions that are actually classified as metaplastic breast carcinoma, histological subtyping and grading separate properly patients with low-risk tumors adequately treated with wide surgical excision only and high-risk tumors requiring adjuvant therapy. Immunohistochemical receptor analysis shows presence or absence of therapeutic target molecules, and therefore is essential for adequate therapy planning.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Adem, C., Reynolds, C., Adlakha, H., Roche, P.C., and Nascimento, A.G. 2002. Wide spectrum screening keratin as a marker of metaplastic spindle cell carcinoma of the breast. An immunohis-tochemical study of 24 patients. Histopathology 40: 556–562
Barnes, P.J., Boutilier, R., Chiasson, D., R., and Rayson, D. 2005. Metaplastic breast carcinoma: clinical-pathologic characteristics and HER2/ neu expression. Breast Cancer Res. Treat. 91: 173–178
Bartek, J., Bartkova, J., and Taylor-Papadimitriu, J. 1990. Keratin 19 expression in the adult and developing human mammary gland. Histochem. J. 22: 537–544
Boecker, W., and Burger, H. 2003. Evidence of progenitor cells of glandular and myoepithelial cell lineages in the human adult female breast epithelium: a new progenitor (adult stem) cell concept. Cell Prolif. 1. (suppl 36): 73–84
Bryan, B.B., Schnitt, S.J., and Collins, L.C.2006. Ductal carcinoma in situ with basal-like phenotype: a possible precursor to invasive basal-like breast cancer. Mod. Pathol. 19: 617–621
Carter, M.R., Hornick, J.L., Lester, S., and Fletcher C.D.M. 2006. Spindle cell (sarcomatoid) carcinoma of the breast. A clinicopathologic and immunohistochemical analysis of 29 cases. Am. J. Surg. Pathol. 30: 300–309
Davis, W.G., Hennessy, B., Babiera, G. Hunt, K., Valero, V. , Buchholz, T.A., Sniege, N., and Gilcrease, M.Z. 2005. Metaplastic sarcomatoid carcinoma of the breast with absent or minimal overt invasive carcinomatous component. Am. J. Surg. Pathol. 29: 1456–1463
Gibson, G.R., Qian, D., Ku, J.K., and Lai, L.L. 2005. Metaplastic breast cancer: clinical features and outcomes. Am. Surg. 71: 725–730
Grenier, J., Soria, J.C., Mathieu, M.C., Andre, F., Abdelmoula, S., Velasco, V., Morat, L., Besse, B., Dunant, A., Spielmann, M., and Delaloge, S. 2007. Differential immunohistochemical and biological profile of squamous cell carcinoma of the breast. Anticancer Res. 27: 547–555
Gunham-Bilgen, I., Memis, A., Ustun, E.E., Zekioglu, O., and Ozdemir, N. 2002. Metaplastic carcinoma of the breast: clinical, mammographic, and sonographic findings with histological correlation. Am. J. Roentgenol. 178: 1421–1425
Hayat, M.A. (Ed.). 2004–2006. Immunohist-ochemistry and In Situ Hybridization of Human Carcinomas, Vols 1–4. Elsevier, San Diego, CA
Huvos, A.G., Lucas, J.C., and Foot, F.W. Jr. 1973. Metaplastic breast carcinoma. Rare form of mammary cancer. N. Y. State J. Med. 73: 1078–1082
Jackson, P.A., Merchant, W., McCormick, C.J., and Cook, M.G. 1994. A comparison of large block macrosectioning and conventional techniques in breast pathology. Virchows Arch. 425: 243–248
Jolicoeur, F., Gaboury, L.A., and Oligny, L.L. 2003. Basal cells of second trimester fetal breasts: immunohistochemical study of myoepithelial precursors. Pediatr. Dev. Pathol. 6: 398–413
Koker, N.M., and Kleer, C.,G. 2004. p63 expression in breast cancer: a highly sensitive and specific marker of metaplastic carcinoma. Am. J. Surg. Pathol. 28: 1506–1512
Leibl, S., and 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: 700–704
Moll, R., Franke, W.W., Schiller, D.L. Geiger, B., and Krepler, R. 1982. The catalogue of Human cytokeratins: patterns of expression in human epithelia, tumors and cultured cells. Cell 31: 11–24
Oliver, R.L. 1940. Metaplasia in the breast. Arch. Surg. 41: 714–722
Pezzi, C.M., Patel-Parekh, L., Cole, K., Franko, J., Klimberg, V.S., and Bland K. 2007. Characteristics and treatment of metaplastic breast cancer: analysis of 892 cases from the National Cancer Data Base. Ann. Surg. Oncol. 14: 166–173
Rakha, E.A., El-Sayed, M.E., Green, A.R., Paish, E.C., Lee, A.H., and Ellis, E.O. 2007. Breast carcinoma with basal differentiation: a proposal for pathology definition based on basal cytokeratin expression. Histopathology 50: 434–438
Reis-Filho, J.S., Milanezi. F., Paredes, J., Silva, P., Pereira, E.M., Maeda, S.A., de Carvalho, L.V., and Schmitt, F.C. 2003. Novel and classic myoepithelial/stem cell markers in meta-plastic carcinokmas of the breast. Appl. Immunohistochem. Mol. Morphol. 11: 1–8
Reis-Filho, J.S., Milanezi, F., Carvalho, S., Simpson, P.T., Steele, D., Savage, K., Lambros, M.B., Pereira, E.M., Nesland, J.M., Lakhani, S.R., and Schmitt, F.C. 2005. Metaplastic breast carcinomas exhibit EGFR, but not HER2, gene amplification and overexpression: immunohisto-chemical and chromogenic in situ hybridization analysis. Breast Cancer Res. 7: R1028–R1035
Reis-Filho, J.S., Milanezi, F., Steele, D., Savage, K., Simpson, P.T., Nesland, J.M, Pereira, E.M., Lakhani, S.R., and Schmitt, F.C. 2006. Mataplastic breast carcinomas are basal-like tumors. Histopathology 49: 10–21
Savage, K., Lambros, M.B., Robertson, D., Jones, R.L., Jones, C., Mackay, A., James M., Hornick, J.L., Pereira, E.M., Milanezi, F., Fletcher, C.D., Schmitt, F.C., Ashworth, A., and Resi-Filho, J.S. 2007. Caveolin 1 is overexpressed and amplified in a subset of basal-like and metaplastic breast carcinomas: a morphologic, ultrastructural, immunohistochemical, and in situ hybridization analysis. Clin. Cancer Res. 13: 90–101
Tavassoli, F.A., and Devilee, P. (Eds.). 2003. World Health Organization Classification of Tumours. Pathology & Genetics. Tumors of the Breast and Female Genital Organs. IARC Press, Lyon, France. pp. 37–41
Tot, T. 2002. Cytokeratins 20 and 7 as biomark-ers: usefulness in discriminating primary from metastatic adenocarcinomas. Eur. J. Cancer. 38: 758–763
Tot, T. 2005. Colorectal Tumors. Atlas of Large Section Histopathology. Thieme, Stuttgart — New York. pp. 129–144
Tot, T. 2006. Eccrine ductal and acrosyringeal differentiation of the breast epithelium — a lesion associated with some metaplastic breast carcinomas. Virchows Arch. 449: 565–51
Tot, T., Tabár, L., and Dean, P.B. 2002. Practical Breast Pathology. Thieme, Stuttgart/New York. pp. 115–123
Tse, G.M., Tam, P.H., Putti, T.C., Lui, P.C., Chaiwun, B., and Law, B.K. 2006. Metaplastic carcinoma of the breast: a clinicopathological review. J. Clin. Pathol. 59: 1079–1083
Zhuang, Z., Lininger, R.A., Man, Y.G., Albuquerque, A., Merino, M.J., and Tavassoli, F.A. 1997. Identical clonality of both components in mammary carcinosarcomas with differential loss of heterozygosity. Mod. Pathol. 10: 354–362
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science + Business Media B.V.
About this chapter
Cite this chapter
Tot, T. (2008). Metaplastic Breast Carcinoma: Detection Using Histology and Immunohistochemistry. In: Hayat, M.A. (eds) Methods of Cancer Diagnosis, Therapy and Prognosis. Methods of Cancer Diagnosis, Therapy and Prognosis, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-8369-3_21
Download citation
DOI: https://doi.org/10.1007/978-1-4020-8369-3_21
Publisher Name: Springer, Dordrecht
Print ISBN: 978-1-4020-8368-6
Online ISBN: 978-1-4020-8369-3
eBook Packages: MedicineMedicine (R0)