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Published in: Breast Cancer Research and Treatment 1/2011

01-11-2011 | Brief Report

Lack of efficacy to systemic chemotherapy for treatment of metaplastic carcinoma of the breast in the modern era

Authors: I. C. Chen, C. H. Lin, C. S. Huang, H. C. Lien, Chiun Hsu, W. H. Kuo, Y. S. Lu, A. L. Cheng

Published in: Breast Cancer Research and Treatment | Issue 1/2011

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Abstract

Metaplastic carcinoma of the breast (MCB) is a rare subtype of breast cancer. Anecdotal reports are available regarding its response to systemic chemotherapy. We reviewed the records of patients diagnosed with MCB at National Taiwan University Hospital between 1988 and 2009. A total of 46 MCB cases were identified from 8,695 breast tumor patients who underwent biopsy or resection. About 11 of 25 patients with initial bulky disease (T3-4) received neoadjuvant chemotherapy before surgery, and 2 (18.2%) exhibited a partial response. About 12 of 18 patients who developed distant metastasis received palliative systemic chemotherapy. Of them, only 1 (8.3%), 1 (10%), and none (0%) responded to first-, second-, or third- and beyond line chemotherapy, respectively. None of the patients who received anthracyline- (n = 13), vinorelbine- (n = 7), or cyclophosphamide-based (n = 18) chemotherapy responded, whereas 3 (17.6%) of 17 patients who received taxane-based chemotherapy exhibited a partial response. Tumor response to systemic chemotherapy remains generally poor for MCB patients. Taxanes may have modest activity, but need to be validated in further studies.
Literature
2.
go back to reference Gibson GR, Qian D, Ku JK, Lai LL (2005) Metaplastic breast cancer: clinical features and outcomes. Am Surg 71:725–730PubMed Gibson GR, Qian D, Ku JK, Lai LL (2005) Metaplastic breast cancer: clinical features and outcomes. Am Surg 71:725–730PubMed
3.
go back to reference Tavassoli FA (1992) Classification of metaplastic carcinomas of the breast. Pathol Annu 27(Pt 2):89–119PubMed Tavassoli FA (1992) Classification of metaplastic carcinomas of the breast. Pathol Annu 27(Pt 2):89–119PubMed
4.
go back to reference Ellis IOSS, Sastre-Garau X (eds) (2003) Metaplasitc carcinoma. IARC Press, Lyon Ellis IOSS, Sastre-Garau X (eds) (2003) Metaplasitc carcinoma. IARC Press, Lyon
5.
go back to reference Pezzi CM, Patel-Parekh L, Cole K, Franko J, Klimberg VS, 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. doi:10.1245/s10434-006-9124-7 PubMedCrossRef Pezzi CM, Patel-Parekh L, Cole K, Franko J, Klimberg VS, 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. doi:10.​1245/​s10434-006-9124-7 PubMedCrossRef
6.
go back to reference Carlson RW, Allerd DC, Anderson BO, Burstein HJ, Carter WB et al (2011) NCCN clinical practice guidelines in oncology. Breast cancer (Version 1.2011). American Society of Clinical Oncology, Alexandria, LA Carlson RW, Allerd DC, Anderson BO, Burstein HJ, Carter WB et al (2011) NCCN clinical practice guidelines in oncology. Breast cancer (Version 1.2011). American Society of Clinical Oncology, Alexandria, LA
7.
go back to reference Hennessy BT, Giordano S, Broglio K, Duan Z, Trent J, Buchholz TA, Babiera G, Hortobagyi GN, Valero V (2006) Biphasic metaplastic sarcomatoid carcinoma of the breast. Ann Oncol 17:605–613.PubMedCrossRef Hennessy BT, Giordano S, Broglio K, Duan Z, Trent J, Buchholz TA, Babiera G, Hortobagyi GN, Valero V (2006) Biphasic metaplastic sarcomatoid carcinoma of the breast. Ann Oncol 17:605–613.PubMedCrossRef
8.
go back to reference Luini A, Aguilar M, Gatti G, Fasani R, Botteri E, Brito JA, Maisonneuve P, Vento AR, Viale G (2007) Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat 101:349–353PubMedCrossRef Luini A, Aguilar M, Gatti G, Fasani R, Botteri E, Brito JA, Maisonneuve P, Vento AR, Viale G (2007) Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat 101:349–353PubMedCrossRef
9.
go back to reference Rayson D, Adjei AA, Suman VJ, Wold LE, Ingle JN (1999) Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol 10:413–419PubMedCrossRef Rayson D, Adjei AA, Suman VJ, Wold LE, Ingle JN (1999) Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol 10:413–419PubMedCrossRef
10.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRef
11.
go back to reference Cardoso F, Bedard PL, Winer EP, Pagani O, Senkus-Konefka E, Fallowfield LJ, Kyriakides S, Costa A, Cufer T, Albain KS (2009) International guidelines for management of metastatic breast cancer: combination vs sequential single-agent chemotherapy. J Natl Cancer Inst 101:1174–1181. doi:10.1093/jnci/djp235 PubMedCrossRef Cardoso F, Bedard PL, Winer EP, Pagani O, Senkus-Konefka E, Fallowfield LJ, Kyriakides S, Costa A, Cufer T, Albain KS (2009) International guidelines for management of metastatic breast cancer: combination vs sequential single-agent chemotherapy. J Natl Cancer Inst 101:1174–1181. doi:10.​1093/​jnci/​djp235 PubMedCrossRef
12.
go back to reference Gasparini G, Dal Fior S, Panizzoni GA, Favretto S, Pozza F (1991) Weekly epirubicin versus doxorubicin as second line therapy in advanced breast cancer. A randomized clinical trial. Am J Clin Oncol 14:38–44PubMedCrossRef Gasparini G, Dal Fior S, Panizzoni GA, Favretto S, Pozza F (1991) Weekly epirubicin versus doxorubicin as second line therapy in advanced breast cancer. A randomized clinical trial. Am J Clin Oncol 14:38–44PubMedCrossRef
13.
go back to reference Kaklamani VG, Gradishar WJ (2003) Epirubicin versus doxorubicin: which is the anthracycline of choice for the treatment of breast cancer? Clin Breast Cancer 4(Suppl 1):S26–S33PubMedCrossRef Kaklamani VG, Gradishar WJ (2003) Epirubicin versus doxorubicin: which is the anthracycline of choice for the treatment of breast cancer? Clin Breast Cancer 4(Suppl 1):S26–S33PubMedCrossRef
14.
go back to reference Lopez M, Papaldo P, Di Lauro L, Vici P, Carpano S, Conti EM (1989) 5-Fluorouracil, adriamycin, cyclophosphamide (FAC) vs. 5-fluorouracil, epirubicin, cyclophosphamide (FEC) in metastatic breast cancer. Oncology 46:1–5PubMedCrossRef Lopez M, Papaldo P, Di Lauro L, Vici P, Carpano S, Conti EM (1989) 5-Fluorouracil, adriamycin, cyclophosphamide (FAC) vs. 5-fluorouracil, epirubicin, cyclophosphamide (FEC) in metastatic breast cancer. Oncology 46:1–5PubMedCrossRef
15.
go back to reference De Lena M, Maiello E, Lorusso V, Brandi M, Calabrese P, Romito S, Mazzei A, Marzullo F (1989) Comparison of CHOP-B vs CEOP-B in “poor prognosis” non-Hodgkin’s lymphomas. A randomized trial. Med Oncol Tumor Pharmacother 6:163–169PubMed De Lena M, Maiello E, Lorusso V, Brandi M, Calabrese P, Romito S, Mazzei A, Marzullo F (1989) Comparison of CHOP-B vs CEOP-B in “poor prognosis” non-Hodgkin’s lymphomas. A randomized trial. Med Oncol Tumor Pharmacother 6:163–169PubMed
16.
go back to reference Nielsen OS, Dombernowsky P, Mouridsen H, Daugaard S, Van Glabbeke M, Kirkpatrick A, Verweij J (2000) Epirubicin is not superior to doxorubicin in the treatment of advanced soft tissue sarcomas. The experience of the EORTC Soft Tissue and Bone Sarcoma Group. Sarcoma 4:31–35PubMedCrossRef Nielsen OS, Dombernowsky P, Mouridsen H, Daugaard S, Van Glabbeke M, Kirkpatrick A, Verweij J (2000) Epirubicin is not superior to doxorubicin in the treatment of advanced soft tissue sarcomas. The experience of the EORTC Soft Tissue and Bone Sarcoma Group. Sarcoma 4:31–35PubMedCrossRef
17.
go back to reference Saad ED, Katz A, Buyse M (2010) Overall survival and post-progression survival in advanced breast cancer: a review of recent randomized clinical trials. J Clin Oncol 28:1958–1962PubMedCrossRef Saad ED, Katz A, Buyse M (2010) Overall survival and post-progression survival in advanced breast cancer: a review of recent randomized clinical trials. J Clin Oncol 28:1958–1962PubMedCrossRef
18.
go back to reference Chien T, Chou J, Chang T, Lin C (2010) Successful treatment of biphasic metaplastic sarcomatoid carcinoma of the breast by evaluation of immunohistochemical markers. Hematol Oncol Stem Cell Ther 3:89–93. doi:10.5144/1658-3876.2010.89 PubMed Chien T, Chou J, Chang T, Lin C (2010) Successful treatment of biphasic metaplastic sarcomatoid carcinoma of the breast by evaluation of immunohistochemical markers. Hematol Oncol Stem Cell Ther 3:89–93. doi:10.​5144/​1658-3876.​2010.​89 PubMed
19.
go back to reference Penel N, Van Glabbeke M, Marreaud S, Ouali M, Blay JY, Hohenberger P (2010) Testing new regimens in patients with advanced soft tissue sarcoma: analysis of publications from the last 10 years. Ann Oncol Penel N, Van Glabbeke M, Marreaud S, Ouali M, Blay JY, Hohenberger P (2010) Testing new regimens in patients with advanced soft tissue sarcoma: analysis of publications from the last 10 years. Ann Oncol
20.
go back to reference Moulder S, Moroney J, Helgason T, Wheler J, Booser D, Albarracin C, Morrow PK, Koenig K, Kurzrock R (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(19):e572–e575PubMedCrossRef Moulder S, Moroney J, Helgason T, Wheler J, Booser D, Albarracin C, Morrow PK, Koenig K, Kurzrock R (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(19):e572–e575PubMedCrossRef
Metadata
Title
Lack of efficacy to systemic chemotherapy for treatment of metaplastic carcinoma of the breast in the modern era
Authors
I. C. Chen
C. H. Lin
C. S. Huang
H. C. Lien
Chiun Hsu
W. H. Kuo
Y. S. Lu
A. L. Cheng
Publication date
01-11-2011
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2011
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-011-1686-9

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