Title: Heterogeneity of Metaplastic Carcinoma of Breast - A Diagnostic Challenge
Authors: Dr Pranita Mohanty, Dr Debahuti Mohapatra, Dr Rohini Choudhuri
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.26
Abstract
Background: Metaplastic carcinoma of breast (MCB) is a rare and aggressive type of invasive breast cancer. As it encompasses a variety of distinct histopathologic designations, diagnostic challenges abound. Here, we have documented the incidence of MCB in our tertiary care hospital for a period of 2 year.
Materials and Methods: This prospective study was carried out in the department of histopathology for a period of 2 years (Sep 2015 to Aug 2017). All the previously diagnosed breast carcinoma cases by FNAC and trucut were included in this study. All these patients were operated in the department of General surgery/ Oncosurgery of our institute. Followed by, the biopsy samples which were analyzed with routine histopathology and immunohistochemistry. With extensive squamous/malignant spindle cell differentiation, increased matrix production and unusually papillaroid patterns, we have diagnosed metaplastic carcinoma.
Results: There were 921 cases of invasive ductal carcinoma of breast (IDC) studied for a period of 2 years. Among them 8 cases were diagnosed as different types of metaplastic carcinoma. Out of which 5 cases showed extensive squamous differentiation, 1 case showed extensive squamous differentiation with papillaroid patterns, 1 case of MCB with spindle cell component & 1 case of matrix producing carcinoma.
Conclusion: MCB merits presentation because of its rarity and difficulty to diagnose, especially if the tumor is composed of areas showing papillaroid pattern or showing direct transition of carcinomatous component to spindle cell,cartilagenous or osseous matrix. Histomorphology and immunohistochemistry is the mainstay for diagnosis of MCB. It is of significant concern because of its prognosis and treatment which is poor in comparison to classical IDC of breast.
Keywords: Invasive breast cancer, papillaroid, squamous differentions, Histomorphology and immunohistochemistry.
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