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A case of metaplastic breast cancer that showed a good response to platinum-based preoperative chemotherapy

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Abstract

Patients with metaplastic breast cancer (MBC) exhibit reduced response to chemotherapy and have poor prognosis. We investigated a case of MBC that showed a positive response to preoperative chemotherapy, resulting in near pathological complete response (pCR). A 59-year-old woman complained of a lump in her right breast. Magnetic resonance imaging (MRI) showed the presence of a solid mass that was 24 mm in diameter. The pathological diagnosis was MBC with cartilaginous differentiation. The clinical stage was T2N0M0, stage IIA according to the International Union against Cancer (UICC) criteria. To observe the response to chemotherapy, we gave her preoperative chemotherapy. The patient was monitored closely, since we realized that failure of chemotherapy carries a risk of tumor progression. Evaluation was carried out using ultrasound, MRI, fluorodeoxyglucose (FDG) positron emission tomography (PET), and a Ki-67 labeling index after the first cycle of chemotherapy, and ultrasound after each additional cycle. FDG-PET showed a positive response after the first cycle of chemotherapy. The patient underwent 4 cycles of docetaxel (75 mg/m2) and cisplatin (75 mg/m2) followed by 4 cycles of cyclophosphamide (500 mg/m2), doxorubicin (50 mg/m2), and cisplatin (50 mg/m2). Ultrasound showed decreases in tumor size after each cycle of chemotherapy. After chemotherapy, MRI showed nearly complete regression of the tumor. Partial mastectomy was performed. Pathological examination showed few cancer cells remaining, indicating near pCR. We report a case of MBC that responded well to platinum-based preoperative chemotherapy. We propose that preoperative chemotherapy may be an option for treatment of MBC in conjunction with careful monitoring.

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References

  1. Chao TC, Wang CS, Chen SC, Chen MF. Metaplastic carcinomas of the breast. J Surg Oncol. 1999;71(4):220–5.

    Article  CAS  PubMed  Google Scholar 

  2. Pezzi CM, Patel-Parekh L, Cole K, Franko J, Klimberg VS, Bland K. Characteristics and treatment of metaplastic breast cancer: analysis of 892 cases from the National Cancer Data Base. Ann Surg Oncol. 2007;14(1):166–73.

    Article  PubMed  Google Scholar 

  3. Al Sayed AD, El Weshi AN, Tulbah AM, Rahal MM, Ezzat AA. Metaplastic carcinoma of the breast clinical presentation, treatment results and prognostic factors. Acta Oncol. 2006;45(2):188–95.

    Article  PubMed  Google Scholar 

  4. Hennessy BT, Giordano S, Broglio K, Duan Z, Trent J, Buchholz TA, et al. Biphasic metaplastic sarcomatoid carcinoma of the breast. Ann Oncol. 2006;17(4):605–13.

    Article  CAS  PubMed  Google Scholar 

  5. Gibson GR, Qian D, Ku JK, Lai LL. Metaplastic breast cancer: clinical features and outcomes. Am Surg. 2005;71(9):725–30.

    PubMed  Google Scholar 

  6. Rayson D, Adjei AA, Suman VJ, LE Wold, Ingle JN. Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol. 1999;10(4):413–9.

    Article  CAS  PubMed  Google Scholar 

  7. Beatty JD, Atwood M, Tickman R, Reiner M. Metaplastic breast cancer: clinical significance. Am J Surg. 2006;191(5):657–64.

    Article  PubMed  Google Scholar 

  8. Dave G, Cosmatos H, Do T, Lodin K, Varshney D. Metaplastic carcinoma of the breast: a retrospective review. Int J Radiat Oncol Biol Phys. 2006;64(3):771–5.

    Article  PubMed  Google Scholar 

  9. Reis-Filho JS, Milanezi F, Steele D, Savage K, Simpson PT, Nesland JM, et al. Metaplastic breast carcinomas are basal-like tumours. Histopathology. 2006;49(1):10–21.

    Article  CAS  PubMed  Google Scholar 

  10. Cheang MC, Voduc D, Bajdik C, Leung S, Mc Kinney S, Chia SK, et al. Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Clin Cancer Res. 2008;14(5):1368–76.

    Article  CAS  PubMed  Google Scholar 

  11. Rouzier R, Perou CM, Symmans WF, Ibrahim N, Cristofanilli M, Anderson K, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res. 2005;11(16):5678–85.

    Article  CAS  PubMed  Google Scholar 

  12. Heys SD, Sarkar T, Hutcheon AW. Primary docetaxel chemotherapy in patients with breast cancer: impact on response and survival. Breast Cancer Res Treat. 2005;90(2):169–85.

    Article  CAS  PubMed  Google Scholar 

  13. Smith IC, Heys SD, Hutcheon AW, Miller ID, Payne S, Gilbert FJ, et al. Neoadjuvant chemotherapy in breast cancer: significantly enhanced response with docetaxel. J Clin Oncol. 2002;20(6):1456–66.

    Article  CAS  PubMed  Google Scholar 

  14. Downs-Kelly E, Nayeemuddin KM, Albarracin C, Wu Y, Hunt KK, Gilcrease MZ. Matrix-producing carcinoma of the breast: an aggressive subtype of metaplastic carcinoma. Am J Surg Pathol. 2009;33(4):534–41.

    Article  PubMed  Google Scholar 

  15. Rakha EA, Reis-Filho JS, Ellis IO. Basal-like breast cancer: a critical review. J Clin Oncol. 2008;26(15):2568–81.

    Article  PubMed  Google Scholar 

  16. Kurosumi M, Akashi-Tanaka S, Akiyama F, Komoike Y, Mukai H, Nakamura S, et al. Histopathological criteria for assessment of therapeutic response in breast cancer (2007 version). Breast Cancer. 2008;15(1):5–7.

    Article  PubMed  Google Scholar 

  17. Schwarz-Dose J, Untch M, Tiling R, Sassen S, Mahner S, Kahlert S, et al. Monitoring primary systemic therapy of large and locally advanced breast cancer by using sequential positron emission tomography imaging with [18F]fluorodeoxyglucose. J Clin Oncol. 2009;27(4):535–41.

    Article  PubMed  Google Scholar 

  18. Rousseau C, Devillers A, Sagan C, Ferrer L, Bridji B, Campion L, et al. Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography. J Clin Oncol. 2006;24(34):5366–72.

    Article  PubMed  Google Scholar 

  19. Kuroi K, Toi M, Tsuda H, Kurosumi M, Akiyama F. Issues in the assessment of the pathologic effect of primary systemic therapy for breast cancer. Breast Cancer. 2006;13(1):38–48.

    Article  PubMed  Google Scholar 

  20. Toi M, Nakamura S, Kuroi K, Iwata H, Ohno S, Masuda N, et al. Phase II study of preoperative sequential FEC and docetaxel predicts of pathological response and disease free survival. Breast Cancer Res Treat. 2008;110(3):531–9.

    Article  CAS  PubMed  Google Scholar 

  21. Symmans WF, Peintinger F, Hatzis C, Rajan R, Kuerer H, Valero V, et al. Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy. J Clin Oncol. 2007;25(28):4414–22.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Dr. Tomomi Nishimura for taking photos of pathology and Ms. Akiko Shiomi and Ms. Kikuko Fujita for their technical assistance with the manuscript.

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Authors and Affiliations

  1. Department of Breast Surgery, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Haruko Takuwa, Takayuki Ueno, Masahiro Takada, Tomoharu Sugie & Masakazu Toi

  2. Department of Chemotherapeutic Section for Outpatients, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Hiroshi Ishiguro

  3. Department of Pathology, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Yoshiki Mikami

  4. Department of Radiology, Graduate School of Medicine, Kyoto University Hospital, 54 Shogoin kawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Shotaro Kanao

Authors
  1. Haruko Takuwa
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  2. Takayuki Ueno
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  3. Hiroshi Ishiguro
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  4. Yoshiki Mikami
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  5. Shotaro Kanao
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  6. Masahiro Takada
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  7. Tomoharu Sugie
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  8. Masakazu Toi
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Corresponding author

Correspondence to Takayuki Ueno.

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Takuwa, H., Ueno, T., Ishiguro, H. et al. A case of metaplastic breast cancer that showed a good response to platinum-based preoperative chemotherapy. Breast Cancer 21, 504–507 (2014). https://doi.org/10.1007/s12282-011-0269-2

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  • DOI: https://doi.org/10.1007/s12282-011-0269-2

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