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Metaplastic carcinoma of the breast: a clinicopathological review
  1. G M Tse1,
  2. P H Tan2,
  3. T C Putti3,
  4. P C W Lui4,
  5. B Chaiwun5,
  6. B K B Law6
  1. 1Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
  2. 2Department of Pathology, Singapore General Hospital, Singapore
  3. 3Department of Pathology, National University Hospital, National University of Singapore, Singapore
  4. 4Department of Pathology, United Christian Hospital, Hong Kong
  5. 5Department of Pathology, Chiang Mai University, Chiang Mai, Thailand
  6. 6Breast Center, Union Hospital, Hong Kong
  1. Correspondence to:
 Gary M Tse
 Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Ngan Shing Street, Shatin, NT, Hong Kong; garytse{at}


Background: Mammary metaplastic carcinoma encompasses epithelial-only carcinoma (high-grade adenosquamous carcinoma or pure squamous cell carcinoma), biphasic epithelial and sarcomatoid carcinoma and monophasic spindle cell carcinoma.

Aim: To evaluate the clinicopathological features of a large series of 34 metaplastic carcinomas.

Methods: 10 epithelial-only, 14 biphasic and 10 monophasic metaplastic carcinomas were assessed for nuclear grade, hormone receptor status, HER2/neu (cerbB2) oncogene expression, Ki-67 and p53, lymph node status and recurrence on follow-up.

Results: Intermediate to high nuclear grade were assessed in most (33/34) tumours. Oestrogen and progesterone receptors were negative in 8 of 10 epithelial-only, all 14 biphasic, and 9 of 10 monophasic tumours, cerbB2 was negative in 7 of 10 epithelial-only, all 14 biphasic and 8 of 10 monophasic tumours. Ki-67 was found to be positive in 6 of 10 epithelial-only, 6 of 14 biphasic, and 7 of 10 monophasic tumours, whereas p53 was positive in 6 of 10 epithelial-only, 7 of 14 biphasic, and 8 of 10 monophasic tumours. Lymph node metastases were seen in 7 of 7 epithelial-only, 7 of 11 biphasic, and 3 of 7 monophasic tumours. Recurrences were seen in 4 of 7 epithelial-only, 8 of 9 biphasic, and 4 of 9 monophasic tumours.

Conclusions: All three subtypes of metaplastic carcinoma are known to behave aggressively, and should be differentiated from the low-grade fibromatosis-like metaplastic carcinoma, which does not metastasise. Oncological treatment options may be limited by the frequently negative status of hormonal receptor and cerbB2.

  • IDC, infiltrating duct carcinoma
  • SCC, squamous cell carcinoma

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  • Published Online First 7 February 2006

  • Competing interests: None declared.