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Clinicopathologic characteristics of HER2-positive metaplastic squamous cell carcinoma of the breast
  1. Ting Lei1,2,
  2. Tianjie Pu1,2,
  3. Bing Wei1,
  4. Yingying Fan1,
  5. Libo Yang1,2,
  6. Mengjia Shen1,2,
  7. Min Chen1,
  8. Jieliang Yang1,
  9. Yu Zhang1,
  10. Zhang Zhang1,
  11. Hong Bu1,2
  1. 1 Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
  2. 2 Laboratory of Pathology, Key Laboratory of Transplant Engineering and Immunology, NHFPC, West China Hospital, Sichuan University, Chengdu, Sichuan, China
  1. Correspondence to Dr Zhang Zhang, West China Hospital, Sichuan University, Chengdu 610041, China; zhangzhang714{at}


Aims The aim of this study was to analyse the clinicopathological features and prognosis of human epidermal growth factor receptor-2 (HER2)-positive metaplastic squamous cell carcinoma (MSCC).

Methods Fifty-eight patients with MSCC of the breast who were classified into 45 triple-negative and 13 HER2-positive subgroups diagnosed at the West China Hospital, Sichuan University, from 2004 to 2018, were enrolled. Clinicopathological features were collected and compared between HER2-positive MSCC, triple-negative MSCC, HER2-positive invasive breast carcinoma of no special type (NST) and triple-negative NST groups. In the prognostic survival analysis, HER2-positive MSCCs was compared with triple-negative MSCCs, HER2-positive NSTs and triple-negative NSTs.

Results Compared with triple-negative MSCCs, more patients with Ki-67 low expression were in HER2-positive MSCCs (p<0.05). More patients with HER2-positive MSCC than patients with HER2-positive NST were postmenopausal (p<0.05). Compared among HER2-positive MSCCs, triple-negative MSCCs and triple-negative NSTs, patients of HER2-positive MSCCs with high Ki-67 expression were the least, and HER2-positive MSCCs had more strongly associated with postmenopausal disease status (p<0.05). In survival analyses, HER2-positive MSCCs had a high risk of recurrence and poor prognosis (p<0.05). Lymph node status was significantly associated with the disease-free survival of patients with HER2-positive MSCC.

Conclusion In conclusion, our study indicates that HER2-positive MSCC is an aggressive disease with unique clinicopathological characteristics. Both HER2-positive status and an SCC component are critical factors for poor prognosis. HER2-positive MSCC and triple-negative MSCC are distinct subgroups. Corresponding targeted therapy recommendations should be made for this HER2-positive MSCC group.

  • breast cancer
  • cancer research
  • breast pathology

Data availability statement

Data are available upon reasonable request to the authors.

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Data availability statement

Data are available upon reasonable request to the authors.

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  • Handling editor Cheok Soon Lee.

  • Contributors ZZ and TL conceived and designed the study. TL and TP performed analysis and interpretation of the data and wrote the manuscript. MC, JY, BW, and ZZ contributed to breast cancer database administration. All authors were involved in providing study data, and commenting on the manuscript. All authors approved the final manuscript.

  • Funding Supported by grants from the National Natural Science Foundation of China (NSFC.81702599).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.