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Open Access Highly Accessed Research

Metaplastic carcinoma of the breast: an immunohistochemical study

Fadwa J Altaf1*, Ghadeer A Mokhtar14, Eman Emam12, Rana Y Bokhary1, Najlaa Bin Mahfouz1, Samia Al Amoudi1 and Zuhoor K AL-Gaithy3

Author Affiliations

1 Pathology Department and General Surgery Department, Faculty of Medicine, King Abdulaziz University (KAU), P.O. Box 51241, Jeddah 21543, Saudi Arabia

2 Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

3 FRCSI, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia

4 Pathology Department, Faculty of Medicine, King Abdulaziz University (KAU), P.O. Box 80215, Jeddah 21589, Saudi Arabia

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Diagnostic Pathology 2014, 9:139  doi:10.1186/1746-1596-9-139

Published: 16 July 2014

Abstract

Background

Metaplastic breast carcinoma is a rare entity of breast cancer expressing epithelial and/or mesenchymal tissue within the same tumor. The aim of this study is to evaluate the clinicopathological features of metaplastic breast carcinoma and to confirm the triple negative, basal-like and/or luminal phenotype of this type of tumor by using immunohistochemical staining.

Methods

Seven cases of MBC were evaluated for clinico-pathological features including follow up data. Cases were studied immunohistochemically by CK-Pan, Vimentin, ER, PR, HER2, basal markers (CK5/6, p63, EGFR, SMA and S-100), luminal cytokeratins (CK8, CK18 and CK19), markers for syncytial cells (β-HCG and PLAP), as well as prognostic markers (p53, ki-67 and calretinin).

Results

The mean age of the patients was 36 years. Three cases showed choriocarcinomatous features. All of our cases were negative for ER, PR and HER2. Six out of the 7 cases showed basal-like differentiation by demonstrating positivity with at least one of the basal/myoepithelial markers. Also 6 out of the 7 cases expressed luminal type cytokeratins (CK8, CK18 and/or CK19). P53 was positive in 3 cases, ki-67 was strongly expressed in only one case, while calretinin was expressed in 6 cases.

Conclusion

Metaplastic breast carcinoma presents in our population at a younger age group than other international studies. All cases are categorized immunohistochemically under the triple negative group of breast cancer and 86% of them exhibited basal-like and luminal phenotype. Majority of cases developed local recurrence and distant metastasis in a relatively short period of time.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1101289295115804 webcite

Keywords:
Breast; Metaplastic carcinoma; Squamous cell carcinoma; Triple-negative carcinoma