Analysis of Clinicopathological Characteristics and Prognosis of Carcinosarcoma of the Breast

Background Few cases of carcinosarcoma of the breast have been reported because of its low incidence rate and rapid progression. Seeking effective therapeutic methods becomes urgent in clinical practice. This study was aimed to investigate the clinical characteristics of carcinosarcoma of the breast and to explore proper therapeutic methods for patients with this rare tumor. Methods We conducted a retrospective analysis on 47 patients with carcinosarcoma of the breast receiving treatment in our hospital from 2003 to 2020. Most of these patients received primary surgery followed by adjuvant chemotherapy, while four patients had lumpectomy only. Statistics showed no preference in age and menopausal status of patients. Results The overall survival rate and progression-free survival rate of all patients at a median follow-up time of 33 months were 63.8% and 57.4%, respectively. Tumor size at diagnosis and chemotherapy strategies were both significant prognostic factors in reference to disease-free survival (DFS) and overall survival (OS) of the patients (tumor size: p=0.023 for DFS and p=0.021 for OS; therapeutic method: p=0.041 for DFS and p=0.024 for OS). N stage at diagnosis was significant only with reference to overall survival of the patients (p=0.009). EGFR expression was positive in some patients. Conclusions Our results elucidated that the patients received comprehensive therapy, especially adjuvant chemotherapy was indispensable for better outcomes. Early detection and treatment were necessary for a higher survival rate when the tumor size was less than 5 cm without lymph node metastasis. Prospective outcomes with novel strategies targeting EGFR need to be further investigated.

[1]  A. Accurso,et al.  A rare case of true carcinosarcoma of the breast , 2016, International journal of surgery case reports.

[2]  Ying Yuan,et al.  Intraductal carcinoma and carcinosarcoma with bone metastases presenting in one breast: A case report , 2014, Oncology letters.

[3]  Xinyu Zheng,et al.  Mixed epithelial and mesenchymal metaplastic carcinoma (carcinosarcoma) of the breast: a case report , 2014, European Journal of Medical Research.

[4]  Dong Xu,et al.  Diagnosis and Management of Multiple Carcinosarcoma of the Breast in a Young Chinese Patient , 2012, Breast Care.

[5]  E. Vardar,et al.  A Rare Tumour of the Breast: Carcinosarcoma , 2010, Journal of clinical medicine research.

[6]  A. Riker,et al.  Carcinosarcoma of the breast: two case reports and review of the literature , 2009, Cases journal.

[7]  T. Çil,et al.  Primary Spindle Cell Sarcoma of the Breast , 2008, Breast Care.

[8]  A. Luini,et al.  Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: the experience of the European Institute of Oncology and review of the literature , 2007, Breast Cancer Research and Treatment.

[9]  J. Beatty,et al.  Metaplastic breast cancer: clinical significance. , 2006, American journal of surgery.

[10]  G. Hortobagyi,et al.  Biphasic metaplastic sarcomatoid carcinoma of the breast. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[11]  P. Tan,et al.  Metaplastic carcinoma of the breast: a clinicopathological review , 2006, Journal of Clinical Pathology.

[12]  D. Tarin,et al.  Carcinoma invasion and metastasis: a role for epithelial-mesenchymal transition? , 2005, Cancer research.

[13]  F. Moinfar,et al.  Metaplastic breast carcinomas are negative for Her-2 but frequently express EGFR (Her-1): potential relevance to adjuvant treatment with EGFR tyrosine kinase inhibitors? , 2005, Journal of Clinical Pathology.

[14]  F. Akiyama,et al.  A case of carcinosarcoma of the breast. , 1997, Breast cancer.

[15]  W. Tjalma,et al.  Biphasic sarcomatoid carcinoma or carcinosarcoma of the breast: prognosis and therapy. , 2005, European journal of gynaecological oncology.

[16]  L. Lai,et al.  Metaplastic breast cancer: Clinical traits and outcomes , 2004 .

[17]  K. Tanaka,et al.  Additive antitumour effect of the epidermal growth factor receptor tyrosine kinase inhibitor gefitinib (Iressa, ZD1839) and the antioestrogen fulvestrant (Faslodex, ICI 182,780) in breast cancer cells , 2004, British Journal of Cancer.

[18]  L. Lai,et al.  Metaplastic breast cancer: Clinical traits and outcomes. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  C. Markopoulos,et al.  Carcinosarcoma of the breast: report of two cases. , 2003, European journal of gynaecological oncology.

[20]  J. Thiery Epithelial–mesenchymal transitions in tumour progression , 2002, Nature Reviews Cancer.

[21]  K. Kurian,et al.  Sarcomatoid/metaplastic carcinoma of the breast: a clinicopathological study of 12 cases , 2002, Histopathology.

[22]  W. Böcker [WHO classification of breast tumors and tumors of the female genital organs: pathology and genetics]. , 2002, Verhandlungen der Deutschen Gesellschaft fur Pathologie.

[23]  K. Shroyer,et al.  Carcinosarcoma of the breast: molecular-biological study for analysis of histogenesis. , 1998, Human pathology.

[24]  P. Bøhler,et al.  Cytogenetic analysis shows that carcinosarcomas of the breast are of monoclonal origin , 1998, Genes, chromosomes & cancer.

[25]  K. Sieunarine,et al.  Carcinosarcoma: a rare tumour of the breast. , 1990, The Australian and New Zealand journal of surgery.

[26]  H. Norris,et al.  Metaplastic carcinomas of the breast. III. Carcinosarcoma , 1989, Cancer.

[27]  H. Oberman Metaplastic Carcinoma of the Breast : A Clinicopathologic Study of 29 Patients , 1987, The American journal of surgical pathology.

[28]  T. Pope,et al.  Carcinosarcoma of the breast: radiologic, ultrasonographic, and pathologic correlation. , 1987, Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes.

[29]  C. Fiévez,et al.  [Angiosarcoma of the breast]. , 1984, Annales de dermatologie et de venereologie.

[30]  K. Hunt,et al.  Angiosarcoma of the breast , 2005, Cancer.

[31]  V. Persaud,et al.  Carcinosarcoma of the breast , 1974, The Journal of pathology.